My Medical Literature Experience

Throughout the semester in Dr. Tuthill’s Medical Visions in Literature course, we have read literature ranging from the Hippocratic Writings, to Mary Shelley’s “Frankenstein,” to Kafka’s “The Metamorphosis,” to Gunther’s memoir about his son Johnny in “Death Be Not Proud,” to Margaret Edson’s “Wit,” and much more.  Throughout the class, we talked about topics ranging from the purpose of medical literature, ethical dilemmas in medicine, medical issues that are captured within literature, the modern use of literature within the medical field, and more.  These topics encouraged thought provoking conversations and discussions within class which I thoroughly enjoyed.  It was very interesting to have a background in biology and develop my own thoughts and opinions about issues, and to hear the thoughts and opinions of an English major or someone who has experienced different things in life or sees a completely different perspective.  Here are some reflections of what was discussed and what I learned during this course:

In the beginning of class, the study of Hippocrates and the early ways of doctoring and medicine established a timeline that depicts the evolution of medicine from a limited understanding of the human body, perceiving medicine as a method of healing but originally not the most preferred or utilized due to the invasiveness of surgery and lack of knowledge about the field of medicine.  As a contextual person, I enjoyed learning about the roots and very beginnings of the field of medicine so that I could put into context how the medical field developed throughout the years and how the perceptions of medicine have changed throughout time.

After reading literature such as “The Journey of Plague Year” and “The Plague” I learned of how drastic and horrible these diseases were.  For something as tiny as a spec of bacteria or a virus to have the potential to wipe-out an entire population gives a testament to the vulnerability of the human body.  In The Plague, we think more about human nature and the fallibility, and conversely, the strength of man as we watch the town of Oran diminish as the plague spreads. 

Then, we began our study of AIDS and it’s breakthrough into American society.  Due to the variety of literature that we read on this topic, the class was able to compile multiple perspectives of this disease to see how it truly affected so many people, society, the medical field, and the health of the World.  We read Abraham Verghese’s work about the man from Tennessee who came home from New York to die with his parents there and they discovered/found out that he was gay.  We were also exposed to Elisapeth Ritchie’s blunt reality of her life as a young female doctor and her interaction with three patients who have acquired AIDS from one way or another.  By reading this literature, it was good to refresh on the dangers of this disease and to never forget that it is still a pressing issue within the World’s community and society today.

In between these larger readings, we read works by William Carlos Williams, Linda Pastan, Heather McHugh, David Schiedermayer, and Lewis Thomas.  All of these reading were very interesting and each presenting a new perspective or aspect of illness, medicine, literature, etc… I especially enjoyed works by William Carlos Williams as he writes about his interpretation of his medical career and the experiences that he has as a doctor and the way in which his writing captures and perfectly explains his thoughts.  The writings by doctors were particularly interesting to me because these stoic men and women who have to always remain strong are able to express a more vulnerable and emotional side than they are generally able to during a typical work day as a doctor.

After reading “The Death of Ivan Illych,” by Tolstoy and “The Snows of Kilamanjaro” by Hemingway, we compared these two men and their reasons for illness and dying and living.  It was interesting to compare a work by a Russian author and a Cuban writer to see how while they were written in different times and on different continents, the themes are so similar.

Margaret Edson’s “Wit” allowed us to read a different genre of literature, a play, and watch the movie to pass some time with Vivian Bearing, a literary scholar who is suffering with terminal ovarian cancer.  We journeyed with her through her last months of life.

We read many other works such as “Ceremony” and smaller works, so even though I did not identify them specifically in this work, they all contributed to my better understanding of human nature in general, especially after being recognized and discussed thoroughly within the realm of medicine and the medical field.   My medical literature journey has been one of intrigue, emotion, interest, learning, comprehension, confusion, and ultimately pure enjoyment.  I have been surrounded by a great class of friends and peers, who together, we discussed and thought about some of life’s deepest issues, but also about some very interesting, but topically lighter subjects.  I have gained a new perspective on literature, but also of the medical field, doctors, patients, their interactions, and the importance of always remembering that a patient is a person too.  I cannot say if this class has made my decision of whether or not to pursue a career in the medical field any more or less easy, but I have gained so much knowledge and appreciation for medical literature that I cannot determine if my purpose in taking this class should have been to determine my path in life, but rather, to enjoy the journey of literature. Either way, I have greatly benefitted from taking this course.  

