Showing 91 - 100 of 471 annotations tagged with the keyword "Art of Medicine"

Summary:

Edited by Victoria Tischler (a psychologist in the Division of Psychiatry at The University of Nottingham), with forewords by Dinesh Bhugra (Professor of Mental Health and Cultural Diversity at King's College London) and Allan D. Peterkin (who founded ARS MEDICA: A Journal of Medicine, The Arts and Humanities), this handbook is intended to provide guidance on medical humanities teaching in the field of mental health.  After a short, familiar introduction to the need for such teaching, Tischler offers concrete guidance on how to begin establishing a medical humanities course.  The subsequent chapters deal with topics, perspectives, and forms of art one might include in such a course.  There is a "brief history of psychiatry through the arts" by Allen Beveridge which is, as we are warned in the title, somewhat cursory, but also well-written and thought-provoking.

Following this are chapters on the use of cinema, poetry, literature, creative writing, drama and theatre, and music in medical humanities teaching for mental health, interspersed with essays on Hans Prinzorn, who collected paintings and pictures by the mentally ill; art psychotherapy; community arts (where, as the authors point out, there is no "interpretative component" but rather a focus on participatory creativity); and the blues.  The authors include psychiatrists, artists, mental health nurses, and counselors/therapists, and the book includes a lovely selection of color plates.

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

On July 5, 1998, physics Professor Alan Cromer suffered a heart attack on a plane, and survived after almost an hour of resuscitation efforts, but sustained brain injury from lack of oxygen.  In this chronicle of caregiving, his wife, a psychiatric nurse by training, gives a very personal, detailed account of the radical adaptations his disability required of both of them.  Her story includes reflection on his and her own emotional adjustments to loss of parity in communication and awareness, practical adjustments to physical limitations, and social adjustments to family, friends and professional colleagues.

Arduously, over time, Alan regained some ability to read and speak--indeed, he spoke to groups with Janet about their life together during the peak of his rehabilitation.  But the road to even partial recovery was bumpy, and the writer fully acknowledges the pain, grief, irritation, and deep frustrations that intersected moments of authentic pleasure, discovery, and mutual kindness.  Professor Cromer died September 3, 2005.

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Wit

Edson, Margaret

Last Updated: Sep-07-2010
Annotated by:
Donley, Carol

Primary Category: Literature / Plays

Genre: Play

Summary:

Wit takes place in a University Hospital Comprehensive Cancer Center. The main character, Vivian Bearing, Ph.D., is a John Donne scholar who has stage IV ovarian cancer. Much of the action takes place in the last few days/hours of her life, although flashback scenes to weeks, months, even years before are interspersed effectively throughout the performance.

Bearing has lived an isolated life. Her love is her teaching and research. She is a stern taskmaster, perhaps "non-humanistic" in her approach. Similarly, she faces doctors and a medical system that emphasize technique over caring. She does find, in the end, compassion from a nurse who prevents the medical team from carrying out a CPR (cardiopulmonary resuscitation) attempt that she did not want.

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One Breath

Clark-Sayles, Catharine

Last Updated: Sep-03-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This suggestively titled collection of poems provides a lyric record of a physician’s way of seeing.  The situations to which the poems bear witness are not only medical, though many are.  Some are cityscapes into which are woven surprisingly astute observations of homeless people or hitchhikers or ducks in the park.  Some explore the geography of a body where memories are held in “neuron chains.”  Some articulate bits of personal history from the point of view of a woman who has spent years in medicine, caring for the elderly, seeing bodies with the double vision of a clinician and a person whose spirituality clearly informs all she sees.

Titles like “ER Alphabet of Hurt” or “Looking for God On the Radio” or “Hippocrates Voyeur” or simply “Scars” may give some sense of the range of focus.  Her vision and voice are strongly local; those who know Marin County, north of San Francisco, will recognize the places that become the poet’s personal geography.  Those who don’t will still see in these poems a sensibility shaped and refined by the knowledge that comes from deep habitation.  

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The Anatomy of Deception

Goldstone, Lawrence

Last Updated: Jul-09-2010
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1889, young doctor Ephraim Carroll is in Philadelphia working with the team of the famous physician and pathologist, William Osler. In their zeal to learn more, they conduct careful autopsies, but the body of a young woman upsets Osler and teammate Dr. George Turk, and they defer the examination. Baffled when her body vanishes, Carroll becomes preoccupied with identifying the woman and the cause of her death.

