Showing 721 - 730 of 840 annotations tagged with the keyword "Doctor-Patient Relationship"
Ingenious Pain tells the life story of James Dyer, a surgeon in eighteenth-century England who is gifted--and cursed--with the inability to feel physical or emotional pain. Beginning with his postmortem, the novel traces the thirty-three years of his life, from his illegitimate conception on a frozen river, through the rise of his career from itinerant quack's assistant to ship's surgeon, and then to the court of Empress Catherine of Russia where he meets Mary, a mysterious woman who performs magical surgery on him with her hands, enabling him for the first time to feel and, as a result, to love.
At first this new ability drives him mad, and he is submitted to the infamous torments of Bethlehem Hospital. He gradually recovers, but his new sensitivity has disrupted his identity as a surgeon. He performs one last operation, saving the life of a Negro wrestler by opening his chest and massaging his heart. His own death, not long after, seems to signify that he has at last become a normal man, and this is a form of redemption.
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.
Dr. Ernest Lash, single and around 40, discovers his enthusiasm and love for psychoanalysis, the talking therapy, after several years of practice as a psychopharmacologist. As the novel opens, we meet a smart, somewhat smug and self-absorbed Dr. Lash who practices from his office located in the privileged community surrounding Sacramento Street in San Francisco. He has an active psychoanalytic practice, ambition for respect and notice by the seniors of his professional community, and some aspiration to greater success as a theoretician and writer on the subject of psychoanalysis. Central to his character is a love for his work, where it appears that pride in technique and outcome shadows genuine concern for his patients and their unhappiness.
Early in the novel, a male patient, Justin, who has been working with Ernest for several years, announces that he is leaving his wife, Carol, for another woman. Ernest is pleased since he views the marriage between Justin and Carol as unhealthy, while a bit dismayed that Justin fails to acknowledge Ernest's contribution in helping Justin develop the confidence to take this step. Justin ends his relationship with Ernest Lash--feeling that he no longer needs his help--as the beginning of the novel takes an intriguing direction.
Justin's now abandoned wife, Carol, in a state of betrayal and desire for vengeance--she has a hateful attitude toward all psychiatrists after her psychotherapist of many years ago had an affair with her--decides to enter therapy with Dr. Ernest Lash in the hope of seducing him. She disguises herself with a name change and enough distortion of her past and present so that Dr. Lash will not be able to connect her to Justin. She wishes to expose him as a charlatan, and destroy his career.
Carol is an attorney, and smart. Dr. Ernest Lash is lonely and drawn to Carol. The therapy sessions and the progression of their relationship are central to Yalom's exploration of the intersubjective experience, where strangers struggle with the ambiguity of their own motives and intentions in the intimate world of psychoanalysis. Who is giving, who is receiving? Who is being helped, and who is helping?
Yalom weaves this central element of the plot with many other relationships. Dr. Marshal Streider is a senior psychoanalyst with ambitions for national recognition and a preoccupation with money. He is Dr. Ernest Lash's supervisor. He takes great pride in the fact that he treats many wealthy patients, and is engaged in his own boundary dilemmas when he invests, using insider information from one of his patients.
Dr. Seymour Trotter is a senior psychoanalyst who is condemned and removed from psychoanalytic practice after entering a sexual relationship with one of his patients. We learn that Seymour Trotter was once president of the American Psychiatric Association, and a mentor to Marshal Streider. His maxim, "My technique is to abandon all technique" (p. 7), both haunts and guides Ernest Lash throughout the novel as Ernest grapples with his own passions and temptations, while striving in his goal to achieve humane and healing therapy for his patients.
This etching illustrated a book criticizing (male) physician birth attendants--"man midwives"--today’s obstetricians. The etching shows a figure that is male on one side, female on the other. The male half stands on a plain wood floor next to a large mortar and pestle, holding an instrument labeled a "lever" in his hand, which is pressed against his thigh. The background seems to be a shop, with shelves lined with vials, bottles, and frightening looking instruments labeled "forceps," "boring scissors," and "blunt book."
In contrast, the female half of the figure stands in a homey room on a decoratively carpeted floor; in her outstretched hand she holds a small cup. Behind her, a fire burns in a grate.
Summary:As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.
This is one of three of Poe's tales that deal with mesmerism, an increasingly common practice of the early nineteenth century. This tale evolves around a young gentleman of Virginia, who has developed a rapport, a dependent relationship centered on mesmerism, with a physician who had been converted to the practices of Mesmer.
One day, after taking his usual morning dose of morphine, the gentleman leaves for his daily walk in the Ragged Mountains. He returns with the tale of a bizarre foreign encounter in which he dies from a snake bite to the temple.
As the "dead" man tells his tale, the doctor confirms that it was not a dream despite the fact that the subject seems quite alive. Within a few days the gentleman is dead, presumably because of the accidental application to his temple of a poisonous leech. The twist at the end of the tale, which includes allusion to reincarnation, will not be revealed here.
Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.
Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)
Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.
However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.
She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)
The narrator describes his chronic illness of two or more years duration. He likens his former good health to "an island / going out of sight behind you." His days are filled with visits to the doctor, medicine, and a loss of interest in "wanting to make love . . . . " He describes going through stages: feelings of being punished, which generate "an enormous effort to be good"; anger; fear of death; "a lake of grief"; "neurotic vigilance"; and finally, "only a desire to be done." In the end, he is still en route.
Anne Finger, a writer and disabled activist whose childhood polio left her with a disability, tells the story of her pregnancy, her birth experience at home and in the hospital, and the serious health problems her newborn son experienced.
Summary:This is a tight, short poem that takes its central metaphor from the uncredited quote, ". . . a madman attacked Michelangelo's Pietà with a hammer." The speaker is presumably a physician who, with a pathology report on his desk, contemplates the task before him. He likens himself, as bearer of grim news, to an avenging creature about to assault his patient, the Pietà, with a catalogue of cutting and pounding tools as images for the effect of such news on the recipient. The speaker also reflects on his own anger, the anger he feels about his patient's bad fortune, yet ". . . not wanting to judge / the cracked face of God."