Showing 61 - 70 of 564 annotations tagged with the keyword "Physician Experience"
Summary:On the Move: A Life describes the extraordinary life of Oliver Sacks from his childhood during World War II to shortly before its 2015 publication. Using his journals (“nearly a thousand,” he writes), correspondence, and memories—as well as his 14 or so books—Sacks has given himself free rein to describe and analyze his long, productive, and unusual life.
Summary:Atul Gawande’s Being Mortal is both ambitious and synthetic, qualities that well suit his difficult subject, death. In Western culture, there are taboos against death because it fits neither into post-Enlightenment notions of progress and perfection nor into medical notions of control, even domination of human biology. A surgeon and an investigator, Gawande draws on his patients, his family, and travels to various hospitals and other caregiving places in order to confront death and see how approaches such as hospice and palliative care can improve our understanding, acceptance, and preparation for death.
Summary:Bursting with Danger and Music reveals Jack Coulehan’s characteristic sensitivity to contradictions, tensions, and creative energy. The book is divided into six sections, thematically held together with such headings as “All Souls’ Day” and “Levitation.” Many of the poems are first person narrations by patients, physicians, and observers of the natural world. Sometimes the patients are near death, as in “Darkness is Gathering Me” and “Slipping Away,” where they observe their own dying without fear but with wonder and even a sense of celebration: “I’m pouring through the pores/ of this room, I’m already/ feeling the jazz and hormones begin” (p. 39). In “The Internship Sonnets,” he experiences the world of the medical intern, often scared and exhausted, who is caught between his subservient duty to the chief of medicine and his own violations of that duty, such as telling the truth to patients. Where is his primary duty? What ought he to do in these conflicting value systems?
Summary:In 1847, one of every six women whose babies were delivered by the medical students and supervising doctors at Allgemeine Krankenhaus (General Hospital) in Vienna died of puerperal fever (also known as childbed fever). In contrast, the incidence of this disease in women delivered by hospital midwives was dramatically lower and puerperal fever was quite rare when mothers had their babies born at home.While a few physicians (most notably Alexander Gordon and Oliver Wendell Holmes) realized that childbed fever was a contagious process, it was Semmelweis who identified the nature of the problem as stemming from the failure of obstetricians and medical students to wash their hands and change their clothing, especially after performing autopsies or doing surgery. He mandated that doctors and students wash with a disinfectant (chloride of lime) before examining any woman in labor.Despite the dramatic reduction of maternal mortality on his obstetrical unit, his ideas and methods were not well received. Semmelweis was reluctant to conduct experiments on animals to prove his theory and resisted publishing his findings in any medical journal. When he finally did write a book, The Etiology, the Concept, and the Prophylaxis of Childbed Fever, it was difficult to read and failed to impress many obstetrical experts.With his health failing and his behavior increasingly erratic and inappropriate, Semmelweis was committed to a state-run mental hospital. He died two weeks later. The official cause of death was sepsis secondary to an infection of his finger. The author is convinced, however, based on the autopsy report and findings upon exhumation of the body in 1963, that Semmelweis was beaten to death by the staff at the asylum. He may well have been suffering from Alzheimer's presenile dementia at the time.
Summary:This anthology is a sequel to Pulse: The First Year (2010). Both anthologies are comprised of postings to the website “Pulse: voices from the heart of medicine,” an online publication that sends out short poems and prose pieces every Friday. As the website subtitle suggests, the topics are from the medical world, the writing is personal (not scientific), and the writers give voice to feelings and perceptions from their direct experience as care-givers, patients, or family members of patients. All the pieces are short (typically one to five pages), usually with a tight subject focus. For example, in "Touched," Karen Myers reports how massage has helped her muscular dystrophy.
Although Dr. Helman’s untimely death did not permit a final editing by this prodigious writer, the published edition is not a book-in-progress. An Amazing Murmur of the Heart: Feeling the Patient’s Beat represents a powerful and persistent continuation of observations and themes that grew out of medical education, close observations of physicians and patients, and his studies in anthropology. All of these forge an approach to patient care that is out of the ordinary.
As his previous writings suggest, Helman is passionate about medicine but concerned, equally about the emergence of those who fail to listen and to those who might be called techno-doctors. While professing his appreciation of and attraction to the magic machine or computer, he is mindful of its absence of emotion and ambiguity. “For this post-human body is one that exists mainly in abstract, immaterial form. It is a body that has become pure information.” (p. 11)
Chapters are comprised of stories about patients and their care providers, each representing complex facets that defy precise measurement, answers and conclusions. As Helman steadily notes, the physician must be an archeologist:
Most patients present their doctors with only the broken shards of human life—the one labeled infection, disease, suffering and pain each of these shards is only a small part of a much larger picture….the doctor will have to try and reconstruct the rest. (p.66)
In general, the chapters illustrate first an initial review of medical history, and then specific patient stories. Of the two, the story is most important. “Mask of Skin,” for example, begins with an overview of skin from Vesalius to the present: largest organ, stripped bare by anatomists, penetrated by disease, later scanned and X-Rayed, tattooed, re-fitted by surgeons, etc. That said, Helman the physician-anthropologist, moves from science to specific stories about patients whose skin may cover profound experiences, psychic and otherwise, that might be overlooked by a dermatologist. Although skin is involved in each of that chapter’s stories, the willing physician must dig deeper in his observations and caring manner to make more profound discoveries.
