Showing 821 - 826 of 826 annotations tagged with the keyword "Communication"
This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.
The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.
The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”
In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.
This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.
Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.
In this poem a patient speaks to "Dr. Green," commenting on how much she likes him compared to her earlier doctor, "Dr. Gold," who wore a long face and would never smile. "Dr. Gold has track shoes on" but to Dr. Green she says: "You never seem / to be in a hurry even // though you're so busy . . . . " The patient would like "a little rest / before the next treatment, at least till / I'm stronger."
In the companion poem, "Dr. Gold & Dr. Green, II" (also found in One Word), the physician responds to his patient, Eleanor, who presumably wrote the first poem. He realizes that he himself is actually Dr. Green and Dr. Gold. Even though he tries to spend time with his patients, he now realizes that sometimes he must have appeared hurried and distant: "You tried / to say that each of us has two sides. / I wish I understood this before you died."
Dunn's poem describes the choreography of married couples after an argument. The narrative voice considers how silence is imposed, then broken and how two people eventually come together after an unpleasant exchange of words. There are, according to the speaker, unspoken rules and rituals. First, a long silence permeates: after all, "whoever spoke first would lose something." In this household drama there is meaning to the clanging of dishes, sleeping arrangements, and accidental touching.
Eventually, one or the other is careless, spontaneously and shamelessly breaking the Yalta-like stalemate with an observation about something ordinary such as a "cardinal on the bird seeder." An accidental comment secures a truce, bringing the couple together in sex, a "knot untying itself."
Summary:Sometimes communication is best served when it doesn't communicate baldly and precisely. In this 12 line poem "a daughter comes in late / and you don't say exactly what you feel . . . ." You tell a patient "the x-ray showed / little change, knowing they won't ask / if the lesion's a little smaller or larger."
Summary:The patient lies in the hospital after having a stroke. The "word" is the patient's best friend, but suddenly it's become what "you can't say." "You lie flat / in the white yards of the clinic" unable to find the word. Like a dog, it "drags its chain over the emptied / bowl, barks," but the patient is unable to call it or command it. The stroke victim must simply wait and listen.