Lee Goatley

Advertisements
Posted in Uncategorized | 1 Comment

Vivian’s Wit

Of all of the literature that I read in this class, “Wit” by Margaret Edson stands out in my mind as the work that evoked the most emotion, made me laugh out loud, and allowed me to gain a new understanding of strength and determination.  The multitude and variety of occurrences in the play all contribute to the success and fulfillment of the play in regard to the appropriate amount of humor, sadness, awkwardness, and empathy.  Vivian Bearing, the character in which the play revolves around, has a personality that is very well developed in the play which allows the reader to gain a better understanding of the professor who is a scholar of Donne but who is also a woman who is living a life without a husband, family, or many friends other than a former professor and mentor.  This play contains the perfect amount of humor, sarcasm, and emotion.

 From the very beginning of the play, Vivian’s dominant and lofty personality is introduced as she is being diagnosed with fourth stage, metastatic ovarian cancer.  The dynamic conversation between Vivian and Dr. Kelekian about the meaning of words as he is diagnosing her and her sarcastic comments that are inserted during this conversation nicely establishes her as a stubborn scholar.  During this initial conversation with Dr. Kelekian, she is critiquing his word selection and speaking patterns.  She is mentally creating a checklist to gather literature and assemble a bibliography about cancer. She breaks down the meaning of the word “antineoplastic” by it Latin roots, making it apparent that she is first and foremost a scholar of English and not just a woman who is suffering from a chronic ovarian cancer.  From the very beginning, the reader understands that this play is ultimately going to be tragic, but the timeline from the diagnosis to the death will be entertaining, humorous, sad, and insightful because of the commentary by Vivian. 

 While this play focuses upon the strong character of Vivian, there are some major medical ethical issues that arise throughout the play.  The poor bedside manner demonstrated by Jason, Dr. Kelekian, and some of the nurses within the play highlight the mentality that is sometimes demonstrated by people within the medical profession.  They sometimes see the patient only as a medical case and not as an actual human being who just happens to be suffering from an illness or disease.  Jason, a doctor in his residency and one of Vivian’s former students, creates an awkward environment when he has to give Vivian a pelvic exam.  During the exam, he presents himself as disengaged when gathering medical information from Vivian.  One question he asks is if Vivian has had cancer, and her response is yes, that the reason is there is because she has cancer.  This demonstrates his lack of engagement and concern for Vivian as a person.  Due to the terminal state of Vivian’s cancer, she and her body were used as a medical research project with a new type of treatment.  This required Vivian to be treated with full doses of chemotherapy instead of modifying the dosages to the amount that Vivian’s body could handle. As a scholar, it seems that Vivian somewhat enjoys the idea of giving back to medicine and research because there is really not other option for her survival than if she participates in this new treatment.  However, as the highly aggressive treatments proceed, Vivian realizes that the treatment of her cancer is ultimately what is killing her and is making her life very miserable.  Another ethical dilemma occurs at the end of the play when Vivian dies.  Susie explains to Vivian about being DNR, and Vivian ends up signing the DNR.  So, when Jason finds Vivian and she has died, he calls the code to resuscitate her when in reality he should have done nothing.  He ignored Susie when she was trying to tell him that Vivian was DNR because it was her decision and her right to decide if she was DNR or not, regardless that she was medical research to the doctors. 

