Showing 751 - 760 of 833 annotations tagged with the keyword "Doctor-Patient Relationship"
A 17 year-old boy, Alan, is brought to a psychiatric hospital because he has blinded several horses with a hoof pick. A psychiatrist, Dysart, works to "normalize" the boy, all the while feeling that though he makes the boy 'safe' for society, he is taking away from him his worship and sexual vitality--both of which are missing in the doctor's own personal life. He actually envies Alan the sexual worship he has experienced.
In spite of his own hang-ups, though, the doctor does help the boy work through his obsession, which identifies the horse Equus with God. But the doctor comments that "when Equus leaves--if he leaves at all--it will be with your intestines in his teeth. . . . I'll give him [Alan] the good Normal world . . . and give him Normal places for his ecstasy. . . Passion, you see, can be destroyed by a doctor. It cannot be created."
Dr. Hertzler leads the reader, topically and generally chronologically, through the nature of the practice of medicine in rural America from the 1880's through the 1930's. His early narratives are those of a child observing the ravages of epidemic diseases in the face of medical futility.
The remainder of the work, divided into subject headings, is devoted to anecdotes and observations on such things as horse and buggy home visits, kitchen surgery, the proprietary hospital and physician education. Having served not only as a rural practitioner, but as a professor of pathology at academic centers and a consulting surgeon, Hertzler draws on a wide experience over a period of time known for rapid advances in basic biological science which would, near the end of the narrator's life, open the way for technological medicine as we know it today.
This collection of vignettes follows the growth and development of one internist as he reflects on some of the critical experiences that shaped him as physician. The common thread of the work is the celebration of the relationship that can, and perhaps should, be built between the physician and his or her patient in the course of caring: this relationship is the sacred space of the title.
The author accomplishes his self-imposed task of describing this space by presenting situations in his practice life that illustrate the concept. The chronological structure of the collection enables the reader to study the maturation of the author as a self-reflective practitioner over the many decades of his professional life. Many of the stories are very funny; others are wrenching; all are gently told.
Summary:Canadian artist, Robert Pope (d.1992), devoted the last years of his short life to documenting his decade-long experience as a patient with Hodgkin's Disease. Shortly after his diagnosis he was influenced by the 1945 autobiographical novel of Elizabeth Smart, By Grand Central Station I Sat Down and Wept. Pope's early work explored the interconnectedness and pain of individuals bound by an imperfect love, in Smart's case for a married man. After his disease went into remission, he began to paint the patient's perspective on illness, hospitals, visitors, family, and health-care providers in a series of images that suggest the lighting of de la Tour, the photographic immediacy of Doisneau, and the menacing surrealism of de Chirico. His book, Illness and Healing: Images of Cancer (1991), became a bestseller.
An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.
At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.
Goya has painted his own portrait as he was during an illness in his old age. The ailing artist sits upright in an olive-green dressing gown; his face is pale and is hands clutch at the sheet against which the carmine blanket glows as the most vivid color element in the painting. He is surrounded and supported by his physician who offers him medicine in a clear glass. The background is both dark and dense, revealing two shadowy figures behind Dr. Arrieta's elbow.
An inscription runs along the bottom border of the canvas, forming a kind of ledge or barrier. It reads in translation: "Goya thankful, to his friend Arrieta: for the skill and care with which he saved his life during his short and dangerous illness, endured at the end of 1819, at seventy-three years of age. He painted it in 1820."
A surgical intern has participated in 86 year old Mrs. Byrnes's abdominal surgery, where extensive metastases from ovarian cancer are found. The surgeons take biopsies, confirm the diagnosis, and close her abdomen, knowing that her case is not treatable. Later that day, it falls to the intern to inform Mrs. Byrne of what they found.
The author describes how he avoided the task, finding other chores to do, appealing to the attending physician to not make him talk to the patient. The attending insists, and the author finally finds the nerve to talk with his patient. Much to his surprise, she has already suspected that she has cancer, tells him not to be upset, and assures him he did his best. The author discovered that learning to be a doctor meant being open to learning from his patients.
The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.
He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.
Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."
A nephrologist is named in a lawsuit after serving as a consulting physician in a diabetes case. The diabetic patient had had a serious infection and later his leg was amputated; he apparently felt the doctors neglected the seriousness of his condition. When the dialysis unit treating this patient requests to transfer his care to the author, whose unit is in the patient's home town, the author is uncertain what to do.
The author is angry about the law suit, and his colleagues counsel him to refuse to take this patient. But after realizing that the lawsuit was merely a reflection of the patient's suffering, and that he needs the same compassion and care as any other human being, the author agrees to accept the patient. The author discovers that his patient is a meek, gentle man; over time, he helps him come to terms with his illness, his disability, and his approaching death. Eventually the patient drops his malpractice suit.
It is the voice of the woman in bed that makes this poem, and she is a tough character as she reveals herself, physically and otherwise. "I won’t work / and I’ve got no cash. / What are you going to do/about it?" she demands in the first few lines. She implies that she is a loose woman and perhaps even comes on to the physician: "Lift the covers / if you want me . . . ." and later, "Corsets / can go to the devil-- / and drawers along with them-- / What do I care!"
The woman shifts subjects rapidly, between poverty and sexuality, hinting that she might be pregnant again, writing off her two sons. At the end, she delivers a proud challenge to the physician who has come to see her in the abandoned house: "Try to help me / if you want trouble / or leave me alone-- / that ends trouble. // The county physician / is a damned fool / and you / can go to hell! // You could have closed the door / when you came in; / do it when you go out. / I’m tired."