Showing 71 - 80 of 82 annotations tagged with the keyword "Heart Disease"
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.
Water is a metaphor for the life cycle as the poet chronicles the role played by water in his life, in all our lives--"the sac of water we live in." The poet evokes the sound of water as he moves through life stages: swaying trees register the sound of the water from which we emerge at birth, "the sound of sighing" denotes the sound made as he washes his dying father’s feet, whispering rain "outlives us."
The poem is replete with images of water that conjure up family relationships over time. In the ocean of his childhood, his athletic brother cannot swim while his crippled sister swims like a "glimmering fish." Water is a visible symptom of the congestive heart failure suffered by his father--"swollen, heavy . . . bloated"-- whose "respirator mask makes him look like a diver."
As the poet tends to his father, testing the wash water "with my wrist" like a parent, there is a powerful recollection of the father’s earlier ordeal as a political prisoner. Finally, there is water that liberated the family, bringing them from Indonesia to America, juxtaposed against the water that is now drowning the father.
This chapbook consists of two parts. The first part is a sequence of 20 poems that describe the final illness and death of the author's father. He is "a man who won't die," a man who has survived the ravages of several chronic illnesses, but who now faces another surgery, "to have the toe / amputated before gangrene set in." Yet the father is finally "slipping / below the horizon." His son sits in the hospital corridor, imbibing the sights and smells of the present, while moving back and forth in his mind between the past and future.
At last his father dies. Life goes on, connection goes on. The author thinks about his son, "my son is lifting the world / on his back . . . " The second part of the chapbook is a long poem called "Kaddesh for My Father," modeled after Allen Ginsberg's Kaddish and written about a year after his father died.
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").
The scene is a medical office where "a white sleeved woman wraps a rubber / sleeve around your arm, steps back, listens, / whistles." Wow! The pressure must be amazingly high. The author imagines the blood pressure's power--"a tide of electrons," a "lightning snake, a "black rain." The patient sits on the cold table. How vibrant his interior chaos is compared to his quiet external appearance! He says the ordinary things--he'll lose weight, he won't complain--but behind his eyes is a flash of turbulence. [30 lines]
By most accounts Dr. Sam Abelman is a failure in life, an irascible old general practitioner who lives in the same grimy Brooklyn neighborhood he has always lived in. He is truculent and tactless, an easy mark for the young specialists who steal his patients. One night a bunch of hoodlums drop a battered young woman on his doorstep. Abelman's nephew, a reporter, publishes a news item about the incident, "Doctor Saves Raped Girl."
Meanwhile, Woody Thrasher, vice president of an advertising agency, is looking for a new type of television show to sell to one of his clients. He comes up with Americans USA, a candid look at "ordinary" Americans who are just doing their jobs, but in an extraordinary way. He decides that Sam Abelman would be the ideal first subject.
Thrasher, a young, high-powered executive, meets Abelman, the last angry man, who summarizes his view on life by saying, "The bastards just won't let you live." The doctor's practice is declining, he can't afford to retire or move away, and the local people certainly don't seem to love him. They don't show gratitude for his services. They don't pay their bills. Many of them consider him a racist, and incompetent to boot. Abelman is clearly not a good candidate for "doctor of the year."
Yet, Thrasher soon finds himself intrigued. Abelman spends hours working in his miniature vegetable garden and reading Henry David Thoreau. He is a brilliant diagnostician, a devoted husband, and an endless campaigner against the "galoots" who think the world owes them a living. Abelman takes aim at "galoots" wherever he finds them, and he finds them everywhere.
The novel interweaves these two men's developing relationship, as Abelman agrees to do the show and Thrasher works to sell it to his bosses, with incidents from Abelman's earlier life. When it turns out that Americans USA will award its subjects their "heart's desire" (in Sam Abelman's case a new house), the doctor declines to go on, refusing to accept "charity" and claiming that Thrasher "tried to crap me up." In the end he agrees to do the show, but suffers a massive heart attack and dies.
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."
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."
This story draws attention to subtle ramifications of organ transplantation for the survivor(s) of the donor as well as for the organ recipient. Also at issue is coming to terms with the sudden death of a loved one. Hannah, a woman in her thirties, finds that three years after the violent death of her husband, she is still caught, "unable to grieve or get on with her life . . . . "
The physician in charge had persuaded her both to allow life-support to be terminated for her brain-dead husband, and to agree to organ donation. "That way your husband will live on." Seven different people are the living recipients of his organs. To Hannah, it seems that her husband is both dead and not dead, an intolerable situation.
She becomes obsessed with trying to meet the person who received her husband's heart. This will be the means by which she can re-connect to the living and achieve closure--she will hear and feel her husband's heart in the chest of the recipient, her ear "a mollusc that would attach itself . . . and cling through whatever crash of the sea." At the end of the story, Hannah has succeeded in her quest and the man who is the heart's recipient, at first suspiciously hostile, has become Hannah's co-conspirator and protector.
Today, Friday June 5th, I am going to meet the man who killed my father. So begins the narrator of this novel, who is about to drive to New Jersey to visit the physician (now retired) who took care of his father during his final illness 20 years previously. The narrator (Peter Cave), who was an adolescent at the time, is now a physician himself.
Most of the novel is a flashback in which the narrator describes his life during the several days prior to June 5th, "the white life," which is the term he uses for the practice of medicine. We learn, in particular, about his patient George Dittus, a difficult man who definitely doesn't want to play the hospital game. "I need to get home" is the first thing Dittus says. Dr. Cave wants to save the life of this gruff, eccentric man who may well have had a serious heart attack, but at the same time, he tries--sometimes painfully--to respect the patient's desire to be in charge.
Cave's encounter with the retired Dr. Gresser, who remembers the elder Cave as a difficult patient, is surprising--"You know he refused to take the medicines I suggested." Cave is disappointed; he wanted a confrontation with the man who "killed" his father, but, instead, is confronted with the realities of human nature. Back at the hospital, he discharges George Dittus, who disappears into the inscrutable future.