Showing 91 - 100 of 251 annotations tagged with the keyword "Medical Education"

Cutting for Stone

Verghese, Abraham

Last Updated: Mar-08-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

View full annotation

Summary:

This survey of the history of women in medicine begins in the mid 19th century and moves forward to the late 20th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

View full annotation

Beat the Reaper

Bazell, Josh

Last Updated: Jan-26-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Pietro Brnwa, nicknamed "The Bearclaw," has embraced change - a new name, a different occupation, and a regenerated outlook. Thanks to the Federal Witness Protection Program, Pietro, who was formerly employed as a hitman by a mafia-connected lawyer, is now Dr. Peter Brown, an intern in the Department of Internal Medicine at Manhattan Catholic Hospital. His career as an assassin was motivated by the desire to avenge the murder of the grandparents who raised him. As a physician, Dr. Brown is paying off a moral debt - doing good deeds to atone for previous acts of violence including killing people.

Unfortunately, life doesn't get any easier for the hit man-turned-physician. Trouble stalks him and finds him. Everyone he loves is lost. In addition to the death of his grandparents, Dr. Brown's girlfriend, Magdalene, is gunned down in a car. His former best friend, "Skinflick" is thrown out of a window of a six-story building, survives, and is later stabbed to death by Dr. Brown.

Life might have been easier if Dr. Brown had not been recognized by a mafia acquaintance named Nicholas LoBrutto who is a patient in Manhattan Catholic Hospital. LoBrutto has stomach cancer and threatens to squeal to Dr. Brown's former crime boss. If Dr. Brown cannot keep LoBrutto alive, the mafia will be notified where to find the physician and he will be eliminated. Dr. Brown assists during LoBrutto's surgery but the mobster experiences ventricular fibrillation postoperatively. Dr. Brown's two medical students mistakenly administer intravenous potassium and LoBrutto dies.

A group of thugs quickly infiltrate the hospital and it appears likely that Dr. Brown will be exterminated. He risks his life to prevent a young woman from having her leg amputated for an erroneous diagnosis. The thugs capture Dr. Brown and detain him in the blood bank freezer. He removes a piece of bone from his own lower leg (an autofibulectomy) to use as a weapon and proceeds to kill the entire gang of murderers. Dr. Brown is sure to be dismissed from Manhattan Catholic Hospital but realizes there is still much he hopes to accomplish as a physician. With some help from friends in the Witness Protection Program (and a likely sequel to this novel on the horizon), it's a good bet that Dr. Brown is not likely to retire his stethoscope (or firearms) anytime soon.

View full annotation

Summary:

The film opens with the discovery of Dr. Victor Frankenstein's will in his Transylvanian village. A skeleton, presumably Dr. Frankenstein's, and a man wrestle for the box holding the will. The man wins, takes it to a town meeting where the will is read and calls for the transfer of the property to the dead scientist's grandson, Frederick. Following this scene we meet the grandson, Dr. Frederick Frankenstein (Gene Wilder), a surgeon who is busy instructing medical students in clinical neuroanatomy (comparing the brain to a cauliflower). When asked about his grandfather by a medical student, Freddy, who pronounces the family name "Fron kon steen", declares that Victor was "a cuckoo". The student is relentless in pursuing the family ties, exasperating Freddy, who finally plunges a scalpel into his thigh, a sight gag paying homage to Peter Sellers' stabbing himself with a letter opener in A Shot in the Dark (1964). When the courier from Transylvania arrives, he persuades Freddy to return to his ancestral castle for the execution of the will. A hilarious railroad platform scene in which Freddy bids goodbye to his "beautiful, flat-chested" (as described in the online original etext of the script by Gene Wilder) fiancée, Elizabeth (Madeline Kahn), only highlights the incredibly neurotic natures of the two lovers -- Wilder as a possessed but wacky scientist and Kahn as a narcissistic and apparently remote and shallow woman.

