Summary:

In this poem, a young male patient receives stitches in an emergency room for a face wound from an alleyway knife fight. It seems the violence involved drugs, as a "broken syringe" is involved in the fight. However, more telling is the label that the ER doctor uses to describe the patient. The narrator of the poem, apparently an exhausted physician-in-training, is told by the ER doctor to quickly "Stitch up the faggot in bed 6."

The narrator meticulously sews his patient's wound, empathizing completely with him: "Each suture thrown reminded me I would never be safe / in that town." He too, could be ripped open "to see the dirty faggot inside." Furthermore, he ruminates that when the perpetrators of such violence themselves become victims, he would also stitch their wounds--silently, carefully, passively, "like an old woman."

View full annotation

Summary:

The subtitle to this collection of insightful and compassionate essays by gastroenterologist David Watts is: "One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer." Watts provides 48 narratives, most of which concern his patients and are written in the first person. In the preface Watts states "The stories in this book are true" (xv), that he has received permission from his patients, and that he has "disguise[d]" his patients to respect their right to privacy.

The stories cover a range of settings, from Watts's home and locations in the San Francisco Bay area, to the clinic and hospital. They also cover a range of his experience from medical school ("Sylvester" and "Love is Just a Four-letter Word") to his current position as a practitioner and an attending physician at a teaching hospital.

Stories in which Watts clearly situates himself with the patient and details the encounter are most compelling. For example, in the opening essay, "White Rabbits" and later, in "Flu Shot," Watts allows the reader to discover that patience and listening are required to in order for the patient to expose why he or she is truly there. In that space, Watts becomes present for his patient, and one learns that what may initially appear tangential is central to the patient's concern.

Watts writes of some very difficult patients and families, such as a woman who stalks him ("The Stalker's Bridegroom"), a woman who obsesses over caring for her elderly mother ("Home Remedy"), and a woman who demands narcotics ("The Third Satisfaction"). In one of the longer pieces, "Codger," Watts describes an irascible, elderly Jewish patient who skewers just about anyone with his critiques, including Watts's young son, and yet who later exposes his vulnerability by unfolding the tale of his World War II service and discovery of a Nazi death camp. It is because Watts spends time with the Codger and recognizes that the doctor-patient relationship is above all a human relationship that the doctor receives the gift of the story: this terrible experience which informed the rest of the Codger's life.

A few of the vignettes explore the therapeutic potential of poetry. For instance, in "Annie's Antidote" a piano teacher, fearful of endoscopy, asks Watts to recite one of his poems. The poem concerns the tender relationship between Watts and his son and is a metaphor for Watts's patient encounters as well: "for this is one of those moments / that turns suddenly towards you, opening / as it turns, as if we paused / on the edge of a heartbeat. . . " The poem works, the moment opens, and the woman has her endoscopy.

View full annotation

Summary:

This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

View full annotation

Summary:

A group of eight women gather for a joint consultation with Dr. Kailey Madrona who is a devotée and colleague of the research endocrinologist, Dr. Jerilynn Prior, a professor at University of British Columbia in Vancouver. Madrona explains that she has arranged for the unorthodox group encounter because she will be leaving practice to pursue graduate studies in medical history.

Dr. Madrona leads an open-ended discussion on the physiological changes associated with perimenopause. Following the controversial research of Prior, she emphasizes that the symptoms are owing to the unbalanced rise in estrogen levels during perimenopause—a period leading up to the cessation of menstruation and continuing for twelve months after the last flow.

Some women patients are skeptical, because they have been placed on estrogen ‘replacement” medication, or they have read that their symptoms are owing to the waning of estrogen. The doctor describes the results of various trials about supplmentary estrogen, including the 2002 Journal of the American Medical Association report. She invites them to keep detailed diaries of their cycles and symptoms.

