Showing 311 - 320 of 608 annotations tagged with the keyword "Physician Experience"

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This remarkable book takes the reader into a Dutch nursing home where many of the 300 patients are terminally ill. The main protagonist is Anton, a competent, tough, and compassionate physician who tries to discover some meaning in the suffering of his patients, while at the same time disavowing any such meaning. Anton’s colleagues include Jaarsma, a somewhat detached and bureaucratic older physician, and Van Gooyer, a young physician who still believes that science has all the answers.

The first-person narrative consists of short, punchy segments (almost like an endless series of discrete physician-patient interactions) detailing the stories of Anton’s patients and his reactions to them. Many of these persons request assisted suicide or euthanasia. Anton reveals what he feels about these requests, how he goes about judging their validity, and the manner in which he actually carries out assisted deaths. A strong spiritual theme permeates the book; while Anton denies the relevance of God and religion, he seems constantly to be searching for a spirituality that "makes sense" of contemporary life.

View full annotation

The Dead Lake

Huyler, Frank

Last Updated: Aug-16-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator is an ICU (intensive care unit) resident. He describes his encounters with three patients: a 23-year-old woman, Kimberley, shot in the head by her fiancé before he killed himself; Mr. Wilson, the alcoholic into whom Kimberley’s liver is transplanted after she has been declared brain dead; and Mr. Griego who, in a failed suicide attempt, has shot off his lower jaw.

In the call room there is a poster that reminds the doctor of a lake in Vermont where his family had vacationed when he was a child. The lake, alive with fishes, had filled the boy and his brother with expectation: "We wanted something to happen, we wanted it to come gliding out to us, miraculous, powerful, full of wonder." (p. 56)

When the resident’s thoughts are interrupted by Mr. Griego, who has leeches attached to the wound where his chin is being constructed, his recollections shift to another lake. Overgrown with algae, it had insufficient oxygen, no fish, and when he and his brother swam in it, they emerged covered with leeches. He recalls the violence with which his brother tried to kill one of the creatures, pounding it with a rock. The lake had become "repugnant" but also "exciting."

These memories are juxtaposed with Mr. Wilson, who has Kimberley’s young liver in its new, "damaged bed." The resident finds himself withdrawing from Mr. Wilson, whom he imagines as a ghost that has haunted Kimberley’s life, drinking it away, or as a kind of monster rising up from beneath the surface of a lake.

The resident is called out a third time, to transfer Mr. Griego to the floor. The leeches have been removed and killed and his chin is healing well, looking both "clean and terrible." His new face will scare his little daughter, the resident thinks.

View full annotation

Annotated by:
Belling, Catherine

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This film traces the shared career and dissolution of Beverly and Elliot Mantle, male identical twins (both played, thanks to seamless special effects, by Jeremy Irons) who are gynecologists, running a successful fertility clinic in Toronto in the 1980’s. They share both work and personal lives; Elliot, the dominant twin, lectures at the hospital, accepts awards, plays the smooth professional--and seduces women. Beverly, the quiet one, sees patients, does research--and sometimes has affairs with women his brother passes on to him.

They usually draw the line at patients, not because of ethics, but because "it’s not safe." Their dealings with women have to be carefully compartmentalized, for the ambiguous intimacy of the gynecological doctor-patient relationship is difficult and dangerous for the twins, who form a psychologically unstable and deeply interdependent relationship on their own, likening themselves to the original Siamese twins, Eng and Chang, whose names they eventually take on, too.

Their symbiotic system is disrupted when a television actress, Claire Niveau (Genevieve Bujold), consults them about her infertility. She has a trifurcate uterus--the twins call her a "mutation"--and will never have children. Elliot, fascinated, seduces her, and then gives her to Beverly, who falls in love, with disastrous consequences. When Claire discovers that they’ve deceived her and temporarily leaves, Beverly becomes addicted to the amphetamines and sleeping pills that Claire habitually abuses.

The drugs impair his work, he begins to hurt patients, is hospitalized, and after a calamitous breakdown in the operating room (where Beverly attempts to use the monstrously beautiful surgical instruments he designed himself

"for operating on mutant women") both brothers keep their hospital privileges only on condition that they don’t use them. Elliot tries to rehabilitate Beverly, but realizes that the need to do so comes from their absolute interdependence--they might as well be physically joined. So Elliot begins taking drugs as well, and when Claire returns and Beverly goes back to her, Elliot breaks down completely.

The rest of the film traces Beverly’s failed attempt to become a separate individual. The instruments he invented are now, he says, "for separating Siamese twins," and, in a terrifying surgery scene, the drugged Beverly "operates" on his conscious though equally drugged brother, apparently disemboweling him. Next morning, Beverly leaves the apartment where his dead brother lies and calls the woman he loves, but he cannot talk to her. He goes back, his bid for independent identity a failure, and the film ends on a shot of the two, dead, in an embrace echoing the Renaissance anatomical illustrations of in utero twins which illuminate the film’s opening credits.

