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Realms of Gold: Medicine, The Arts and a Personal Canon Ottawa April 19, 2009 David J. Elpern, M.D. 12 Meadow Street Willi...
Why Read? By Mark Edmundson Distinguished Teaching Professor University of Virginia
William Carlos Williams Asphodel: That greeny flower Look at what passes for the new. You will not find it there but in  d...
Robertson Davies:  The Cunning Man (1994) More humanism and less science.  That’s what medicine needs. But humanism is har...
In the beginning…
Osler and the Bed-Side Library
A liberal education may be had at a very slight cost of time and money. Before going to sleep read for half an hour, and i...
Osler’s Bedside Library for Medical Students circa 1895 I.  Old and New Testaments II.  Shakespeare III.  Montaigne IV.  P...
Great Writers Who Inspired a  Great Physician Book Launch Osler Library Montreal October 2009
Canon: choice of books, films, music, art for our personal and professional growth.  “What shall the individual who desire...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
The soul selects her own Society - Then shuts the Door - To her divine Majority - Present no more - Unmoved - she notes th...
Surgeons must be very careful When they take the knife! Underneath their fine incisions Stirs the Culprit - Life! On Medic...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Cushing’s Life of Osler <ul><li>Won the Pulitzer Prize in 1926 </li></ul><ul><li>A wonderful introduction to a modern </li...
Cushing’s Life of Osler The practice of medicine is an art, not a trade;  a calling, not a business: a calling in which yo...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Viktor Frankl  (1905 -1997)
Man’s Search for Meaning Nietzsche's words, “He who has a  why  to live can bear with almost any  how,”  could be the guid...
Man’s Search for Meaning The central theme of existentialism: to live is to suffer, to survive is to find meaning in the s...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
The medical establishment has become a major threat to health. The disabling impact of professional control over medicine ...
Illich’s Medical Nemesis Iatrogenic medicine reinforces a morbid society in which social control of the population by the ...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Francis Weld Peabody 1881-1927 <ul><li>The Caring Physician </li></ul><ul><li>The Life of Dr. F.W. Peabody </li></ul><ul><...
Peabody’s Care of the Patient The good physician knows his patients through and through…Time, sympathy and understanding m...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Lydgate’s Lament &quot;Apropos of what you said about wearing harness, I made up my mind some time ago to do with as littl...
Middlemarch “Finale” Who can quit young lives after being long in company with them, and not desire to know what befell th...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Closing the Chart There is a place in our busy lives for spending a little time with a dying patient. When I have taken su...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Wit takes place in a University Hospital Cancer Center. The main character, Vivian Bearing, Ph.D., is a John Donne scholar...
Wit, the Film (2001)  Based on Donne’s Sonnet Death be not proud, though some have called thee   Mighty and dreadfull, for...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
The New York Times Journal of Humane Medicine <ul><li>Online access is Free </li></ul><ul><li>Health Section Tuesdays </li...
Screen or Not?  What Those Prostate Studies Mean March 24, 2009
Screen or Not?  What Those Prostate Studies Mean March 24, 2009   P.S.A. testing increases a man’s risk of being treated f...
Cases: Comforter and Comforted  in an Unfolding Mystery   March 31, 2009   by Nell Burger Kirst This extraordinary essay b...
My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William...
Education on the Run
 
 
Keats:  Chapman’s Homer Much have I travell'd in the realms of gold, And many goodly states and kingdoms seen; Round many ...
 
 
Aloha   and  Mahalo
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Personal Canons

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This presentation deals with the importance of literature as a path to personal and professional growth and satisfaction. It describes a personal canon and asks the observer to formulate on of her/his own.

