Showing 1 - 10 of 858 annotations tagged with the keyword "Communication"

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A murder mystery set in Harlem of the 1930s. The Conjure-Man, Frimbo, is a reclusive, highly educated soothsayer and fortune teller born in Africa. His Harlem dwelling is a popular destination for local people seeking direction for the decisions that they confront. He takes pains to conceal much about his identity.

One evening, Frimbo is found dead by a client, while a handful of people occupy his waiting room. Doctor Archer, who lives across the street, is summoned to pronounce the death, and the police come soon, led by detective Dart. Then the corpse disappears, and the Conjure-Man reappears alive to the amazement of all.

The investigators use recent technology, including blood typing, to establish that the corpse was not that of the Conjure-Man. Over just a few days, the doctor and the detective work their way through all the possible scenarios to establish the identity and motive of the killer. The ending is surprising.

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An Enemy of the People

Ray, Satyajit

Last Updated: Aug-09-2021
Annotated by:
Galbo, Sebastian

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In this 1989 Bengali-language film, the director and screenwriter Satyajit Ray presents an arresting contemporary reimagining of Henrik Ibsen’s 1882 play, An Enemy of the People. In Chandipur, India, Dr. Ashoke Gupta treats an increasing number of patients with hepatitis and jaundice. After some patients die, Dr. Gupta fears that the town could succumb to an epidemic. A water quality report reveals that bacteria contaminate local sources, and that the pollution lies in the town’s most populous area. Further complicating the crisis is Dr. Gupta’s determination that the holy water distributed at a new Hindu temple is culpable for sickening visitors. Eager to publish the findings in a local newspaper and advocate for the closure of the temple (a major pilgrimage destination) until the contamination is abated, Dr. Gupta must contend with his younger brother, Nisith, and other municipal bureaucrats and journalists who suppress his findings to protect the tourism revenue. The physician struggles to communicate medical information to a population deluded by religious superstition and deceived by avaricious leaders.

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Secret Wounds

Berlin, Richard

Last Updated: Aug-06-2021
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In Secret Wounds, his second full length collection of poetry, psychiatrist Richard Berlin continues his exploration of the inner world of medicine with a sequence of 73 poems that flow seamlessly, uninterrupted by grouping into topics or sections. In the first poem, “Lay Down Sally,” the author attends a man dying on dialysis, and concludes with “A nurse hangs the morphine. / I write my blue notes.” In the last, “The Last Concert of Summer,” he reflects on his long experience with the sick and suffering, ending the poem with, “I place a stethoscope in my ears and listen / to the heart when I’ve run out of things to say.” In between, the poems reflect varied incidents, topics, conflicts, and wounds, as they occur from medical education (“Teaching Rounds,” “Touch,” “On Call, 3 AM”) through a life in medical practice (“Rage,” “The Scientists,” “How a Psychiatrist Parties”) to something like enlightenment (“Note to Pablo Neruda,” “A Psychiatrist’s Guitar,” “End of Summer”).

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The Ministry of Bodies

O'Mahony, Seamus

Last Updated: Jul-26-2021
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Starting eight months before his retirement, a gastroenterologist chronicles a myriad of encounters between himself and others - patients and their family members, colleagues, administrators, hospital staff, and even drug reps. He has worked for many years at a large Irish hospital dubbed the "ministry." His professional work there is divided between the endoscopy unit (where he performs colonoscopies and EGDs), medical wards, an outpatient clinic, and the ER.

Given his specialty, the roster of patients tilts heavily towards gastrointestinal problems: alcoholic cirrhosis, GI bleeding, chronic diarrhea, and abdominal pain. But additionally, his days are filled with patients presenting with a variety of medical problems including pneumonia, mental health issues, heart failure, serious fractures, dementia, seizures, anemia, and cancer. He attends to many frail elderly folks in the emergency department. His interactions with patients range from intense to jovial, from unexpected to heart-wrenching. For example, a woman with chronic abdominal pain asks the doctor if she might be suffering from PTSD. When asked why she thinks that might be possible, her reply is "My son hung himself. I found him" (p191).

The doctor is beleaguered by frequent, and at times wacky, emails generated by the hospital bureaucracy as well as unproductive meetings. He must cope with his own health problems too (a vitreous detachment, arthritic hands, and unexplained nosebleeds). He decries the "foolishness" of excessive medical testing and overtreatment and cites the case of a young woman with irritable bowel syndrome who already had over 1,200 test results logged in the hospital lab. He describes the ministry as "an oasis of kindness and comfort" but "also a place of chaos and conflict, of institutional cruelty" (p8).

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Collective

Nanau, Alexander

Last Updated: Mar-29-2021
Annotated by:
Bruell , MS, Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Colective was a popular nightclub in Bucharest, Romania.  In 2015, a fire broke out during a band performance killing 27 people and injuring 180. The public protests that erupted over the lack of fire exits in the club led to the resignations of government officials, including the Minister of Health.  Within four months of the fire, 37 of the critically burned died, not as originally thought from the burns they suffered, but from hospital- acquired infections.
 
The feature documentary follows Catalin Tolontan, an investigative journalist at a sports newspaper and his team as they track down the cause of the fatal infections.  They are aided by doctors from the hospital who come forward to voice their suspicion that the infection control agents used by the hospital were diluted to the point of being ineffective.  The journalists bring samples to a lab which verifies that the agents were diluted to 10% of their effective strength.  The owner of the company supplying the agents had been engaged in the practice for years.
 
