Showing 631 - 640 of 825 annotations tagged with the keyword "Doctor-Patient Relationship"

To Render the Lives of Patients

Charon, Rita

Last Updated: Nov-16-2001
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The author, an internist and medical educator with a long-term interest in literature (she recently was awarded a Ph.D. in English literature), describes the literary exercise she uses to develop empathy in students taking her required course in medical interviewing. Charon has her students choose a difficult medical encounter from their own recent training and then write, using the first person, the story of that patient’s life in the day before the difficulty--including being treated by the medical student who is doing the writing. Because much of the story must be imagined, the writer’s intuition is automatically brought into play.

Because it is told from the patient’s point of view, the medical student is forced to see the patient whole and without reference to medical terms. Charon argues that this exercise of the imagination yields a combination of objectivity and empathy that forms the basis for good medical care. She also finds that the exercise helps medical students see themselves as their patients see them--and thus to understand, for instance, the effect on their patients of their youth and nervousness.

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Annotated by:
Shafer, Audrey

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Photography

Genre: Photography

Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Collection (Case Studies)

Summary:

Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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Eva Moves the Furniture

Livesey, Margot

Last Updated: Nov-01-2001
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Eva McEwen is born in Scotland in 1920. Her mother dies shortly after giving birth to her. At the age of six, Eva is "visited" by two strangers (an older woman and a teenage girl) that only she can see and hear. These mysterious companions steer the course of her life. During World War II, Eva serves as a nurse in a burn unit.

She falls in love with a plastic surgeon but her supernatural attendants have other plans for Eva. She secures a job as a school nurse, marries a teacher, and has a daughter. Sadly, Eva dies at a young age from cancer of the liver and pancreas. Thus the novel ends much like it began, with the tragic death of a young mother who leaves behind a devoted husband and daughter while ghostly visitors are poised to both share and meddle in the youngster's life.

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Annotated by:
Wear, Delese

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

Living on the Margins is a literary anthology of breast cancer with a distinguished list of 18 contributors, all writers--poets, critics, academics, editors, essayists. Their writing, wide-ranging in genre, style, and tone, includes personal narratives, poetry, academic essays, and an interview.

Contributors include Maxine Kumin, Safiya Henderson-Holmes, Eve Kosofsky Sedgwick, Lucille Clifton, Alicia Suskin Ostriker, and Marilyn Hacker. The editor, Hilda Raz, argues that because there hasn't been much literature on breast cancer (there's been a "margin of missing literature," she claims) this collection was brought into being.

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Pilgrim

Findley, Timothy

Last Updated: Sep-18-2001
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Novel

Summary:

The novel opens with a man known only as Pilgrim hanging himself in London in 1912. Despite being pronounced dead by two physicians, he somehow lives. Pilgrim has attempted suicide many times before but is seemingly unable to die. He claims to have endured life for thousands of years but has tired of living and only longs for death. He has crossed paths with many historical figures including Leonardo da Vinci, Saint Teresa, Oscar Wilde, and Auguste Rodin.

After his most recent suicide attempt, he is admitted to a psychiatric facility in Zurich as a patient of the famous Swiss psychiatrist, Carl Jung. Pilgrim eventually escapes from the institution and masterminds the successful theft of the Mona Lisa from the Louvre. Next, he sets the cathedral at Chartres on fire. The novel ends with Pilgrim driving a car into a river on the eve of World War I. His body is never found.

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Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Essay

Summary:

Seeking redemption in the bloody business of surgery, Selzer's narrator tells several medical stories that humbled his surgeon's pride and refers approvingly to an atheist priest in a story by Unamuno who carried on for the sake of his congregation because "their need is greater than his sacrifice." Selzer finally tells us that it is in writing, if anywhere, that the elusive soul can be represented.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Essay

Summary:

The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

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Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A physician seeks solace at the South Pole. Her planned one year stay there is cut short when she discovers a lump in her breast. The attempts to care for her at the South Pole (with telecommunicated help from the U.S.) prove insufficient and a plan to rescue her is successful.

There's more than the drama of illness in a remote location in this book, however. Intertwined with this story of illness is the story of the author's troubled marriage (to her physician-husband), the eventual estrangement from her children, the support of her family of origin, and most fascinatingly the daily rhythms of living (and doctoring) at the South Pole. Scattered throughout the memoir are occasional critiques of "corporate" medicine and poems that inspired the author throughout her ordeal.

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