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Personal Canons

  1. 1. Realms of Gold: Medicine, The Arts and a Personal Canon Ottawa April 19, 2009 David J. Elpern, M.D. 12 Meadow Street Williamstown, MA 01267 Email djelpern@gmail.com
  2. 2. Why Read? By Mark Edmundson Distinguished Teaching Professor University of Virginia
  3. 3. William Carlos Williams Asphodel: That greeny flower Look at what passes for the new. You will not find it there but in despised poems. It is difficult to get the news from poems yet men die miserably every day for lack of what is found there.
  4. 4. Robertson Davies: The Cunning Man (1994) More humanism and less science. That’s what medicine needs. But humanism is hard work, and so much of science is just Tinkertoy.
  5. 5. In the beginning…
  6. 6. Osler and the Bed-Side Library
  7. 7. A liberal education may be had at a very slight cost of time and money. Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. You will be surprised how much can be accomplished in the course of a year. I have put down a list of ten books … There are many others; studied carefully these will help in [your] inner education. William Osler (1849 - 1919)
  8. 8. Osler’s Bedside Library for Medical Students circa 1895 I. Old and New Testaments II. Shakespeare III. Montaigne IV. Plutarch’s Lives V. Marcus Aurelius VI. Religio Medici VII. Epictetus VIII. Don Quixote IX. Emerson X. Oliver Wendell Holmes - Breakfast-Table Series
  9. 9. Great Writers Who Inspired a Great Physician Book Launch Osler Library Montreal October 2009
  10. 10. Canon: choice of books, films, music, art for our personal and professional growth. “What shall the individual who desires to read attempt to read since he can’t read everything?” A Physician’s Canon
  11. 11. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  12. 12. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  13. 13. The soul selects her own Society - Then shuts the Door - To her divine Majority - Present no more - Unmoved - she notes the Chariots - pausing - At her low Gate - Unmoved - an Emperor be kneeling Upon her Mat - I've known her - from an ample nation - Choose One - Then - close the Valves of her attention - Like Stone - The Soul Selects Her Own Society
  14. 14. Surgeons must be very careful When they take the knife! Underneath their fine incisions Stirs the Culprit - Life! On Medicine
  15. 15. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  16. 16. Cushing’s Life of Osler <ul><li>Won the Pulitzer Prize in 1926 </li></ul><ul><li>A wonderful introduction to a modern </li></ul><ul><li>medical hero. </li></ul><ul><li>Invaluable Olser Resource </li></ul><ul><li>Go to www.davidelpern.com for quotes </li></ul>
  17. 17. Cushing’s Life of Osler The practice of medicine is an art, not a trade; a calling, not a business: a calling in which your heart will be exercised equally with your head.  Often the best part of your work will have nothing to do with powders or potions, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, the wise upon the foolish. William Osler
  18. 18. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  19. 19. Viktor Frankl (1905 -1997)
  20. 20. Man’s Search for Meaning Nietzsche's words, “He who has a why to live can bear with almost any how,” could be the guiding motto. One had to give them a why - an aim - for their lives, in order to strengthen them to bear the terrible how of their existence. Woe to him who saw no sense in his life, no aim, no purpose, and therefore no point in carrying on. He was soon lost.
  21. 21. Man’s Search for Meaning The central theme of existentialism: to live is to suffer, to survive is to find meaning in the suffering. If there is a purpose in life at all, there must be a purpose in suffering and a purpose in dying. But no man can tell another what this purpose is. Each must find out for himself, and must accept the responsibility that his answer prescribes…
  22. 22. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  23. 23. The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis [is] the name for this new epidemic. Medical Nemesis (1976)
  24. 24. Illich’s Medical Nemesis Iatrogenic medicine reinforces a morbid society in which social control of the population by the medical system turns into a principal economic activity. The most handy measure of the medicalization of life is the share taken out of a typical yearly income to be spent under doctor’s orders.
  25. 25. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  26. 26. Francis Weld Peabody 1881-1927 <ul><li>The Caring Physician </li></ul><ul><li>The Life of Dr. F.W. Peabody </li></ul><ul><li>Ogelsby Paul </li></ul><ul><li>The Countway Library </li></ul><ul><li>Boston, Massachusetts </li></ul><ul><li>1991 </li></ul>