A darling of Philadelphia society, Osler arranges for Carroll to attend a dinner where Carroll meets and falls head over heels in love with the unconventional Abigail Benedict. Abigail is a painter and free thinker, friendly with the great artist Thomas Eakins. Both are worried about their missing friend, Rebecca Lachtmann, and they engage Carroll to help find her. Through a series of adventures he is able to locate and identify the missing corpse as hers. He discovers the cause of death by exhuming the body.

In the meantime, Turk is found dead of what appears to be cholera; however, Carroll’s suspicions lead him to conclude that the young doctor was murdered by a dose of arsenic cleverly calculated to mimic symptoms of the infection. Drug addiction and an abortion ring lie at the heart of this crime.

Osler is being courted for a position at the new Johns Hopkins Medical School and he invites Carroll to consider joining him there.  But Carroll decides not to go to Baltimore.

To write more would give too much away. The surprise ending implicates famous doctors for unethical behavior, if not murder.

 

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Holding Our Own: Embracing the End of Life is a documentary film that shows aging and dying as anything but morbid, and death as the final healing in the hospice way. Art and music are combined as a way to bring people into a subject that they'd rather resist.

The film begins with an art opening in New York City and with the commentaries of curator and others as they view Deidre Scherer's large fabric and thread paintings (see annotation of "Surrounded by Family and Friends")--of people at the last moments of their lives. The artist has captured for us, even in the midst of suffering, genuine moments of tenderness.

An interview with palliative care physician Ira Byock guides the conversation, presenting a most refreshing doctor's perspective. The commentaries of hospice personnel, artist, and members of the Hallowell singing group punctuate the profoundly intimate scenes, filmed in institutional settings and in homes. The singers, who sing to the dying patients, see beyond their own fears; they recognize and want to honor dying persons for who they are: "This is not about singing it right for an audience...its about being totally present for the people you're singing for...and wanting it to be a gift." They model the magic of human connection called by Byock "the ground substance of therapeutics" The healing is mutual: "I can feel sad, cry, I can feel a heavy heart...but it's not depressing....It's a wonder...you can feel love, joy, sorrow, but so alive.... you feel the blessing of your own life."

Two additional segments, "More about Deidre Scherer," and "More about the Hallowell Chorus, and a concise study guide are offered with the DVD.

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This groundbreaking international film documents the positive impact of art and other creative activities on people with Alzheimer's disease. The film's intention is to change the way we look at the disease.  It does just that.  Brilliantly.

Narrated by the actress Olivia de Havilland, the film opens with a 96 year old woman reading classical music as she's playing at the piano. Her music becomes gentle background sound track for the first vignette, a group of people intently viewing and commenting on Seurat's canvas, "Sunday in the Park."  From their intense concentration and voiced observations, one would never believe this was a group of nursing facility residents on an outing to the Chicago Art Museum.

Throughout the film--at the circus, visiting museums, or in painting workshops conducted at day care centers, nursing homes and assisted-living facilities in Europe and the US-- the hopeless, fatalistic, nobody's there stereotypes of Alzheimer's sufferers is unequivocally denied.  We continually witness people with serious memory problems being brought back into active communication and a rich quality of life.  This is more than busywork arts and crafts: trained professionals knowledgeable about both art and Alzheimer's are providing essential treatment "just as effective if not more so than the drugs."  The benefits of the non-pharmacological along with the pharmacological not only extend life, but create a life worthwhile, where people find meaning and connection.
 
In direct interview, voice-overs and interacting with "patients" and their family members, eminent experts from multiple medical fields - neurology, gerontology, psychiatry- punctuate the film reviewing the latest technologies and concurring that the essence of the person lives on. The latest brain research provides evidence that the parts of the brain related to emotions and creativity are largely spared by the disease and that our technologies for assessing dementia --dealing with sequencing things, dates in order, and what one did this morning--rely on short term memory which is totally irrelevant when enjoying a masterpiece or listening to a symphony.  The documentary also includes comments from art therapists, occupational therapists, directors of specialized care facilities, but the film is anything but talking heads.  The cutaways and extensive footage of the care giving staff and specialists interacting emotionally and physically, visibly bonding with the residents and family members is sincere, loving and inspiring professionalism.

