Showing 581 - 590 of 879 annotations tagged with the keyword "Patient Experience"

Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Following the death of an aphasic hermit woman in the woods of North Carolina, it is discovered that she is survived by a daughter (Jodie Foster), a young woman who lives by herself as a kind of wild child, speaking a private language, and intensely fearful of human contact. The authorities decide that she must be normalized for her own good, but Dr. Jerry Lovell (Liam Neeson) disagrees, arguing that, although different, she is fine and has not asked for help. He insists on getting her informed consent before treatment. A judge agrees to give Lovell three months to observe the woman, whose name turns out to be Nell, and find evidence that she should not be treated against her will.

Lovell recruits a partner, psychologist Paula Olsen (Natasha Richardson), and together they set up an observation base on a houseboat with a view of Nell's cabin. From there Lovell makes a series of attempts to win Nell's confidence and understand her language. (Olsen for much of the film mainly represents a set of professional values more conservative that Lovell's unconventional therapeutic moves--which, for example, make her suspect that he is sexually attracted to Nell. Her own sexual presence, while downplayed, serves to defuse this potential.)

Lovell wins Nell's confidence (she calls him her "guardian angel") and the secrets of her speech and wounded psyche (a twin sister died young, and Nell has apparently at least witnessed sexual abuse). Following a court hearing in which Nell speaks in her own defense, the world gets word of her case and journalists descend on her remote cabin on foot and by helicopter.

Fearing that civilization will destroy Nell, Lovell arranges to have her hospitalized as the least available evil. However, when he finds her drugged, he sees that hospitalization is no solution, and he carries Nell out of the hospital and back to her cabin. He tries to make her understand that he is not her guardian angel.

The film switches to a warmly-lit lakeside scene five years later, when all problems seem to have been solved. Lovell and Olsen, who are married with a little girl, and several other sympathetic characters are picnicking with Nell near her cabin, and Nell is shown entranced and somehow emotionally fulfilled in being with the child, who is the age at which her twin sister died.

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Death on Request

Nederhorst, Maarten

Last Updated: Oct-21-2003
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

In this documentary film about euthanasia in the Netherlands, a man--Kees van Wendel de Joode--with amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) requests death in his home, to be performed by his doctor, Wilfred Sidney van Oijen. The film mostly consists of what appear to be unscripted discussions between Kees, his wife Antoinette, and the doctor; however, there are also interviews with the doctor and views of the doctor seeing other patients. The film shows the doctor performing euthanasia: we watch him inject a barbiturate and then a muscle relaxant and we see him supporting Antoinette during the bedside deathwatch.

Kees has had a rapid deterioration of his ability to function: he is unable to move his legs and right arm, he can no longer speak coherently, and he is having difficulty swallowing. His wife cares for him in their Amsterdam apartment. The film documents the legal requirements for euthanasia in the Netherlands: Kees's repeated requests for euthanasia, confirmation that he has an incurable disease, the second opinion doctor's visit, and reporting the death to the municipal coroner and public prosecutor.

The film's strength lies in the sensitive treatment of the impact of this request on the patient, his wife, and especially on his doctor. Dr. van Oijen is an introspective man who cares for his patients--he makes house calls, explains medical terms to his patients, touches his patients, and asks what they are concerned about. He allows his patients (Antoinette is, in many ways, his patient too) to weep and be emotional.

The religious and moral dimensions of euthanasia are explored mostly with the doctor, who does not view himself as a wanton killer, but rather a doctor whose duty includes the alleviation of suffering. The film concludes with a voice-over stating the doctor will not sleep this night, but still has a clinic full of patients awaiting him in the morning.

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Annotated by:
Martinez, Richard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer argues that "the traditional western ethic has collapsed" as we enter "a period of transition in our attitude to the sanctity of life" (pp. 1). The book begins with the tale of Trisha Marshall, a twenty-eight year old woman, who in 1993 was seventeen weeks pregnant when a gunshot to her head left her in an intensive care unit, her body warm, her heart beating, a respirator supporting her breathing. However, she was brain dead.

Her boyfriend and her parents wanted the hospital to do everything possible so that the baby would be born. The ethics committee of the hospital supported the decision. For the next 100 days, Trisha Marshall continued to be supported in the ICU until her baby was delivered by cesarean birth. After a blood test showed that the boyfriend was not the father, and after three weeks in the intensive care unit, the baby went to live with Marshall's parents.