We hear tragic stories from parents whose children died, prevented by “communication errors” from having them transferred to other, better equipped burn units in other European countries.  And we meet the survivors, among them, Tedy Ursuleanu, who, despite her disfigurement, bravely poses for photographs for an exhibit about the event.  The film returns to Tedy at several moments--- she is a reminder of the human tragedy that has caused so much suffering. And we listen to the despair of a doctor who says, “We’re doctors; but we are no longer human. All that matters is money,” as she describes how politics, bribery and greed have taken over the health system and made patients’ lives expendable.
 
This is a story without a happy ending.  Vlad Voiculescu, the newly appointed health minister who previously worked in patient advocacy tries to reform the system and install safeguards against hospital procedures that fall short of accreditation requirements.  But the system proves too strong.  This time political corruption wins over people’s health.


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Camouflage

Nisker, Jeffrey

Last Updated: Mar-19-2021
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Summary:

This short play has three characters: a woman, a man in camouflage, and a second man who turns out to be a doctor. The camouflage man talks on the phone with his unseen wife; he is angry and suspicious of what she has been doing during his absence. The doctor overhears – and thinks about confronting him, but lets it go. The woman is a victim of coercive sex in marriage. She has two places where she can take refuge, if only in her mind:  her garden and an imaginary elephant. The woman’s description of the elephant tells us that she is seeing the elephant as a reflection of herself, and it also reflects her traumatized awareness of the physical changes in her husband’s body as he helps himself to hers.

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Summary:

In this collection of autobiographical essays, Koven contemplates some unique challenges confronting female physicians: discrimination, sexism, lower annual salary on average than male counterparts, possible pregnancy and motherhood. She recalls her medical school and residency experience, describes her internal medicine practice, and highlights her role as a daughter, spouse, and mother.

Worry is a theme that works its way into many phases of Koven's life and chapters of this book. The opening one, "Letter to a Young Female Physician," introduces self-doubt and concerns of inadequacy regarding her clinical competence. "Imposter syndrome" is the term she assigns to this fear of fraudulence (that she is pretending to be a genuine, qualified doctor). She worries about her elderly parents, her children, patients, and herself. Over time, she learns to cope with the insecurity that plagues both her professional and personal life.

Some of these essays are especially emotional. "We Have a Body" dwells on the difficult subject of dying, spotlighting a 27-year-old woman who is 27 weeks pregnant and diagnosed with adenocarcinoma of the lung. "Mom at Bedside, Appears Calm" chronicles the author's terror when her young son experiences grand mal seizures and undergoes multiple brain surgeries for the tumor causing them.

Listening emerges as the most important part of a doctor's job. Koven encourages all doctors to utilize their "own personal armamentarium" which might include gentleness, exemplary communication skills, a light sense of humor, or unwavering patience. She fully endorses a concept articulated by another physician-writer, Gavin Francis: "Medicine is an alliance of science and kindness" (p228).

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Pearl, a plastic surgeon and former CEO of a large medical group, writes powerfully and poignantly about the major role of physician culture - the customs and rituals, traits and beliefs of doctors. This culture is entrenched through years of medical training. He decides that physician culture "can be both a virtuous force and an equally destructive influence" (p70).

Some of that culture is readily on display: attire, tools of the trade, unique medical terminology, insensitive humor, frequent handwashing. Positive aspects of physician culture include self-confidence, integrity, compassion, and selflessness. Negative elements are ingrained to keep emotions and dread at bay: detachment, callousness, denial. This culture of medicine must navigate dual interests - healing (the mission of medicine) and profit (income, status, prestige).

Pearl suggests an evolutionary pathway for physician culture that he dubs "the five C's of Cultural Change" - confront, commit, connect, collaborate, contribute. He tackles issues of sexism, racism, and elitism in American healthcare. He explores the suffering of physicians and their need to seek forgiveness - often secretly and even in cases of perceived "failure" when everything possible was done correctly. His discussion is filled with agonizing, frustrating, and loving stories about patients, family members, and colleagues (including physician suicide).

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Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor. 

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.           

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123). 

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Together

Murthy, Vivek

Last Updated: Nov-09-2020
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Longform journalism

Summary:

Since the first surgeon general was sworn into office in the 19th century, the Office of the Surgeon General has positioned itself as the leading voice on public health matters in the United States. In recent history, the office has had its highest profile campaigns rallying against issues such as tobacco use, obesity, and HIV/AIDS. Considering the combination of prevalence, morbidity, and mortality associated with these health issues, there is no doubt that any effort to stem the tide was a worthwhile endeavor.

When Dr. Vivek Murthy became the surgeon general in 2014, his office continued the historical campaigns against these health issues. At the same time, Dr. Murthy began investigating a looming epidemic within our borders: loneliness and social isolation.

It may be hard to convince the average person that loneliness is a problem of similar scale as tobacco use, obesity, or AIDS. There is no question that loneliness is unpleasant, even if it only lasts for a few moments. But the notion that one’s state of mind can predispose to disease or premature death somehow feels like a stretch. Addressing this skepticism, Dr. Murthy writes in his book about Dr. Julianne Holt-Lunstad, a psychologist at Brigham Young University who also faced a great deal of cynicism surrounding her research into the effect of social relationships on “everything from our behavior to our cellular function.” She had a breakthrough in 2010 when she published a massive study analyzing the health outcomes of over 300,000 participants, categorized by their degree of social connectedness. She found that social isolation was significantly linked to premature death, representing a risk nearly as serious as pack-per-day smoking, and more serious than obesity, alcohol use, and lack of exercise. Dr. Holt-Lunstad’s research spurred further studies which linked loneliness to heart disease, stroke, and depression, amongst other diseases.

These findings are hard to ignore, especially in light of the ongoing opioid addiction crisis and rises in teenage depression and suicide, all of which have been linked to loneliness and social isolation. In Together, Dr. Murthy weaves together scientific research, personal anecdotes, and current events to create a manifesto for tackling the next great public health crisis.

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