The inspiration for the film and project is filmmaker Berna Huebner's mother, Hilda Gorenstein, once an accomplished painter known as Hilgos.  In one of Huebner's visits to the nursing home, she asks "Mom, would you like to paint again?"  Quite unexpected came the reply, "Yes, I remember better when I paint."  Learning this, the staff psychiatrist who had been prescribing small doses of a tranquilizer for her apathy, anxiety and agitation suggested Huebner enlist art students from the Chicago Museum school to help her mother to begin painting again.  We are not spared the slow and sometimes discouraging process as Mrs. Gorenstein comes alive regaining mobility and communication skills and interacting--bonding-- with the art students.  The film is replete with her colorful paintings created in the next few years until her death at age 93.

"The creative arts are a doorway.  Once that doorway is opened ... things are tapped ... that are genuine and active and alive that don't get tapped in our normal day social interactions when we sit at a table and make conversations over a meal or we read a newspaper article and then talk about the headlines of the day.... The creative arts bypass the [cognitive] limitations and simply go to the strengths. People still have imagination in tact all the way to the end of their disease."

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As Audrey Young describes her process of becoming a compassionate internist in a besieged public hospital, she simultaneously argues for turning the hospital's patient care and financial practices into a model for improving health care in America.  Young, a compelling storyteller, first entered Seattle's Harborview Medical Center in 1996 as a third-year medical student on trauma surgery service.  She completed a residency there in general internal medicine and stayed on as an attending for six more years.  She stayed, she tells us, because she met physicians "committed to a vision of equality" who were "the sort of people I hoped to become" (xiii).   She also "fell in love" with "the story of a unique place" (xiii).  Young's stories of that often chaotic place, where ambulances regularly transport homeless, indigent, addicted, and mentally ill refugees from neighboring private hospitals, emphasizes the ways the Harborview staff manages to treat patients with dignity and to choose an ethic of hope in the face of dire circumstances.           

We quickly learn that at Harborview compassion is expressed concretely as actions toward patients.  Michael Copass, known as "the mostly benign dictator of emergency operations," pronounced the core of these actions in what came to be known as his commandments:  "1. Work hard.  2. Be polite.  3. Treat the patient graciously, even if he is not the president of the United States" (9).  Politeness always meant asking "'How may I help you, sir?'" regardless of the patient's social status or addiction history.  Politeness sometimes meant finding a way to reach the patient who regularly threatened the staff.  Young finds ways and creates a therapeutic bond.  But working hard and treating patients considerately also took measurable forms, such as not allowing emergency patients to wait.  Facing a flurry of admissions, the Emergency Department (ED) staff interpreted a young Ethiopian's complaints about pain as a drug addict's ploy.  Because Young glanced at the admissions board and noticed that he remained unattended for three hours--far longer than Copass could tolerate--she jumped into action.  He suffered, she discovered, from a collapsed lung. 

However, Young moves her narrative beyond individual doctor and patient encounters and into the larger, interrelated social and financial structures in which medicine is practiced.  For instance, she links meager funding for drug and alcohol rehabilitation programs with expensive ED admissions and rising healthcare costs.  In the chapter "Bunks for Drunks," Young visits an experimental residence that houses homeless addicts in furnished studios with private baths and cooking appliances.  Although residents can keep alcohol in their rooms and elect not to participate in the home's social services, including counseling, alcohol consumption and ED admissions decrease.  While the chapter points out the cost savings of such arrangements, Young further urges readers to value the dignity residents experience there.

In "Black Friday," Young details the hospital's tense, but ingenious responses to a Mass Casualty Incident, the result of carbon monoxide poisoning, which almost depleted the resources of all of Seattle's medical centers.  The final chapter, "A Vision," outlines how Harborview has tried to succeed as both a charitable institution and a business, as a provider of both indigent and luxury care, with the hope that others will follow the medical center's example.  However, in presenting her recommendations for "health justice," Audrey Young also makes the case that "seemingly ordinary citizens" are implicated in healthcare reform (231).  To enable their informed participation in making changes, Young includes an appendix with further readings and another that lists strategies for effecting reform.  