 Throughout all of this, Vivian’s character and personality are depicted highlighted upon and expanded throughout the play.  The audience sees Vivian as a small girl, learning new words with her father, they see her as a struggling college student, they see her as a strict and relentless college professor, and then as a dying woman who only wants someone to her.  Vivian’s body was conquered by cancer and the treatments that were given to her, but her spirit and determination and wit were not destroyed which makes her a survivor and heroine to a vicious disease.  While she may have been physically defeated, she was not mentally defeated, never once losing her sense of intellect and astuteness.

Lee Goatley

Posted in Uncategorized | 1 Comment

Doctors Without Borders

I feel that doctors who choose to sacrifice their time in commercial settings to travel to areas with a greater need for medical help demonstrate the true essence of what it means to be a doctor.

Posted in Uncategorized | 1 Comment

Johnny’s Parents

Some criticize the work of John Gunther’s “Death Be Not Proud.” They say that there is too much raw emotion and that he wrote it too soon after Johnny passed away.  They say that Gunther’s portrayal of Johnny is of a young boy instead of a teenager and young man. To counter these arguments, I say, let the man write, he just lost his only son to a tragic battle with brain cancer. If the publisher did not think worthy of publishing, it would not have been published.

Still, I am a little critical of the actions taken by Johnny’s parents during his disease.  One of the arguments that I am countering is that John Gunther portrays his son as a child instead of as a young man.  I am not denying this fact.  I am trying to prove that while Gunther did portray Johnny as a child, it is not reason to denounce this work as a legitimate piece of literature. 

The truth in the matter is that John Gunther and his wife Frances took some actions during Johnny’s sickness that I find insulting to Johnny, but others may argue that these actions were just precautionary measures that parents take.  After Johnny was diagnosed with a brain cancer had gone through his first surgery, they took the liberty of hiding the encyclopedia which had information about brain tumors.

The first minute he was home after the operation he did what we had anticipated—dived for the Britannica to look up brain tumors.  We had taken the precaution to hide this particular volume because, among much else, the article said that almost all brain tumors end with blindness. I cannot recall now how we explained its absence.  Johnny fumed for a while and then resigned himself to the mysterious ways of parents.”

If I were in Johnny’s situation, I would have been just like him, curious to see what all of the implications, side-effects, and symptoms were a part of this new found illness.  Is hiding the truth always the best option?  Whether or not Johnny had been able to acquire this information, I feel that it was his right to be able to find the information he was searching for if he wanted it.  Yet, his parents had already hidden the book.  Even though he was searching for this information, it was being censored by his parents against his will.  A boy of sixteen or seventeen may not be privileged to all knowledge, but in a situation such a Johnny’s when he is a mature, wise, and very intelligent young man, it is almost as if he deserves this information.  Yet, his parents may have still viewed him as their little boy who should be guarded from the reality of the situation that he was in.  To an extent, I cannot blame them because he is their only child, but to another degree, I resent them for withholding this information from Johnny.     

John Gunther presents his son as a child in many regards throughout the memoir, yet one can still gather the maturity of Johnny.  One of his best friends is a man who taught Chemistry at Andover College.  Mr. Weaver is one of Johnny’s best adult friends, who came over and helped Johnny complete some of his chemistry projects whenever he was physically incapable.  As Johnny’s parents, it may have been difficult, but in some way that had to realize the exceptional maturity of their son.  He is “great friends” with a chemistry professor.  In so many ways, Johnny presents his maturity, and it is even noted by his father as he writes this memoir, yet it is never fully accepted. 

Sometimes I attribute Johnny’s lack of perspective about his illness to his parents.  At one point during the memoir, Gunther shares an excerpt from France’s diary about how Johnny and his mother dance in preparation for an upcoming dance at his school.

 “Today Johnny said, “Oh, Mother—I’ve been waiting for you—I have a confession to make—You were right—as usual about the dancing. At the end of this term, you know, they have the senior prom.  When I get back to school, what’ll I do?…I’ll have to dance! Oh, Mother I’ve been so depressed—“ He was cheerful, confessing…Now he said would I practice with him and I said I’d love to.  I was surprised.  But then injections interrupted and dinner. But after dinner he asked again, and I pushed back the chairs and rug.  And we danced!”

