Showing 91 - 100 of 108 annotations tagged with the keyword "Physical Examination"

Blood Pressure

Gilbert, Sandra

Last Updated: Feb-12-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The scene is a medical office where "a white sleeved woman wraps a rubber / sleeve around your arm, steps back, listens, / whistles." Wow! The pressure must be amazingly high. The author imagines the blood pressure's power--"a tide of electrons," a "lightning snake, a "black rain." The patient sits on the cold table. How vibrant his interior chaos is compared to his quiet external appearance! He says the ordinary things--he'll lose weight, he won't complain--but behind his eyes is a flash of turbulence. [30 lines]

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Taking the History

Watts, H. David

Last Updated: Jun-19-2000
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In the first poem, Starting the I.V. (see this database) the poet tells us that he will approach the secrets of the body without flinching, "I have learned not to hesitate here, / not to let fears of my own" get in the way. The instrument he uses is the poem. Through these poems he reveals some of the hidden truth of the healing relationship. "A transformation," he calls it, "as if through this intimacy / we have become part / of each other." ("Physical Exam")

Watts captures the pain and horror of illness in striking images. For example, the numbness felt by a person suffering from multiple sclerosis "felt like oatmeal / drying on the skin" and the disease itself was "this moth of his nightmare / . . . eating at the wool / of his nerve endings." ("ms") In another poem ("restrictive") a patient's tortured breath "creaks like a tight box / a ship in a storm." Among the most remarkable of these 35 poems are "The Body of My Brother," "July 16th," "Chronic Pain Syndrome," and the exquisite prose-poem, "The Girl in the Painting by Vermeer."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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Summary:

This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the Fran├žois Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

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Death in the Seine

Greenaway, Peter

Last Updated: Feb-04-2000
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Between April 1795 and September 1801, 306 bodies were pulled from the river Seine in Paris. A register of these deaths, indicating, sex, age, hair colour, wounds (if any) and a description of clothing (if any) was kept by two mortuary clerks, Citizen Bouille and Citizen Daude. If witnesses came forward in the days that followed, the names, occupations of the "silent guests" and the witnesses would be added together with the circumstances of the deaths. In most cases the cause of violent death was unknown, or unrecorded--be it "accident, misadventure, suicide, or murder." Bouille and Daude would not speculate.

This artistic documentary uses a male narrator and an eloquent text to present 23 out of the 306 cases: traveling clerks, hearty horsemen, children, mothers, mistresses, aged widows, and a laundress with her little daughter drowned together. These people had lived through the Revolution, the Terror and the early Consultate and it seems reasonable to wonder if the political circumstances they had experienced were somehow connected to their demise. On the other hand, the occupations--tobacco-pouch maker, carter, delivery clerk--invoke the continuity of daily life in the great city despite the political turmoil.

Each case is presented with the site and details of the discovery of the body, followed by a description of the external anatomy as the camera moves slowly and clinically upward over the naked corpse from the feet to head. The shadowy antics of the crude yet sympathetic bureaucrats Bouille and Daude appear throughout, as they retrieve bodies, wash them, label them, and arrange for the witnesses to view them with enforced respect. But we know less about Bouille and Daude than we do about their "guests."

The narrator reminds us how memory rarely survives more than three generations. Who will remember us, he asks, or these actors who lay very still? And as the register ends, the Revolutionary calendar that governed it ended too. These people who no longer exist could be said to have lived in a time that also no longer exists, because it is no longer measured.

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Sugar

Huyler, Frank

Last Updated: Dec-21-1999
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A two-year-old girl is brought to the Emergency Room. Her father believes there's nothing wrong with her, but the mother says that earlier the child had looked "blank," and is sure there's a problem. The physician tries to work out what might be wrong.

The child seems fine, but he automatically looks for signs of abuse, and the triage nurse suggests the parents, who are African-American and on Medicaid, are there because they want "something for free" (127). There are other patients waiting, the child's vital signs are fine, the father wants to leave.

As the doctor is leaving the examining room, he asks whether she might have taken someone's medication, and the mother mentions that the child's grandmother takes "sugar pills," hypoglycemics. They test the child's blood sugar and it is dangerously low. She is admitted to the hospital.

The physician tells the mother she has saved her child's life, and then considers how lucky they had all been--"I felt sick, cold, and damp, terrified by what I had almost missed" (131). He says that since then, he often thinks of the child, "alive in the world, going out into it, . . . decade after decade ahead."