Singer uses this introduction to pose the many ethical questions that are raised because of medicine's ability to keep a "brain dead" body warm for an extended period of time. "How should we treat someone whose brain is dead, but whose body is still warm and breathing? Is a fetus the kind of being whose life we should make great efforts to preserve? If so, should these efforts be made irrespective of their cost? Shall we just ignore the other lives that might be saved with the medical resources required?

Should efforts to preserve the fetus be made only when it is clear that the mother would have wanted this? Or when the (presumed?) father or other close relatives ask for the fetus to be saved? Or do we make these efforts because the fetus has a right to life which could only be overridden by the right of the pregnant woman to control her own body--and in this case there is no living pregnant woman whose rights override those of the fetus?" (pp. 17-18).

In the chapters that follow, Singer argues that whether western society will acknowledge it or not, we have, in our actions and decisions, moved to an ethic where "quality of life" distinctions trump "sanctity of life" positions. Yet, many continue to raise the "sanctity of life" position when it is clear that our legal and ethical positions in western society have embraced the "quality of life" stance. For Singer, this paradox results in an incoherent and illogical approach to the ethical challenges presented by modern medicine.

Throughout his book, Singer presents evidence for his argument through ethical and historical analysis of brain death, abortion, physician assisted suicide and euthanasia, organ donation, and the nature of persons. For those uncomfortable with Singer's position on "infanticide," this book allows one to follow Singer's argument and his recommendations in the last chapter for a coherent approach to these "quality of life" decisions.

He closes his book with the recommendation that a new ethic should embrace five new commandments to replace the old "sanctity of life" commandments. His commandments are: 1) Recognize that the worth of human life varies; 2) Take responsibility for the consequences of our decisions (in end of life care); 3) Respect a person's desire to live or die; 4) Bring children into the world only if they are wanted; and 5) Do not discriminate on the basis of species.

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Summary:

The film opens with a bird's-eye sweep over the frieze of a post-engagement battlefield--mud, strewn with bodies and shards of machinery, all iron grey and relieved only by rare patches of crimson blood. Psychiatrist William Rivers (Jonathan Pryce) treats shell-shocked soldiers in the converted Craiglockhart Manor. He is obliged to admit the poet and decorated war hero, Siegfried Sassoon (James Wilby), because his military superiors prefer to label the much-loved Sassoon's public criticism of the war as insanity rather than treason. Rivers is supposed to "cure" the very sane poet of his anti-war sentiments.

At the hospital, Sassoon meets another poet, Wilfred Owen (Stuart Bunce), equally horrified by the war although he, like Sassoon, believes himself not to be a pacifist. A secondary plot is devoted to the mute officer Billy Pryor (Jonny Lee Miller) who recovers his speech, his memories, and a small portion of his self-respect through the patience of his doctor and his lover, Sarah (Tanya Allen). Vignettes of other personal horrors and the brutal psychological wounds they have caused are presented with riveting flashbacks to the ugly trenches. Sassoon, Owen, and Pryor return to active service. The film closes with a dismal scene of Owen's dead body lying in a trench.

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This is the true story of Christy Brown (Daniel Day-Lewis), who was born with cerebral palsy (CP) into a poor Irish family in 1932 and overcame severe physical disability to become a famous artist and writer. In his early years Christy is severely disabled and disfigured--spastic, unable to speak, and close to quadriplegic, able to control only his left foot. His father (Ray McAnally) initially regards him as both retarded and sinful, but his mother (Brenda Fricker) faithfully and heroically cares for him.

Gradually, as he begins to speak, Christy's intelligence becomes apparent, his father accepts him into the family, and he trains himself to paint with his left foot. In his Dublin neighborhood, Christy is widely accepted, playing football goalie (by lying across the goal) and being made King of the Bonfire on All Hallows Eve, and he at least passively participates in an adolescent game of spin-the-bottle.

CP specialist Dr. Eileen Cole (Fiona Shaw) recognizes Christy's artistic talent and offers to train him. She brings him Shakespeare's "To be or not to be" soliloquy, gives him training in speech and movement control, and arranges for a one-man show of his artistic work. Christy falls in love with Dr. Cole and is crushed when she reveals that she is already engaged, and he tries unsuccessfully to slit his wrists.

Recovering emotionally from that disappointment, Christy in the years that follow sees more success as an artist and writes the autobiography on which this film is based--and, we are told in a closing title, he marries his nurse when he is about 40. (Christy Brown died in 1981 in his late forties.)

