Showing 61 - 70 of 470 annotations tagged with the keyword "Medical Ethics"

Immortal Bird: A Family Memoir

Weber, Doron

Last Updated: Feb-10-2014
Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Damon Weber's proud father, Doron, has written a searing memoir that enfolds a story of parental love and loss into a medical exposé. By the time Damon turned four, he had two open-heart surgeries to correct a congenital malformation that affected circulation to his lungs. His parents were led to believe that after the surgeries, their effervescent, sociable, academically and artistically talented son was set for life. However, as Damon turned 12, they became concerned about what his father calls "his unsprung height," his shortness of breath, and a strange protrusion in his abdomen (40). Returning to his attending physician, they were surprised that she withheld information from them about a condition known as PLE (protein-losing entropy), which can manifest months or years after the kind of surgery (Fontan) their son underwent. PLE enlarges the liver and allows proteins to leak from the intestines. Without adequate protein, Damon's body could not grow. His father worried that they might have passed the established window of opportunity to treat the complication.

The memoir, which reads like an extended eulogy to a beloved son, fuses scenes of family life with difficult medical decisions aimed at reversing the effects of PLE. However, none of the interventions succeed, leaving a heart transplant as Damon's last hope. As Weber recounts each decision leading to the transplant, he exposes flaws in the way hospital systems operate, in the way families are treated, and in the care provided by the medical team that lobbied to perform the transplant. Damon died after his transplant physician made herself scarce after misdiagnosing a post-operative complication, and an inattentive hospital staff ignored his parents' justifiable alerts to ominous symptoms. Scenes of the hospital staff waiting impatiently at the door to Damon's room to remove the machines sustaining and monitoring him, as his distraught parents say good-bye, are disturbing. When the Webers initiate a lawsuit, the transplant physician cannot locate Damon's medical records. The narrative fully absorbs Weber's sorrow and anger.

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Augustine

Soko; Winocour, Alice; Lindon, Vincent

Last Updated: Feb-07-2014
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Augustine, a fifteen-year old maid in a wealthy home, collapses with a seizure while she is serving an elegant dinner. When she recovers, she is unable to open one eye. She is transported to Salpetriere hospital in Paris under the care of the famous J. M. Charcot, neurologist and psychiatrist who is fascinated by the condition of hysteria. He uses hypnosis to suggest cures to his patients and to trigger attacks which he demonstrates to his colleagues. Augustine is particularly susceptible to fits under hypnosis and obliges her doctor with lewd, convulsive performances virtually on command.

After one such episode the paralysis moves from her eye to her hand. She says that she wishes to be cured, but life in the asylum is not terrible: she has a warm room and food; she no longer needs to work in a kitchen or serve demanding masters.  The doctor is clearly taken with her as a scientific subject. “Augustine est une patient magnifique,” he assures a colleague. He is personally intrigued by her too.

Finally, one day she announces that she is cured. When Charcot tries to hypnotize her for another demonstration, she does not succumb; however, a look passes between them. Taking pity on her doctor, she stages a seizure that satisfies the audience. Immediately after, she and the doctor have a single passionate encounter against a clinic wall, and then she runs away.

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Far From The Tree

Solomon, Andrew

Last Updated: Dec-20-2013
Annotated by:
Henderson, Schuyler

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author of this long, compassionate and often startling treatise on identity interviewed over three hundred families to elicit stories about raising exceptional children, stories that also come from these exceptional children ('exceptional' is the term chosen to describe the children in the author's material about the book).

'Far From The Tree' explores the challenges children face in being raised in families where one prominent feature in their identity is forged by something out of their parents' control and generally not part of the family's experience until then. These identities are not 'vertical' (passed down from generations of parents to their children), but 'horizontal', springing up between those who share in that identity at any one time. Solomon begins by wondering about his own relationship with his parents when he was a child discovering his sexuality and ends with his own role as a father, 'the terrifying joy of unbearable responsibility' (702); between the two poles of his own experience, he meets parents and children who have experienced deafness, dwarfism, autism, schizophrenia, severe physical disabilities and diverse gender identities, prodigies, children who were concieved by rape and children who became criminal.  