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Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Anthology (Poems)

Summary:

Editors Angela Belli, professor of English at St. John’s University in New York, and Jack Coulehan, physician-poet and director of the Institute for Medicine in Contemporary Society at the State University of New York at Stony Brook, have selected 100 poems by 32 contemporary physician-poets for this succinct yet meaty anthology. The book is subdivided into four sections, each of which is prefaced by an informative description and highlights of the poems to follow.

Section headings take their names from excerpts of the poems contained therein. There are poems that describe individuals--patients, family members ("from patient one to next"), poems that consider the interface between personal and professional life ("a different picture of me"), poems that "celebrate the learning process" ("in ways that help them see"), and poems in which the poet’s medical training is brought to bear on larger societal issues ("this was the music of our lives").

Several of the poems have been annotated in this database: Abse’s Pathology of Colours (9); Campo’s Towards Curing AIDS (13) and What the Body Told (94); Coulehan’s Anatomy Lesson (97), I’m Gonna Slap Those Doctors (21), The Dynamizer and the Oscilloclast: in memory of Albert Abrams, an American quack (129); Moolten’s Motorcycle Ward (105); Mukand’s Lullaby (33); Stone’s Talking to the Family (79) and Gaudeamus Igitur (109).

Other wonderful poems by these authors are also included in the anthology, e.g. Her Final Show by Rafael Campo, in which the physician tends to a dying drag queen, finally "pronouncing her to no applause" (11); "Lovesickness: a Medieval Text" by Jack Coulehan, wherein the ultimate prescription for this malady is to "prescribe sexual relations, / following which a cure will usually occur" (131); "Madame Butterfly" by David N. Moolten, in which the passengers in a trolley car are jolted out of their cocoons by a deranged screaming woman (142).

Space prohibits descriptions of all 100 poems, but each should be read and savored. Some others are particularly memorable. "Carmelita" by D. A. Feinfeld tells of the physician’s encounter with a feisty tattooed prisoner, who ends up with "a six-inch steel shank" through his chest as the physician labors futiley to save him (23). In "Candor" physician-poet John Graham-Pole struggles with having to tell an eight-year old that he will die from cancer (27). Audrey Shafer writes of a Monday Morning when she makes the transition from the "just-awakened warmth" of her naked little son to tend to the patient whom she will anesthetize "naked under hospital issue / ready to sleep" (72).

In "The Log of Pi" Marc J. Straus muses about being asked "the question / I never knew" that he "pretend[s] not to hear" whose "answer floats on angel’s lips / and is whispered in our ear just once" (113). Richard Donze wants to know why "Vermont Has a Suicide Rate" (132). Vernon Rowe remembers the "hulk of a man" who shriveled away from an abdominal wound and begged, " ’Let me go, Doc,’ / and I did" (44).

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The Interior Castle

Stafford, Jean

Last Updated: Aug-18-1999
Annotated by:
Aull, Felice
Chen, Irene

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A victim of a car accident suffers severe cranial fractures and facial disfigurement. Assuming a passive-aggressive stance toward the medical staff, and carrying on a sarcastic inner dialogue with her surgeon, she creates her own world, to escape and combat the pain. She becomes infatuated with the mystery and power of her own brain.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

To escape accusations of plagiarism, Swedish neurosurgeon Stig Helmer (Ernst Hugo Jaregard) has come to work at The Kingdom, a large Copenhagen hospital. He is a surgical butcher with lamentable bedside manners and utter contempt for Denmark, but he resembles his colleagues in his medical positivism and abhorrence of spiritualism. His inadequacies are easily perceived by the hospital staff and resident Dr. Hook (Soren Pilmark), but his fellow consultants celebrate his arrival and make him a member of their lodge.

The malingering spiritualist Mrs. Drusse (Kirsten Rolffes), admitted for a variety of fictitious ailments, discovers The Kingdom is haunted by a little girl murdered there a century ago by her scientist stepfather. Drusse engages the help of her son, who is an orderly, to trace the child's secret.

Tangents to the main plot involve a pathologist, who is so obsessed with obtaining research tissue that he has a cancerous liver transplanted into himself, and the psychopathic medical student son of the hospital director, whose sick sense of humor leads him to mutilate corpses in the hospital morgue. The ending is pure horror.

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Summary:

As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.

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