 This excerpt demonstrates that Johnny was a fighter and that he was bound and determined to make it back to school in the spring, yet the reality of the situation was that he was more than likely never going back to school, yet his parents allowed him the false hope of thinking that he would make it back.  It is difficult for me to debate this topic because there is such a fine line between killing Johnny’s hope and determination for survival and then allowing him to accept the reality of his situation. 

From what I gathered in the memoir, Johnny had a very realistic grasp of the situation.  This scenario happened after one of Johnny’s operations.

Johnny recognized me after a while and whispered, “Hello, Pop.” Pause. “Are there going to be any more tests?”

“Good Lord, no! You’re all through with those tests.  Don’t you realize that you’ve had quite a serious operation?”

“Of course,” Johnny answered. “I heard them drilling three holes through my skull, also the sound of my brains sloshing around.  From the sound, one of the drills must have had a three-eighths of an inch bit.”

Another example of when Johnny’s parents treat him as a child is when they attach a cover letter to Johnny’s not to Einstein.  By attaching their own letter, they are informing Einstein of Johnny’s situation, but also invoking a sense of pity from Einstein that I’m sure Johnny would not have wished to have received.  If he were to receive a response from Einstein, he would have wanted it to be because of the content of his own letter, not that of his parents. 

Through criticism of others and my own, I still cannot imagine what Johnny’s parents went through, watching their son die a very painful death to brain cancer.  It is a dreadful circumstance and regardless of how the memoir is written and how Johnny’s parents treated him during the treatment process, he is still ultimately their young son, and will always be their baby boy.  Whether or not Johnny could have maturely processed and handled the information that they withheld from him is never to be determined, but what we do know is that Johnny was a great, caring, bright, and wonderful son whose loss greatly affected the lives of his parents and those around him. 

Lee Goatley

Posted in Uncategorized | 1 Comment

Johnny Gunther

John Gunther’s work “Death Be Not Proud,” a memoir about the death of his son Johnny caused by a brain tumor, is not light reading.  For some reason, I chose to read this memoir during high school for a “leisurely” read.  As a high school student, I recognized the plot, and the story, and tried to indentify with Johnny as he lived his last days.  It was a decent read, but I never thought that I would read this again because it was not a type of writing that I would call “uplifting.” So, when I found out that I would be reading this again in college, I thought to myself, “What more is there about this book that I haven’t already read?” What I found out is that I was able to delve into an entire new level of this memoir.         

Upon reading this memoir for the second time, I recognized the subtleties and humility of Johnny’s personality.  It was evident that Johnny always thought of others first, even though he was the person who was suffering from a malignant brain tumor.  There were many instances and actions throughout the memoir when Gunther highlights Johnny’s character.  He reflects about Johnny soon after his first operation,

 “Particularly, I remember Johnny’s considerateness, even when he got sicker.  Of course he wanted his classmates and other friends of his own age to come for weekends, and several did.  But he would hesitate to ask them, for fear they might be bored—inasmuch as he himself could not join them in sports or outdoor games.  He was vehemently worried that his illness might upset our future plans and about how much it was costing and about France’s work and my book.” 

How often does one meet a teenager who worries about the well-being of his parents in regard to money and their careers?  Maybe I am being critical of teenagers?  Still, for Johnny’s father to stress this aspect of Johnny’s character throughout the memoir is indicative of the respect for Johnny’s character that he had for his son.  It is a large realization for a teenager to understand that by asking friends to come and visit, he there was the potential for them to feel obliged to come and visit him instead of enjoying the weekend to play outdoor sports and spend the time doing things that they would have wanted to do.  And yet, Johnny did have many friends who chose to come and visit him without him even asking for them to come over.  He was a kid that people wanted to be around and with whom they wanted to spend time.  What is more, he was acutely aware of the financial burden that his treatment was costing his mother and father as well as how his illness was affecting their careers.  He wanted to make sure that his father was finishing his writings and considered the time that his mother spent with him and worried about her not working. 