  27. 27. Peabody’s Care of the Patient The good physician knows his patients through and through…Time, sympathy and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the most essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.
  28. 28. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  29. 29. Lydgate’s Lament &quot;Apropos of what you said about wearing harness, I made up my mind some time ago to do with as little of it as possible. That was why I determined not to try anything in London, for a good many years. I didn't like what I saw when I was studying there--so much empty bigwiggism, and trickery. In the country, people have less pretension.
  30. 30. Middlemarch “Finale” Who can quit young lives after being long in company with them, and not desire to know what befell them in their after-years? For the fragment of a life, however typical, is not the sample of an even web: promises may not be kept, and an ardent outset may be followed by declension; latent powers may find their long-waited opportunity; a past error may urge a grand retrieval.
  31. 31. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  32. 32. Closing the Chart There is a place in our busy lives for spending a little time with a dying patient. When I have taken such time, I have seen painful things and good things. My patients have expressed their anger and their hopes to me. And I hoped with them, for a cure, and for an end to their pain, and for peace. They faced death as I had faced it. We had nothing to lose by laughing -- my patients were a joy to be with and I cherish the time I spent with them.
  33. 33. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  34. 34. Wit takes place in a University Hospital Cancer Center. The main character, Vivian Bearing, Ph.D., is a John Donne scholar who has stage IV ovarian cancer. Much of the action takes place in the last few days/hours of her life, with flashbacks to weeks, months, even years before interspersed throughout the performance. Wit, the Film (2001) 99 minutes Director, Mike Nichols, Starring Emma Thompson
  35. 35. Wit, the Film (2001) Based on Donne’s Sonnet Death be not proud, though some have called thee Mighty and dreadfull, for, thou art not so, For, those, whom thou think'st, thou dost overthrow, Die not, poore death, nor yet canst thou kill me. … Thou art slave to Fate, Chance, kings, and desperate men And dost with poyson, warre, and sicknesse dwell, And poppie, or charmes can make us sleepe as well, And better then thy stroake; why swell'st thou then; One short sleepe past, wee wake eternally, And death shall be no more; death, thou shalt die.
  36. 36. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  37. 37. The New York Times Journal of Humane Medicine <ul><li>Online access is Free </li></ul><ul><li>Health Section Tuesdays </li></ul><ul><li>Book and Movie Reviews </li></ul><ul><li>Obituaries </li></ul><ul><li>Op-Ed </li></ul><ul><li>The Arts </li></ul><ul><li>A Full Service Personal University </li></ul><ul><li>www.nytimes.com </li></ul>
  38. 38. Screen or Not? What Those Prostate Studies Mean March 24, 2009
  39. 39. Screen or Not? What Those Prostate Studies Mean March 24, 2009 P.S.A. testing increases a man’s risk of being treated for a cancer that would never have harmed him in the first place. For every man helped by P.S.A. screening, at least 48 received unnecessary treatment that increased risk for impotency and incontinence. Dr. Brawley, CMO of the American Cancer Society, summed up the data this way: “The test is about 50 times more likely to ruin your life than it is to save your life.”
  40. 40. Cases: Comforter and Comforted in an Unfolding Mystery March 31, 2009 by Nell Burger Kirst This extraordinary essay by a fourth year medical student discussed the nature of caregiving much better than any textook or “scholarly” article.
  41. 41. My Personal Canon 2009 <ul><li>The Complete Poems of Emily Dickinson </li></ul><ul><li>Harvey Cushing: The Life of William Osler </li></ul><ul><li>Viktor Frankl: Man’s Search for Meaning </li></ul><ul><li>Ivan Illich: Medical Nemesis </li></ul><ul><li>F. W. Peabody: The Care of the Patient </li></ul><ul><li>George Eliot: Middlemarch </li></ul><ul><li>Steven Hsi: Closing the Chart </li></ul><ul><li>Wit (Film with Emma Thompson) </li></ul><ul><li>The New York Times Online </li></ul><ul><li>Audible.com </li></ul>
  42. 42. Education on the Run
  43. 45. Keats: Chapman’s Homer Much have I travell'd in the realms of gold, And many goodly states and kingdoms seen; Round many western islands have I been Which bards in fealty to Apollo hold. … Then felt I like some watcher of the skies When a new planet swims into his ken; Or like stout Cortez when with eagle eyes He star'd at the Pacific-and all his men Look'd at each other with a wild surmise- Silent, upon a peak in Darien.
  44. 48. Aloha and Mahalo

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