Showing 641 - 650 of 875 annotations tagged with the keyword "Patient Experience"

Rebecca

Sacks, Oliver

Last Updated: Feb-05-2002
Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Case Study

Summary:

This is one of the two dozen studies of patients with right-brain disorders that make up Sacks's volume The Man Who Mistook His Wife for a Hat. The nineteen-year-old Rebecca has significant physical and mental defects (her IQ is 60 at best), and by conventional neurological standards she is severely impaired, but Sacks discovers that she has moments of being quite in touch and "together" (her word).

The essay tells of Sacks's discovery of Rebecca's poetic expression and spiritual qualities, and of her self-awareness, in planes unknown to standard neurological and psychiatric categories. Sacks is broadly critical of psychological and neurological testing as constituting a "defectology" that is blind to important human qualities. He warmly recommends music and story-telling, both as modes of understanding and also as narrative therapies that work by ignoring the defects and speaking to the soul.

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Hearing Impairment

Murray, Les

Last Updated: Dec-27-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Hearing loss? Yes, loss is what we hear / who are starting to go deaf. This humorous poem surveys the specific deficits and behaviors that people develop as they progressively lose their hearing. Eventually they reach the point of needing hearing aids and being "wired / back into a slightly thinned world / with a faint plastic undertone to it."

An especially disabling (and potentially humorous) aspect of hearing loss is the inability to decipher speech. The poem provides several examples of garbled interpretation. In the first stanza, "the sad surrealism of the deaf" becomes "dad's a real prism of the Left, " thereby giving a verbal and visual example of the meaning of the phrase. Another illustration: "Hearing Impairment" ends with the line "I'm sorry, sir. It's a red alert!" An urgent statement that earlier in the stanza the hearing-impaired narrator has understood to mean, "a warrior is a ready flirt." [50 lines]

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Annotated by:
Belling, Catherine

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Nan Shin was an American woman living as a Zen Buddhist nun in France. She is diagnosed with advanced uterine cancer, undergoes surgery and chemotherapy and, by the end of the book, it appears, is dying. Her account does not, however, take the conventional form of the illness narrative; in fact its form might be called anti-narrative, for its focus is not on the story of Shin's illness and dying, but rather on the "every day living" that is at the center of her Zen beliefs.

The book consists of several strands that recur in alternating sections. One strand describes, in minute detail, the course of a single day's devotions and activities in the life of a Zen nun. Another traces the author's travels in the United States with her sensei, an astonishing man whose perspective on American culture is both detached and hilariously insightful.

A third tells of the author's frequent horseback rides through the French countryside, with beautifully focused and precise descriptions of the natural surroundings. Finally, there is the illness, presented matter-of-factly but conveying powerfully the author's (not always wholly successful) efforts to put into practice, in such trying circumstances, all she has learnt as a practitioner of Zen.

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Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Anthology (Essays)

Summary:

The editor, herself a writer and one who has suffered depressive episodes, collects a series of personal essays or illness narratives about experiences with depression. Her contributors are all artists, primarily writers, who generally but not exclusively speak to the relationship between their art and their mood disorders. Some of the essays included have been previously published, but most are original contributions to this collection. The collection is introduced by Kay Redfield Jamison whose academic work has examined the relationship between creativity and depression, including manic-depressive disease.

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The Healing Muse

St. Andrews, B. A. (Bonnie)

Last Updated: Dec-19-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The first poem in this chapbook ("Sonogram") contains two images of a small, mysterious life (the fetus imagined as a "white boat on whiter water" and as a "tiny orca") in the midst of the coldly technical medical world. This juxtaposition is characteristic of B. A. St. Andrews's poems in this small collection. In most of them, she uses disciplined and sparkling language to explore the interface between modern medicine with its impersonal machinery and the irreducible mystery of life.

Some of the images are simply breathtaking. For example, in "A Dying Art: Room 309," a terminally ill artist lies in bed, surrounded by "plastic bags that hang / like udders dripping pigment / into her." In a love poem called "The Body of Science," the poet confesses, "Each time your voluntary / muscles make contact / my involuntary ones / contract." And at the end of "Alzheimer's," she observes, "She stood at the big bay / window screaming but he never / heard what it was she never said."

The four poems entitled "Your Breast a Unicorn" consider the fate of breasts attacked "at consolation's center" by "one aberrant cell metastasized." These learned, wise, and witty poems are, in my opinion, among the very best of the breast cancer genre.

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I Want to Live!

Jones, Thom

Last Updated: Dec-13-2001
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Mrs. Wilson is a woman diagnosed with an advanced malignancy of the genital tract. Her husband had died from cancer ten years earlier. She is treated with a hysterectomy and oophorectomy along with aggressive chemotherapy by a good doctor who has no bedside manner.

