Showing 1 - 10 of 190 annotations tagged with the keyword "Women in Medicine"

The Pull of the Stars

Donoghue, Emma

Last Updated: May-02-2023
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It is Dublin in late autumn 1918, the waning days of World War I, and nurse-midwife Julia Power is suddenly thrust into the task of managing a small ward of heavily pregnant women who have contracted the deadly influenza. Having survived influenza herself, she does not fear infection, but she worries about her lack of experience. She also worries about her shell-shocked brother with whom she shares a home. 

Two people appear to help: the intelligent but uneducated young volunteer Bridie Sweeney raised in an institution; and the legendary woman doctor Kathleen Lynn –who quietly reveals her competence and skill, even as authorities are lurking to arrest her.  

Over the course of just a few days, they encounter recalcitrant mothers, complicated deliveries, battered wives, stillbirths, and deaths. Influenza adds special dangers to the natural event, but some patients survive their ordeal. 

Although Bridie was to help for just one day, she learns quickly and returns. Julia is impressed by her diligence and drawn ever closer to her kindness and earthy wisdom. They pass a night together sharing confidences, and Julia begins to understand the physical and emotional mistreatment that Bridie suffered in the care of nuns. Their embrace awakens in Julia a yearning she had never imagined. But only hours later Bridie falls ill and succumbs rapidly to the deadly infection.

When an unwed mother suddenly dies after giving birth to a deformed child, Julia is horrified that the baby must be placed in an institution. Instead, she takes the baby home to an uncertain future but sparing the child the same horrors that Bridie once suffered. 

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The Doctor

Icke, Robert

Last Updated: Feb-28-2023
Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

The Doctor is a new play that was “very freely adapted” from a work by 19th-century Viennese doctor/playwright Arthur Schnitzler.  The author, Robert Icke, is an English playwright and director who is especially known for his reworkings of classics.  

The doctor to whom the title refers is Ruth Wolff, the renowned and rather formidable director of a private medical institute.  We learn that we are in the present day, and Dr Wolff is Jewish.  At the play’s outset, the organization is attempting to secure funding for a new building, and a new head of pharmacology is about to be chosen.  One of Dr. Wolff’s patients, a 14-year-old girl, is in sepsis following a self-induced abortion.  Her health rapidly declines.  When it becomes clear the patient is not going to make it, her parents send a Catholic priest to the hospital.  Dr. Wolff prevents the priest from entering the room to administer the last rites.  

Dr. Wolff’s actions set off a chain of events.  Her confrontation with the priest goes viral on social media, resulting in a public relations nightmare for the hospital.  In her characteristically uncompromising way, when asked to smooth things over, the doctor responds: “I think the lack of my having done something makes that really quite difficult” (p.31).  She is labelled anti-Catholic and her car is painted with a swastika.  Her choice for head of pharmacology, also Jewish, is deliberately rejected by the board in favor of a Catholic.  The funding for the institute’s new building is suddenly in doubt as a formal inquiry is opened by the Minister for Health. Disgraced, Dr. Wolff is forced to resign.    

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Summary:

In Medical Bondage: Race, Gender, and the Origins of American Gynecology, Owens argues that the emergence, practice, and professionalization of American gynecology in the 19th century were inextricably enmeshed with the institution of slavery and discourses of biological racism. “Modern American gynecology,” writes Owens, “could certainly exist without slavery, but slavery’s existence allowed for the rapid development of this branch of medicine, and especially of gynecological surgery” (6). As she shows, gynecology developed as quickly as it did only because white American physicians had access to women’s bodies marked as racially inferior. That gynecology’s maturation accelerated in the American South is no indication that its practitioners had a humane interest in enslaved women’s health (66). On the contrary. Owens argues that slave owners were invested in maintaining the reproductive health of enslaved women in the interest of increasing the size of their population: “Thus the repair of any medical condition that could render an otherwise healthy slave woman incapable of bearing children further strengthened the institution of slavery” (39). Additionally, there were broader implications, as medical research using enslaved women’s bodies produced knowledge about how to treat, in turn, white women: “Black lives mattered medically because they made white lives healthier and better” (107).

