Showing 81 - 90 of 106 annotations tagged with the keyword "Impaired Physician"
At the heart of this novel is a simple love story. Dr. Bruno Sachs, a slight, stooped, and somewhat unkempt general practitioner in a French village is dedicated to his work and loved by his patients. Sachs is a solitary, self-effacing man who takes his Hippocratic duties seriously and is especially sensitive to the needs of his patients.
In addition to his private practice, Sachs works part-time at an abortion clinic, where he performs an abortion on a distraught young woman named Pauline Kasser. Soon the doctor and his patient fall in love. She moves in with him and becomes pregnant. An editor by profession, Pauline also encourages and assists Dr. Sachs in completing the book he is writing.
The story has many additional layers and dimensions. The reader views Sachs through the eyes of multiple narrators--his patients, colleagues, friends and acquaintances, all of whom write in the first person and present Bruno Sachs as "you" or "he." Thus, the reader gradually builds up a "connection" (empathy) with Sachs by synthesizing multiple glimpses of his behavior and facets of his character. At the same time, Sachs is trying to find his own voice, his own connection, by becoming a writer. At first he jots down random thoughts, then he keeps a notebook, and eventually he produces a complete manuscript.
The book has innovative structural elements that introduce other layers of meaning. For example, the 112 short chapters are organized into seven sections, corresponding with the components of a complete clinical case history: presentation (as in "chief complaint"), history, clinical examination, further investigations, diagnosis, treatment, and prognosis. Similarly, the narratives delve progressively into Sachs' "illness" and follow the "patient" through his course of "treatment."
Another structural element is the cycle of fertility and gestation. The story takes place from September through June, precisely 40 weeks, a pregnancy of nine months, during which Sachs is re-born.
Christ stopped at Eboli, say the southern Italians, meaning that they are "not Christian," uncivilized, forgotten, and deprived. Physician, writer, and painter, Levi was arrested and 'exiled' from his home in Turin for opposing Fascism during the Abyssinian war (1935). This is the memoir of his life as a political prisoner under house arrest in a malaria-ridden village in Lucania (Basilicata).
The peasants immediately seek his advice for their ailments, but the two local doctors are jealous, as well as incompetent, and they have him stopped. Grinding poverty, illness, superstition, and despair work on each individual in different ways; but the peasants move with the cycle of seasons and religious festivals. The feast of the black Madonna (Chapter 12) and an unforgettable pig castration (Chapter 19) are vividly described. In the 'atmosphere permeated by divinities' (p. 151), the animal, human, and spiritual spheres combine (Chapters 8, 13, 15).
The closing chapters are a political meditation. Deprivation and isolation make the south an irrelevant and different country to the powerful middle class that runs the Fascist party. In return, Fascism finds no supporters here other than corrupt, petty officials. Levi contends that "the State" of any political stripe will never solve the problems of southern Italy until peasants are involved.
To relieve her insomnia, Claire Vornoff seeks help from Dr. Declan Farrell, a well-known holistic physician, who begins to see her professionally at his country home. Farrell's methods focus on massage and bodywork, along with some acupuncture. Claire finds him an attractive paradox--sensitive and "tuned in" to her, yet also blunt and emotionally unsettling.
The client-therapist relationship becomes deeper and more complex. After Claire has a brief sexual escapade with a married man, she admits to herself that she actually loves Declan and confesses her love to him. Indirectly, he reveals that he also has strong feelings for her, but is desperately resisting those feelings and attempting to maintain his professionalism.
Claire finally breaks off their relationship and attempts to go on with her life. Over the next couple of years, Declan closes his practice, moves elsewhere, divorces his wife, and ultimately commits suicide. Claire learns of these events gradually, at second hand, as she, too, moves on, but in much a different direction. Eventually she begins a new life in Toronto.
Although the relationship between Claire and Declan occupies center stage, Claire's quest for improved health leads her to consider, and sometimes consult with, other alternative medicine practitioners as well. (I say "improved health" rather than "relief of insomnia" because, although never stated, it seems clear that Claire seeks a sense of completeness and meaning in life that goes far beyond solving her sleep problem.)