View full annotation

Doctor Zhivago

Pasternak, Boris

Last Updated: Aug-09-2006

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This complex novel is difficult to summarize. The main characters are introduced separately. We meet Yurii Andreievich Zhivago (Yura) when he is ten, at his mother’s funeral. He goes on to study medicine, write poetry, and marry a young woman named Tonya. We first encounter Larisa Foedorovna (Lara) as the adolescent daughter of a widow who has been set up in a dressmaking business by Komarovsky. Komarovsky later harasses and seduces the young woman. In her anger and guilt, the impulsive Lara tries to shoot Komarovsky at a grand Christmas party, but she misses and inadvertently wounds another man. Subsequently, Lara marries Pavel Pavlovich (Pasha), her childhood sweetheart.

All this takes place against the background of social upheaval in pre-World War I Russia. When the war begins, Yura joins the Army medical corps. Pasha leaves Lara and their daughter Tanya to enlist in the army. When Pasha is reported lost behind enemy lines, Lara becomes a military nurse in order to search for him. Thus, Lara and Yura meet at a hospital where his wife Tonya has just delivered a baby boy. Lara and Yura feel attracted to one another, but neither one expresses it. At this point the Revolution breaks out in Petersburg.

As the fighting rages, Lara and Yura are posted to a hospital in a small town, where Yura struggles with his feelings. When he reports his friendship with Lara, Tonya assumes incorrectly that they have become lovers. Over the winter there are food shortages and the threat of a typhus epidemic. As the war ends, Yura returns home to Moscow, and to his old job at the hospital, but his co-workers are suspicious of him. Influenced by Bolshevism, they dislike his use of intuition instead of logic. The family resolves to travel to the Urals. Amidst Marxist rebellions, Yura's family finds room in a cargo train. During the long train ride, Yura reflects on the suffering of peasants and prisoners caused by the revolution. He shares the desire for equality and freedom, but is disenchanted by the revolutionaries' pedantic, insensitive opinions.

The family safely arrives in the Urals and set up a farm. During the long winters, Yura returns to writing poetry. While visiting the local library, he re-encounters Lara. They begin an affair, sharing a common joy in a fully-lived existence. Lara is aware that her husband is still alive, having become a feared member of the Red faction under another name (Strelnikov). Yura resolves to tell his wife about his unfaithfulness and to ask forgiveness, but as he rides home, he is kidnapped by a faction in the Civil War (the Reds) and forced to serve as their doctor.

After some years, Yura escapes from the Reds and walks back to find Lara, who still lives in the same place.  To escape being informed upon, Lara and Yura flee to the farm house where Yura and his family once lived. Again, Yura turns to his poetry, expressing his fears, courage, and love for Lara. He learns that Tonya and a new baby daughter have been deported from Russia. One night, Lara's old lover, Komarovsky, appears and tells them that the triumphant revolutionaries know where they are and will inevitably kill them both. He offers to take them abroad, where Yura could rejoin his family. Yura refuses to accept help from Komarovsky. To save Lara's life, though, he tells her that he will follow them out of the country, but actually remains behind. Alone, he turns to drink.

One night Lara's husband, Strelnikov (Pasha), who is fleeing the new government, arrives. When he learns of Yura and Lara’s love, he leaves the house and shoots himself. Yura then goes to Moscow where he strikes up an affair with Marina and becomes a writer of literary booklets.  His brother finds him a job at a hospital, but on his way to his first day at work, he dies, presumably of a heart attack. Lara, who had been living in Irkutsk, has returned to Moscow and wanders accidentally into the house where his body lies waiting for burial. After several days, Lara disappears, presumably captured and sent to a concentration camp.

View full annotation

Mercy

Selzer, Richard

Last Updated: Aug-08-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A man dying of pancreatic cancer has reached the point where the pain is no longer controlled by morphine. In the hospital he begs for death. The surgeon tells his wife, "To give him any more would kill him." "Then do it," she says.

He returns with three syringes of morphine and finally injects them, but the man will not die. How easy it would be to suffocate him! But the surgeon rejects this thought and leaves the room, having failed to provide euthanasia.

View full annotation

Search for Oz

Bronson, Richard

Last Updated: Jul-26-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is a collection of 61 poems by physician-poet Richard Bronson. The first and largest section contains many poems related to the poet's medical life and experience, including several that arose from his formative and bittersweet years at New York's Bellevue Hospital ("A Bellevue Story," "I Shall Be Your Vasari," and "Pain"). Others re-imagine events in the history of medicine ("The Knowledge," "Plague Doctor," and "The Man Who Dissected His Wife's Brain")

The second section, "Ten Portents of the Future," contains poems that examine the symptoms and signs of contemporary malaise, but find the diagnosis uncertain and the prognosis . . . who knows? It appears grim, though: "I am a lame man / gone to seed / at the terminus of an age." ("After the Big Bang," p. 94) In his last suite of poems, "Six Aspects of Love," written to his wife, Bronson reveals his strong, but purely personal, antidote for the cruelty of our "barbarous times."

