Showing 641 - 650 of 906 annotations tagged with the keyword "Doctor-Patient Relationship"

Bodily Harm

Atwood, Margaret

Last Updated: Nov-17-2003
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Rennie is a freelance magazine writer. She writes mostly about fashion trends or travel and spends her free time with her controlling but sensual boyfriend, Jake. Her life changes dramatically when she finds out she has breast cancer, then has one breast removed. She feels as if she is about to die, as if worms are eating away at her insides.

Her boyfriend pretends to feel fine about it, but Rennie senses his disgust and their relationship ends. She realizes that she is in love with her surgeon. After all, he has seen a part of her that even she herself has never seen--her inside. The married surgeon is guilt-ridden and Rennie decides to go on vacation.

She ends up on a small island near Grenada. While she is there, a coup breaks out. Rennie becomes a hostage. Upon her release, she returns home. Now, however, she feels lucky to be alive and feels more alive than many around her.

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Middlesex

Eugenides, Jeffrey

Last Updated: Nov-16-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The narrator of this fictional autobiography is Cal Stephanides, an American of Greek descent with a hereditary 5-alpha-reductase deficiency that gives her the prepubertal anatomy (and thus the social upbringing) of a girl, but at puberty begins her transformation into ambiguity, then maleness, and then, gradually, masculinity.

The novel is a kind of biography, not just of Cal, but also of the mutant gene that causes her/his condition. It is transmitted from a small village in Smyrna, through his grandparents, who were also brother and sister and who married on the ship to America, apparently leaving behind family as well as national identity. Their Greekness and the gene come with them, and the consequences of their incest haunts Cal's grandmother, Desdemona, until the very end of the novel.

The family settles in Detroit, and a third biographical strand is the story of the Greek immigrant community in 20th century America, from Ford's assembly lines to bootlegging during the prohibition, through Detroit race riots and then to affluent suburbia.

Cal's family settles in the suburb of Middlesex, and the focus narrows to the individual. Calliope is raised as a girl, but in adolescence, Callie learns about hermaphroditism, narrowly escapes sex-assignment surgery, becomes a performer in a seventies sex show in San Francisco, and finally returns home to Middlesex, Grosse Point, Michigan, as a male. The story is framed by Cal's much later adult life as a man in Berlin, and his successful romance with a woman he meets there.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In 1869, national and medical attention was focused on a poor family in Wales. The daughter, twelve year-old Sarah Jacob, was bedridden with a strange ailment characterized by paralysis, staring fits, and anorexia. Yet she did not waste away. On the contrary, she seemed to survive comfortably with only few drops of water daily. Credulous folk came to visit, knowing that such abstinence had been the practice of many Christian saints; they would leave a few coins as an offering, although the family protested that money had never been requested. Others claimed it was a hoax.

Eventually the doctors and vicars became curious. An initial investigation upheld the family’s position that the girl did not eat. A more rigorous second investigation was designed by medical professors from Guy’s Hospital in London and carried out by trained nurses who sat knitting at the bedside. It resulted in the girl’s death.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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Wrongful Death

Gilbert, Sandra

Last Updated: Oct-21-2003
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir reconstructs event by event the hospitalization of the author’s husband, Elliot Gilbert, for prostate surgery, his death in the recovery room, and the efforts of his wife and family to find out why he died. The account of those efforts over the ensuing months, which involved friends and lawyers, raises numerous legal, social, and medical questions about how medical mistakes occur; how the medical establishment may seek to protect itself; patients’ and families’ rights to information about norms and procedures; and the vulnerability of both patients and doctors in a litigious environment. The book also reflects on the process of mourning, and begins with an acknowledgment that the writing of it has constituted part of that process.

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Annotated by:
Woodcock, John

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.

Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.

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The Imaginary Invalid

Molière

Last Updated: Oct-21-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Summary:

Argan, a fearful but miserly hypochondriac, divides his time between summoning the doctor to care for his ills and trying not to settle the resultant bills. He resolves to marry his daughter, Angélique, to a medical student, hoping to acquire unlimited access to gratis consultation. The chosen fiancé is an unattractive dolt, who would never interest Angélique, even if she were not already in love with clever, handsome Cléante, who poses as her music instructor.

