Showing 61 - 70 of 94 annotations tagged with the keyword "Tuberculosis"
Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.
Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.
This poem--"not graveyard roses"--is the poet's gift to her dead friend Bulgakov. He was defiant and steadfast in the face of all the tragedies of his "high, stricken life." While others may not raise their voices to praise Bulgakov (because of the danger of doing so in Stalinist Russia), "one voice at least / Must break that silence, like a flute." The poet remarks how amazing it is that she who has lost so much in her life should now be eulogizing "one so full of energy / And will" who "only yesterday" was "hiding the illness crucifying him." [20 lines]
In this short volume, Janet Malcolm frames a series of reflections on Chekhov's life and work with her pilgrimage to Chekhov-related sites in Russia and the Ukraine. The book begins with Malcolm's visit to Oreanda, a village on the Crimean coast near Yalta, which is the site where the fictional lovers in Chekhov's story The Lady with the Dog (1899, see annotation) sit quietly and look out at the sea on the morning after their first sexual encounter. While these lovers are fictional, their creator actually spent the last several years of his life as a respiratory cripple living amid the seascapes around Yalta.
The visit to Oreanda occurred near the end of Janet Malcolm's literary journey, but it provides a fulcrum or center of gravity for the book. From there, she constructs a narrative with three interweaving plots. One consists of her reminiscences of the last 10 days or so in St. Petersburg and Moscow, and her visit to Chekhov's estate (now a state museum) in the village of Melikhovo, south of Moscow. A second presents biographical material about Chekhov. Malcolm triangulates and interweaves these two with critical observations about the writer's stories and plays.
This is an excellent review of the authors' choices of the ten greatest medical discoveries. They arrived at the ten selected after narrowing five thousand or more possibilities down to one hundred and then finally down to ten based on these three components in the field of medicine: 1) structure and function of the human body, 2) diagnosis of medical conditions and 3) treatment of such maladies. Finally the ten selected were approved by four avid and informed physician collectors of rare and important medical publications.
Chronologically, the anatomical observations of Vesalius come first with his publication of the Fabrica in 1543. Harvey's discovery of the circulation of the blood is considered the single most important discovery. Leeuwenhoek gets credit as the founder of bacteriology, but Koch and Pasteur are included in a discussion of this discovery. Jenner gets his just recognition for introducing vaccination and Roentgen for discovering the X-ray beam.
Crawford Long is recognized for the initial use of surgical anesthesia and Fleming for the discovery of penicillin. More unlikely choices are Ross Harrison for tissue culture, Anichkov for the relation of cholesterol to atherosclerosis and Wilkins, rather than Watson and Crick, for the DNA story.
Each chapter describes not only the discovery but also tells the life stories of the chosen "discoverers" and others who contributed to extension and usefulness of the discoveries. The authors conclude that it is not genius so much as curiosity and the ability to conduct methodological investigations that distinguish these men.
The story takes place in the winter at Einfried, a sanatorium directed by Dr. Leander, a physician "whom science has cooled and hardened and filled with silent, forbearing pessimism." A young married woman (Frau Kloterjahn) arrives as a patient. Her husband denies the seriousness of her illness by calling it merely "a problem of the trachea." In reality, Frau Kloterjahn, who had recently given birth to a healthy son, is dying of consumption.
A not-so-sick novelist (Detlev Spinell) also lives in the sanatorium, and he quickly develops a romantic obsession with the new patient. One day most of the residents go for a sleigh ride, but Spinell and Frau Kloterjahn remain indoors. He cajoles her to play the piano for him, which has been forbidden. Picking up a score from "Tristan und Isolde," Frau Kloterjahn plays beautifully until exhausted. When her death becomes imminent, Herr Kloterjahn returns to her bedside. At this point Spinell writes Kloterjahn an excoriating letter, saying (in essence) that the man is an insensitive slob who doesn't understand his own wife.
