Medical Humanities Final Exam: History & Literature

Primum non nocere

"first, do no harm"

Islamic institution for care of the sick

Bimauristan

The art of dying

Ars Moriendi

The father of the patient in the In My Own Country reacted to finding out about his son's diagnosis of AIDS by doing which of the following? - Turning away and walking out into the parking lot "unable to stay in the building where that word had been uttered" - eventually joining his wife at their son's side in the ICU "spending along hours with him, holding his hand, talking to him" - both of these - none of these

Both of these

Where and when was the first department of humanities in an American medical school established? - Harvard Medical School in Boston, 1965 - Pennsylvania State University School of Medicine in Hershey Pennsylvania, 1969 - Yale Medical School in Princeton, NJ, 1970 - Purdue Medical School in Indiana, 1968 - The University of Pennsylvania in Philadelphia, 1952

Pennsylvania State University School of Medicine in Hershey Pennsylvania, 1969

Acting for the benefit of others

Beneficence

"I would have been happy to die the most painful death, though I was too dumbly lethargic even to conceptualize suicide. Every second of being alive hurt me. Because this thing had drained all fluid from me, I could not even cry. My mouth was parched as well. I had thought that when you feel your worst your tears flood, but the very worst pain is the arid pain of total violation that comes after the tears are all used up, the pain that stops up every space through which you once metered the world, or the world, you."

Andrew Solomon "The Noonday Demon"

Austrian physician whose father was a tavern keeper and who developed the percussion technique for physical exam

Auenbrugger

'The Gross Clinic' and 'the Agnew Clinic' by Thomas Eakins have many features in common. Which statement is FALSE: - both patients being operated on were female - both paintings were in color - both were of physicians in Philadelphia - both paintings feature a famous surgeon who is pausing during the procedure to lecture to a large audience - both patients were receiving an early form of anesthesia

Both patients being operated on were female

Latin word for compassion, concern, or caring

Humanitas

Term that originally meant 'good death'

Euthanasia

This type of story is the only one in which the teller is the focus or the main actor of the story

Quest or Journey Story

Which one of the following dates most closely corresponds to the year that the bubonic plague first struck in Europe - 1150-1151 - 1222-1223 - 1347-1348 - 1450-1451 - 1502-1503

1347-1348

Ether was first-successfully and famously used to induce general anesthesia on which date and in which place - 1749, Boston - 1797, Philadelphia - 1802, Philadelphia - 1846, Boston - 1902, Boston

1846 Boston

The American Medical Association was created in what year? - 1747 - 1776 - 1817 - 1847 - 1898

1847

What is the flexner model? - 4 years of university education plus 4 years of medical school - 2 years of basic science study followed by 2 years of clinical training - internship and residency must follow medical school graduation - a medical education that is flexible and adapted to the individual learn's ability to achieve competency in required areas - medical education that is affordable for qualified applicants

2 years of basic science study followed by 2 years of clinical training

Which ONE of the following is NOT associated with the term "tame death" - a conception of death that developed after the year of the Black plague - an ideal of "a good death" that developed in the early Middle Ages - one dies as one goes to sleep: "peacefully, silently, without a fight" - Arthurian legends of knights and warriors who calmly accept their death are given as examples of "tame death" in this chapter

A conception of death that developed after the years of the Black Plague

In the essay "from the heart" by Rachel Naomi Remen," she describes a medical student who had a classmate that died suddenly. How did this classmate die?

A congenital heart abnormality

"I had no reason to believe that he was not good. He was in a good hospital. He was one of the major urologists there, and yet I continued to observe him with something like displeasure. He proposed to do a cystoscopy on me. He said he wanted to examine the architecture of my bladder. I pondered the word "architecture. Was it justified or was he being pretentious? Was he trying to accommodate himself to my vocabulary by talking about the architecture of the bladder as though it had a vault like a cathedral...? I thought, I can't die with this man. He wouldn't understand what I was saying. I'm going to say something brilliant when I die."

Anatole Broyard "Doctor, Talk to Me"

The authors from this textbook give a definition of medical humanities as a field that has four main components. Which of the following is NOT one of these four main components? - Context: Using various disciplines such as history and anthropology to understand the cultural and temporal dimensions of medicine - Compassion: the cultivation of empathy and right emotional responses to patients' needs - Conceptual and critical analysis: primarily refers to philosophy to define and to clarify ideas terms and issues related to medicine - Formation: cultivating self-awareness and commitment to the welfare of others and the development of professional identity - Experience: Using various disciplines such as literature and psychology to understand how it feels to be a patient or practitioner

Compassion: the cultivation of empathy and right emotional responses to patients' needs

"I think of my fears as a left lower quadrant abscess--tucked in a corner away from all the vital organs so I can function in my day to day work in medicine"

Danielle Ofri

One of the principal leaders of the humanistic movement that was implemented in medical school curriculums. Stated that by the 1980s the humanistic movement had "established a beachhead in an unpromising place, the medical school curriculum."

Edmund Pellegrino

The Library of Alexandria (sometimes called the Museum of Alexandria) was in what country? - Greece - Italy - Egypt - Syria - Turkey

Egypt

The obligation of physicians to relieve suffering stretches back into antiquity. Despite this fact, little attention is explicitly given to the problem of suffering in medical education, research, or pratcice. I will begin by focusing on a modern paradox: Even in the best settings and with the best physicians, it is not uncommon for suffering to occur not only during the course of a disease, but also as a result of its treatment. To understand this paradox and its resolution requires an understanding of what suffering is and how it relates to medical care.

