Showing 581 - 590 of 906 annotations tagged with the keyword "Doctor-Patient Relationship"

An Absence of Windows

Selzer, Richard

Last Updated: Jan-31-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Fifty-two year old Pete, the hospital mailman, suddenly experiences severe abdominal pain. He is evaluated and treated in the emergency room. His diagnosis is acute surgical abdomen, but the exact cause of his pain is still unknown. The surgeon-narrator determines that the severity of Pete's condition mandates exploratory surgery. During the operation, "an old enemy" (18) is encountered--pancreatitis.

Afterwards, the surgeon assures Pete that he will get better. One week later though, the mailman dies. His death has been painful. An autopsy is scheduled, but the surgeon deliberately arrives 20 minutes late. He does not want to view the intact body of his deceased patient. No matter, the pathologist has waited for him to arrive before beginning the post-mortem examination. The pathologist closes Pete's eyelids before starting the autopsy, mindful of how the mailman's "blue eyes used to twinkle" (21) when he delivered the mail everyday.

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The Vanishing Eye

Bulgakov, Mikhail

Last Updated: Jan-28-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

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Kirk

Groopman, Jerome

Last Updated: Jan-28-2005
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.

Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.

Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."

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Black as Egypt's Night

Bulgakov, Mikhail

Last Updated: Jan-26-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The physician-narrator celebrates his 24th birthday in the company of two midwives and a feldsher (physician’s assistant). They toil in a remote area of Russia where conditions are harsh. The doctor tells the group about a peasant woman who requested a refill of belladonna (an atropine-like drug) that was prescribed for stomach pain the day before. Although the instructions were to take five drops as needed, the bottle was completely empty already. Since the woman had no signs of belladonna poisoning, the feldsher concludes she shared it or maybe even sold it to other villagers.

The group shares other stories about patient mistakes and misguided beliefs. That same night a man comes to the doctor’s house. He is a miller suffering from recurrent fevers. The physician diagnoses malaria and remarks how sensible and literate the patient is. Powdered quinine is prescribed to be taken once a day before the onset of fever. Soon the doctor receives word the miller is dying. The patient has defied the instructions and taken all 10 doses of quinine at one time to expedite his recovery. His stomach is pumped, and he survives the overdose.

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The Blizzard

Bulgakov, Mikhail

Last Updated: Jan-26-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator is an inexperienced and overworked doctor in a remote region of Russia. Although accustomed to seeing as many as a hundred or more patients in a day, a blizzard brings him unexpected relief. Only two patients show up in the clinic. He welcomes the prospect of a leisurely day but soon receives a summons for help from a physician in a nearby district.

A bride-to-be has fallen out of a sleigh and is unconscious. The narrator travels more than 2 hours to lend his help, but she is already dying. He later realizes the young woman had a fracture at the base of the skull. Ignoring advice to stay the night, the doctor insists on returning home. Four hours after departing in a sleigh, the doctor and driver are lost and trapped in the snow. With great effort, the two men free the sleigh and horses from the drifts.

As their journey resumes, wolves chase the sleigh until the doctor fires his pistol. Finally, he sees the lights of his hospital in the distance. Once safe in his house, the doctor picks up a manual containing information about skull fractures but decides instead to go to sleep.

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How Do You Feel?

Emmott, Kirsten

Last Updated: Jan-24-2005
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This collection by the Canadian physician-poet Kirsten Emmott includes poems on a wide range of medical topics, focusing on the physician's personal and professional growth, and the patient's experience as seen through the physician's eyes. Many of the poems deal with pregnancy, childbirth, and women's health issues. (104 pages)

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Lessons from the Art

Selzer, Richard

Last Updated: Jan-13-2005
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Selzer tells four stories of surgical loss: a surprise loss on the operating table, the drowning of a sick child in a flood in wartime Korea, the sudden death of a professor due to a perforated ulcer, and the loss of some facial mobility in a young woman following the removal of a tumor in her cheek. As we move from one vignette to the next, the narrator's mood goes from despair to accepting to redeemed, with various forms of love the agent.

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The Surgeon as Priest

Selzer, Richard

Last Updated: Jan-13-2005
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Selzer begins by describing an anonymous painting of Vesalius at the dissecting table, about to cut into the cadaver in front of him, yet glancing over his shoulder at a crucifix on the wall behind him. He then tells two medical stories in which spirituality has played a crucial role.

In the first, a man who has repeatedly refused to have a brain cancer operated on turns up one day healed, attributing it to the holy water a family member brought back from Lourdes. In the second, the Dalai Lama's personal physician does rounds in an American hospital and, using ancient techniques, diagnoses correctly, and in some detail, a case of congenital heart disease.

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Summary:

This is a collection of 14 contemporary patients' accounts of dealing with their illness or injury. (The patients, four men and ten women, including the editors, are all writers.) Among them the stories cover numerous medical conditions: erythroblastosis, environmental illness, obsessive-compulsive disorder, hip dysplasia, osteoarthritis, hip replacement, H.I.V., Crohn's disease, broken leg, ruptured cervical disc, myelitis, rheumatoid arthritis, paroxysmal nocturnal hemoglobinuria, lupus, alcoholism, multiple sclerosis, diabetic retinopathy, breast cancer, severe facial scarring, and depression. The collection is unified by a focus on selfhood--the recovery, discovery, or reconstruction of the psyche that the editors propose is the deepest form of healing.

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Science and Charity

Picasso, Pablo

Last Updated: Nov-12-2004
Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

A sick woman (dying mother) in a comfortably made-up bed serenely occupies the center of the canvas's diagonal composition. She lies between a seated doctor focused on his hand-held watch while he takes her pulse, and a nun who holds the woman's child and extends her a drink (tea, medicine). The simple, calm, orderliness of the sparse setting is echoed in the postures and countenances of the four figures.

In his biographical study, Robert Maillard documents that Picasso's father--art teacher and model who posed as the doctor--worked out both the composition and the title of the painting for his 16-year-old son (Picasso. New York: Tudor, 1972, p. 180).

An earlier watercolor draft of this work sketches the child with arms outstretched reaching forward to the sick mother. In the draft, the physician and nun, too, are more concerned with the mother's condition. Though strengthening the allegorical significance of this academic composition, the dramatic intensity is lessened if not lost in the final version (1897), which was awarded an honorable mention in Madrid and a gold medal at the Exposición de Bellas Artes in Málaga.

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