One of these healers, for example, is Mr. Spaulding, who reviews Claire's blood work and concludes, "You're in rough shape, girl." (p. 231) He explains that her "body salts are so high I can't measure them" and that her "body is throwing off one hundred times more dead cells than it should . . . "
Dr. Constance Petersen (Ingrid Bergman) is a beautiful, unattached psychiatrist whose business-like facade fails to conceal a natural empathy that draws men. For her, however, love is a mere epi-phenomenon, easy to explain and resist, until she meets Dr. Edwardes (Gregory Peck). The famous expert on the guilt complex has arrived to replace the retiring chief (Leo Carroll). Constance is smitten, and so, it seems, is he.
But soon, she realizes that Edwardes is "not well," that he is terrified of dark lines on white: fork marks on a tablecloth; threads in her robe. Worse, she discovers that Edwardes is not, in fact, Edwardes, but an amnesic physician of initials "J. B." who is convinced that he has murdered his analyst. Constance does the right thing by having him removed from work, but she refuses to believe he is a murderer. Wanting to protect her, he leaves. But she, intent on curing her lover, follows him on a journey to retrace his last movements. The task is to recover both a memory and a missing person.
They go skiing (dark lines on white) at a resort where the real Dr. Edwardes had sojourned with his patient-colleague. On a dangerous slope, J. B. suddenly remembers that Edwardes went over the cliff. The body is found, but it has a bullet in the back.
Now hiding from the police, the couple pose as newlyweds and flee to her old mentor in Rochester. Complete with accent and beard, Dr. Brulov (Michael Chekhov) is a delightful double of the recently deceased Sigmund Freud (1858-1939). It emerges that John Ballantine (Peck) never lost his childhood feelings of guilt over the accidental death of his little brother.
In a gruesome ten-second flashback, the tyke is abruptly impaled on a iron-spike fence. This ancient guilt was reactivated by his doctor’s demise and it was sublimated by the defense mechanism of an assumed identity to keep the dead man alive. An idle slip of the tongue reveals the murderer to be the jealous retiree. The killer threatens Constance and then makes a quick end by dispatching himself instead.
Andy Safian (Bill Pullman), an English professor, and his wife Tracy (Nicole Kidman), recently married, have bought a new house. Short of money, they take in a lodger, Dr. Jed Hill (Alec Baldwin), a surgeon who went to high school with Andy. Tracy suffers from mysterious abdominal pains and then has to have emergency surgery when an ovarian cyst ruptures. Jed Hill performs the surgery. He finds that her other ovary appears necrotic and removes it. It later turns out to have been healthy.
Tracy sues for malpractice and receives a huge settlement. She then leaves her husband, who gradually realizes that she and the surgeon had been lovers and that he has been the victim of their complex con game: she has sacrificed her fertility and Dr. Hill his career in exchange for the millions of dollars paid out by the hospital's insurance company. Andy sets about seeking revenge.
In 1871 the Polaris, a rebuilt tugboat commissioned by the U.S. Navy, set sail with a dual mission: planting the stars and stripes on the North Pole and providing scientific data and specimens for the Smithsonian Institution. A number of poor decisions were made early on in the planning and initiation of the expedition, including an inadequately structured vessel, a vague power distribution lacking a clear absolute authority, and a sailing captain with a significant alcohol problem.
The power struggles begin early. By the third month of the voyage the ship is in physical trouble and the designated expedition head (Charles Francis Hall) has died suddenly of an unexplained illness. There is no leader and the struggle for control erupts between the German scientist/physician who is responsible for the scientific mission and the drunken whaleboat captain who is responsible for keeping his ship and crew safe.
Bad weather, terrible luck, and lack of discipline result in the loss of the Polaris, the splitting of the crew onto separate ice floes, and several months of harrowing experience trying to survive the Arctic winter and hope for rescue. The good news is that everyone except Mr. Hall miraculously survives the ordeal. The subsequent Naval inquiry into the failed endeavor ends without resolution as to the cause of Hall’s death despite hints from crew members that it was not natural. In 1968, long after all crew members had expired, Hall’s grave was located and forensic samples proved that he had died of arsenic poisoning.
A retired professor has returned to his estate to live with his beautiful young wife, Yelena. The estate originally belonged to his first wife, now deceased; her mother and brother still live there and manage the farm. For many years the brother (Uncle Vanya) has sent the farm’s proceeds to the professor, while receiving only a small salary himself. Sonya, the professor’s daughter, who is about the same age as his new wife, also lives on the estate. The professor is pompous, vain, and irritable. He calls the doctor (Astrov) to treat his gout, only to send him away without seeing him. Astrov is an experienced physician who performs his job conscientiously, but has lost all idealism and spends much of his time drinking.