View full annotation

The Blood of Strangers

Huyler, Frank

Last Updated: Jun-21-2006
Annotated by:
Davis, Cortney

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In 28 autobiographical stories, the narrator writes of his patient encounters (and self encounters) as a medical student, resident, and finally Emergency Room attending physician. "The Unknown Assailant" opens the collection, a tale of a criminal and his victim who are both brought into the doctor-narrator's emergency room. The young doctor chooses "the young one" (p. 1), not knowing he is the assailant, and works frantically to save his life. This criminal allegedly killed two men a year before, but his current victim lives and the doctor learns the story of the attack from this victim's point of view. The assailant, who slowly recovers, has "an aura about him" (p. 5) and the doctor is strangely drawn to him, thankful that this man means him no harm. Perhaps aware of the irony of healing a man who, in another environment, might kill him, the doctor helps the assailant get better.

This underlying theme--that nothing is black and white in medicine or life--shapes every story. "Prelude," is the revealing, three-page tale of a medical student's life outside the hospital juxtaposed with his first encounter with death in the anatomy lab.

Every story deals with significant issues: the physician's inner emptiness when a patient dies ("Through the Dark, Softly"), how a greater power might suddenly intervene ("Faith"), how narrow the margin is between a successful and a missed diagnosis ("Sugar"), how both patients and residents survive because of, or in spite of, their medical attendings ("A Difference of Opinion"), and how things that seem final or sinister--like death and leeches--become instruments of hope and cure ("The Dead Lake"). [Sugar and The Dead Lake have been annotated in this database.)

View full annotation

A Country Doctor

Jewett, Sarah Orne

Last Updated: May-17-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Nan Prince is an orphan who becomes the ward of the local general practitioner, Dr. Leslie, upon the death of her elderly aunt. Nan and Dr. Leslie develop a close emotional bond. She is a bright young woman who enjoys accompanying him during his long day's work as a country doctor in Oldfields. They often discuss medicine and healing. Dr. Leslie encourages Nan to read medical books, while instilling in her an understanding of the intimacies of his patients' lives and a love of caring for them. He would like to see her become a physician, an ambition she soon begins to pursue despite many obstacles. She goes away to medical school in the city.

After her first year at medical school, she spends part of the summer in the town of Dunport where she is introduced to her closest relative, Miss Prince (her father's sister), and the "smart" society she has never experienced in the country. Miss Prince and Nan's new friends are all amazed and scandalized by the thought of a woman becoming a physician. They think the whole idea is utterly outrageous, especially for a young, attractive woman like Nan.

She meets and falls in love with a young lawyer, George Gerry, who asks her to marry him. With great emotional pain (but no hesitation), Nan chooses medicine over marriage. She returns to medical school and, after graduation, to spend a year in Oldfields practicing with Dr. Leslie. In the end she stands by the river on a beautiful summer day, raises her hands to the sky, and exclaims, "O God . . . I thank thee for my future!"

View full annotation

Remnant

Lieberman, Michael

Last Updated: May-12-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is a sequence of 45 poems on the Holocaust. Of course, "on" is impossible. These poems suggest, approach, reflect and consider. They range from the tale of the Maker of Walls in Krakow who chooses to make his new wall out of "jewstone," which is cheap and conveniently sized, since it consists of gravestones; to a paean in which the poet asks the blessing of "the god of small poets" to take pity on him: "May a self-righting gyroscope inhabit me and guide me. / May I smell the lilacs of my parents' yard."

The poems situate themselves in gnomic utterance ("Black Forest Cake" and "Women"), narrative movement ("Amsterdam" and "Grace Note"), ironic lyricism ("Idyll" and "Spring"), and reflective toughness; take "Nothing" for example: "He leaves us nothing / as a remnant of His people."

View full annotation

Change

Massad, Stewart

Last Updated: May-08-2006

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator is an aging, male gynecologist who works in a small North Carolina town. The National Health Service sends a young doctor, Rachel, to work in the clinic. From Boston, she is unused to the town's racial politics. She learns slowly to understand the motivations and concerns of her patients. As she campaigns for condom distribution, she ends up insulting the white men who run the town by calling them racists.

The narrator protests that they have power in the town only because no blacks ever run for office and that their policies are meant to distribute wealth evenly. He encourages Rachel to be more gentle and womanly. She will get her way more easily if she smiles. But Rachel eventually turns her back on the narrator, too, when in order to get a violent black man out of the clinic's lobby he calls the man "boy" and threatens to call the police. Rachel moves in with a black man. The town has revenge when a hit and run driver kills her lover and Rachel is hounded out of town.

View full annotation