In Transylvania, Freddy and the viewers meet the remainder of the major characters. Inga (Teri Garr), a bosomy and mindless but beautiful and dedicated blonde, escorts him to the castle, where he meets the hunchback Igor, played by the incomparable Marty Feldman, who instructs Freddy, with one of the lines all Young Frankenstein addicts love to quote, to "walk this way", by which he means with a limp and a cane, not directions to anywhere at all. After remarking that the huge castle doors have huge knockers (which they do) -- which Teri Garr winsomely mistakes for a compliment on her equally huge knockers -- Freddy and his entourage enter the castle and meet Frau Blücher (played magnificently by Cloris Leachman), the spinster who keeps the castle, nourishing an undying flame for Freddy's dead grandfather. Soon Freddy and Inga discover, by means of a secret passageway behind a  -- surprise! surprise! -- revolving bookcase wall in Freddy's room, his grandfather's hidden subterranean laboratory (Brooks used the same electrical apparatus as the 1931 Frankenstein film) and scientific journals. With the materials and methods now at hand, Freddy undergoes a spiritual transformation, embracing his forebear's obsession with creating life from dead bodies, rejecting his earlier rejection of Victor's work as "Doo-Doo!".

At this juncture we move into the scientific creation mode and of course meet the Monster, exuberantly portrayed by the talented Peter Boyle. When Igor tries to steal a brain from a neighboring morgue there occurs the infamous mix-up of an "Abnormal" brain (labelled "DO NOT USE THIS BRAIN!") for the intended brain of H. Delbrück ("the finest natural philosopher, internal medicine diagnostician and chemical therapist of this century" and also the author of 17 cookbooks) making at least this viewer wonder if Mel Brooks had in mind a real scientific genius, Max Delbrück, who had received, only 5 years before, a Nobel Prize in Physiology or Medicine in 1969 for his work on bacteriophages.

The predicted spoofs ensue: the actual process of transforming the very large corpse of Peter Boyle into the very large body of the living Monster (with Inga remarking, after Freddy states that for the experiment to be a success, the monster must have enlarged body parts, that he "vould have an enormous schwanzstucker" -- a pseudo-German/Yiddish word that everyone in the audience immediately comprehends); the inclusion of Gene Wilder's rendition of the legendary exclamation, "It's alive!" by Colin Clive in the 1931 Frankenstein; the monster's mercurial disposition; the wildly comic scene with the Monster meeting the Blind Man (Gene Hackman); the Monster's fascination with music and antipathy to fire -- they all give rise to set pieces of Brooks's unique mix of lowbrow comedy with intellectual puns, Yiddish asides and the ubiquitous combination of visual and physical jokes.

After Elizabeth unexpectedly arrives in Transylvania we witness an apparently unlikely, and therefore uproariously believable, liaison with the Monster outside the castle, with Madeline Kahn eventually taking on the classic Marge Simpson type hairdo of Elsa Lanchester in the 1935 Bride of Frankenstein. The last important scene before the ending involves Freddy nostalgically summoning the Monster back to his natal castle for a transference of Freddy's calm brain to the Monster's. The ending, with the Monster a fully acculturated and now sophisticated man about town, and with Freddy and Inga still in love in Transylvania, is a brilliant win-win result for Freddy, Inga, Elizabeth and the Monster, although hardly predictable. Without giving away too much of the denouement, suffice it to say that the movie ends on a high note transforming, as it were, a linguistic pun into a musical one.

View full annotation

Something for the Pain

Austin, Paul

Last Updated: Sep-29-2008
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

After several years as a firefighter, Paul Austin decided to return to school and become a doctor.  Both his training as firefighter and a somewhat late start at medical school gave him an unusual perspective on his selected specialty-emergency medicine.  The book chronicles a wide variety of surprises, learning moments, and challenges from his years in the emergency room.  These are interspersed with vignettes about the interrupted home life of an emergency physician rotating into night duty three to four times a month.  The pace is lively and the stories confessional in the best sense-rich with reflection on what he has learned, often at great cost to his resilient wife and three children, one with Down syndrome.  A strong theme in the book is the importance of developing strategies for sustaining humanity and compassion even under intense pressure to be quick, clinical, and detached. 

