Showing 791 - 800 of 840 annotations tagged with the keyword "Doctor-Patient Relationship"

The Bell Jar

Plath, Sylvia

Last Updated: Feb-17-1997
Annotated by:
Schaffer, Amanda

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In this autobiographical novel, Plath's protagonist, Esther Greenwood, sinks into a profound depression during the summer after her third year of college. Esther spends the month of June interning at a ladies' fashion magazine in Manhattan, but despite her initial expectations, is uninterested in the work and increasingly unsure of her own prospects.

Esther grows disenchanted with her traditional-minded boyfriend, Buddy Willard, a medical student who “had won a prize for persuading the most relatives of dead people to have their dead ones cut up, whether they needed it or not . . . . ” Returning home to a New England suburb, Esther also discovers that she's been rejected from a Harvard summer school fiction course. Her relationship with her mother is painfully strained.

Suddenly, Esther finds herself unable to sleep or read or concentrate. She undergoes a few unsuccessful sessions with a psychiatrist, Dr. Gordon, as well as terrifying electroshock therapy. She becomes increasingly depressed, thinks obsessively about suicide, then attempts to kill herself by crawling into the cellar and taking a bottle of sleeping pills: "red and blue lights began to flash before my eyes. The bottle slid from my fingers and I lay down." Esther vomits, however, and so, does not die. She is taken to a city hospital and then, through the financial intervention of a benefactor, to a private psychiatric institution.

There, Esther begins gradually to recover. She enjoys the pleasant country-club surroundings and develops a closeness with her analytically-oriented psychiatrist, Dr. Nolan. Esther also undergoes a more successful regimen of shock therapy, after which she feels the "bell jar" of depression lifting.

The stigma of attempted suicide and hospitalization seems to free Esther to behave less traditionally; defiantly, she loses her virginity to a man she's met on the steps of Harvard's Widener Library. At the novel's end, Esther is preparing to leave the psychiatric hospital and is describing herself, optimistically, as transformed.

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The Biopsy

Jones, Alice

Last Updated: Feb-11-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poet undergoes a breast biopsy under local anesthesia: "I had thought my skin was a permanent seal. / Now I watch this layer of myself / . . . sprout red flowers . . . . " She observes the (male) surgeon closely, imagines her tissue on its journey to the pathology laboratory, and listens carefully to the surgeon's first words: "this man / who went beyond my skin / as no one else has . . . / as he made me for the first time, his."

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The Youngest Doll

Ferre, Rosario

Last Updated: Feb-04-1997
Annotated by:
Taylor, Nancy

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A maiden aunt never marries because a river prawn bites her calf and, due to minimal treatment by her physician, nestles there to grow. She devotes her life to her nieces, making for them life-sized dolls on their birthdays and wedding days. When only the youngest niece is left at home, the doctor comes to see his patient and brings his son, also a physician. When the son realizes the father could have cured the leg, the doctor says, "I wanted you to see the prawn that has paid for your education these twenty years."

The young doctor becomes the aunt's physician and marries the youngest niece, taking her and her wedding doll to live in a house like a cement block, requiring his wife to sit on the porch so passersby can see he has married into society. The doctor sells the doll's diamond-eardrop eyes, and when he wants to sell its porcelain, his wife tells him the ants ate the doll because it had been filled with honey.

The doctor grows older, but his wife keeps the firm, porcelained skin she's always had. One night he watches her sleep and notices her chest isn't moving. Placing his stethoscope over her heart, he hears a distant swish of water. "Then the doll lifted up her eyelids, and out of the empty sockets of her eyes came the frenzied antennae of all those prawns."

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Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Narrated in the style of an "advice" manual, this is the chronicle of a woman who undergoes a hysterectomy and removal of her ovaries. The tone is sardonic. The story begins with the office visit in which the doctor delivers the news and reassures her that she is too "intelligent and sophisticated" to associate her womanhood with her reproductive organs. The physician attempts to persuade the narrator to have her ovaries removed--preventive medicine against the possibility of ovarian cancer--and she finally agrees while groggy from pre-operative anaesthesia. Nothing has prepared her for the emotional and physical lability she experiences after surgery. Even her sexual relationship with her husband is changed.