This leads Owens to argue why enslaved women should be esteemed as the maternal counterparts to the oft-celebrated white ‘fathers’ of American gynecology: “. . . black women, especially those who were enslaved, can arguably be called the ‘mothers’ of this branch of medicine because of the medical roles they played as patients, plantation nurses, and midwives. Their bodies enabled the research that yielded the data for white doctors to write medical articles about gynecological illnesses, pharmacology, treatments, and cures” (25). This is especially true, as she points out, when examining the medical research of the lauded gynecologist, James Marion Sims, who opened and operated a “sick house” for enslaved women suffering from gynecological ailments (36). Sims operated this clinic to devise a surgical solution to a serious and commonplace gynecological issue among enslaved women, vesico-vaginal fistulae. As an enterprising young physician, Sims took advantage of enslaved women’s bodies to conduct his surgical trials. Eventually, he triumphed and cured an enslaved woman, and published the results in a respected medical journal, thus enshrining his reputation (39). The point, Owen emphasizes, is that “[t]hanks in large part to his experimentation on enslaved black women, Sims had established himself as one of the country’s preeminent gynecological surgeons less than a decade after he began his gynecological career” (39). Medical Bondage thus strives, in part, to restore the lives and contributions of these enslaved women to the story of American gynecology’s genesis.

Owens’ study takes a surprising turn, arguing that “. . . the later development of modern American gynecology can no more be disentangled from Irish immigration than it can be separated from its roots in slavery” (90). This shift in racial and geographic focus parallels the similar roles of enslaved black women of the South and poor, immigrant Irish women of the urban North in the development of gynecology. Owens shows how racial alterity was “mapped onto” poor Irish immigrant women living in major urban centers, such as New York City (20). As many Irish immigrant women suffered poverty, inadequate (if any) medical care, sexual assault, and were drawn into prostitution (and the attendant onslaught of venereal diseases), they became ideal medical subjects for gynecologists. Physicians eventually published their Irish patient case studies, which “. . . helped to create the foundation for the racist laws that colored the Irish as not quite white and sometimes placed them alongside black people as biological models for racial inferiority” (90). Just as Southern gynecologists had access to enslaved women’s bodies, their Northern counterparts treated and experimented on racially othered immigrant women. In this way, Owens argues, “[t]he scientific and medical beliefs that doctors held about Irish women were nearly indistinguishable to [sic] those they held about African women” (115). Overall, Medical Bondage articulates a well-researched and sobering retelling of the dominant accounts of American gynecology.

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Barefoot Doctor: A Novel

Xue, Can

Last Updated: Sep-06-2022
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction — Secondary Category: Literature /

Genre: Novel

Summary:

Yun Village, China is a remote town near the mountains. Its 2,438 inhabitants are mostly poor but remarkably optimistic and stoic. Ancestors from the spirit realm visit the hamlet and roam the mountainside. The living and the dead appear to communicate with relative ease. Mrs. Yi (Chunxiu), more than fifty years old, is the village's vibrant "barefoot doctor" - an essentially self-taught healthcare provider with only six months of formal medical training under her belt. Yi's husband is quite supportive of her work. Their only child died at age two.

Yi is revered for her knowledge, patience, and compassion. Most afflictions she treats are chronic diseases, but Yi also delivers babies, cares for children with measles, and counsels a woman who attempted suicide. The therapeutic benefit of attentive, concerned listening along with reassurance are evident in her interactions with patients.

Traditional Chinese herbs, acupuncture, and Western medicine are all in the healer's armamentarium. Yi cultivates herbs and also forages on the mountain for other useful plants. She supposes, "Sickness and herbs are lovers" (p244). As Yi grows older, the need for a successor - a devoted, younger barefoot doctor - is always on her mind. She successfully identifies candidates, then inspires and mentors them.


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The Dropout

Meriwether, Elizabeth

Last Updated: May-19-2022
Annotated by:
Sood, Shefali

Primary Category: Performing Arts / Film, TV, Video

Genre: TV Program

Summary:

Based on the 2021 podcast of the same title produced by Rebecca Jarvis, The Dropout is an 8-episode miniseries starring Amanda Seyfried as the infamous biotechnology fraudster Elizabeth Holmes and Naveen Andrews as her much older boyfriend-turned-accomplice, Ramesh “Sunny” Balwani. The miniseries documents the real-life story of Elizabeth Holmes and her evolution from an ambitious, dedicated and somewhat awkward teenager into a ruthless, immoral and still quite awkward CEO of Theranos, a company she founded after dropping out of Stanford her sophomore year. She claimed to develop technology to run hundreds of diagnostic medical tests on a single drop of a patient’s blood. She defrauded hundreds of doctors, investors, pharmaceutical companies and even Walgreens along the way and put hundreds of patients who received faulty Theranos blood test results at risk. This year, Holmes was found guilty on four counts of fraud by a federal grand jury.