 There was another instance when Johnny does express discontent about having to start a new treatment but he demonstrates composure and positivity the next day.  John Gunther writes, 

I took Johnny out to dinner in Madison and broke it to him that we would be going into town the next day for new and further treatment.  This was a grievous shock.  It was the first time that I saw him seriously upset.  He struggled to keep from tears.  He flung himself away from me and crept upstairs.  Mostly this was because he was midway through preparations for another serious experiment. But by the next morning he was buoyant again-so much so that I dreaded more than I can tell what would have to be the next bad news broken to him, that he could not go back to school.”

 As a person who likes to complete projects that are started, I empathize with Johnny’s frustration when told that he must but his project on hold.  Once a project is in progress, especially a chemistry project which may have to be re-started completely, it is difficult to stop, especially when the reason for stopping is to go and be pricked, prodded, and possibly going through extensive surgeries.  Yet, once again, Johnny wakes up the next morning and chooses to have a positive attitude and to put the feelings of others before his.  I have to wonder if his compliance was due to the hope that he lived longer for his parents’ sake.  Not that Johnny was not resilient and wanted to give up, but he was such a compliant patient and son and rarely showed his resentment to all of the treatments in which he had partaken.

 Johnny had a desire to live and to make others happy.  Just because he was suffering and dying, he chose to make the most of every day that he had instead of giving up and sulking about his situation.  Although, in the end, the cancer ended up victorious over Johnny’s body, Johnny’s attitude was victorious over the cancer. John Gunther says his son “maintained the boldest kind of front,” “he hated to be helped,” and “he died like a man with perfect dignity.”

Lee Goatley

Posted in Uncategorized | 1 Comment

Hands

 The Life of a Hand

The hand is the initial contact place where a mother holds her child for the first time. 

The hand is the support that the child uses when he is beginning to take his first steps in life. 

The hand also serves as a security blanket when the child is walking to his first day of school and he needs that extra little squeeze of support from mom and dad walking on each side. 

 The son then begins to rely on his own hands. 

He learns the importance of helping hands, and how the work of his hands can make a difference. 

He never knew that these two body parts could enable him, in so many ways, to help and provide aid throughout the world. 

He reaches out to others.

He holds their hands through the tough times.

He uses his skillful hands to touch others. 

And then, when he is using his helping hands in a far away country, he holds the hand of a girl who he will forever hold hands with. 

The feel of her hand in his, leaves an imprint in his memory that he cherishes forever.  Her hand, like his, has been a helping hand. 

Together, the strength and potential for the good work that is a result of their hands joining in marriage is amazing.    

Then, as their hands become wrinkled, and hard worked as time progresses, they only hold their grips even stronger as their love has strengthened through the years. 

Their hands shake and are not as dependable, but the evidence of the work of their hands is prevalent. 

The ability of hands to touch so many peoples’ lives when they are acting as helping hands is amazing. 

The gentleness of the hands as they stroke the face of the person they love is indescribable. 

The possibilities and capabilities that are contained within the palm of a hand are drastically understated, simple, and beautiful.     

                                                                                                     Lee Goatley

 We take for granted the capabilities of our hands.  We do not know what it is like without hands, therefore, thoughts of coping through life without them is never a thought.  Now I ask you to reflect on your day, and recall that from the very moment that we wake up in the morning to the moment when our eyes finally close after a long day, we use our hands.  The hand is one of the most significant parts of the body.

During my Gross Anatomy Dissection, I have been constantly switching my thoughts back and forth from physically being in the dissection room with our cadaver and thinking only of the muscles, tissues, organs, and vasculature that I need to know and that I dissect through as the course progresses.  I cut through the spinal column of the cadaver and removed a piece of her back so I could see the spinal cord. Or, I just removed the breast plate and ribs from the body so I could see the heart and lungs, which enabled the donor to live a long life. Then, I leave the lab, and I realize what I just did. 