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Dying for Beginners

Clary, Patrick

Last Updated: Jun-04-2010
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Patrick Clary's Dying for Beginners is a collection of vibrant poems about living (as well as dying); about family, friends, music, loss, war and love. The book's title is evocative of the countercultural insight that dying is an essential part of living.  We only become fully human by coming to grips with our own mortality.  This engagement with mortality emerges from love and humor, as well as from suffering and loss.  Clary's poems speak to what he has discovered about himself, as a beginner to his fellow beginners.

The poet's route to discovery traverses Death Valley, where, during a spiritual retreat and vision quest, he has this epiphany: "Suddenly, I find all my wounds are turning into blessings" (p. 1). This inversion of categories is not an exotic, one-off event, but becomes a new way of looking at the world, a perspective in which life events, carefully observed and described, blossom with deeper meanings that can only be expressed by metaphor or paradox. For example, in "Days I Don't Remember," Clary reflects, "And all my roads are turning into rivers" (p. 27). Or, in "Meditation on the Pays d'Oc," he observes, "Instead of dying, I cough up a butterfly, watch it / dry its wings in the sun..." (p. 74). Or the essential quietism of "That silence moving through our lives was me" (p. 33).

The poet had his first lessons in dying when he worked as a medic during the Vietnam War, In "Orientation at Bien Hoa," he discovers, "Yes, gentlemen / This little war here / Exists only / For one reason: / To give you all the pleasure / You can handle" (p. 10).  He also learns how easy it is to kill with an M 16 rifle, which can "Put eighteen holes in / Whatever you point it at / Inside of two seconds" (p. 11). Meanwhile, the human tragedy of Vietnam takes place all around him.  

Clary reflects on the limits of his calling in "Three Variations", where he observes his own hands, "professionally / Tender on demand, but still uneasy / At your easy tenderness" (p. 35). The words "professionally tender on demand" evoke his work in palliative medicine, although the same words could-and should-apply to medical practice in general.  But Clary recognizes that the human capacity for compassion is not inexhaustible. There will always be a tension between the work that needs to be done ("another pair of hands in the emergency room," p. 63) and our limited reserves of kindness and empathy.

The book ends with a humorous and moving short prose narrative ("Origins of the Earwax Patrol," pp. 83-86) about caring for terminally ill patients.

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Annotated by:
Henderson, Schuyler

Primary Category: Performing Arts / Theater

Genre: Theater

Summary:

This annotation is based upon the version presented at The Mint Theatre in New York City in 2010, translated and directed by Gus Kaikkonnen.  It featured Thomas M. Hammond as Dr Knock and Patrick Husted as Dr Parpalaid, with Chris Mixon, Scott Barrow, and Patti Perkins in supporting roles.

A middle-aged but recently licensed physician, one Dr Knock, has arrived in rural France to take over a practice purchased from the genial old country doctor, Dr Paraplaid.  Much to Dr Knock's surprise, he discovers that Dr Paraplaid has done very little over the past three decades, seeing only a few patients a week and enjoying much of the time playing pool, riding around in his jalopy, and admiring the countryside.  Feeling slightly cheated, Dr Knock realizes that the practice he has purchased at some expense amounts to very little at all. He is, however, an ambitious man.  He did not become a licensed physician in the eager flush of late adolescence but as a man of the world, or rather, a man of the entreprenurial modern world where opportunities are seized and technology is transformative.  

Once Dr Paraplaid has gone, Dr Knock promptly sets about employing the town crier to advertise his practice so that the entire valley knows he is there.  He meets up with the local school teacher and the pharmacist, enlisting them as allies.  With everybody he encounters, he smilingly and then sharply insists that unlike Dr Paraplaid, he will not go by "Monsieur" but by "Doctor".  And when he actually opens the office, he begins by offering free consultations.  Of course, he always seems to find something wrong, elaborately explaining the aches, pains, and illnesses he discovers (or induces), but the free consultations, like free "samples" are designed to create grateful customers.  Invariably, they learn that the cost of the treatment is commensurate with the exact maximum amount they could pay.  And thus, Dr Knock takes a placid, lazy practice and builds up an expanding medical business. 

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