Showing 681 - 690 of 833 annotations tagged with the keyword "Doctor-Patient Relationship"

Survival Rates

Clyde, Mary

Last Updated: Jul-06-2000
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In the title story of this collection, "Survival Rates," a husband's thyroid cancer appears to be a greater threat to his marriage than it does to his health. The young girl who survives an accident in "Jumping" ends up a casualty anyway. In "Howard Johnson's House," a plastic surgeon repairs a nine year old girl's nose after it is severely damaged by a dog bite. Even before the injury, however, the child's nose was hideous. When the surgeon gives her a cosmetically perfect nose, the girl's mother is not merely disappointed but outraged. Two girls must adapt to life after colon surgery in "Krista Had a Treble Clef Rose."

View full annotation

The Wisdom of the Body

Nuland, Sherwin

Last Updated: Jun-19-2000
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

View full annotation

Taking the History

Watts, H. David

Last Updated: Jun-19-2000
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In the first poem, Starting the I.V. (see this database) the poet tells us that he will approach the secrets of the body without flinching, "I have learned not to hesitate here, / not to let fears of my own" get in the way. The instrument he uses is the poem. Through these poems he reveals some of the hidden truth of the healing relationship. "A transformation," he calls it, "as if through this intimacy / we have become part / of each other." ("Physical Exam")

Watts captures the pain and horror of illness in striking images. For example, the numbness felt by a person suffering from multiple sclerosis "felt like oatmeal / drying on the skin" and the disease itself was "this moth of his nightmare / . . . eating at the wool / of his nerve endings." ("ms") In another poem ("restrictive") a patient's tortured breath "creaks like a tight box / a ship in a storm." Among the most remarkable of these 35 poems are "The Body of My Brother," "July 16th," "Chronic Pain Syndrome," and the exquisite prose-poem, "The Girl in the Painting by Vermeer."

View full annotation

Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

This book is the very personal story of one woman's struggle against a debilitating mental illness, which fortunately she was helped to overcome in time to allow her to complete her medical education and become a practicing physician. She says that the material was recalled partly from a diary kept during the time of original events, from memories of others, and from medical records.

The first chapter describes the author as a medical student assigned to a psychiatric service; subsequent chapters go back to the beginning of her personally perceived problems at age six, concluding with her amazing recovery after being treated with dialysis and her eventual acceptance to and success in completing medical school.

Dr. North's descriptions of her own perceptions of the sensations she experienced, the voices which talked to her and her remarkable persistence in school despite this are mesmerizing. Also, her description of treatment by physicians and care in mental institutions is very instructive. Her description of family relationships is intrinsic to the telling of her story. This book describes the anguish of mental illness from the inside.

View full annotation

Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When Ruth's unfaithful and unappreciative husband Bobbo calls her a she-devil, she decides to appropriate that identity with a vengeance and take a different spot in the power relations of the world. She wants revenge, power, money, and "to be loved and not love in return"(49). Specifically, Ruth wants to bring about the downfall of her husband's lover, Mary Fisher, a pretty, blonde romance novelist who lives in a tower by the sea and lacks for neither love nor money nor power.

Ruth commences her elaborate revenge by burning down her own home and dumping her surly children with Mary and Bobbo. She continues on a literally shape-shifting quest in which she changes identities; gains skill, power, and money; and explores and critiques key sites of power and powerlessness in contemporary society, including the church, the law, the geriatric institution, the family home, and (above all) the bedroom.

By the end of the novel, Ruth achieves all four of her goals in abundance. Her success, however, raises complex ethical questions, not only because she uses the same strategies of manipulation and cruelty of which she was a victim, but also because of the painful physical reconstruction of her body that is the tool of her victory.

View full annotation

Rich Men Tend to Be Strange

Klíma, Ivan

Last Updated: May-10-2000
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Alois Burda loves money. He is a wealthy owner of a car dealership who has many acquaintances but no true friends. He has been married twice and has three children but is uninterested in his family. Prior to his sixtieth birthday, he experiences weight loss, abdominal pain, and night sweats. Burda is diagnosed with inoperable metastatic cancer of the pancreas.

