Showing 501 - 510 of 574 annotations tagged with the keyword "Physician Experience"
This collection of vignettes follows the growth and development of one internist as he reflects on some of the critical experiences that shaped him as physician. The common thread of the work is the celebration of the relationship that can, and perhaps should, be built between the physician and his or her patient in the course of caring: this relationship is the sacred space of the title.
The author accomplishes his self-imposed task of describing this space by presenting situations in his practice life that illustrate the concept. The chronological structure of the collection enables the reader to study the maturation of the author as a self-reflective practitioner over the many decades of his professional life. Many of the stories are very funny; others are wrenching; all are gently told.
Summary:Canadian artist, Robert Pope (d.1992), devoted the last years of his short life to documenting his decade-long experience as a patient with Hodgkin's Disease. Shortly after his diagnosis he was influenced by the 1945 autobiographical novel of Elizabeth Smart, By Grand Central Station I Sat Down and Wept. Pope's early work explored the interconnectedness and pain of individuals bound by an imperfect love, in Smart's case for a married man. After his disease went into remission, he began to paint the patient's perspective on illness, hospitals, visitors, family, and health-care providers in a series of images that suggest the lighting of de la Tour, the photographic immediacy of Doisneau, and the menacing surrealism of de Chirico. His book, Illness and Healing: Images of Cancer (1991), became a bestseller.
An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.
At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.
The author is a fourth year medical student dealing simultaneously with the rigors of medical training and the difficulties of living with diabetes. She has discovered that when she tries to interact with patients she over-identifies with them. When she reads about diabetes in medical textbooks, which present a rigid equation for balancing diet, exercise, and insulin need, she tries to adopt this approach to her personal diabetes management, convincing herself that emotions, fatigue, stress and other factors have no effect on her diabetes control. When this biomedical approach fails, she feels deep shame and frustration.
Only over time does she develop the confidence to realize that it is not shameful to admit one's personal needs even in medical training, that disease is a part of all humans and is not an enemy, that she need not be defined solely by her disease (or her profession), and that blurred boundaries between doctors and patients are not as dangerous as she was first led to believe.
A surgical intern has participated in 86 year old Mrs. Byrnes's abdominal surgery, where extensive metastases from ovarian cancer are found. The surgeons take biopsies, confirm the diagnosis, and close her abdomen, knowing that her case is not treatable. Later that day, it falls to the intern to inform Mrs. Byrne of what they found.
The author describes how he avoided the task, finding other chores to do, appealing to the attending physician to not make him talk to the patient. The attending insists, and the author finally finds the nerve to talk with his patient. Much to his surprise, she has already suspected that she has cancer, tells him not to be upset, and assures him he did his best. The author discovered that learning to be a doctor meant being open to learning from his patients.
The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.
He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.
Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."
A nephrologist is named in a lawsuit after serving as a consulting physician in a diabetes case. The diabetic patient had had a serious infection and later his leg was amputated; he apparently felt the doctors neglected the seriousness of his condition. When the dialysis unit treating this patient requests to transfer his care to the author, whose unit is in the patient's home town, the author is uncertain what to do.
The author is angry about the law suit, and his colleagues counsel him to refuse to take this patient. But after realizing that the lawsuit was merely a reflection of the patient's suffering, and that he needs the same compassion and care as any other human being, the author agrees to accept the patient. The author discovers that his patient is a meek, gentle man; over time, he helps him come to terms with his illness, his disability, and his approaching death. Eventually the patient drops his malpractice suit.
In a South American town during the early years of this century, a retired doctor long known as an eccentric flatly refuses treatment to victims of a riot. Years later, the doctor hangs himself. For the vengeful town, the issue becomes whether he will receive a proper burial or be allowed to rot in the house where he had lately secluded himself.
This issue becomes the focal point of recollections, from many points of view, of fragments of the doctor's bizarre history. An old military man, who was originally the doctor's sponsor and host, braves the town's anger and forces his family members to help him carry out the burial. As it turns out, no one remembers the outrage apart from a few town officials, and the burial takes place without incident.
This early 20th century novel is largely a tale of complex family and love relationships. It is the story of two brothers who vie for the love of the same woman, a competition that nearly destroys the men's friendship but that also leads the narrative into adventures on the frontiers of the Canadian Rockies during the building of the transcontinental railroad.
One of the brothers is inspired by a country surgeon to enter medicine and the middle third of the book deals with the physician training system of the time. The reader is introduced to representatives of both the finest and the most immoral of practitioners and practices. Running from his broken love relationship, the newly minted physician travels to the frontier where he assumes a pseudonym and practices medicine in the railroad camps. His work is inspired and he becomes a folk hero.
In a parallel narrative, the second brother, now a minister, also goes west, while grieving the fracture in his relationship with his younger sibling. Neither knows that the other has relocated to the Rockies. The remainder of the story details the doctor's work and eventual reunion with his estranged brother.
In the past, "tuberculosis" was a taboo word. The poet reviews the disease's many names and its history. John Keats said, "Bring me a candle, Brown. / That is arterial blood, I cannot be deceived / in that color. It is my death warrant."
For centuries so many died of tuberculosis; physicians were so impotent to help. Now, a patient accepts the fact that his chest x-ray has cleared as unremarkable, "as his right / and is right."