From a doctor Oliver Sacks has called a “born storyteller,” a riveting account of practicing medicine at a fast-paced urban hospital For two decades, Dr. Danielle Ofri has cared for patients at Bellevue, the oldest public hospital in the country and a crossroads for the world’s cultures. In Medicine in Translation she introduces us, in vivid, moving portraits, to her patients, who have braved language barriers, religious and racial divides, and the emotional and practical difficulties of exile in order to access quality health care. Living and dying in the foreign country we call home, they have much to teach us about the American way, in sickness and in health.
Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.
Patients, anxious to convey their symptoms, feel an urgency to "make their case" to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. ... Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us."--Jacket.
“A fascinating journey into the heart and mind of a physician” that explores the doctor-patient relationship, the flaws in our health care system, and how doctors’ emotions impact medical care (Boston Globe) While much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But understanding doctors’ emotional responses to the life-and-death dramas of everyday practice can make all the difference on giving and getting the best medical care. Digging deep into the lives of doctors, Dr. Danielle Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Ofri offers up an unflinching look at the impact of emotions on health care. Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. Ofri also reveals that doctors cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.
A “finely gifted writer” shares “fifteen brilliantly written episodes covering the years from studenthood to the end of medical residency” (Oliver Sacks, MD, author of The Man Who Mistook His Wife for a Hat) Singular Intimacies is the story of becoming a doctor by immersion at Bellevue Hospital, the oldest public hospital in the country—and perhaps the most legendary. It is both the classic inner-city hospital and a unique amalgam of history, insanity, beauty, and intellect. When Danielle Ofri enters these 250-year-old doors as a tentative medical student, she is immediately plunged into the teeming world of urban medicine: mysterious illnesses, life-and-death decisions, patients speaking any one of a dozen languages, and overworked interns devising creative strategies to cope with the feverish intensity of a big-city hospital. Yet the emphasis of Singular Intimacies is not so much on the arduous hours in medical training (which certainly exist here), but on the evolution of an instinct for healing. In a hospital without the luxury of private physicians, where patients lack resources both financial and societal, where poverty and social strife are as much a part of the pathology as any microbe, it is the medical students and interns who are thrust into the searing intimacy that is the doctor-patient relationship. In each memorable chapter, Ofri’s progress toward becoming an experienced healer introduces not just a patient in medical crisis, but a human being with an intricate and compelling history. Ofri learns to navigate the tangled vulnerabilities of doctor and patient—not to simply battle the disease.
In Singular Intimacies, which the New England Journal of Medicine said captured the'essence of becoming and being a doctor,' Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, she's finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: She's had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the real'slight prick and pressure' of a long needle as well as the very real sense of invasion and panic that routinely visits her patients. These fifteen intertwined tales include 'Living Will,' where Dr. Ofri treats a man who has lost the will to live, and she too comes dangerously close to concluding that he has nothing to live for;'Common Ground,' in which a patient's difficult decision to have an abortion highlights the vulnerabilities of doctor and patient alike;'Acne,' where she is confronted by a patient whose physical and emotional abuse she can't possibly heal, so she must settle on treating the one thing she can, the least of her patient's problems; and finally a stunning concluding chapter,'Tools of the Trade,' where Dr. Ofri's touch is the last in a woman's long life.
A collection of riveting and compassionate stories about the triumphs and trials of medicine, from a doctor and “gifted storyteller” on the front lines (The Washington Post) This eBook original exhibits Danielle Ofri's range and skill as a storyteller as well as her empathy and astuteness as a doctor. Her vivid prose brings the reader into bustling hospitals, tense exam rooms, and Ofri's own life, giving an up-close look at the fast-paced, life-and-death drama of becoming a doctor. She tells of a young man uncertain of his future who comes into the clinic with a stomach complaint but for whom Dr. Ofri sees that the most useful “treatment” she can offer him is SAT tutoring. She writes of a desperate struggle to communicate with a critically ill patient who only speaks Mandarin, of a doctor whose experience in the NICU leaves her paralyzed with PTSD, and of her own struggles with the fear of making fatal errors, the dangers of overconfidence, and the impossible attempts to balance the empathy necessary for good care with the distance necessary for self-preservation. Through these stories of her patients, colleagues, and her own experiences, Intensive Care offers poignant insight into the medical world, and into the hearts and minds of doctors and their patients. These stories are drawn from the author’s previous books.