Throughout the story her best friends are always medications to relieve pain: Dilaudid, morphine, Tylenol #3, and methadone. Only her son-in-law really understands her needs and comprehends how to care for her. He is genuine and vital and appears to know as much or more than the doctors in the story.

Mrs. Wilson acknowledges that "to maybe get well you first had to poison yourself within a whisker of death" but discovers that "if you had something to live for, if you loved life, you lived." She dies in a hospital room receiving an IV morphine drip. Before fading into oblivion, she recalls her youth and makes one last attempt at fathoming the meaning of life.

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Summary:

Kirklin, a physician and Lecturer in Medical Humanities at the Royal Free and University College Medical School, and Richardson, a historian and associate at the Wellcome Trust Centre for the History of Medicine, are both educators in medical humanities in London. This well-written and concise volume focuses on "the role of the humanities in medical education" and is aimed at "those wishing to integrate medical humanities into their own teaching, and learning." (p. xv) The chapters are written by a variety of educators with a wide range of backgrounds, including artist, medical student, writer, nurse, surgeon and philosopher.

At least two stimuli are cited as reasons for the development of this book: (1) the 1993 publication by the General Medical Council of Tomorrow's Doctors which recommends the inclusion of medical humanities in the required curriculum for undergraduate medical education in the UK and (2) a national conference, "The healing arts: The role of the humanities in medical education" in London, March, 2000. The rationale for such a book is delineated in several prefatory statements including remarks by Professors Sir David Weatherall and Sir K. George M. M. Alberti (Alberti is the president of the Royal College of Physicians). The book concludes with recommendations for further reading, schemata for undergraduate and graduate degrees in medical humanities at University of Wales, Swansea, and an index.

The nine chapters in this volume combine pedagogic philosophy, citations for literature and art and how to encourage reflection about these selections, tools for encouraging student creativity, reproductions of art and literature generated by students or patients or used by teachers for discussion, and some practical advice about teaching medical humanities and its, at times, uneasy connection to the rest of the curriculum. Each chapter reflects the individual contributor's area of expertise and experience. For example, in "Fostering the creativity of medical students", the authors Heather Allan, Michele Petrone (who painted the striking cover art), and Deborah Kirklin provide useful guides for teaching creative writing and art production by students studying cancer and genetic disease.

In a particularly insightful chapter, "Medical humanities for postgraduates: an integrated approach and its implications for teaching," Martyn Evans describes the challenges of developing a full-fledged interdisciplinary program for graduate as well as undergraduate studies in Wales. He addresses concerns about "bolt-on" versus integration of medical humanities in the curriculum, risks of superficiality, and how such studies may transform the culture of modern medicine. Several chapters address a theme (such as "clinical detachment" or understanding the patient's perspective) and include topic-specific sources and guidelines.

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The Cancer Journals

Lorde, Audre

Last Updated: Nov-18-2001
Annotated by:
Moore, Pamela

Primary Category: Literature / Nonfiction

Genre: Journal

Summary:

Through a compilation of journal entries, prose, and poetry, poet and activist Audre Lorde considers her breast cancer and mastectomy. Lorde emphasizes the importance of having a support network of other women. As a lesbian and feminist, she also offers a different perspective on this surgery. Her concern is not attracting or pleasing men despite the loss of a breast.

In one chapter, "Breast Cancer: Power vs. Prosthesis," Lorde considers the political implications of prosthetic breasts, arguing that hiding women’s pain and suffering disguises the widespread nature of the disease and places too much emphasis on "normal" femininity. She also writes about plastic surgeons who perform dangerous reconstructive surgery in the name of "quality of life."

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Cancer Winter

Hacker, Marilyn

Last Updated: Nov-18-2001
Annotated by:
Terry, James

Primary Category: Literature / Poetry

Genre: Poems (Sequence)

Summary:

These fourteen sonnets interweave themselves to form a unified work, just as lines are repeated or echoed to interweave in the individual poems, providing an account of the author’s experience of breast cancer, radical mastectomy, and recovery. The medical details appear more prominently in the early sonnets, but gradually, other themes take precedence: suffering and how to compare relative degrees of suffering among individuals and groups; the reaction of oneself and one’s lovers to a disfigured body; and the search for affirmation, for a reason to want to live and be rid of the horror of disease and death.

Note: A relevant Web site about and by artist-model Matuschka, http://www.songster.net/projects/matuschka/, has been annotated in the art section of this database (Matuschka: Matuschka Archive).

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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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