He seems worried most about what to do with his property and money. Before entering the hospital, he hides his money in some old slippers until he can decide what to do with it. He is comforted by a young nurse, Vera, whose voice reminds him of his mother's. After he dies, Burda's wife discards her husband's belongings into a heap of rubbish, unaware of the fortune hidden in his slippers.

View full annotation

Summary:

The spoiled Long Island heiress, Judith Traherne (Bette Davis) is suffering from severe headaches and visual disturbances, which she tries to ignore in pursuit of wild parties and frenetic horse-back riding. Her friend and secretary, Ann (Geraldine Fitzgerald), and the old family doctor bring her to Dr. Frederick Steele (George Brent). Steele has just sold his neurosurgical practice and is about to catch a train to Vermont where he will devote himself to fulltime research on malignant brain tumors. He delays his departure to operate successfully on Judith's glioma.

He and his patient fall in love. But Steele learns that her disease will recur in a predictable manner: blindness followed by painless death. He and Ann conspire to hide the prognosis from Judith. A wedding is planned and the move to Vermont. But Judith uncovers the secret and flies into a rage at the treachery, breaking off the engagement.

She tries to drown her sorrow of impending doom in drink, a frivolous dalliance with a drunken suitor (Ronald Reagan), and a more serious dalliance with her horse-trainer, Michael (Humphrey Bogart). On the verge of sin with Michael, she realizes that her only hope lies in life itself, marriage and the house in Vermont. Steele conducts his laboratory research in a back shed and the couple carry on as if her death sentence did not exist.

Living a lie provides their few months of happiness, their "Dark Victory," Judith says, over the cruel promise of her death. Just as Steele is invited to New York to present his research, her vision begins to cloud and fade. She tells Ann, but keeps the news from her husband. He leaves the now blind Judith and her friend in the garden planting bulbs that will bloom in spring. She sends Ann away too, and lies down to face her romantic (but painless) end alone.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Diary

Summary:

Gottlieb, nearing thirty years old, discovered her childhood diaries in a closet in her parents' home as she searched for some chemistry notes to aid in her quest to attend medical school. This book is "based on diaries" she wrote when she was diagnosed with and underwent treatment for anorexia nervosa. It is the writing of a precocious, strong-willed preteen who enjoys chess, being unique, writing, and getting straight A's in school, yet who is lonely and desperate to fit in and be popular.

Lori is eleven years old, lives in Beverly Hills, California with her fashion-conscious, loves-to-shop mother, her somewhat distant stockbroker father, her older brother David who now is into music and friends and not-Lori, and her best friend Chrissy, a pet parakeet. Lori's diary entries are filled with astute observations of adults (teachers, parents, relatives, medical personnel, even a television star she meets, Jaclyn Smith) and classmates.

She is wry and witty. An early entry gives an English essay she rewrote to get an "A". These "power paragraphs" are generously and hilariously sprinkled with "proper transitions" such as "to begin with", "moreover", and "on the other hand" that her teacher insists are necessary for readability. This essay provides telling insights about Lori's perceptions of her family, particularly (note transition word) her mother's superficiality.

Lori is surrounded by messages of the glories of thinness for women. Every female she encounters, from peer to adult, is on a diet, counts calories, avoids desserts and gossips about how other women and girls look. The culture is not only anti-obesity, but pro-superthinness. Hence it is logical that Lori, angry about being taken from school to go on a family trip to Washington, D.C., begins her rebellion and search for control by skipping meals and dieting.

She gets the attention she craves from her parents. Her schoolmates ask her for diet advice and admire her weight loss. Self-denial, obsession with calories (that she believes can even be gained by breathing), and secret exercising lead to an alarming weight loss in this already skinny kid.

Her mother takes her to the pediatrician, who prescribes whole milk which Lori refuses. He refers her to a psychiatrist, who eventually hospitalizes her for behavior modification, observation, and a possible feeding tube. At the hospital, Lori meets medical students, nurses and fellow patients, but becomes progressively more depressed, dehydrated and lonely. She attempts to run away and makes a suicide gesture. Finally, she sees herself for what she has become--an emaciated stick figure.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

View full annotation

Summary:

This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

View full annotation