Showing 1 - 10 of 929 annotations tagged with the keyword "Empathy"

The Empathy Exams

Jamison, Leslie

Last Updated: Aug-02-2021
Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Leslie Jamison starts The Empathy Exams with a quote from The Self-Tormentor by Terence, first in Latin, then in English: “I am human: nothing human is alien to me.”  In beginning this way, she sets up the book to explore the human condition and what it means to relate to one another with caring despite the interpersonal complications that can often arise. Through a series of nonfiction essays (some initially published elsewhere) she explores how we express our feelings and process those of others. To do this, Jamison uses a number of different lenses, large and small, including ultramarathons, immigration, incarceration, a Morgellons disease conference, and more.  

The book takes its name from the first essay in which Jamison juxtaposes her experience as a standardized patient for students in medical school with being an actual patient. She specifically explores the ways in which empathy is created/manufactured and extended in medicine, both from medical professionals and loved ones.

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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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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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Global Healing

Thornber, Karen

Last Updated: Dec-14-2020
Annotated by:
Bruell , MS, Lucy

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Karen Thornber is the Harry Tuchman Levin Professor in Literature and Professor of East Asian Languages and Civilizations at Harvard. In this expansive nearly 700 page book, she draws on work from global literature to explore the many ways societies view illness, stigma and healing.  She defines global literature as “narratives that grapple with challenges and crises that have global implications or counterparts globally, whether at present, in the past, or likely in the future” (p.10). 

The book is divided into three sections: Shattering Stigmas, in which she looks at Leprosy, AIDS, and Alzheimer’s disease; Humanizing Healthcare; and Prioritizing Partnerships.  Among the topics she addresses are patient-focused care as an imperative, the need to advance partnerships in caregiving, and support that extends beyond family and friends to the patient’s relationships with health professionals.  Healing, she notes, involves “changing the circumstances that exacerbate or even trigger a health condition, enabling the individual to obtain long-term wellbeing liberated from as much distress, if not disease, as possible.” (P331).

Thornber has selected literature that addresses the illness experience and the need to reduce suffering and promote healing, which she places within three interwoven  frameworks:  “Societies/communities, healthcare settings, and families/ friendships” (p.583).  She looks at both positive approaches to care as well as the negative impact of suffering, whether from stigma, inaccessibility to care, or dehumanized care. The book considers literary works from Africa, Asia, Europe, the Middle East, and Oceania, many that will be new to readers.  

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The City We Became

Jemisin, N.K.

Last Updated: Dec-07-2020
Annotated by:
McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is the first in an intended trilogy of speculative fiction (read: what we used to struggle to label as sci-fi or fantasy). by author N.K. Jemisin.  It tells the story of a world where cities can come alive, not in the corporeal sense, and not in this universe, but in a way that intersects nonetheless with our reality.  The trouble is, not all cities distinguish themselves enough to be born, and those that do often are interrupted in the process and suffer a stillbirth.  We are plopped down in New York City at the moment of its intended birth, in a struggle between the city, its six human avatars (one for each borough, and one for the city as a whole) and the otherworldly force that is trying to destroy it.  

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The Beauty in Breaking

Harper, Michele

Last Updated: Sep-18-2020
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The Beauty in Breaking is the memoir of an African American physician who, in her own words, has “been broken many times” (p. xiii).  

Despite maintaining a veneer of affluence, the author, her mother and siblings live in constant fear of being battered by her father. Following one particularly vicious attack, she accompanies her injured brother to the local emergency room. That day she serendipitously discovers her calling: “As my brother and I left the ER, I marveled at the place, one of bright lights and dark hallways, a place so quiet and yet so throbbing with life. I marveled at how a little girl could be carried in cut and crying and then skip out laughing” (p. 18).  

Much later, the author (Michele Harper) undergoes a shattering breakup and divorce. She endures disappointments at work, some of which, regrettably, can only be explained by the color of her skin.    

As she picks herself up time and time again, Harper discovers her inner resilience: “The previously broken object is considered more beautiful for its imperfections” (p. xiii). She learns from the experience of her own suffering to develop compassion in her clinical work. The bulk of the Beauty in Breaking is devoted to case studies of the author’s clinical encounters with patients in the emergency room.

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Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The Talking Cure is Jack Coulehan’s 11th book, seven of which, including this collection, are books of his poetry. This collection begins with selected works from his six previous books of poetry and continues with a selection of poems in the imagined voice of Chekhov. These sections are followed by previously uncollected poems, and the book ends with 25 new poems reflecting the title of this book--“The Talking Cure”. The poems represent multiple viewpoints—patients, caregivers, family members as they struggle to make sense of the vicissitudes—and unexpected joys—in life. The poems have appeared over the past four decades in medical journals (primarily Annals of Internal Medicine and Journal of the American Medical Association) and in many literary journals including Prairie Schooner and Negative Capability Press. 

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Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

At 23 years of age, Caitlin Doughty went to work for a crematory in Oakland, California, and looked human mortality right in the eye. She reports on her first six years in the funeral industry, learning about it and also resolving to stay in it so that she can improve it. Her eye-witness account provides the basic narrative structure of this book. 

She makes house calls to gather up the dead and drive them to the crematory. She is fascinated by several specific bodies, giving us portraits of them and their past lives. Some of them are our least-well-off citizens, and these occasion touching prose.

Doughty realizes that her fear of death has roots of seeing, at eight years of age, a child dying from a fall in a two-story shopping mall. Her work with bodies helps her heal from her trauma. She imagines that her history may be a parallel for American society as a whole that now hides, covers up, and ignores the realities death and dying. She specifically envisions changes that will result in healthier attitudes and practices in the funeral industry. 

Doughty describes in detail how the dead are embalmed, made up to look “natural,” and presented to relatives at viewings. She criticizes these rituals as demeaning to the dead and causing unnecessary expense to their families. She describes Forest Lawn cemetery as the Disneyland of the Dead, recalling Jessica Mitford’s critical book, The American Way of Death (1963).
             

Having studied medieval history at the University of Chicago as an undergrad, Doughty brings many texts into her discussion, from history, anthropology, literature, philosophy, medico-legal discussions, religion, and social criticism. All societies have customs for dying, death, and burial; many of them, she feels, are healthier and more realistic than those of contemporary America.         

Finishing her time at the crematory, she decides to stay in the industry in order to improve it. She graduates from the Cypress College of Mortuary Science and passes exams to become a licensed funeral director in the state of California. She posts her essays and manifestos on the Internet under the name “The Order of the Good Death.” Many others join her in a movement against American “death dystopia” (p. 234).  

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