Showing 621 - 630 of 820 annotations tagged with the keyword "Communication"
This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.
The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)
The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).
Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.
Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.
Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)
In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.
Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.
The story, set in small-town Ontario in 1960, takes the form of letters to her ex-fiancé from a young woman who has returned to the home of her father, a widowed physician who lives with his housekeeper, Mrs. Barrie. She recalls growing up with her strict and remote father and realizes now that he had been performing illegal abortions all her life. He will not discuss it, will not allow the word "abortion" to be said in his house, though she tells him she believes abortion should be legalized.
We are led to suspect that she herself has recently been pregnant.
When Mrs. Barrie breaks her arm, the doctor is forced to ask his daughter to assist with one of his "special" patients. She helps the young woman throughout the procedure, and disposes of the aborted fetus afterwards. Later, trapped indoors by a heavy snowfall, she and her father are sitting together at the kitchen table when she tells him about her own pregnancy.
She had carried it to term, giving up the baby for adoption. She had ended the engagement because her fiancé, a theology student, had insisted that she have an abortion before their wedding because he feared the social consequences of rumors that she had been pregnant before marriage. She is about to ask her father about his own work, and about what might happen should the law change and abortion become legal, when she realizes that he is not listening. He has had a massive stroke, and dies later the same day. The daughter turns away the next patient who calls about having an abortion.
She learns from the lawyer that, mysteriously, her father had virtually no money saved. She gives Mrs. Barrie most of the small amount her father had given her, and then realizes that all his money has already been given to Mrs. Barrie, either because she was blackmailing him, or because he loved her. She cannot tell which, but is oddly exhilarated and is now able to say goodbye to her fiancé for good.
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.
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.
When Alice Sebold, author of the best-selling novel, The Lovely Bones (see this database), was completing her freshmen year at Syracuse University, she was assaulted and raped. Years after the fact, Sebold wrote this memoir about the rape and its aftermath. The book's title, "Lucky," is explained in the prologue: the police told Sebold that she was lucky to have escaped the fate of another girl who had been murdered and dismembered in the same spot. In point of fact, Sebold, a virgin before the rape, was in a sense murdered, since life as she had known it would never be the same: "My life was over; my life had just begun" (33).
In crisp, lively prose the author takes us relentlessly through the details of her rape and the police inquiry that followed. We learn also that the narrator had suffered from a poor body self-image, loved to spend her time reading, had day-dreams of becoming a poet. We learn about her family--a mother prone to severe panic attacks and a professorial father who hid behind his books, an older sister who helped Alice take care of their mother. The family was considered by neighbors to be "weird."
After the rape, Sebold felt even more isolated and "Other." She could not bring herself to tell her family, who tip-toed around her, all of the horrendous details of the assault. She realized that all who knew her were aware she had been raped and were uneasy in her presence. Her father could not understand how she could have been raped if the assailant's knife had dropped out of reach.
In spite of everything, Alice returns to Syracuse, taking poetry workshops with Tess Gallagher and a writing workshop with Tobias Wolff. Incredibly, she spots her assailant one day on the street near the college. The author notifies the police, the assailant is later arrested, and Alice agrees to press charges and to be a witness at the trial. Neither her father nor her mother have the stomach to come to the trial, but Tess Gallagher accompanies her. The account of the trial is detailed, agonizing, and fascinating.
The film covers a brief period in the life of a working-class English family: Mum (Tilda Swinton), Dad (Ray Winstone), their 18-year-old daughter, Jessie (Lara Belmont), and 15-year-old Tom (Freddie Cunliffe). They have recently moved from London to an isolated cottage on the Dorset coast. Mum gives birth to a baby girl, Alice. Tom discovers that Dad is sexually abusing Jessie. When the baby is hospitalized with an unexplained injury, apparently genital, Tom tells Mum about the incest, and when Dad confronts him and denies it, Tom stabs him.
The Longhettis are an Italian-American working class family. Nick (Peter Falk) is a construction worker. He and his wife Mabel (Gena Rowlands) have three children. Mabel is unusual, perhaps mentally ill, maybe with a bipolar or borderline disorder, but diagnosis is not really the point. She is warm, spontaneous, beautiful, and an affectionate if inconsistent mother. Because Mabel is so eccentric and unpredictable, the Longhetti family seems to function at a kind of delicate equilibrium.
This stability is disrupted when Nick fails to get away from work on a night he and Mabel had planned to spend alone together. The children are with her mother, and Mabel finds it intolerable to be alone, so she gets drunk, goes out, and picks up someone in a bar. The next morning Nick brings a crowd of work mates home with him after the night shift and Mabel copes with the invasion by cooking up a spectacular spaghetti breakfast and flirting outrageously with one of Nick's friends.
Later when a neighbour brings his children to play, Mabel again behaves inappropriately. Nick, under pressure from his mother and Mabel's physician, is persuaded to have his wife institutionalized. She is taken away. Nick angrily rejects the concern of his friends, but struggles terribly to manage the children.
The film ends with the evening of Mabel's return from hospital. Nick and his mother have arranged a dinner party to celebrate her recovery, but it is quickly clear that, despite electroconvulsive therapy, Mabel is unchanged. It also becomes more evident than ever that her "madness" is rooted as much in the family's social network, her uncomprehending parents, judgmental mother-in-law, and volatile husband, as it is in her own brain or personality. But, after an appalling evening, Mabel and Nick put the children to bed and then go about cleaning up the house as usual, their fragile normality restored for now.
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.)
Jose is a patient who exhibits all the classical symptoms of autism. The caregivers in his institution treat him dismissively, as though he is stupid. Sacks notices, however, that, given a pencil, Jose draws not only with amazing accuracy, but with a quality of liveliness in his representations that betokens close, insightful, and even empathetic observation and awareness. As he encourages Jose to draw, he finds his drawings diagnostically helpful, and powerful evidence of an active interior life to which they provide a valuable link.