Argan's wife, however, plans to send Angélique to a convent, removing her from the line inheritance. At the urging of the sensible servant Toinette, he feigns death to test his wife's affection only to discover her contempt. Again with the help of Toinette, the young lovers convince Argan to liberate himself from the twin tyrannies of his ailing body and his grasping physicians by becoming his own doctor. The play closes with the physicians' lively examination of Argan and his entry into the profession, full of musical pomp and pidgin Latin.

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Doctor Glas

Soderberg, Hjalmar

Last Updated: Oct-21-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is the fictional journal of four months in the life of Doctor Tyko Glas, a turn-of-the century Swedish physician, who writes, "How can it have come about that, out of all possible trades, I should have chosen the one which suits me least?" Though Doctor Glas is over 30 years old, he has "never been near a woman." In fact, he finds the physical aspects of sexual intercourse rather repulsive. Even more repulsive is his patient Rev. Gregorius, a nasty 57-year-old minister who happens to have a lovely young wife.

One day Mrs. Gregorius, also his patient, presents Doctor Glas with a strange request. Her husband's sexual advances have become onerous to her. Could the doctor tell him that she suffers from a pelvic disease and, therefore, must avoid sexual relations for several months? Doctor Glas agrees to do so, but the Rev. Gregorius is not easily put off. He believes that God has given married couples the duty to procreate, so sex is not simply a question of pleasure or preference. It is a question of duty. Thus, he rapes his wife, believing that their sacred marital duty is more important than her health.

Meanwhile, Mrs. Gregorius admits (to the doctor) that she has fallen in love with someone else, a handsome young businessman. As the summer progresses, it is clear that Doctor Glas has fallen in love with his patient, a love that is as tortured as it is silent and unrequited. Eventually Glas becomes convinced that he must save his patient from her repulsive husband's advances by murdering him.

Thus, the doctor carefully plans to poison the minister, using cyanide pills that he had once prepared for his own suicide. His plan is successful. The minister dies of an apparent "heart attack." Unfortunately, at around that time the handsome lover announces his engagement to another woman. The bereft Mrs. Gregorius, who sees nothing in the doctor, is left alone. Doctor Glas is also alone. "Life has passed me by," he ruminates.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

A philosopher and a clinical ethicist conduct an analysis of the practice of assisted suicide. They begin with the premise that health care providers may at times be assisting with suicide now, whether or not it is legal and whether or not the ethical dimensions have been solved. They contend that assisting a suicide might be morally right, but only when the patient’s choice is rational and free.

Referring to an earlier publication by Prado (Last Choice: Preemptive Suicide in Advanced Age, 1990; 2nd ed. 1998), they devote a chapter to each of three criteria used to determine the "rationality" of a choice for suicide, and another chapter to the "slippery slope" argument. A final chapter summarizes their contribution to this topic.

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Summary:

The sculptor Ken Harrison (Richard Dreyfuss) is badly injured in a car accident and finds himself in the middle of life permanently paralyzed below the neck and dependent on others for his care and survival. Ken is a strong-minded, passionate man totally dedicated to his art, and he decides he does not want to go on with the compromised, highly dependent life that his doctors, his girlfriend Pat (Janet Eilber), and others urge on him. He breaks up with Pat and fights to be released from the hospital, to gain control of his life in order to stop the care that keeps him alive and unhappy.

His antagonist is the hospital's medical director Dr. Emerson (John Cassavetes), who believes in preserving life no matter what, and so tries to get Ken committed as clinically depressed. Ken's attending physician, Dr. Scott (Christine Lahti), begins with the establishment but gradually moves toward Ken's position.

The film ends with the judge at a legal hearing deciding that Ken is not clinically depressed and that he thus has the right to refuse treatment and be discharged. In the last scene, Ken lies in a hospital bed framed by his own sculptural realization of the forearm and hand of God from Michelangelo's Creation of Man.

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