Warren here supposedly presents the papers of a late friend, detailing the interesting cases he had encountered as a physician. In fact, the "cases" are sensational short stories, presented as a novel due to the framing chapter introducing the narrator's "Early Struggles" to make a living as a physician. Other stories investigate typically Gothic themes like ghosts, duels, graverobbing, elopements, and broken hearts, with other scandalous problems like gambling, dissipation, murder, domestic abuse, and suicide. Medical topics include mental illness, epilepsy, hysterical paralysis ("catalepsy"), cancer, toothache, consumption, syphilis, heart disease, alcoholism, disease of the spine, gout, amaurosis (blindness), puerperal hemorrhage, measles, and stroke ("apoplexy").
The philosophy student Kovrin is on the verge of a nervous breakdown. His doctor suggests a rest in the country and so Kovrin decides to visit his childhood friend Tanya Pesotsky on her father's estate. While there he tells Tanya the legend of the black monk: a desert monk whose image has been reflected in mirages for a thousand years and who will soon return in the flesh.
One day in the garden, the black monk appears to the young man. This gives him joy and energy, even though he realizes that it is a hallucination. "What harm is in it?" Kovrin asks himself. As the summer goes on, the black monk continues to visit. Kovrin asks Tanya to marry him, they wed and move to the city. At one point Kovrin's hallucinations and disordered thinking overwhelm him; he agrees to medical treatment which evidently cures his mental disorder. Yet, his feelings of energy and creativity also disappear, along with the black monk.
Kovrin realizes that he hates his wife and she hates him. She returns to her father and his beloved garden, while Kovrin receives a professorship, a position he never actually takes because he is too ill--he has begun to hemorrhage from the lungs. Soon after receiving news of his father-in-law's death, he sees the black monk again and dies of a hemorrhage.
Young Prince Yegorushka has managed to squander his family's limited resources and now lies in a drunken stupor. His mother (Princess Priklonsky) and sister (Marusya) reluctantly send for Dr. Toporkov, the elegant and highly successful physician whose father was once a serf on their estate. The cold, haughty, and uncommunicative Toporkov appears, gives a few orders, and rushes away. Yet, the princess views the man as a savior and exclaims: "How considerate, how nice he is!"
Marusya also falls ill, and Toporkov makes several house calls, "walking importantly, looking at no one." Old Princess Priklonsky tries to ingratiate the doctor by providing him with a hefty bonus and inviting him to tea. But rather than warming up, Toporkov lectures them "with medical terms without using a single phrase which his listeners could understand."
Some time later, a matchmaker arrives with an astounding proposal--the doctor wishes to marry Marusya for a dowry of 60,000 rubles. (The truth is he will marry anyone for that price.) The Priklonsky family immediately turns the down proposition, ostensibly because of Toporkov's peasant background, but really because they don't have 60,000 rubles to their name.
Meanwhile, as time goes on, Marusya falls in love with the doctor. As she becomes sicker with consumption, the family's financial straits become worse. Finally, with her last five rubles, Marusya seeks help from Toporkov, throwing herself at his feet and proclaiming her love. The astounded doctor experiences an epiphany. He suddenly realizes the worthlessness of all his money-grubbing in an outpouring of love for the dying woman.
Year after year Dr. Lin Kong returned to his country village from his army hospital post in the city with the intention of divorcing his wife, Shuyu. Except for the conception of their single child, Lin and his wife had no conjugal relationship. Their marriage had been arranged by Lin's parents and his wife had remained in the village and cared for Lin's parents until they died and then raised his daughter, Hua.
In the meantime, Lin had developed a relationship with a military nurse, Manna, in his hospital. Manna pressed him each summer to request a divorce from his wife; each summer he got Shuyu's consent, but she backed down when they appeared in court. Still Manna waited--for 18 years she waited for Lin to be free.
Eventually the waiting ended as the law allowed a divorce without consent after 18 years of separation. Lin moved his former wife and his daughter to the city and he married Manna. The remainder of the tale is that of the new marriage. Lin still waits for something that doesn't seem to exist. Manna also waits for a dream that doesn't materialize. Shuyu and Hua quietly wait in the background for Lin to come to his senses.
In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.
In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.
Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).
He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.