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

In the prologue to "The Anatomist" author Bill Hayes explains why he undertook the task of writing a biography of the author of the famous illustrated textbook "Gray's Anatomy." The reasons stem from his childhood and are multifold: an early interest in becoming a doctor, a fascination with religious (particularly Catholic) and artistic perspectives of the body coupled with an acceptance of his own homosexuality, a growing admiration for the writing and drawing in his bargain table copy of "Gray's Anatomy," and finally an attraction to a photograph of the enigmatic author in his anatomy lab - one of the few traceable artifacts of the man himself. Hence "The Anatomist" is not only a meticulous and fascinating biography of Henry Gray, the writer, and Henry V. Carter, the illustrator of "Gray's Anatomy," but also a memoir of the education and life of Bill Hayes himself during the period of research and writing this book. The book is a masterful mix of the history of medicine, anatomy education both current and historic, methodology of historical research, and poignant, insightful commentary on the frailties of human bodies and human relationships.

Hayes took three anatomy courses at University of California, San Francisco during the preparation of the book - one with pharmacy students, one with physical therapy students, and the final one with medical students. By the third course, Hayes was a pro at dissection and had first hand knowledge and appreciation of the skills needed to be an anatomist.

Because of the paucity of information available on Henry Gray, the bulk of the research rests on the diaries and letters of the tireless, self-critical and amazingly skilled younger member of the book's creative team - the artist-physician Henry Carter. Through Carter's diaries we learn of the formidable genius of Gray, his academic accomplishments, the genesis of the idea for the book, and Gray's early death at age 34.

Interestingly, in a pattern similar to that of Andreas Vesalius's "De Humani Corporis Fabrica," whose illustrator was most likely Jan Stephen van Calcar, the artist Carter receives scant reward or acknowledgement of his vast contributions to the book. Hayes's biography rectifies this hundred-and-fifty-year-old omission by tracking not only the career of Gray, but also Carter. Indeed, peppered throughout "The Anatomist" are more illustrations than quotes from "Gray's Anatomy."

View full annotation

Summary:

Body of Work is a cleverly crafted memoir - or, rather, the first chapter of a memoir - of the author's medical school experience at Brown University School of Medicine in Providence, Rhode Island. Ms Montross relates the chronological course of her team's dissection of a female cadaver with no discernible umbilicus and whom they therefore name Eve. (She neglects to comment on Eve's ribs and whether she has the normal complement or a supernumerary, more masculine, rib.) As she and her team of four (later three as one student drops out of school) proceed with the orderly dismantling of Eve, bone by bone, nerve by nerve and blood vessel by blood vessel, she uses this experience as a springboard to analyze her and her team's emotional reactions to the often unnatural process of deconstructing, literally (at times with a saw), a former person now cadaver, as well as the gradual, almost imperceptible acculturation that transmogrifies medical students into doctors. In fact, she devotes the final pages to this metamorphosis and what it means to the person undergoing the transition from caring student to detached physician, and whether one can retain enough caring, while remaining sufficiently detached to function as one must as a clinician, to become both a whole person and competent physician: "How much of becoming a doctor demands releasing the well-known and well-loved parts of my self?" (page 209)

Although it primarily revolves about the axis of her gross anatomy (cadaver dissection) course, the author's narrative includes tangents that have variably relevant relationships to this course, e.g., a trip to Italy to inspect first hand the anatomy theater of Vesalius in Padua and the Basilica of St. Anthony; another trip to the anatomical wax sculptures museum in Bologna, where the author also observes the "incorrupt corpse of Santa Caterina" in a "small church called Corpus Domini" (pages 223-224); interspersed histories of the traffic of corpses for dissection, including the infamous Burke and Hare story; some flash-forwards to her second and third years; and a prolonged narration of the final illnesses of her grandmother and grandfather. This last bit of family history is worth the price of the book alone. Despite the apparently incongruous collection of such asides, the author makes it work smoothly, if not seamlessly.

