DOCTORS AT WIT’S ENDS
- Williams and Bulgakov: Doctors AND writers - russian literature
1. ethics of relationship with the patient & DEONTOLOGY of the medical practice - how he is recognised as “healer” - social authority
2. dramatize relationships of conflict and collaboration - doctor is cultural/social economically removed - williams and bulgakov do not share same socio-economic and cultural-linguistic background w/ their patients
3. 1920s-1930s context
BULGAKOV
- the stories we read are the first - city doctor thrown into rural village, displacement of the doctor
DOCTOR’S PERSPECTIVE - similarities & differences
- half of the 20th century: rural area in soviet and eastern united states (williams) - impoverished social context
- dramatic encounters: focus on doctor’s ability to rise to the occasion - life and death situation
- bulgakov: dramatize coming into being a young doctor into his own role as an authoritative professional - trial by fire
- williams: ongoing challenges of an experienced doctor
- bulgakov: comedian and satirical writer, williams: lyrical
THE PRACTICE
- “often after i have gone….” “this is why as a writer….” medicine nurtured as writer - healing for the doctor - meaningful experience to his own practice for story-making / brody: what he insists on
- relational ethics, attention given to patient
- “poem of life” - stylistic mark
- what he tries to extract: (125) physician enjoys a wonderful opportunity actually to witness the words being born / they say the same thing and then a new beginning starts to intervene - literature captures the surface of medicine - makes visible
- juxtaposition of role of practice medicine w/ literature - heightened, complementary relations: lyrical aspect,
“the physician, listening from day to day…”
MIND AND BODY
- relational ethics (brody)
- the patient’s story: dramatizes how patients want a name for a disease, on-going search (rambling) from the patient’s experience - page 1
- williams interjecting every now and then - sympathetic listener, occupies his role, giving reader where she’s from alternated w the patient’s story itself
- patient trusts doctor
- “oh you have read that too, she said and seemed pleased…”
- placebo effect - someone to tell troubles is what we need
- the doctor gives a physical condition for her - a relational ethics
- him becoming a professional doctor
PARALLEL STORIES
- “use of force” & “steel windpipe” : deal with cases of diphtheria
> bulgakov: vaccination didn’t exist
> williams: vaccination has been made
>> overpowering moment of the doctor
>> he confesses to having attack the child: “pleasure to attack her” “social necessity”
- “a night in june” and baptism by rotation”: stories about birth
>> a night in june: experienced doctor who knows her patient well
>> baptism: first birth this doctor is attending - life and death situation drama
>>”then i fell asleep….” medicine moving into scientific standards, minimise humanity
>> foreshadowing of avoidance of culture of pain - doctors try to minimize discomfort
>> cultural relation to pain
- attention and deference both doctors pay to the midwives of the story
- stories of doctors know best attitude - they need rationalisation, overpowering moment of the doctor
- doctors the enlightened one vs. ignorance - not knowing what to do, doctor configures himself as someone who got the patient’s back
> use of force: “disgust” - “damned little brat” (60)- social necessity that doesn’t only affect the patient but also everyone
> steel windpipe: conflict between medical institutions vs. advocates of patients -
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