One by one the women return for private consultation, physical examination, discussion and another follow up visit. Although they have reached roughly the same physiological moment in life, they are a diverse group with different symptoms and needs. Darlene, an angry nurse, is suspicious and non-compliant. Beverley, an Asian immigrant is still hoping to become pregnant. A lesbian wishes to control her moods and hot flashes. A very hard-working waitress needs to understand her strange lack of energy. A wiry, lean athelete wants to improve her performance and is irritated by the inexplicable alterations in her abilities. Others are plagued by sweats, nausea, or migraines. They all are confused about sex.

Dr. Madrona listens to them carefully, examines them with special attention to their breasts, not their genitalia, and recommends treatment with progesterone for everyone. She also urges weight gain for most and readily volunteers personal information about her own perimenopause. All but the nurse eventually comply and are relieved of their symptoms. At the end of a year they meet for a pot-luck dinner to celebrate their recovered health and thank their doctor. Beverley is pregrant.

View full annotation

Summary:

Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.

In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.

The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.

View full annotation

Summary:

Cameron, 18, and her sister Allie, 15, have inherited their father’s large nose. Living in Los Angeles, at the epicenter of the entertainment industry, they are familiar with the social currencies of money and beauty. Their mother, a former film actress, auditioning again after years at home, is exceptionally beautiful. Cameron’s “nose job”—the rhinoplastic surgery her parents arranged for her when she entered high school—has changed her life; it is debatable whether altogether for the better. She is now popular and accepted, but also, after a history of rejection and peers’ mockery, fixated on the kinds of beauty that bring social acceptance. Her interest in photography dovetails with this fascination.

At just the time her parents decide to arrange for a similar “nose job” for Allie, who doesn’t want it, and would rather spend the summer at soccer camp, Cameron decides to use her savings, and her new legal freedom as an 18-year-old, to have breast augmentation. Her parents and most of her friends oppose it, her boyfriend most strenuously, who can’t understand why she would take the risks entailed to do something so clearly unnecessary. As the girls learn, their mother has, at the same time, decided to have a face-lift as a return-to-career move.

Both Cameron and her mother go through the surgery—Cameron at the cost of considerable pain in recovery and aware of the long-term risks and costs. Allie, on the other hand, after coming to know an aging actress who was once a beauty, makes an eleventh-hour decision to refuse surgery and with it, the impossible standards of beauty that seem to her to entrap so many like her sister.

View full annotation

Summary:

This film combines light-hearted scenarios of poor to absurd communications with patients on issues of death and dying, with measured advice from physicians expert in such communications. In addition, a scenario of a woman physician and her patient with advanced breast cancer models a positive example for doctor-patient communication on issues of planning for death and choosing life-sustaining options.

The film opens with a madcap grim reaper dancing and singing a message from Dr. Fletcher to a patient at home: you have six months to a year to live. These same actors morph through a series of roles sprinkled through the film: a physician using medical jargon with a non-comprehending patient, an ad for a phrase book to "speak like a patient," another doctor-patient scene with the physician now graphically describing cardiopulmonary resuscitation using wild gestures, and a waiter advising a patient/patron on item selection from the Terminal Cafée menu (no vegetables!).

The experts discussing death and dying are: Michael Clement, MD; Lisa Capaldini, MD; Doriane Miller, MD; Bernard Lo, MD and Kate Christensen, MD. They offer sage advice on communication, avoidance of medical terminology (even words like 'diagnosis' and 'procedure' can be misunderstood), pain management, informing patients of anticipated poor outcome with cardiopulmonary resuscitation, asking patients what is important to them, goals of treatment, who should make medical decisions, and the setting of such discussions. Cultural sensitivity is briefly discussed, with an emphasis on respecting the patient's individuality rather than assuming a fit within cultural expectations.

The exemplary scenario demonstrates positive qualities and key points: both physician and patient are seated and dressed; the physician asks the patient if she wants another person present for the ensuing discussion and also inquires as to the quality of discussions with the spouse, whom the patient designates as the one to potentially make medical decisions; the specific fears and desires of the patient are sought; and the physician recaps what the patient says and asks her if the summary is correct. In addition, resuscitation is explained in detail. The visit concludes with the doctor encouraging future discussions and allowing decision changes.