View full annotation

Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sandeep Jauhar, M.D., Ph.D. is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York. Thus, one can assume that he is an accomplished cardiologist and administrator. It was not always so. This memoir flashes back to 10-15 years earlier when the author was casting about for a career, finally settling on medicine almost by default; it follows him to medical school (at Washington University in St. Louis) and then centers on his first year of residency training at Cornell's New York Hospital in Manhattan -- the internship year.

We learn in the introduction to the book that the author will speak freely of self-doubt about career choice, constant anxiety and feelings of inadequacy, exhaustion, and disillusionment. Which indeed he does. But Jauhar first discusses his family background: born in India and emigrating with his family to the USA at age 8; father holding a Ph.D. in plant genetics, now writing academic textbooks and still regretting that he had not been able to afford his dream of becoming a doctor; mother helping to support the family as a lab technician; older brother, Rajiv, a mentor and competitor, charming, self-assured, and unquestioningly headed for a medical career; sister, Suneeta. Sandeep (the author) undertakes graduate work in theoretical physics but as he nears completion of his doctoral degree, realizes that he probably does not have what it takes to be successful in the field. When his girlfriend, Lisa, becomes seriously ill, he begins to (re)consider medicine as a career. Against the advice of his parents who are now convinced he is a dilettante, he applies to medical school and is accepted.

Disillusionment began during the first two years of medical school: "In graduate school I had never learned to memorize . . . But now I couldn't rely on logic and reasoning; I had to commit huge swaths of material to memory" (32). He considered quitting to become a journalist, a profession that had always intrigued him, but which had been discouraged: "my father made it clear that journalism and writing were never to be considered career options because they offered no security" (33). Yet, amazingly, he was awarded a summer fellowship just before starting medical school that placed him in the Washington, DC office of Time magazine; the contacts he made then allowed him to work as a student reporter for the St. Louis Post-Dispatch during medical school and led ultimately to his ongoing and current position as a contributing medical essayist for the New York Times.

Internship for Jauhar unfolds as a series of anxiety-provoking encounters with patients and humiliating encounters with his physician superiors. Feeling inept and inadequate, he stumbles along and worries that he is harming patients. There is too much to keep track of, too many "little things that I find burdensome" (91). "Having so much to do was bad enough, but not knowing why you were doing what you were doing was terrifying . . . Patients were needy, their demands overwhelming . . . Everyone seemed to know how the place worked except me . . . The ecology on the wards was hostile; interactions were hard-bitten, fast paced" (112-113). He is in constant doubt and conflict about his career choice. Even his private life is affected -- his girlfriend Sonia, still a medical student, comes from a medical family, is strongly motivated and secure in her career choice, which aggravates his own sense of insecurity. (Reader, he married her.)

Midway through internship Jauhar suffers a herniated disk. He tries to tough it out without taking time off but his stint as "night float" at Memorial Sloan-Kettering hospital, which specializes in treating cancer patients, proves too difficult-- up all night trying to tend to the severely ill and "taking care of patients about whom you knew next to nothing" (154). He takes a brief leave followed by a reduced schedule. He recognizes that his problems are emotional as well as physical -- he is depressed. But gradually, as his neck problem improves, as he recognizes that medical professionals are actually able to help patients feel better -- his neurologist and physical therapist had "provided hope and comfort to me at a vulnerable time" (181)--, as he makes a house call to a dying patient, as his essays are published in the New York Times, and as the season moves to Spring, his depression lifts and he looks forward to his work.

View full annotation

Summary:

Two hospice nurses describe their work with dying patients, especially with the special forms of communication typical of dying patients. The authors define "Nearing Death Awareness" as patients' knowledge and expression about their own dying. What doctors and family members may assume is the patient "losing it" or "hallucinating" actually is often a kind of symbolic communication dying patients typically use, either to describe their dying experiences or to request something they need for a peaceful death (such as seeing a loved one). By dismissing the patient as "confused," caregivers miss the opportunity to help the patient and may also alienate and frustrate both patient and family. By being aware of what is going on, caregivers can be more responsive and comforting to the patient and the family.

View full annotation

Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

View full annotation