Showing 781 - 790 of 829 annotations tagged with the keyword "Patient Experience"

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

William Osler served as one of Walt Whitman’s physicians from 1884, when he moved to Philadelphia to become Professor of Medicine at the University of Pennsylvania, until 1889, when he left Philadelphia for Baltimore. Osler was introduced to Whitman by a mutual friend, Dr. Richard Maurice Bucke, Whitman’s avid disciple and biographer. After his stroke of 1873, Whitman suffered from recurrent episodes of illness (perhaps small strokes?). Osler first paid a call to Whitman’s home in Camden at Bucke’s request and subsequently visited him on numerous occasions.

Published in this book for the first time is Osler’s unfinished 1919 manuscript for a lecture recounting his relationship with Whitman. Much of the book is a gloss on this short manuscript. The book actually deals as much (or more) with the remarkable figure of Richard Maurice Bucke, Whitman’s spokesman and the developer of a theory of "cosmic consciousness," as it does with the two title characters. In sum, Whitman respected Osler, but did not particularly like his sunny, optimistic bedside manner. Osler respected Whitman, but for the most part did not like his poetry. (Leon, however, discovered some handwritten notes on Osler’s copy of Leaves of Grass that suggest Osler grew in his later years to appreciate Whitman’s poetry.)

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The Culture of Pain

Morris, David

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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Losses

Silbert, Layle

Last Updated: Jan-30-1997
Annotated by:
Chen, Irene
Aull, Felice

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Short Story

Summary:

A woman admitted to a hospital for cancer treatment describes her progressive loss of identity, from the trading of clothes for a hospital gown to her gradual hair loss. Feelings about the loss of hair (shame, embarrassment, nonchalance) reflect how she confronts the illness; in time, she is ready to face the world again.

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As We Are Now

Sarton, May

Last Updated: Jan-30-1997
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Fiction

Genre: Novel

Summary:

As you are now, so once was I; Prepare for death and follow me. The novel's advisory epigram prepares readers for the realities of aging and death which affect both narrator and reader. Following surgery, Caro Spencer is delivered to Twin Elms, a nursing home in a rural New England setting. While this intelligent woman requires only short-term care, she is deposited, permanently, in an understaffed, sub-standard care facility by relatives unwilling to add her minor but time-consuming difficulties to their own.

It is not a pretty setting. The staff is overworked and demeaning, especially to the new resident who is well-educated and accustomed to better circumstances. The nursing home routine is careless of individual differences and needs, and set up to strip away autonomy and dignity through petty and cruel indignations.

Caro is able to survive by keeping a secret diary for observations, reflections, and interpretations; ultimately, this alone sustains her. While the voice is that of an elderly woman (as we are now), the journal is for us, those still able to manage their lives, but unable to predict or control end-of-life events.

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Mother

Wolitzer, Hilma

Last Updated: Jan-30-1997
Annotated by:
Squier, Harriet

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Mother is set in the 1930's and deals with a woman's difficult life, low self-esteem, and sense of having inherited tragedy and misfortune from her mother. Even though she finally marries, and unexpectedly conceives long after her husband and she had given up trying, her outcome is destined to be unhappy. She goes into premature labor, and gives birth to a stillborn child.

When she finally wakes up, she is weak, and cannot remember anything about the delivery. Her paternalistic physician, her husband, and the hospital staff withhold from her the news that her child has died. One night, in her frustration and need, and believing that her child is in the nursery "in the basement," she searches the basement corridors for her child. Outside the morgue she begins to hemorrhage and despite the efforts of her physician, she dies.

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A Country Doctor

Kafka, Franz

Last Updated: Jan-29-1997

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A hapless country doctor describes with breathless urgency a night-time summons to attend a young patient. Events soon take on a surreal aspect as "unearthly horses" transport him instantaneously to the bedside. The doctor, preoccupied with personal distractions and grievances against those he is employed to care for, fails to find what is revealed to be a vile, fatal wound (symbolizing the Crucifixion?). He is humiliated by the villagers, who are "always expecting the impossible from the doctor," and doomed to an endless return trip, losing everything.

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Hard Cash

Reade, Charles

Last Updated: Jan-29-1997
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Reade was known for writing "novels with a cause." Here, as in several other of his novels, his cause is the deplorable condition of mental hospitals in the early to mid-nineteenth century. Until late in the century, many considered the mentally ill untreatable. Hospitals were more like prisons than places for treatment. Admission policies were also fairly lax. Reade records a common fear that healthy people would be incarcerated.

In Hard Cash, a father incarcerates his son in order to cover up a crime. The doctors who admit him have a kickback scheme worked out with the hospital--they get money for each patient admitted. Once in the hospital, the hero tries to prove his sanity but finds it impossible to battle against doctors who refuse to look past the diagnosis that caused his admission to his actual mental condition. He also must negotiate with the head of the hospital, a woman who is madly in love with him and refuses to allow him out of her sight.

He cannot prove his sanity and only escapes when there is a fire in the asylum. There is one "good" doctor in the story who refuses to bleed patients, deny them food, or admit the sane to mental hospitals. The other doctors think him a quack, but he saves several lives.

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Annotated by:
Moore, Pamela

Primary Category: Literature / Poetry

Genre: Poem

Summary:

In this poem, the narrator describes her father who is in a nursing home suffering from dementia. The poem opens with a description of the narrator's dying cat, with whom her father is compared. The most distinctive thing about the father's anger and confusion is his loss of power. In a home he is denied access to his money, his house, even his ability to boss others around. He calls his daughter and insists that she is not his daughter at all, but his wife.

He feels as if it's the wrong year, "and the world bristles with women who make short hard statements like men and don't apologize enough, who don't cry when he yells or makes a fist." He has lost his masculinity. He accuses his daughter of stealing his money, the money he hoarded from her as she grew up and that is now useless to him. No one on the ward remembers or cares that he once walked the picket line, worked, or had a desirable wife. He is as angry as "a four-hundred-horsepower car," but he has lost his license to drive.

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Annotated by:
Terry, James

Primary Category: Literature / Plays

Genre: Play

Summary:

Two radically different people find themselves together on a hospital roof garden, where they first come to terms with each other, then with their pasts, their illnesses, and death. Parmigian has a fruit and vegetable stand, a terminal cancer, and a bitter wit. Richard Landau is an investment adviser in fine art, fastidious, but haunted by his childhood escape from the Holocaust.

Only in for tests, Landau becomes forced to confront Parmigian's fatalistic view of the world. As Parmigian taunts and jokes, he draws Landau into his laughter and wild imaginings, as key weapons in the fight to stay alive.

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