In a chapter entitle “Healing and Curing” the author describes an old friend, a practitioner who provides advice about patient care that ”was not included in his medical texts”. Patients are more than a diagnosis dressed in clothes. Doctors must make patients “feel seen, listened to, alive”. Always patients should be regarded as people who happen to be sick. From his admired colleague Helman learned to be an attentive listener to the "tiny, trivial, almost invisible things" in patient encounters and stories. To truly heal as well as cure requires the doctor to empathise with what the patient is feeling thereby requiring both an act of imagination and of the heart. The chapter, of course, continues with with stories that illustrate the points enunciated by his colleague and accepted by his disciple.
In his introduction, the author summarizes the history of polio’s first appearance as an epidemic in the United States, the ensuing research, subsequent applications of new information, attempts at abatement and ultimate success in the development of preventative measures.
Embedded in the successes and failures of the research applications are the details of human interactions. Their impact on the goal of achieving near extinction of polio in America constitutes a dramatic subplot, which the historian adroitly weaves into the work.
For the reader who has only a sketchy knowledge of this important period in medical research, this history provides details of human exchanges, conflicts and resolutions necessary to bring the scientific developments to fruition. Central among the multiple struggles rests the basic disagreement between Jonas Salk and Albert Sabin, two of the most prominent scientists working against the clock to develop the most effective and safest form of immunization. Each new surge of the disease added to the urgency of the problem as well as to the question of the best solution. Salk felt strongly that the immune system should be stimulated by a killed virus preparation, while Sabin was equally convinced that only the living virus could provide this need. Each view had its own cadre of supporters and of opponents.
Funding issues also troubled those fighting the polio epidemics. The March of Dimes is credited with raising a record $55 million in the fight against polio in early 1954, becoming the first major infectious disease battle to benefit from a concerted public awareness campaign and demonstrating the power of such volunteer driven efforts to supplement public and other private funding efforts.
Following the 9-11 terrorist attacks, approximately 20 New York University medical students volunteered to work with the Office of the Chief Medical Examiner of the City of New York (OCME) attached to the NYU School of Medicine to sort, catalogue and identify human remains recovered at Ground Zero. On September 11, Barry Goldstein, Adjunct Professor of Humanism in Medicine at NYU, was to begin teaching a course on aspects of photography to medical students. After 9-11, Goldstein decided to photograph and interview the volunteer medical students in order to document their individual experiences and memories of the events of September 11 and their personal reflections of working with the dead.
Photographed with a simple black background in the "scrubs" they wore while working in the morgue, and with a personal "prop" of their choosing, the colour portraits are intensely sorrowful and candid. Goldstein, who is an experienced portrait photographer, observed that "for reasons I still find unclear, these students were surprisingly adept at absenting themselves from the entire process of picture taking. As a result, the masks that we generally put on for the world when faced with a camera were absent." Accompanying each student's image is an excerpt from his/her interview about memories of working in the morgue and the meaning of that work.
According to the editor’s introduction, this collection is based on the AMSA (American Medical Student Association) assertion that the physician must be a humanist, a communicator and an advocate as well as a scientist. To support these and related commitments, it offers essays that demonstrate how and under what circumstances the introduction of creative arts into the lives of professional care providers and their patients and families may be achieved. Included in some essays are general themes, while in others there are very detailed descriptions of methodology. Others utilize more standard research designs and outcomes.
What creative arts are included in the discussions? Visual arts, drama, music, and story-telling stand out in terms of potential and, in some cases, already demonstrated applicability to a medical practice. Some of the essays propose art forms that can be translated into a useful frame for health practitioners, artists and/or patients and their families.
Some essays include assessment of research projects or various designs of methodologies for using creative art in the medial professional education environment. Others rely on personal experiences using the arts in the learning and teaching of skills such as communication with peers, patients, family and friends.
The volume is divided into four sections. The first cluster of essays considers using the arts to illustrate empathy in encounters among providers and recipients of health care services. This is demonstrated in a variety of settings as disparate as end-of-life situations and dental training programs.
The second section includes examples of drama, music and drawing as part of caring for caregivers. Through group settings and peer support, art serves as a stress reducer for those whose work involves the highly emotional situations health professionals often encounter.
Section three explains and demonstrates the narrative reflective process, in which experiences and stories are shared among those persons involved as patients, family members and caregivers. The special situation of interviews in pediatrics is given attention in one portion of this section.
The final section addresses the question of using art to explore troublesome issues that demand change or special attention. Included are ethical dilemmas and the need for health professions to build bridges to the community at large.
Summary:The author is a practicing neurosurgeon, one of only two hundred or so women in this specialty which numbers about 4,500. She was the first woman to be admitted to her neurosurgery residency program. Her father was a surgeon and she was definitely influenced by him and says that, as the oldest of four children, it was always expected that she would become a doctor; but she didn't decide for sure until partway through her second year of college.