From a doctor Oliver Sacks has called a “born storyteller,” a riveting account of practicing medicine at a fast-paced urban hospital For two decades, Dr. Danielle Ofri has cared for patients at Bellevue, the oldest public hospital in the country and a crossroads for the world’s cultures. In Medicine in Translation she introduces us, in vivid, moving portraits, to her patients, who have braved language barriers, religious and racial divides, and the emotional and practical difficulties of exile in order to access quality health care. Living and dying in the foreign country we call home, they have much to teach us about the American way, in sickness and in health.
Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s compassionate stories and research explore patient safety. “An essential read for anyone involved or interested in the care of patients.” —Booklist Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.
A “finely gifted writer” shares “fifteen brilliantly written episodes covering the years from studenthood to the end of medical residency” (Oliver Sacks, MD, author of The Man Who Mistook His Wife for a Hat) Singular Intimacies is the story of becoming a doctor by immersion at Bellevue Hospital, the oldest public hospital in the country—and perhaps the most legendary. It is both the classic inner-city hospital and a unique amalgam of history, insanity, beauty, and intellect. When Danielle Ofri enters these 250-year-old doors as a tentative medical student, she is immediately plunged into the teeming world of urban medicine: mysterious illnesses, life-and-death decisions, patients speaking any one of a dozen languages, and overworked interns devising creative strategies to cope with the feverish intensity of a big-city hospital. Yet the emphasis of Singular Intimacies is not so much on the arduous hours in medical training (which certainly exist here), but on the evolution of an instinct for healing. In a hospital without the luxury of private physicians, where patients lack resources both financial and societal, where poverty and social strife are as much a part of the pathology as any microbe, it is the medical students and interns who are thrust into the searing intimacy that is the doctor-patient relationship. In each memorable chapter, Ofri’s progress toward becoming an experienced healer introduces not just a patient in medical crisis, but a human being with an intricate and compelling history. Ofri learns to navigate the tangled vulnerabilities of doctor and patient—not to simply battle the disease.
Founded just six years ago, Bellevue Literary Review is already widely recognized as a rare forum for emerging and celebrated writers - Julia Alvarez, Raphael Campo, Rick Moody and Abraham Verghese among them - on issues of health and healing. Gat...
Patients, anxious to convey their symptoms, feel an urgency to "make their case" to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. ... Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us."--Jacket.
In Singular Intimacies, which the New England Journal of Medicine said captured the'essence of becoming and being a doctor,' Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, she's finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: She's had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the real'slight prick and pressure' of a long needle as well as the very real sense of invasion and panic that routinely visits her patients. These fifteen intertwined tales include 'Living Will,' where Dr. Ofri treats a man who has lost the will to live, and she too comes dangerously close to concluding that he has nothing to live for;'Common Ground,' in which a patient's difficult decision to have an abortion highlights the vulnerabilities of doctor and patient alike;'Acne,' where she is confronted by a patient whose physical and emotional abuse she can't possibly heal, so she must settle on treating the one thing she can, the least of her patient's problems; and finally a stunning concluding chapter,'Tools of the Trade,' where Dr. Ofri's touch is the last in a woman's long life.