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The Way of the Physician

Needleman, Jacob

Last Updated: Dec-02-2013
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Jacob Needleman, a philosopher concerned with "applying philosophy to the questions of everyday life," taught medical ethics at San Francisco State University (SFSU). In this highly personal book he addresses what it means to be a "good doctor" and the role of physicians in contemporary society. The book is structured as a series of imaginary letters addressed to his childhood idol, the physician who treated him when he was 12 years old.

The aged Dr. Kaufman responds to these letters, although we see only the philosopher’s side of the correspondence. Toward the end of the book, Needleman makes a pilgrimage to Philadelphia to visit his ailing mentor. They talk for a while, then when the old man takes a nap, Needleman spends the rest of the day conversing with Dr. Kaufman’s daughter, a pediatrician who in some sense represents the "good" medicine of the future, just as her father represented the "good" medicine of the past.

In these letters the author addresses the deep questions of character and motivation in the form of a personal narrative. He recalls his experiences as a boy, his ambition to become a doctor, and several incidents from his life as an autopsy assistant and hospital orderly. For example, there is the bizarre story of the young man transporting an amputated leg by elevator; he accidentally drops the leg to the floor and the wrappings flip open, much to the astonishment of others on the elevator.

"People don’t trust science; people trust people." (p. 15) Similarly, Jacob Needleman writes, people don’t trust or distrust medicine as an institution; they trust or distrust doctors. "To be a good doctor, one must first of all be a good (person). And to be a good (person) one has to begin by discovering in oneself the desire for truth . . . truth is the only effective force." (p. 68)

To facilitate this quest for truth, Needleman describes in these letters a four-seminar sequence he teaches at SFSU: "To whom is the physician responsible?," "The art of living and the art of medicine," "Care," and "The financial disease of modern medicine." (pp. 71-72) Through these seminars the author hopes to re-awaken in prospective physicians the quest for truth, and the possibility of care, that he believes have been submerged by technology and infected by the financial disease. Dr. Kaufman’s daughter serves as a real-life example of the possibility of cultivating the contemporary version of the "good doctor."

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Open Heart

Yehoshua, A. B.

Last Updated: Nov-30-2013
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Benjamin Rubin is completing his surgical residency in a Tel Aviv hospital when the director of the hospital asks him to accompany him and his wife to India to rescue their daughter who is critically ill.  This invitation distresses him, as he recognizes in it a way of removing him from competition for a position in surgery at the hospital.  He makes the trip, however, and is entranced by Indian culture and mysticism, and, eventually, not by the daughter but by the mother he accompanied.  Back in Tel Aviv, he has a brief affair with the mother, moves into an apartment she owns, leaving his mother's home, and, to allay his obsession with an unavailable woman, marries an independent-minded woman who has also traveled in India and absorbed Buddhist spirituality and Eastern philosophy she discovered there.  Working as an anesthesiologist, Benjy continues in that setting, conflicted about both work and life, unable to connect deeply with any of those whose love he has received or sought.  Eventually his wife leaves with their baby daughter to return to India, where she has found a spiritual home, and Benjy remains in a divided state of mind in a divided country where his own spiritual heritage remains to be plumbed.

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Fever

Keane, Mary

Last Updated: Aug-22-2013
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1907, Mary Mallon, an Irish-born cook, is identified as the source of typhoid fever outbreaks in several of the households where she has been employed. Deemed a healthy carrier, she nevertheless cannot comprehend her role in the tragedies and rejects her responsibility. How could she harbor the germ that causes the disease and not be ill herself?

Led by Dr. George Soper, the authorities ensure that she is incarcerated on North Brother Island in the Hudson River – until a lawyer takes an interest in her case. An important part of her defence comes from the growing knowledge that many other people are also healthy carriers of the germ and they have not been incarcerated. Finally in 1910, she regains her freedom on condition that she never cook for others again.

But Mary loves cooking, and it is a far more lucrative occupation than her work as a laundress. In addition, she needs to support her common-law partner, Alfred, who has a serious drinking problem and is chronically unable to find work. Alfred had left her for another woman during her incarceration and succeeds in giving up alcohol. But he still loves Mary and abandons the other woman; he vanishes out west and is injured in a horrible fire that leaves him deformed and in chronic pain. Mary finds him and tries to help him, but Alfred now slowly slips into drug addiction.

