Summary:

This 14 line poem deals with a physician's compassion for a hopelessly ill patient ("An apparatus not for me to mend--") and his participation in active euthanasia. The patient, Annandale, was "a wreck . . . and I was there." The narrator asks the reader to view himself or herself "as I was, on the spot-- / with a slight kind of engine." (This "engine" is a hypodermic needle.) He concludes, "You wouldn't hang me? I thought not."

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In this long poem (47 quatrains), Annandale visits his doctor after years of absence and tells the doctor his story. When his wife Miriam died, he mourned her, "wept and said that all was done." Then he met Damaris, "who knows everything, / Knows how to find so much in me." Damaris, who became his second wife, comforts and accepts him. Even though sometimes "her complexities / Are restive" and she becomes angry, soon "She folds her paws and purrs again.

Annandale tells this story of late life happiness, then leaves the doctor's office. He never reaches home: "There was a sick crash in the street, / And after that there was no doubt, / Of what there was." In the last five quatrains, the doctor reflects on what he did for Annandale after the accident ("the one thing to do")--euthanasia.

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This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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This is a collection of short stories by a young physician, Stewart Massad, who completed a residency in obstetrics and gynecology and a fellowship in gynecologic cancer. The stories are all written in the first person, all physicians. The subjects include the physical/emotional demands of residency ("Fatigue"), especially as they strain a marriage; the motivations of a doctor who runs an abortion clinic ("Healers"); and a young doctor facing his own fatal illness and his experience as a patient ("Casualties"). While the stories do portray the difficulties (and often angst) of training, they do so without the despair/cynicism often found in other accounts of the same experience.

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The story is told from the perspective of an obstetrician's wife. She encourages her husband as he finishes school and gets his first job. Then she becomes pregnant. She tells of the changes in her body and in her perspective. Her husband is busy treating other women, while she goes to childbirth classes alone. He arrives just at the end of the birth. She wants him to be with her more often, but understands his need to be with his patients.

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The male narrator works in an abortion clinic. On a daily basis he faces taunts from protesters and the bloody fragments of fetuses. His only consolations are his loving dog and a female lover. He says that he sticks with the job because he loves women and can't turn them down when they ask for his help. One day, he comes home from work to find that a protester has killed his dog. His lover comes and comforts him.

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An intern is on duty in a cancer ward. He especially deals with leukemia. He tells one of his patients that he understands how she feels as she cries, facing death. She turns on him, telling him that he can't possibly understand. A short time later, the intern grows weak and ill. He is diagnosed as having leukemia. He spends months in the hospital, feeling helpless as his old classmates treat him. He makes them promise to let him die peacefully when his time comes. He dies when an intern accidentally pierces his spleen while trying to tap his lung.

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Old Doc Rivers is an old-time doctor who believes in prompt decisions and quick action. Although he is recognized as an alcoholic and drug abuser, the people in the community still hold him in high esteem and often turn to him for help when all else has failed. His story is told from the perspective of several people in his home town after his death.

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The doctor-narrator is working in a hospital during the Great Depression. The pediatric ward cares for many children left there by families unable to feed or care for them. The doctor sometimes thinks the children should just be allowed to die. One particular child captures his interest. She has a high fever and he cannot figure out why. Her condition becomes progressively worse and she dies. It turns out that she had meningitis. Perhaps he could have saved her if he had made the correct diagnosis. Yet, he doesn't feel guilty.

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The initial chapter in this novel, Of Mist, and Grass, and Sand (annotated separately), sets the stage for the quest of the young healer/heroine, "Snake," to find a replacement for the snake she had carelessly allowed to come to harm, in the course of caring for a seriously ill child. The remainder of this coming-of-age novel chronicles Snake's journey during her "proving year" (aka/residency training).

Over the course of this year, Snake continues to minister to the sick and encounters, among others, a patient who demands assistance in suicide, a patient who refuses treatment for a gangrenous leg, and a young girl who has been sexually abused (whom Snake eventually adopts and begins to apprentice). There are, as well, myriad lessons in humility, rigidity of thought, and ethnocentrism.

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