As she returns for post-operative check-ups, she becomes increasingly conscious of the indignities of the office visit and physical examination: "it strikes [her] that this maximum-efficiency set-up [three cubicles with naked, waiting women] might serve equally well for a brothel and perhaps already does." She feels that she has made a terrible mistake in allowing the doctor to have talked her into anything and that as a male, "there is nothing he can tell you about how you feel, for the simple reason that he does not know."

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Aequanimitas

Osler, William

Last Updated: Feb-03-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Osler’s famous essay was first delivered as a valedictory address at the University of Pennsylvania School of Medicine in 1889. Osler urges the graduates to develop two qualities or virtues. First is the "bodily" virtue of imperturbability or "a judicious measure of obtuseness." This means the outward expression of calmness and coolness, even under difficult circumstances. This virtue suggests that physicians should be relatively "insensible" to the slings-and-arrows of patient care, always maintaining a degree of detachment from their patients.

The complementary "mental" virtue is aequanimitas, which is the personal quality of calmly accepting whatever comes in life. These virtues, however, should not lead to "hardness" in dealing with patients. Osler also urges his students and colleagues to develop the other gentlemanly virtues of courage, patience, and honor.

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What Is a Profession?

Scarlett, Earle

Last Updated: Feb-03-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Scarlett writes about the tradition of medicine in a recognizably British (Canadian) voice. He presents a definition of a profession that features social responsibility and duty to serve others, and notes that "an organized profession does not seek to advance the money-making feature of professional activity." Scarlett identifies seven "pillars" (principal qualities) of the physician, or any other professional: technical skill, social responsibility, knowledge of history, knowledge of literature and the arts, personal integrity, faith that there is some meaning and value in life, and "the grace of humility."

Scarlett critiques the medical profession in two ways. First, physicians are not skeptical enough and willing enough to correct their errors. Secondly, professional qualities have declined "at the hands of the scarcely literate pushing public . . . . " As a result of this, some physicians now believe that "all this rhetoric about the essential nobility of the medical profession is a load of old rubbish" (p. 129).

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Welcome to My Country

Slater, Lauren

Last Updated: Feb-03-1997
Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Slater subtitles her book, A Therapist's Memoir of Madness. Embedded in this definition are two elements: a psychotherapist's composite experiences with a small cadre of patients and the therapist's personal experience with a mental disorder. The author draws the reader into a fascinating series of anecdotes based on therapeutic encounters.

These stories are as much, if not more, about the therapist's deepest responses to her patients than about the patient him or herself. This particular approach adds an element of confession to the work that one does not often find in clinical studies. And, finally, Slater takes the reader backward in time to her own past as a woman with profound emotional pain.

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Arrowsmith

Lewis, Sinclair

Last Updated: Jan-31-1997
Annotated by:
Aull, Felice

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

Genre: Novel

Summary:

This novel was inspirational for several generations of pre-medical and medical students. It follows the hero, Martin Arrowsmith, from his days as a medical student through the vicissitudes of his medical/scientific career. There is much agonizing along the way concerning career and life decisions. While detailing Martin’s pursuit of the noble ideals of medical research for the benefit of mankind and of selfless devotion to the care of patients, Lewis throws many less noble temptations and self-deceptions in Martin’s path. The attractions of financial security, recognition, even wealth and power distract Arrowsmith from his original plan to follow in the footsteps of his first mentor, Max Gottlieb, a brilliant but abrasive bacteriologist.

In the course of the novel Lewis describes many aspects of medical training, medical practice, scientific research, scientific fraud, medical ethics, public health, and of personal/professional conflicts that are still relevant today. Professional jealousy, institutional pressures, greed, stupidity, and negligence are all satirically depicted, and Martin himself is exasperatingly self-involved. But there is also tireless dedication, and respect for the scientific method and intellectual honesty.

Martin’s wife, Leora, is the steadying, sensible, self-abnegating anchor of his life. In today’s Western culture it is difficult to imagine such a marital relationship between two professionals (she is a nurse). When Leora dies in the tropics, of the plague that Martin is there to study, he seems to lose all sense of himself and of his principles. The novel comes full circle at the end as Arrowsmith gives up his wealthy second wife and the high-powered, high-paying directorship of a research institute to go back to hands-on laboratory research.

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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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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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