Winter 2004
ARTICLES Disease and Destiny and the postcard from Athens Commentary: Medical history without medicine
William Carlos Williams, M.D.: Lessons for physicians from his life and writings This paper introduces the life and literary works of physician-author William Carlos Williams (1883-1963). Williams trained in pediatrics and obstetrics, practiced full-time, and wrote voluminously. In his stories, he portrayed the variety of individuals he met in the clinic and on home visits; recounted many of the frustrations, setbacks, and failures that he experienced as a small town physician; and described his encounters with poverty and other social ills, non-paying and non-compliant patients, unethical doctors, and monolithic, unsympathetic bureaucracies. Through his writing, he achieved a catharsis and, he believed, improved his ability to communicate with his patients. Many of Williams' concerns continue to affect today's physicians, and his observations and advice possess immense value for those interested in ethics and humanism in medicine.
Everyday amnesia: The curious effects of a common drug Versed (midazolam) belongs to a class of drugs called the benzodiazepines, drugs which are well known for their sedative, anti-anxiety and memory-blocking effects. Versed's anti-anxiety effect is arguably its most clinically useful attribute; however, the amnesia it produces certainly is its most striking feature. Under the influence of Versed, patients become powerless and vulnerable. They are in a state of diminished inhibition and judgement. And they will not likely remember much, if anything, about their experiences on Versed. While Versed may render patients remarkably vulnerable and potentially leave imprints invisible to the conscious mind, its utility in the clinical setting is undeniable, its effects clearly beneficial. Used properly, Versed can dissolve the tension and discomfort of hospital visits and contribute to the efficiency and ease of modern medicine.
Is there magic in tropical rain?
A medical student's review of the British National Health Service (PDF) Great Britain's National Health Service (NHS) was examined from the perspective of an American medical student. The NHS is a government financed health system that provides health care to all people in Britain regardless of their ability to pay. Its history, evolution and current operations are influenced by politics and the media. Universal access to care in the NHS is limited by waiting lists and the NHS is stretched to its capacity, creating roadblocks to effective patient care. Its commitment to the entire lifespan of a patient gives the NHS incentive to invest in preventive medicine. However, its totality of responsibility accentuates the moral dilemma of balancing what is best for an individual and what is best for society given limited resources. In light of its many differences, the NHS has similar health outcomes to the US health care system, with the exception of Britain's lower infant mortality rate. Commentary
Guidance for the doctor's physician child
PERSPECTIVES How life imitates baseball A patient with an unusual genetic disease, von Hippel-Lindau syndrome, confronts his mortality. He relates to his physician through their mutual interest in baseball, and gives him a special gift that perfectly expresses his pre-operative anxiety.
POETRY Code Blue The Dead Baby Desire VA April 2002 What Doctors Depend On Sleeper Cells The Hypochondriac |
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