Latest Issue - Winter 2008
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Editorial: "There is nothing more hostile than water turning into ice"
And then there were eight “My medical school class is smaller now. Out of the ten of us who started in September, now there are eight. The cost of a career in medicine never felt so real.” Among medical students the prevalence of mental illness is 15-30%, three times higher than the rate of depression in either the general population or age-matched peers. Even more alarming is a report that the chance of dying by suicide is 70% higher for male physicians and 250-400% higher for female physicians compared to non-physicians. Untreated depression is a major concern in our professional community. Many in the medical profession continue to stigmatize mental illness and several organizational and regulatory barriers discourage physicians from seeking help. This essay discusses the recent experience of my medical school class and potential reasons physicians are reluctant to seek help. My university’s comprehensive plan for medical student wellbeing is presented as well as suggestions for practicing physicians and educators.
Portraits: Goya and his physician, Dr. Arrieta Many artists have depicted doctors, either alone as in portraits, or with their patients, but there was no picture of the doctor-patient relationship to rival the one Goya painted in 1820. It is variously titled Goya curado por el Dr. Arrieta, or Self-portrait with Dr. Arrieta.
Gravy and gratitude in the poetry of Raymond Carver In 1977, the great short story writer and poet, Raymond Carver, was told he had 6 months to live- unless he quit alcohol. Somehow, he managed to do it, only to be stricken with metastatic lung cancer 10 years later. In this essay, the author examines Carver’s poem, My Death, in which he expresses gratitude to his friends and family for their support and love. Reading this poem may change the way readers, particularly physicians, think about death. The poem describes what many of us would call “a good death.”
Captive of art, not disease: Paul Klee and his illness, scleroderma Paul Klee (1879–1940) was one of the twentieth century's most influential artists. Klee's life was cut short by the autoimmune disease scleroderma that, as so often is the case, began insidiously and was at first difficult to diagnose. Finally diagnosed at the age of 57, Klee's scleroderma had a profound effect on both his artistic style and productivity. Following a year of profound fatigue and malaise with marked reduction in artistic output, Klee's spirit seemed to rally. Perhaps sensing his own mortality, the final years of Klee's life saw a tremendous outpouring of work. Like the metaphor of one of his late paintings, Gefangen (Captive), Klee felt imprisoned by his disease, yet he managed to escape and come to grips with his mortality through artistic creativity.
Jack London's "chronic interstitial nephritis": A historical differential diagnosis On November 22, 1916, Jack London, America’s best known author at the time, died in his California home at the age of 40. Although the death certificate reported renal failure as the cause of death, almost a century later, questions remain for some whether London committed suicide with a morphine overdose. Unfortunately, an autopsy was not performed and his medical records have not been preserved. We do, however, have a rich medical history provided by the patient. London’s own writing and the archive of his personal papers at the Huntington Library in San Marino, CA, unravel a case of self-inflicted mercury toxicity that began during London’s cruise of the South Seas in 1907 and defines the author’s heretofore unexplained chronic kidney disease.
The smirk My first rotation as a third-year student was in the colorful neighborhood known as "Boystown" in Chicago. Armed with my stethoscope, reflex hammer, tuning fork, and pocket book, I was eager to diagnose and save everyone. However, the people were not sick. What was the purpose of seeing the not-so-sick patients? I was beginning to doubt my patients and myself. Then, Jon walked in.
Searching for God below the vocal cords It is Saturday, June 21, 2003, approximately 7:00 am. I am content, as I have managed to capture a few hours of uninterrupted sleep while on call. I am eager to leave—I was not supposed to take call last night, but the resident in charge had a family emergency and I was summoned to duty. Suddenly the speaker next to the head of my bed announces, “Attention, attention, code blue, pediatrics, admission entrance!” My first thoughts are “It can’t be real! It cannot be there. No one codes in the entrance to the hospital!”
Path in the Afternoon Dance of the Student Doctor A July Matinee She Lay Quietly New Art A Tribute to Medical Stereotypes Encourage Their Children A Moment My Own Two Eyes |
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