Syllabi: Literature and Medical Interventions

INSTITUTION: Stanford University School of Medicine

COURSE DIRECTOR: Audrey Shafer, M.D. (email: ashafer@stanford.edu)

INSTRUCTORS: Juliana Barr, MD (email: barrj@leland)

ENROLLMENT: Undergraduate 2nd year students; elective

SEMESTER: Fall 2000

Thursdays, 12:30p to 1:30 p.m.

COURSE OBJECTIVES:

We will read and discuss literature (selected poems, stories, and essays) related to the practice of modern medicine and its effect on patients and physicians. We will focus on three areas of medicine: surgery, anesthesia, and critical care. Class time will also be used for observation in the operating rooms and intensive care unit at the Veterans Affairs Palo Also Health Care System (VAPAHCS). By seeing firsthand the interface between people and medical technology, we can begin to understand how technology affects moral choices in modern health care. Readings include works by Plath, Selzer, and Harper.

COURSE OUTLINE:

Sept 28      classroom, introduction     Audrey Shafer and Juli Barr reading:

• Unknown artist. Leg Amputation. In Sherwin B. Nuland, Medicine: The

  Art of Healing. New York: Macmillan Pub. Co., 1992, date mid-18th c.

  Painting

• Hinckley, Robert C. First Operation Under Ether. As above. 1881-94,

  of event on October 16, 1846. Painting

• Eakins, Thomas. The Gross Clinic. As above. 1875. Painting

• Seligmann, Adelbert. Theodor Billroth Operating. As above. 1890.

  Painting

• Stone, John. Wearing of the Green. In In the Country of Hearts. New

  York: Delacorte Press, 1990, pp. 203-11. Essay

• Shafer, A. The Anesthesiologist and the Arts: Anesthesia for

  Amputation. California Society of Anesthesiologists Bulletin 47(4):

  52-7, 1998 (includes poem, McGonigle's Foot by Jack Coulehan)

Oct 5      OR (operating room)             Audrey Shafer (meet in her office)

Oct 12      classroom: Focus on surgery      Audrey Shafer reading:

• Selzer, Richard. The Exact Location of the Soul. In Mortal Lessons:

  Notes on the Art of Surgery, 1974, pp. 15-23. Essay

• Selzer, Richard. Sarcophagus. In Confessions of a Knife. New York:

  Morrow, 1979, pp. 50-60. Essay

• Selzer, Richard. Witness. In Letters to a Young Doctor. New York:

  Simon & Schuster, 1982, pp. 120-5. Essay

• Plath, Sylvia. Face Lift. In The Collected Poems Ted Hughes, Editor. New York: Harper & Row, Pub. 1992 pp. 155-6. Written 1961 Poem

• Wyrebek, Michele. Putting Me Out. JAMA, 265:962, 1991. Poem

• Davis, Courtney. What Grown-ups Do. JAMA 283:1538, 2000

• Berger, Suzanne. Horizontal Woman: The Story of a Body in Exile. New York: Houghton Mifflin Co., 1996, excerpt from pp.44-50.

• Keene, Nancy. "He Lifted His Eyes" JAMA 277:1502, 1997

Oct 19      ICU (intensive care unit)           Juli Barr (meet in her office)

Oct 26      Focus on intensive care      Juli Barr reading:

• Harper, Michael S. Nightmare Begins Responsibility. Plus interview by Bill Moyers in The Language of Life, pp. 183-185, 1995. Poem

• Nye, Naomi Shihab. Intensive Care. In Jon Mukand, ed. Articulations, Iowa City: University of Iowa Press 1994, p. 48-49. Poem

• Raffin T, Shurkin JN, Sinkler W. excerpts from chapters 1 and 2 of Intensive Care: Facing the Critical Choices, 1989

• Nasca, Thomas. In Her Own Time. In Caring for the Dying: Personal Narratives. American Board of Internal Medicine, 1996, pp. 57-8

• Braunstein, Glenn. My Father. In Caring for the Dying: Personal Narratives. American Board of Internal Medicine, 1996, pp. 65-6

• Young, EWD. Ethical Issues at the End of Life. Stanford Law & Policy 9(2):267-88, 1998

Nov 2      OR (operating room)               Audrey Shafer (meet in her office)

Nov 9      ICU      Juli Barr (meet in her office)

Nov 16      Hospice/ Palliative Care (2C)           Audrey Shafer / Jim Hallenbeck (meet in Audrey's office) reading:

• Pastan, Linda. The Five Stages of Grief. In In the Midst of Winter; Selections from the Literature of Mourning. Edited by MJ Moffat, New York: Random House, 1982

• Shapiro, Alan. "The Vision" Chapter 1 from Vigil. Chicago: U. Chicago, 1997, pp. 3-17.

(November 23 Thanksgiving Holiday - no class)

Nov 30      classroom, evaluation and summary           Juli Barr and Audrey Shafer

   Notes: