Showing 71 - 80 of 849 annotations tagged with the keyword "Doctor-Patient Relationship"

Black Man in a White Coat

Tweedy, Damon

Last Updated: Nov-09-2015
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir focuses on the various ways in which his being an African American affected Tweedy’s medical education and early practice as a medical resident and later in psychiatry. Raised in the relative safety and privilege of an intact family, he found himself underprepared for some of the blatant forms of personal prejudice and institutional racism he encountered in his first years of medical education at Duke Medical School.  One shocking moment he recounts in some detail occurred when a professor, seeing him seated in the lecture hall, assumed he’d come to fix the lights.  Other distressing learning moments occur in his work at a clinic serving the rural poor, mostly black patients, where he comes to a new, heightened awareness of the socioeconomic forces that entrap them and how their lives and health are circumscribed and often shortened by those forces.  Well into his early years of practice he notices, with more and more awareness of social contexts and political forces, how the color line continues to make a difference in professional life, though in subtler ways.  The narrative recounts clearly and judiciously the moments of recognition and decision that have shaped his subsequent medical career.    

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Not God: A Play in Verse

Straus, Marc

Last Updated: Oct-06-2015
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Not God is a "play in verse" with two characters, a hospitalized patient and the patient's doctor. The scare quotes indicate the fluid quality of Not God, which the author originally conceived as a sequence of poems spoken in a patient's voice. Subsequently, he added the doctor poems (monologues) to create a "dialog" between the two voices. Once again, scare quotes suggest the atypical quality of this dialogue, since the two characters express different feelings and perspectives on the situation, but do not directly address one another. The play version has received several performances at colleges and small theaters.The patient speaks first in a monologue that begins "A man's cough bounces down the hallway / like pick up sticks... " and ends with "I am here two weeks." (p. 7) It soon becomes evident that he/she has cancer and is receiving chemotherapy. The doctor has changed this person's life by speaking "one word," after which "nothing / would ever be the same again." (p. 10). The patient is knowledgeable, accepting of his/her condition, a keen observer with a good sense of humor, as in "Doldrums" (p. 19) and "Cricket" (p. 23), and a person who affirms life in spite of adversity. The doctor is burdened with the power of medical knowledge. In particular, he understands the deadly meaning of signs and symptoms: "We say / excess water and swelling of the belly, knowing / full well... / an ovarian cancer is almost certain." (p. 33) But the meaning this represents is chaos: there is nothing humane or transcendent about cancer. Unlike his baseball card collection in childhood ("Shoebox," p. 35), cancer is neither confined nor orderly. In the second act, the patient sympathizes with the doctor whose "head is so cluttered / with obligatory data." Paradoxically, the doctor must be protected because he is "filled with dying." (p. 41) The doctor becomes angry with the burden, "Why / ask me a question that only God can answer?" (p. 49) and cries out that his work is "alchemy, / potions and witches' brews." (p. 54) In the end, while dying, the patient imagines "a bridge that can cross / the Atlantic." (p. 68), while the doctor speaks a prayer, "The word cure, dear God, is always / near my lips, though I have been constrained from / saying it aloud." (p. 66)

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One Word

Straus, Marc

Last Updated: Oct-06-2015
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

In this collection (80 pages), Marc Straus speaks of the inadequacy of communication and knowledge in medicine; the pauses, the distance, the hesitations. You think you know what you are doing, "But no, they always ask the question / I never knew." ("The Log of Pi") "The question / might be so simple, so clear / that you’re unprepared to answer." ("Questions and Answers") Though words are in one way inadequate, the medical word carries great power: " . . . I knew that moment / I would say one word for her and nothing / would ever be the same again." (One Word, annotated in this database.)The poet comes to understand that he represents both sides of medicine, both the detached and distant Dr. Gold, and the warm and trustworthy Dr. Green. (See annotation of Dr. Gold & Dr. Green) Unfortunately, this knowledge only comes about after the patient has died ("Dr. Gold & Dr. Green, II"). We learn from experience, sometimes too late.

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One Word

Straus, Marc

Last Updated: Oct-06-2015
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The speaker reflects that "life is sometimes reduced / to a single word . . . . " He remembers one incident at a bus stop, another interviewing a man "for a job in my lab." Then there was the time a woman "walked / into my office for one thing . . . . " He discovered a "fullness" in her neck and knew that the word he would say to her, the one word, would change her life: "nothing / would ever be the same again."

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Sleep Talker

Shafer, Audrey

Last Updated: Oct-06-2015
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

This fine collection of work by Audrey Shafer is subtitled "Poems by a Doctor/Mother." The book begins with a section containing poems of personal history and experience ("that I call home"), descends into the nether world of anesthesia ("not quite sleep"), and in the final section returns to the light with a new perspective on the texture and occurrences of ordinary life ("okay for re-entry").Among the more medically oriented poems, see especially "Spring," "Anesthesia," "Three Mothers," Monday Morning (see annotation in this database), "Gurney Tears," "Center Stage," and "Reading Leaves." "Don’t Start, Friend" takes up the topic of substance abuse among anesthesiologists (or physicians, in general).

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.

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An Unquiet Mind

Jamison, Kay Redfield

Last Updated: Oct-06-2015
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The author, Professor of Psychiatry at Johns Hopkins University School of Medicine, is an authority on manic depressive illness. With this powerful, well-written memoir she "came out of the closet," publicly declaring that she herself had suffered from manic depressive illness for years. Jamison describes the manifestations of her illness, her initial denial and resistance to treatment with medication, attempted suicide, and her struggle to maintain an active professional and satisfying personal life.The author was "intensely emotional as a child," (p.4) and in high school first experienced "a light lovely tincture of true mania" (p.37) during which she felt marvelous, but following which she was unable to concentrate or comprehend, felt exhausted, preoccupied with death, and frightened. (pp. 36-40) Interested in medicine as an adolescent, she pursued her goal in spite of mood swings and periods of mental paralysis. Jamison completed graduate work in clinical psychology; shortly after obtaining a faculty appointment "I was manic beyond recognition and just beginning a long, costly personal war against a medication that I would, in a few year’s time, be strongly encouraging others to take [lithium]." (p. 4)Jamison eventually, through strong support from friends and colleagues, excellent psychiatric care, and her own acceptance of illness, has been able to reach a state of relative equilibrium--tolerable levels of medication (fewer side effects) and dampened mood swings. But she makes clear that she must stay on lithium and remain vigilant.

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The Six Hundred Pound Man

Coulehan, Jack

Last Updated: Oct-06-2015
Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The extraordinary image of a six hundred pound man, spread across two beds, dying, whom the doctor might at first find to be grotesque, is transformed in the doctor's dream. In that dream he sees the man as the center of a ceremony in which healers "wrestle the souls of old bodies back to bones . . . back back to their beginnings." The doctor comes to realize that this "worthless and alien" body is beautiful.

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The Man with Stars Inside Him

Coulehan, Jack

Last Updated: Oct-06-2015
Annotated by:
Aull, Felice
Chen, Irene

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

During the physical examination of an elderly cancer patient, the doctor considers the tell-tale symptoms of pneumonia. While the patient is dying, the physician imagines that the symptoms represent the birth of a universe and that the patient is becoming a part of the galaxy.

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Irene

Coulehan, Jack

Last Updated: Oct-06-2015
Annotated by:
Aull, Felice
Chen, Irene

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The author poetically describes the neurological deficits left by his patient’s third stroke. Her misshapen words are "small stones and loose particles of meaning "as he attempts to understand her. Her husband, however, states that "her gulps don’t make no sense," emphasizing his perception of the hopelessness of the situation.

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