The temptation to start cooking again is too great. The inevitable happens and Mary is caught. This time, however, she does not protest and ends her days as a captive of New York City.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The pediatrician-author of this autobiography was the first Jewish professor of medicine at the prestigious McGill University.

Born in Montreal in 1890, Alton was an only child whose immigrant father was an itinerant merchant with somewhat shady dealings. The shy boy developed hemoptysis and was sent away from home and family to the healthier air of Denver on the erroneous suspicion of tuberculosis.

He overcame shyness and found an ability to speak in acting and “declaiming” passages from Shakespeare. Literature remained a lifelong passion. Notwithstanding the quotas on Jewish students, he attended McGill medical school, followed by residency in the United States where he encountered many luminaries of twentieth-century pediatrics.  

Upon his return to Montreal, he confronted entrenched anti-semitism, but was instrumental in founding the Jewish General Hospital and a children’s hospital. He witnessed exciting medical discoveries and, like many other pediatricians, championed initiatives for child health that relied on social intervention.

The book closes with a few case histories of small patients, many of whom fell ill because of parental and societal ignorance.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The author was the first blind physician to be licensed in Canada. Her autobiography is also an autopathography.

From her anger over developing severe diabetes as a teenager, through her relentless pursuit of a scientific degree and medical school, through a brief failed marriage – followed by the tragedy of completely losing her sight while still in training, to a rewarding and responsible career as a palliative care physician and educator.

Sustained by her religious faith and by loyal family members and friends, Poulson explains choices, compromises and supports that allowed her to continue studying and working in Montreal and later in Toronto.

Her complications from diabetes were numerous, and included heart disease for which she required surgery. Then she developed breast cancer, which eventually metastasized. In closing her narrative, she knows it will likely take her life.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In 1904, the 19 year-old Russian Jewish Sabina Spielrein (Keira Knightley) is admitted to Burgholzi clinic under the care of Dr. Carl Jung (Michael Fassbender) who is beginning to adopt the talk-therapy methods of psychoanalysis promoted by Sigmund Freud (Viggo Mortensen). 

She is hysterical and difficult to control, but she is also bright and has been studying to become a doctor. Jung slowly breaks through her resistence using dream interpretation and word association; eventually she reveals that her mental distress has its origin in her relationship with her father. He would punish her physically and she found it sexually exciting. 

The married Jung is obsessed with his patient and seduces her. They conduct a heated affair that entails sessions of bondage and beating, that they pursue almost like a scientific experiment.

On this background, Jung is becoming the protégé and anticipated heir of Freud—but they disagree over whether or not psychotherapy can cure. Spielrein recovers and goes on to become a physician and psychiatrist who develops her own methods of therapy. Freud comes to admire her and Jung is torn by jealousy. 

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The Miracle Cures of Dr. Aira

Aira, Cesar

Last Updated: Jun-30-2013
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novella

Summary:

The protagonist-physician, Dr. Aira, is an almost 50-year-old sleepwalker who resides in Buenos Aires. He's nearsighted, introspective, and paranoid. Dr. Aira's fame stems from his "miracle cures" - even though it's not clear that he's ever actually performed one. Dr. Aira does not believe in God.

His initial encounter with "paranormal medicine" occurred during childhood when dog owners in his town were led to believe that by submitting themselves to a lengthy set of penicillin injections their pets would be painlessly neutered. Acknowledging the absurdity of that situation, he remained intrigued by the "possibility of action from a distance" (p10) and the lure of magical healing.

Dr. Aira's nemesis is Dr. Actyn, Chief of Medicine who tries to ridicule Dr. Aira and debunk his claims. Dr. Actyn sets elaborate traps including one with a "dying" actor on an ambulance who Dr. Aira refuses to cure.

Dr. Aira obtains enough money to devote 10 months solely to writing his secrets and eventually self-publishing his knowledge in the form of pamphlets. His plan is interrupted by an urgent request to perform a miracle cure on a terminally-ill cancer patient. He consents and makes a house call to treat the wealthy man. After one hour of intense deliberation and theorizing, Dr. Aira's work is complete. Laughter erupts. The "patient" is a fake. It's his archenemy Dr. Actyn in disguise. Dr. Aira's failure is captured on camera.

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