 Reflecting on dissecting humanizes the donor much more than being in the actual dissection room with a task at hand.  Reflection allows my mind to wander.  This happens daily, and each time I have to realize that the muscles and organs and tissue that I dissect through still comprise a human being, who graciously gave herself for the benefit of science.  It is during these times that I think of the one body part that humanizes the donor in my mind more than any other, and it is her hands.  I think about the peoples’ lives that she has touched with her hands, mine included.  I think about the children that she probably had how she raised them all with her hands and heart.  When I hold her hand to dissect it, I hold her fingers in mine, but it’s almost as if she is holding my hand through it all.  Her spirit and decision to donate her body to science, keeps me motivated to do my best and take the best care of her.   

Lee Goatley

Posted in Uncategorized | 1 Comment

Unspoken Words

We hear what is said, but do we listen to what is said?  Are words necessary to listen? When you are listening, are you listening to what is being said or the words that go unspoken?  

Suddenly I understand, on a moonlit night, after a long, emotional, and tiring day, that within me are these unspoken words that I do not know how to express and cannot describe; yet, they have the deepest significance.  I do not need for anyone to listen, because they cannot hear these words.  And, while I may not understand why I feel the way that I do and why I am the way that I am, these unspoken words that exist outside of the realm of language   There are times when I feel like the unspoken words that resonate within me are the aspects of my being that define me so precisely, yet no one has ever heard these words.  What is more, I wonder if how I define myself can be formulated into some structure that is not only precise, but accurate.  Then I think, if these words that define me were ever verbalized, would they establish all that I am and all that I am meant to be? Would these words forever represent only me, nothing more, nothing less? Consequently, my existence would be reduced to words. 

Does a grandmother still speak the unspoken words of love to her grandchildren even though she cannot physically verbalize the words as a result of a paralyzing and debilitating stroke?  Just because she cannot share advice, wisdom, and knowledge with her grandchildren, her words of love are demonstrated through a hand squeeze, or when she closes her eyes when you kiss her cheek, or when you see that tear of joy escape from her loving eyes.  The beautiful eyes that have watched you grow from an infant to the woman you are today.  The words within her soul soar to you through her spirit, and her love, and her legacy.  It is easy to forget her words if you are deafened by her frail condition, the hard work and personal sacrifices that are necessary for her care, and when it comes down to it, the lack of her actual verbalized words.  But, if you listen carefully, the words of her soul are the loudest and most pronounced of them all, as long as you listen and see the unspoken words.

And what of the doctor? The doctor is reminded daily of his obligation to confidentiality.  He has the ability and talent to formulate the words that relate symptoms to illnesses, patients to healing, medicine to diseases, yet so many times, he must repress all of this knowledge for the protection and safety of patients, their families, and even himself.   Amidst the brilliant minds of doctors, how many original, creative, never-before-thought-of thoughts must occur on a daily basis within the minds of doctors that go unspoken due to their vocational responsibilities?  The amount of information that must be withheld, even from their spouses, is probably not imaginable for those of us who do not live the life of a doctor.  Verbalizing thoughts and sharing feelings are therapeutic acts that allow people to cope with challenging situations in life.  

I hold within me, my unspoken words—some to be shared some day, others have their permanent residence within my mind, my heart, my soul.  I have seen the transfer of the inaudible words of love from heart of my grandmother to the depths of my own heart.  Those words signified a piece of her love to reside within me forever.  Then, I imagine, can I be the doctor who has the unspoken words perfectly aligned and categorized within my mind, yet be restricted with the inability to tell a soul of what I know?  Can I express my compassion and understanding through unspoken words? Can I rationalize within my mind that though the words that I may have in my mind cannot be spoken, they exist nonetheless, and that is why I choose to hold back so many words, because the actuality of the art of healing and care for others wins out over unspoken words? Maybe someday those unspoken words of the doctor will be my next set of unspoken words?

Lee Goatley

Posted in Uncategorized | 1 Comment