The film ends with the finale to the opening scene. The patient slams the door on the grim reaper, who, beset by dogs, returns to Dr. Fletcher and advises the doctor to talk to his patients himself.

View full annotation

Summary:

Maren Grainger-Monsen, a filmmaker and emergency medicine physician, chronicles her personal journey towards understanding death and dying as she explores the stories of those near death. The film uses a metaphor of the thread of life, and the three Greek Fates who control life (spinning, measuring and cutting this thread), to interweave Monsen's journey with the lives--and deaths--she encounters.

The film begins with her recollection of two experiences during her emergency medicine training: the first time she is paged to pronounce someone dead and a "crisis point"--resuscitating a patient, brought to the emergency room, who had specifically requested no resuscitation. The remainder of the film focuses on Jim Brigham, a social worker for a hospice program, whom Monsen joins for his home hospice visits and who relates the touching and memorable story of his wife's life and death.

Some of the patients Jim visits are Tex, a man dying of heart failure who had experienced a difficult, scary night; Sean, who has Lou Gehrig's disease and who needs help with paperwork and family concerns; and Anna Marie, who has lymphoma and is taken via ambulance to the hospital for comfort measures. Monsen notes how comfortable Jim is discussing death issues and how compassionate and caring he is with a recent widow in the midst of her "grief work." By contrast, Monsen admits to feelings of helplessness, vulnerability, even terror. She wishes her medical education had not been so devoid of teaching regarding death and dying.

Monsen comments on the wavering line between life and death, and whether the "medical machine" prolongs life or death. She visits a young boy left with severe brain damage following a near-drowning incident and "successful" resuscitation 5 years previously. The boy requires constant care, but his father notes that his son is "doing pretty good."

By the end of the film, Monsen has learned "how to sit with someone . . . while death walks into the room." Death no longer equates with failure. She concludes with her overvoice, "I wonder what it will be like to be a doctor who doesn't see death as the enemy."

View full annotation

Summary:

This book, designed to accompany an exhibition "on the frequently Excessive & flamboyant Seller of Nostrums as shown in prints, posters, caricatures, books, pamphlets, advertisements & other Graphic arts over the last five centuries," displays and comments on 183 illustrations associated with the art of quackery. As the title suggests, Helfand surveys the graphic material of quackery of England, France, and America during the modern period, although most of the material dates from the eighteenth and nineteenth centuries. In his introduction, Helfand discusses the uncertain boundaries between "regular" (now termed allopathic) physicians and their "irregular" or "empiric" counterparts--quacks.

Through the mid-nineteenth century, many practitioners of both sorts relied on pharmaceutical agents like mercury, antimony, and opium; developed trade symbols and packaging; and flaunted the honorific "Dr." and their affiliation with science. Many patients visited both regulars and irregulars, who might consult with each other. Some physicians even prescribed quacks' proprietary preparations. Helfand also notes differences, such as irregulars' lack of medical training, exaggerated advertising, refusal to disclose the contents of their products, and use of entertainment and sometimes even religion in their "medicine shows."

View full annotation

Summary:

In the fall of 1979, Keith Burton, a free-lance journalist, saw the videotape 0105 in a bioethics seminar at Southern Methodist University (see annotation in this database). The structural centerpiece of this 1974 documentary is the interview of a burn patient, Donald "Dax" Cowart, by psychiatrist Dr. Robert B. White at the University of Texas Medical Branch in Galveston. Dr. White had been called in to determine the patient’s competency because of his persistent requests to end the painful treatments, to go home, and to die.

Similar to most viewers of Please Let Me Die, Burton was intrigued by the unanswered questions and the uncertain outcome of the case and ultimately contacted Dax Cowart and his mother, Ada Cowart. Burton invited their collaboration on a follow-up videotape to Please Let Me Die, with the intention of providing "a living record of this man’s struggle for release from pain and despair." [see Keith Burton, "A Chronicle: Dax’s Case As It Happened." In Dax’s Case: Essays In Medical Ethics And Human Meaning, ed. Lonnie D. Kliever. (Dallas: Southern Methodist University Press) 1989: 1].

View full annotation