Showing 661 - 670 of 833 annotations tagged with the keyword "Doctor-Patient Relationship"
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").
August is divided into two sections: "On the Corner of Fourth & Irving" and "To Marie Curie." The narrator, on a street corner in San Francisco near the teaching hospitals and medical school of University of California, San Francisco, meditates on the recurrence of lymphoma in a patient. Evening is approaching, fog blows in from the ocean, and the city pigeons are unsettled--landing and taking flight.
The meditation includes a tribute to Madame Curie and her discovery of the effects of radium. The patient had had a good chance of cure by radiation treatment--unfortunately, this patient is in the twenty percent who are not cured. The narrator, probably a physician-in-training due to the load of textbooks, had read the patient's chest x-ray as negative (normal) previously.
By the end of the poem, we learn that the physician had felt enlarged lymph nodes in this patient's neck today and he bluntly states: "I have failed. He has not been cured." The poem closes with the sound of the wind and the "beating and beating of wings."
In the first section of the book ("Rejected Prayers"), Liveson proves that the prayers were not rejected; rather, they resulted in a group of thoughtful and moving poems. These poems speak eloquently of suffering patients, especially the elderly and neurologically compromised; for example, "Jenna," wearing her "diapered dress" (p. 16), "Sonnet to Sarah," who "lets her fingers trace the pattern on the wall," (p. 20), and the patient in "Praxis," whose "smile was rare but even" (p. 21).
These poems also speak passionately of social and historical pain, and of injustice writ large. Some of the most powerful are in the section called "Before the Plaster Sets," with which the book ends: "My First Death" (p. 63), "Holocaust Torah" (p. 66), and "Yom Kippur, 5760--Musaf" (p. 68).
The latter poem is a kind of contemporary re-envisioning of Allen Ginsburg’s 1956 poem "America." Jay Liveson writes, "Yom Kippur, this is serious. We sit here / hoping to somehow tune the engine / or at least check the map." Is tuning the engine enough? Perhaps we are fooling ourselves; much more needs to be done. How can we be content to sit and tune the engine in this unjust world? Perhaps the poem that speaks this theme most eloquently is "Statistical Causes of Traumatic Shock Syndrome in Gaza--Chart VII" (p. 72).
Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.
Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).
A man walks through the countryside after a night of rain. The creatures around him are lively and refreshed. At first, he shares their joy, but his mood soon turns as he reflects that care and pain are the inevitable balance to the care-free life he has lead so far: "We poets in our youth begin in gladness; But thereof come in the end despondency and madness."
He comes upon an old man staring into a muddy pond. The man seems weighed down with care; he is so still he seems dead. He greets the man and asks what he is doing. The old man is a leech-gatherer, leeches being needed by eighteenth-century doctors. He wanders the moors, sleeping outside, and thus makes a steady living. The wanderer resolves not to give in to misery, but to think instead of the courage and firm mind of the leech gatherer.
Summary:A doctor is called to the home of a poor, immigrant family. A beautiful little girl is quite ill. As diphtheria has been going around, the doctor attempts to examine her throat. The girl, however, won't open her mouth. She fights him off and all attempts to cajole her into compliance fail. Yet, the doctor is resolved to see that throat. He forces the girl's father to hold her down, while he manages to wrest open her mouth after a long battle. She does, in fact, have diphtheria.
Summary:A sharp poem, directed to the sons of men. The poet wishes them periods, cramps, clots, and hot flashes. She wishes them the difficulties and embarrassments of the female gender. Mostly, she wishes that they experience the arrogance of gynecologists, "not unlike themselves."
Tom Hogue is a nonpracticing Catholic who develops a mysterious dermatologic disorder. Five areas of chapped and painful skin located on his hands, feet, and below his ribs begin to bleed simultaneously. The reluctant stigmatic soon experiences weight loss and insomnia and has premonitions. He attempts self-treatment before consulting in order his local pharmacist, primary care physician, a dermatologist, and eventually a psychiatrist.
He is diagnosed as having "psychogenic purpura" and his condition seems to improve with psychiatric treatment. Initially Hogue questions the validity of his stigmata and is uneasy with his religious celebrity. When his affliction spontaneously resolves, he has difficulty adjusting to his new life. A chance encounter with a woman whose life had been profoundly affected by Hogue when he still retained the stigmata leads him to consider self-mutilation as he fondles a steak knife beneath the table during their conversation.
This is the second anthology from Donley and Buckley derived after many years of teaching "What's Normal?"--a literature and medicine course at Hiram College where they explore the cultural and contextual influences upon the concept of normality. With the first anthology, The Tyranny of the Normal, the editors focused on physical abnormalities (see this database for annotation). In this second anthology, the focus is exclusively on mental and behavioral deviations from societal norms. With this edition, Donley and Buckley present their case that, as with physical abnormalities, there is a similar tyranny of the normal that "dominates those who do not fit within the culture's norms for mental ability, mental health and acceptable behavior (xi)".
The anthology is divided into two parts. Part I is a collection of essays that introduce various clinical and bioethical perspectives on the subject of mental illness. These essays bring philosophic and analytic voices to the topic. Stephen Jay Gould's terrific essay on Carrie Buck and the "eugenic" movement in the United States in the early part of the 20th century illustrates one of the major themes that can be found throughout the anthology.
Oliver Wendell Holmes wrote the majority opinion in the 8-1 Supreme Court decision that sealed Buck's fate. Gould begins his essay reminding his readers of the often referenced Holmes quote, "three generations of imbeciles are enough." He then takes us on a fascinating historical adventure that uncovers a deeper and more complicated drama that led to this unfortunate period in American history, and the tragic incarceration and sterilization of Carrie Buck.
This essay, as with other stories, poems, and drama in the anthology, contemplates the relationship between societal values and mental illness, and illustrates how society through medicine can turn to the myth of "objective" diagnostic labels as a way to compartmentalize and control behavior and imaginations that are "abnormal." D. L. Rosenhan's essay from "On Being Sane in Insane Places" further illustrates the failure of the mental illness label. Irvin Yalom's story from Love's Executioner and Other Tales of Psychotherapy provides an example of what is possible when diagnostic labels are avoided, when health care professionals with power turn with humility, curiosity, and kindness toward others, substantiating that these qualities are far more powerful than statistical notions of "normal."
Part II is a collection of fiction, poetry and drama. Intended as a complement to part I, part II engages the reader in the lived experience of the narrators. It is divided into six sections. Section one considers children and adolescent experience of mental illness. Included are Conrad Aiken's "Silent Snow, Secret Snow," an excerpt from Susanna Kaysen's Girl, Interrupted (see annotation in this database), and an excerpt from Peter Shaffer's Equus (see annotation).
Section two includes stories that capture the world of mental disability and retardation. An excerpt from Of Mice and Men and Eudora Welty's short story Lilly Daw and the Three Ladies are included. Charlotte Perkins Gilman's The Yellow Wallpaper (annotated by Felice Aull; also annotated by Jack Coulehan) is in section three where women's experiences with mental disorders is the theme (these are annotated in this database).
Section four and five focus on men and mental illness. War experience is considered in the works of Toni Morrison and Virginia Woolf. Section six concludes the anthology. Alzheimer's disease and dementia are examined in Robert Davis's My Journey into Alzheimer's Disease, and in the story, "A Wonderful Party" by Jean Wood.
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.