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Dehiscence

Haddad, Amy Marie

Last Updated: Jun-02-2003
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poem

Summary:

In her poem, "Dehiscence," Amy Haddad speaks in the voice of a nurse tending a suffering patient. The patient has "come unstitched," and, seen through the nurse's eyes, the patient's wounds are devastating: fistulas "connect bowel, liver, pancreas"; the "stench is overwhelming," telling everyone, caregiver and patient alike, that medical science has failed, that no more can be done.

Moved by her patient's suffering and her own inability to help, the nurse does what she can. She washes the patient, changes the soiled sheets, removes the dirty dressings and replaces them with clean gauze and tape. "Done," she says. Stepping back, looking from a distance, she can no longer see the patient's wounds. She "is caught," as all caregivers have been at one time or another, in "the illusion" of the patient's "wholeness."

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Gusev

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story is set in a ship's infirmary where five soldiers and sailors are returning to Russia after serving in the Far East. One of them, Gusev, served as an orderly. He is content to do his duty and get by. His delirious dreams are filled with images of his family's farm. He is concerned that if he does not make it home, the farm will fail and his parents will be thrown into the streets.

He makes kind overtures to another patient, Pavel Ivanych, who responds angrily. Pavel Ivanych considers himself a realist, a truth-teller, and a member of the revolutionary intelligentsia. He ridicules Gusev's optimistic good nature. Where Gusev is blind to the oppression he has suffered, Pavel Ivanych denounces injustice wherever he sees it and has a reputation for being a troublemaker. Even as his illness advances, Pavel Ivanych protests. He refuses to believe that he can die like the others; indeed, he insists that he is improving. Nonetheless, he dies.

Gusev grows worse, too. He feels an insatiable yearning for something that he cannot define. Shortly afterward, he, too, dies and is buried at sea. The story closes with a description of his body descending through a school of fish while a brilliant sunset shines above.

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Typhus

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

An army lieutenant named Klimov is returning home to his sister and aunt in Moscow and falls ill while on the train. His mouth is dry, his brain turns to mush, and he keeps hearing a strange voice cry, "Is the mail ready?" When he finally arrives at the station, he collapses. During the next days or weeks, he thrashes around his bed in delirium, latching onto disconnected images of a cheerful doctor, a grave priest, and various acquaintances and events.

One morning Klimov awakens feeling well. His whole being is filled with a sensation of happiness. He learns from the doctor that he has survived a case of spotted typhus. But where is his sister Katya? His aunt groans, "Ah, Katya, Katya! Our angel is gone! Is gone!" Indeed, Katya had caught typhus from her brother and died. Her funeral had taken place the day before. Pavel's "heart ached, he burst into tears, and leaned his forehead against the window frame."

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

May-Alice Culhane (Mary McDonnell) is a daytime soap opera star who is struck by a taxi in New York and wakes up in a hospital paralyzed from the waist down. Upset and bitter, and unable to continue acting, which she says is the only thing she was ever good at, she returns to her Louisiana bayou family home to begin the rest of her life in isolation.

An employment agency sends out a string of helpers. Some are better than others, but all are quickly defeated by May-Alice’s deep bitterness and negativity and her incipient alcoholism. Then comes Chantelle (Alfre Woodard), who needs the job so badly, as part of digging herself out from a cocaine addiction, that her determination makes her a match for May-Alice.

It is decidedly bumpy going, but Chantelle persists and May-Alice finally strops drinking and begins to make some progress in physical therapy. She takes up black-and-white photography, developing her own prints from her wheelchair, and she gratefully receives the gentlemanly attentions of her high school idol Rennie, played by David Strathairn. (The film takes its title from a practice that locals believe can make love-wishes come true.)

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Frida

Hayek, Salma; Taymor, Julie; Molina, Alfred

Last Updated: May-26-2003
Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This is the story of the life, loves, wounds, grit, artistic genius, and death of the well-known Mexican artist Frida Kahlo, played by Salma Hayek. At the age of eighteen Kahlo was in a near-fatal bus accident that left her with lifelong injuries to her pelvis, spine, and uterus. (The film does not include the fact that Kahlo had suffered some physical disability since a case of polio at the age of six.)

The life Kahlo survived to live was artistically enormously productive and successful, but it also had more than the usual share of physical suffering, medical procedures, attempts to self-medicate, and accompanying emotional distress. The film covers these things, as well as what Kahlo called the second disaster in her life, her marriage to the famous Mexican muralist Diego Rivera, played by Alfred Molina.

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