Showing 91 - 100 of 565 annotations tagged with the keyword "Physician Experience"
Jerome Lowenstein is a nephrologist, author, and founder of the Bellevue Literary Press and the Humanistic Aspects of Medicine Education seminar program at the NYU School of Medicine. In this thoughtful and illuminating book of essays he explores the patient/physician relationship in a world where medicine has embraced technology and scientific advances in the laboratory at the risk of neglecting the humanistic underpinnings of the field.
Dr. Lowenstein graduated from medical school at NYU in the late 1950s and spent nearly his entire professional career at NYU Medical Center and Bellevue Hospital. When he was a resident, long before work hour limits were instituted, the house staff gathered in the cafeteria at midnight to dine on the days’ leftovers. This communal meal “provided a fine opportunity to communicate with colleagues directly, rather than by beeper and phone, about many of the days ‘medical leftovers,’ ” (1) sharing information as well as the frustrations and rewards of caring for patients. “The Midnight Meal” poses the challenge of retaining the core of relationships, both between patient and physician and among colleagues in the rapidly changing world of medicine today.
In the essay, “Can You Teach Compassion,” Dr. Lowenstein tells his readers about the student who responded to the question with “I don’t know if you can teach compassion, but you surely can teach the opposite.” (13) The student was referring to how students become “desensitized” during their clinical years to the suffering of their patients, sometimes to the point of using derogatory terms to describe them. Dr. Lowenstein argues that teaching attendings can and should encourage students to learn about their patients. He writes how he once interrupted an intern who began to present a case by stating: “This is the first hospital admission of this thirty-five year old IVDA.” Dr. Lowenstein asks: “Would our thinking or care be different if you began your history by telling us that this is a thirty-five-year-old Marine veteran who has been addicted to drugs since he served with valor, in Vietnam?” (17) Learning about the lives of their patients, Lowenstein emphasizes, does not detract from the clinical picture, but rather enhances it.
Summary:In this collection of "clinical tales," to use Oliver Sacks' term, Sue Hall, an experienced neonatologist who spent some years as a social worker before medical school, tells a remarkable range of stories about newborns in the NICU and their parents. As memoir, the stories record moments in a life full of other people's traumas, disappointments, anxieties, and hard-won triumphs where her job has been to hold steady, find a balance point between professionalism and empathy as young parents go through one of the hardest kinds of loss. Each story is told with clarity and grace, sketching the characters deftly and offering useful medical information along the way on the assumption that many who read the book will do so because they are facing similar challenges and decisions. Each story is followed by a two- to three-page "Note" giving more precise medical background and offering further resources for those who have particular interest in the kind of case it was.
Summary:Parts of medical history read like detective novels. The discovery of the source of cholera by Dr. John Snow in London in 1854 is one of those episodes. The Ghost Map tells the story of Snow's pioneering work in what have now become standard epidemiological methods. Tracing a cholera outbreak to a local pump in a poor section of London involved many door-to-door visits working with people who weren't always cooperative, incurring the suspicion and/or ridicule of both them and the medical professionals with whom he worked. In the course of the story the author offers reflections on the organization of cities and on public hygiene. Snow, an out-of-the-box thinker, also helped develop surgical anesthesia.
Summary:Open Wound is a novel crafted from the extensive documents of an unsettling, little-known, yet remarkable episode in the history of medicine.
A collection of poetry written by a family doctor who practices in New Zealand. They are grouped around themes: patients (20 poems), diseases (10 poems), spells (9 poems), a doctor (9 poems), and end with “Playing God,” which is a collection in 10 parts about clinical practice.
Miracles and wonders are found in the physiological workings of the body. Myths and spells are identified in the rituals of practice guidelines.
The poet loves medicine even as he realizes some of the unpleasant challenges and distortions it brings to his life and behavior.
Summary:Mary Sutter has been trained as a midwife by her widowed mother, and has demonstrated an unusual aptitude. She is an eager learner, but her deepest desire is to be a surgeon. No medical school will take her, however. As reports reach her home town of Albany of the escalation toward civil war around Washington DC, and in the wake of a disappointment in love, she decides to board a train and offer her services to Dorothea Dix as a nurse. Though Miss Dix refuses her on the grounds of her youth, Mary finds her way into apprenticeship with a surgeon who, as the numbers of injured climb, needs all the hands he can get. Slowly and grudgingly, he comes to accept her as a competent assistant and, eventually, to teach her as a respected apprentice, and the remarkable companion she has become to him. She learns surgery in the most grueling circumstances possible, amputating shattered limbs of young men, many of whom die anyway of infection or water-borne diseases. In the course of her sojourn in Washington she meets John Hay and, through him, President Lincoln, whose compassionate attention she manages to direct to the dire need for medical supplies. Two men love her not only for her intelligence and courage, but for the passion she brings to the hard-won skill that, though it cannot save her brother from the respiratory illness that is rampant in the camps, or her sister from a disastrous childbirth, saves many lives and makes a wider way for women of her generation who find themselves called to medicine.
Summary:A Natural History of the Dead is a story in The Complete Short Stories of Ernest Hemingway. It is divided, by subject and style, into two parts, the first part of which reads like non-fiction and the second a short story, or the nidus of one.