The miniseries begins in Holmes’ childhood and utilizes footage from her federal deposition and media interviews to document her evolution from having an innocent desire to invent something to help people to a grifter who put others in danger without a second thought. In her teenage years, Holmes idolizes Steve Jobs. Instead of boyband posters in her room, she has photos of him with Apple products. She spends a summer in China in a language immersion program, where she meets a man 30 years her senior, Sunny Balwani, and strikes up an uncomfortable friendship after learning of his success in business. She is shown to be somewhat of an outcast in school, practicing being excited for a party in a mirror and speaking almost every day with Balwani instead of her peers. Her conversations with Balwani mostly are about her ideas to help people and her desire to be a billionaire. This goal of helping others pushes her to study biomedical engineering at Stanford. She proudly proclaims to family friend Dr. Richard Fuisz, a physician-turned-inventor, that she is in the top 10% of applicants. At Stanford, she is incredibly focused on her goal to invent, and with an unrelenting fervor, she enrolls in graduate level classes and pitches ideas to professors. She is a teacher’s pet; however, when she pitches her idea for a medical drug delivery patch to Dr. Phyliss Gardner, a highly accomplished physician and researcher, her world crashes. Dr. Gardner immediately shoots down her idea and tells her to focus on her schoolwork before trying to invent the next big thing. Holmes can’t take no for an answer and quotes Yoda from Star Wars: “Do or do not. There is no try.” Dr. Gardner responds that in medicine and science, some things are impossible and recognizing that is also part of the scientific process.

This all changes soon after pitching an idea for a blood test using a single drop of blood to Dr. Channing Robertson, an influential chemical engineer at Stanford. He backs her idea and gives her capital for a company. She encourages her parents to let her drop out of Stanford, citing Steve Jobs, Michael Dell and other influential tech leaders as examples, and uses her tuition money to establish Theranos.   

Theranos, a combination of the words therapy and diagnosis, takes off, with significant roadblocks, fueled only by Holmes' dreams. Holmes neither has the scientific background nor the leadership skills to lead the company.  She does little in the chemistry labs and her lack of engineering, chemistry and medical knowledge prevents her from being able to pitch the idea successfully to healthcare venture capitalists. The blood testing device requires technology that would take years to build and require significant scientific collaboration that does not exist at Theranos. She needs data for investors that the devices are complete and work, so enrolls the faulty, not yet completed devices in a trial testing the blood of cancer patients. This leads to a tense encounter between lead engineer Edmond Ku and Holmes outside a cancer clinic. Ku states that he is an engineer, not a healthcare provider, and he is uncomfortable looking these patients in the eye and testing their blood on a machine he knows does not work. He is clearly very upset; but Holmes forces him to go inside and collect the samples. The clinical trial goes nowhere. 

After almost running the company into the ground, she convinces the Board to let her stay CEO if she brings on Balwani, with whom she is in a romantic relationship, as chief operating officer. Balwani offers advice on how to be a CEO of a tech company and encourages her to change her management style. The departments at Theranos become siloed to a point that scientists have no idea what is happening in the executive, marketing and media departments and vice versa. All information comes from Holmes. She spends no more time in the lab and has no meetings with lab personnel, but her name is on every patent. She markets herself as a young female tech CEO in a landscape dominated by men in sweatshirts. Her charisma and newfound business acumen allows her to secure a deal with Walgreens in which Theranos’ devices will be in Walgreens Wellness Centers for use by patients. She does not tell any of the scientists working on the device and does not consult any physicians. She shares no data with Walgreens about the design of the device, its accuracy or validity, citing trade secrets. When her lead chemist, the celebrated Dr. Ian Gibbons, catches wind of this plan, he confronts Holmes, who fires him on the spot for not having the same vision. Amidst pressure from the scientists, she rehires him the next day, but prevents him from working in the lab ever again. The toxic environment created by Holmes eventually causes Dr. Gibbons to commit suicide.   

The Theranos devices for the Walgreens agreement fail quality control checks and cannot be used.  Holmes and Balwani create a plan in which they use Siemens devices with Theranos logos to run the single drop blood patient samples which have been diluted to provide enough sample to be read by the Siemens machine. This leads to wildly inaccurate results being sent to patients. Examples include a high estrogen reading in a woman with a history of ovarian cancer, suggesting remission; a high thyroid hormone level in a pregnant woman already on thyroid medication, almost prompting her doctor to alter her dosage, which would be fatal for the fetus; and a high troponin level in a man with cardiovascular disease indicating he may be having a myocardial infarction. The lab technicians are aware of these inaccurate results. Eventually two techs, Erika Cheung and Tyler Schultz, the grandson of former Secretary of State George Schultz a and a Board member at Theranos, leak what is happening to a journalist, John Carreyrou at the Wall Street Journal, despite immense legal and physical threats from Holmes and Balwani. Eventually, using evidence from Cheung, Schultz, former scientists at Theranos, and physician-advocates among others, Carreyrou writes an article in the Journal exposing Theranos and Holmes for what they are --frauds. This spirals into the Centers for Medicare and Medicaid Services shutting down Theranos labs indefinitely and leads to thousands of lawsuits regarding Theranos products. Holmes loses all credibility and is arrested on federal charges of fraud and conspiracy to commit fraud.   