The presence of Yelena introduces a bit of sexual tension into the household. Astrov and Uncle Vanya both fall in love with Yelena; she spurns them both. Meanwhile, Sonya is in love with Astrov, who fails even to notice her. Finally, when the professor announces he wants to sell the estate, Vanya, whose admiration for the man died with his sister, tries to kill him. But the professor survives and he and Yelena leave the estate.
This memoir begins in Africa, where Dr. Grim is with Médecins sans Frontières managing a meningitis outbreak in Nigeria. Conditions are appalling, but she has come here because of burnout: "so I won't be back home and in the ER" (11). Later in the book, she describes her other "escapes" from the Emergency Room, caring for war refugees in the Balkans.
The book centers, however, on life in an American emergency department, as Grim remembers it from the vantage point of Africa (where she does eventually become nostalgic for well-stocked supply cupboards and a more comprehensible chaos). She organizes her stories into a series of "Lessons in Emergency Medicine," in which she addresses the reader directly. After going through a step-by-step account of death in the ER, illustrated with several moving and alarming cases, she concludes: "Congratulations: you have successfully declared someone dead. Now, as an encore . . . you'll get to do it all over again" (28).
The ironic, even bitter, tone warns us of the difficulty of working in such perpetually crisis-ridden circumstances, but it does not conceal a vulnerability that seems necessary to doing the job well, such as when Grim has to tell a family that the father has died of the heart attack he had at his daughter's wedding: "you just stood there," she says, "looking at the corsage, the tuxedo and the pearls . . . You had no idea what to say and you don't really remember what you finally came out with" (26).
The stories are organized around several lessons: "How to deliver a baby," "How to crack a chest," "How to write a prescription" (which includes a discussion of addiction to prescription medication and a withering account of the doctor who overprescribes), and, as if it's as inevitable as the rest, "How to burn out."
By the book's final chapter, emergency medicine has merged, along with the vaccination of refugee children and the impossibility of treating tetanus in Nigeria, into the story of almost unreasonable determination in the face of endless frustration--but this, Grim shows in her final chapter, "Why I do what I do," is the point. Against this backdrop her final story, about the rescue of a child, makes its point: the feeling of saving a life explains all the rest.
This collection contains all 52 of Williams’s published stories, together with a new introduction by physician-writer, Sherwin B. Nuland. The stories were first collected in one volume in 1961 under the title The Farmer’s Daughers (New Directions); that book, in turn, included three earlier collections, plus "The Farmer’s Daughters"(1956), Williams’s last published story.
Thirteen stories featuring physician protagonists were previously collected by Robert Coles and issued by New Directions as The Doctor Stories (1984). (That volume also includes several poems and an "Afterword" by Williams’s son.) Among the stories with medical themes are Old Doc Rivers, The Girl with a Pimply Face annotated by Jack Coulehan (also annotated by John A. Woodcock), The Use of Force annotated by Felice Aull (also annotated by Pamela Moore and Jack Coulehan), Jean Beicke(annotated by Felice Aull and also by Pamela Moore and Jack Coulehan--see Jean Beicke), A Night in June, and A Face of Stone. The tales of a nonmedical nature include such masterpieces as "The Knife of the Times," "A Visit to the Fair," "Life Along the Passaic River," "The Dawn of Another Day," "The Burden of Loveliness," and "Frankie the Newspaper Man."
A medical instrument kit from the year 2450 is transported back in time and falls into the possession of old Dr. Full, a retired physician and drunkard who had been expelled from the medical association for milking patients. The futuristic instruments are awe-inspiring and virtually operate themselves. The discovery of the black bag restores Dr. Full's self-worth and dedication to healing.
A street-wise woman, Angie, realizes the value of the medical instruments and their origin. She forces Dr. Full to accept her as a partner. The two of them soon establish a successful medical practice. When Dr. Full decides to donate the instrument kit to the College of Surgeons, Angie murders him.
While demonstrating the safety of the medical bag to a patient, Angie plunges the futuristic surgical scalpel into her own neck, confident it will do no harm. Meanwhile, authorities in the future learn that the medical bag is missing and deactivate it just prior to Angie's demonstration. She slits her own throat. By the time the police arrive, the contents of the black bag had already rusted and are decomposing.