In 1964, newly minted doctor, Barry Laverty, begins practice as the young assistant of crusty, seasoned, Dr. Fingal O’Reilly, in the small, Northern Irish village of Ballybucklebo. At first he thinks his new boss is fierce and unprofessional. But soon, Barry uncovers the sadness in the older doctor’s past and realizes that O’Reilly has excellent, clinical acumen. If he bends the rules, it is usually for the best.
Over the course of a month they face the ordinary struggles of general practice with Barry slowly learning the ropes: appendicitis in a child, a rushed delivery, pneumonia combined with heart failure, hypothyroidism, unwanted pregnancy, and stroke. And of course, the more minor staples of headache, cuts, and scrapes.
Not everything turns out well. Barry misses a diagnosis and cannot stop blaming himself, but his admission of the error to the patient’s wife is an important step in his education. The patients, however, leave the practice.
Social factors such as poverty, discrimination, and corruption of local officials pervade each vignette.
Barry also meets the beautiful Patricia—a survivor of polio—whose desire to pursue a career in civil engineering seems to pose an obstacle until all is happily resolved in the end.
Zol Szabo, is public health doctor for the Hamilton Ontario region. He is also a single parent to nine year-old, Max, because his wife could not deal with Max’s mild physical disability. He is dating Colleen an attractive woman detective whom he met in the previous novel. The story opens with Zol’s angst over his son’s expensive misuse of a cell phone that he’d been given for safety reasons.
Soon he and his team are investigating cases of diarrhea in a seniors’ residence. The diagnosis is difficult—but the doctors are confident they know what it is; however, the recommended treatments prove ineffective. Gradually they begin to suspect that the drugs are not working because they might be fake. Even worse, they notice that the people infected are all taking the same arthritis medicine—could that drug be the source of the infection?
In the background an unbending hospital administration and a hostile boss make the situation even worse.
A team of elderly friends who reside in the senior’s home collaborate to help solve the mystery. And of course the son’s cell phone is crucial to the dramatic conclusion.
This is a huge and wonderful book about cancer, the collection of diseases that sickens people all over the globe and kills many of them. An epigraph to the book states, “A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer,” but the book also describes medical advances that now heal, prevent, or palliate most forms of cancer.
Mukherjee, a cancer physician and researcher, has several strong themes. He sees cancer as an affliction with a long history, a story worthy of a biography; indeed recent discoveries show it to be rooted in our genes (although external factors such as viruses, asbestos, and tobacco smoke can cause genetic disruption). The story of cancer implies a surrounding triangle, the stories of sick people, treating physicians, and biological researchers, all of which Mukherjee artfully weaves across 472 pages. Cancer has Rohrschach blot qualities: depending on time, place, and role in life, humans have perceived different attributes of cancer. As the book ends, however, there is a coalescence of scientific understanding that is satisfying—although there is certainly more to be learned and we are all still vulnerable to genetic errors and, of course, we are intractably mortal.
Another strand is the nature of stories themselves, their twists and turns, presumed early solutions, and personal and social values embedded in them. Mukherjee threads throughout the book the case of a contemporary kindergarten teacher, Carla Reed, who has a leukemia. He bookends his text with ancient Persian Queen Atossa with (presumably) breast cancer. Reed, healed by the end of the book, was Mukherjee’s patient; Atossa was described by Herodotus: both suffered emotional turmoil because of their disease. Mukherjee understands the affective dimensions of disease for patients and caregivers alike; literature represents these in various ways, and he quotes in his chapter epigraphs and in his prose many writers who describe human experience deeply: Aleksandr Solzhenitsyn, Susan Sontag, Charles Dickens, Thomas Mann, William Carlos Williams, Carlo Levi, and Italo Calvino, to name a few.
The primary story, however, is the interplay of cancer and a large cast of observers, investigators, doctors, scientists, activists, and government officials. Sidney Farber and Mary Lasker dominate the first 100 pages with their two-decade war against cancer. While surgery—historically dramatic and disfiguring—had been a mainstay for treatment of cancer, Farber pursued a biochemical route, which elaborated into chemotherapy, the second major approach of the late 20th century.
Mukherjee also explains ancient views, Hippocrates’, Galen’s humors, Vasealius’ anatomy, Hunter’s stages, Lister’s antisepsis, and Röntgen’s X-rays, which became the third major approach. By 1980, however, the American “War on Cancer” had not been won.
Further advances in cellular biology and genetics would be needed to make targeted molecular therapy possible. Mukherjee tells this complicated story clearly and engagingly, showing the human investigators to be personable and dogged in their pursuits.
Another important approach is prevention. The biostatistical work of Doll and Hill, for example, showed the links between tobacco and lung cancer. Screening, such as Pap smears and mammograms, also saved lives, but the basic cellular understanding still eluded investigators.
The final 150 pages explain the search for and discovery of genetic factors, specifically oncogenes. Harold Varmus and J. Michael Bishop were the leaders, winning a Nobel Prize in 1989. Bert Vogelstein, Judah Folkman, Robert Weinberg and Douglas Hanahan took the work further, opening the doors for such drugs as Herceptin, Gleevec, and Avastin.