In the last scene, Holmes visits the office with her new dog to speak with a former Theranos lawyer, who can no longer find a job as a result of the scandal. She boasts about her new boyfriend. The lawyer confronts her, “you hurt people.” Holmes denies this vehemently saying she just ‘failed to deliver’ as CEO and runs frantically out of the office where she breaks down while waiting for her Uber. 


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Summary:

The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
 
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   









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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:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

 Cortney Davis has divided this collection of her poetry into seven major sections which she calls “Voices.” The first and last sections are “Voices of Healing” which frame and wrap around the others: “Home,” “Desire,” “Suffering,” “Faith,” and “Letting Go and Holding On.” The sections include previously published poems as well as new ones.  Davis is known for her ability to see and understand what is going on and to express that in ways that help the reader “get it.”  This collection also shows her ability to hear the unique voices that express suffering, faith, desire—and to convey empathic understanding of the speaker.  Sometimes she gets angry with the speaker. The poems range through time, from her childhood, nursing training, nursing experiences, deaths of her parents, to more current experiences with grandchildren.  Throughout there is a consistent caring and compassion, mixed with many other feelings, many of them contradictory.

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Man's 4th Best Hospital

Shem, Samuel

Last Updated: Feb-28-2020
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Most of the group are reunited in this sequel to the 1978 blockbuster, The House of God: narrator Dr. Roy Basch and his girlfriend (now wife) Berry, former fellow interns (Eat My Dust Eddie, Hyper Hooper, the Runt, Chuck), surgeon Gath, the two articulate police officers (Gilheeny and Quick), and the Fat Man (a brilliant, larger-than-life former teaching resident). As interns, Basch and his comrades were a crazy, exhausted, cynical crew just trying to survive their brutal internship. Years later, the midlife doctors have changed but remain emotionally scarred.

The Fat Man (“Fats”), now a wealthy California internist who is beginning a biotech company targeting memory restoration, is recruited to reestablish the fortunes – financial and prestige – of Man’s Best Hospital which has slipped to 4th place in the annual hospital rankings. He calls on his former protégés to assist him in an honorable mission, “To put the human back in health care” (p34). Fats enlists other physicians (Drs. Naidoo and Humbo) along with a promising medical student (Mo Ahern) to staff his new Future of Medicine Clinic (FMC), an oasis of empathic medical care that strives to be with the patient.

Every great story needs a villain. Here the main bad guys are hospital president Jared Krashinsky, evil senior resident Jack Rowk Junior, and CEO of the BUDDIES hospital conglomerate Pat Flambeau. The electronic medical records system dubbed HEAL is a major antagonist, and the FMC docs wage war against it and the “screens.”

Poor Roy Basch works long hours, deals with family problems, has trouble paying bills, and experiences health issues (a bout of atrial fibrillation, a grand mal seizure, and alcohol use). Fats has warned of a “tipping point when medical care could go one way or another, either toward humane care or toward money and screens” (p8). Alas, the computers and cash appear victorious. A major character is killed. Many of the doctors working in the FMC including Basch leave the clinic. And fittingly, Man’s Best Hospital plummets in the latest rankings from 4th to 19th place.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A British physician-writer reflects on her topsy-turvy medical training emphasizing the mental and emotional burden of becoming a doctor. In 22 brief chapters with titles including "The Darkest Hour," "Buried," and "The Wrong Kind of Kindness," a struggle between hope and despair furiously plays out - in patients, hospital staff, and the narrator.

Dr. Jo (as one patient calls her) remembers interviewing for medical school admission, the difficulty dissecting a cadaver, starting lots of IV's, dutifully toting an almost always buzzing pager, and breaking bad news. She shares with readers her own serious car accident with resulting facial injuries. She comments on the underfunded UK National Health Service (NHS) that is "held together by the goodwill of those who work within it, but even then it will fracture" (p104).

Anecdotes of memorable encounters are scattered throughout the narrative: a fortyish woman in the emergency department who describes a fast pulse and sense of impending doom diagnosed as having an anxiety attack who ten minutes later suffers a cardiac arrest, a man with severe schizophrenia, a suicide, an elderly blind person, a young woman with metastatic breast cancer.

But the lessons that have stuck with her are primarily dark and somber ones. "Sacrifice and the surrender of the self are woven into the job" (p77). She realizes that "perhaps not all good doctors are good people" (p125) and that as wonderful and essential as the virtue of compassion is, "compassion will eat away at your sanity" (p16). She chooses psychiatry as a specialty where kindness, empathy, creating trust with patients, and careful listening work wonders for people. "I learned that saving a life often has nothing to do with a scalpel or a defibrillator" (pp13-14).

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