Narrative medicine is a fresh discipline of health care that helps patients and health professionals to tell and listen to the complex and unique stories of illness. The Principles and Practice of Narrative Medicine expresses the collective experience and discoveries of the originators of the field. Arising at Columbia University in 2000 from roots in the humanities and patient-centered care, narrative medicine draws patients, doctors, nurses, therapists, and health activists together to re-imagine a health care based on trust and trustworthiness, humility, and mutual recognition. Over a decade of education and research has crystallized the goals and methods of narrative medicine, leading to increasingly powerful means to improve the care that patients receive. The methods described in this book harness creativity and insight to help the professionals in being with patients, not just to diagnose and treat them but to bear witness to what they undergo. Narrative medicine training in literary theory, philosophy, narrative ethics, and the creative arts increases clinicians' capacity to perceive the turmoil and suffering borne by patients and to help them to cohere or endure the chaos of illness. Narrative medicine has achieved an international reputation and reach. Many health care settings adopt methods of narrative medicine in teaching and practice. Through the Master of Science in Narrative Medicine graduate program and health professions school curricula at Columbia University, more and more clinicians and scholars have obtained the rigorous training necessary to practice and teach narrative medicine. This text is offered to all who seek the opportunity for disciplined training in narrative medicine. By clearly articulating our principles and practice, this book provides the standards of the field for those who want to join us in seeking authenticity, recognition, affiliation, and justice in a narrative health care.
A collection of riveting and compassionate stories about the triumphs and trials of medicine, from a doctor and “gifted storyteller” on the front lines (The Washington Post) This eBook original exhibits Danielle Ofri's range and skill as a storyteller as well as her empathy and astuteness as a doctor. Her vivid prose brings the reader into bustling hospitals, tense exam rooms, and Ofri's own life, giving an up-close look at the fast-paced, life-and-death drama of becoming a doctor. She tells of a young man uncertain of his future who comes into the clinic with a stomach complaint but for whom Dr. Ofri sees that the most useful “treatment” she can offer him is SAT tutoring. She writes of a desperate struggle to communicate with a critically ill patient who only speaks Mandarin, of a doctor whose experience in the NICU leaves her paralyzed with PTSD, and of her own struggles with the fear of making fatal errors, the dangers of overconfidence, and the impossible attempts to balance the empathy necessary for good care with the distance necessary for self-preservation. Through these stories of her patients, colleagues, and her own experiences, Intensive Care offers poignant insight into the medical world, and into the hearts and minds of doctors and their patients. These stories are drawn from the author’s previous books.
Bridging memoir with key concepts in narratology, philosophy and history of medicine, and disability studies, this book identifies and names the phenomenon of metagnosis: the experience of learning in adulthood of a longstanding condition. It can occur when the condition has remained undetected (e.g. colorblindness) and/or when the diagnostic categories themselves have shifted (e.g. ADHD). More broadly, it can occur with unexpected revelations bearing upon selfhood, such as surprising genetic test results. Though this phenomenon has received relatively scant attention, learning of an unknown condition is often a significant and bewildering revelation, one that subverts narrative expectations and customary categories. How do we understand these revelations? In addressing this topic Danielle Spencer approaches narrative medicine as a robust research methodology comprising interdisciplinarity, narrative attentiveness, and the creation of writerly texts. Beginning with Spencer's own experience, the book explores the issues raised by metagnosis, from communicability to narrative intelligibility to different ways of seeing. Next, it traces the distinctive metagnostic narrative arc through the stages of recognition, subversion, and renegotiation, discussing this trajectory in light of a range of metagnostic experiences-from Blade Runner to real-world mid-life diagnoses. Finally, it situates metagnosis in relation to genetic revelations and the broader discourses concerning identity. Spencer proposes that better understanding metagnosis will not simply aid those directly affected, but will serve as a bellwether for how we will all navigate advancing biomedical and genomic knowledge, and how we may fruitfully interrogate the very notion of identity.
Founded just six years ago, Bellevue Literary Review is already widely recognized as a rare forum for emerging and celebrated writers - Julia Alvarez, Raphael Campo, Rick Moody and Abraham Verghese among them - on issues of health and healing. Gat...
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