Eric Cassel "Suffering and the Goals of Medicine"

T/F: Galen practiced bloodletting but HIPPOCRATES did not

False

T/F: The Plague of Athens was also known as the Plague of Galen

False

All of the following are true of the Flexner Report on Medical Education EXCEPT which ONE? - it was funded by the Carnegie Foundation - it recommended that the number of medical schools should be reduced - it was published in 1910 - Flexner was himself a physician - it involved an investigation of schools in the United States and Canada

Flexner was himself a physician

All of the following are part of the threefold aims of humanist education as described in the introduction chapter to our textbook EXCEPT which of the following: - forming a person who is compassionate - forming a person who is well-rounded - forming a person who acts in the world - forming a person who is knowledgeable

Forming a person who is well-rounded

"Disease in man is never exactly the same as disease in an experimental animal, for in man the disease at once affects and is affected by what we call the emotional life. Thus, the physician who attempts to take care of a patient while he neglects this factor is as unscientific as the investigator who neglects to control all the conditions that may affect his experiment. The good physician knows his patients through and through, and his knowledge is bought dearly. 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."

Francis Peabody "The Care of the Patient"

This physician is most often associated with Roman, helped take care of gladiators, wrote numerous books, and his work was influential in western medicine for over 1,000 years. The emperor Marcus Aurelius was his most famous and influential patient.

Galen

Which ONE of the following is FALSE about Hippocrates and Hippocratic medicine? - He was Greek and from the Island of Kos, which us now in Turkey - he lived at the time of Alexander the Great - he believed in health as equilibrium and disease as disequilibrium - he is credited with separating medicine from religion and supernatural beliefs - it is thought that Hippocrates and his disciples are responsible for "The Hippocratic Corpus" — not just Hippocrates himself

He lived at the time of Alexander the Great

Which one of the following is the correct definition of the "epidemiological transition?' - the transition from rural to urban life - the transition from ancient to modern understanding of disease - the transition from more deaths in the population from infectious disease to more deaths by chronic illness - the transition from a lack of immunity in a population to a population that is resistant to an infectious disease - when the rate of infant mortality is less than the death rate of the elderly

The transition from more deaths in the population from infectious disease to more deaths by chronic illness

Which ONE of the following killed the greatest number of soldiers during the Civil War? - injuries from battle - starvation - infectious diseases - amputations and gangrene

Infectious diseases

"When I discovered that I had cancer, one hour and 40 minutes before leaving for Paris, I was transported into an eerie seam between thought and feeling. In this wordless void I groped for understanding and emotion-the usual evidence of my existence. The shock of my disembodiment unmoored me from physical time and I drifted chaotically through future, past, and present... The airport taxi would arrive at noon. As I clutched the airline tickets, a strange logic supplanted my medical mind, which knew that disease did not heed human desire. But I am leaving for Paris, I told myself. I begin my sabbatical today. I can't possibly have cancer now."

Kate Scanell "Leave of Absence"

"I leave and go to the restroom. Although the door is wide enough, the "handicapped accessible" stall is too short to accommodate the length of my wheelchair. I must, therefore, sit in the stall with the door partially open. Obviously if that particular stall is occupied -whether by a person with a disability or by an "able bodied" individual -I must wait until it is vacant, since I cannot get through the door of the normal sized stalls with a wheelchair."

Kay Toombs "Going on a Professional Trip"

This French physician studied tuberculosis, died of tuberculosis, and invented one of the most famous medical instruments even known, which he first named 'the cylinder'

Laennec

The English surgeon, spent much of his career in Scotland, and was credited for the development of antisepsis after successfully treating a patient with a compound fracture with carbolic acid.

Lister

Autopsy

Literally, "to see for oneself"

The Carnegie Report was published in 2010. It had four main findings. Which ONE of the following was NOT a funding in the Carnegie Report? - medical training is poorly coordinated the first 2 years and second 2 years of medical - medical training does not include adequate research and is not evidence based - medical education is characterized by a lack of holistic learning - medical education is lacking in the teaching of professional values - Medical training is inflexible, overly long and not learner-centered

Medical training does not include adequate research and is not evidence-based

Thought to cause disease before germ theory was understood

Miasma

This physician also worked at the medical school in Padua, and was famous for a series of 700 autopsies which he wrote about and correlated with the patient's history and clinical course of the disease.

Morgagni

The only dentist on this list, an American, famous for first successful use of anesthesia

Morton

"One moment I was running like a madman, conscious of heavy panting and heavy thudding footsteps, unsure whether they came from the bull or from me, and the next I was lying at the bottom of a short sharp cliff of rock, with my left leg twisted grotesquely beneath me and in my knee such a pain as I had never, ever known before. To be full of strength and vigor one moment and virtually helpless the next, in the pink and pride of health one moment and a cripple the next, with all one's powers and faculties one moment and without them the next-such a change, such suddenness, is difficult to comprehend, and the mind casts about for explanations"

Oliver Sacks "The Bull on the Mountain"

This Canadian physician is strongly associated with the founding of Johns Hopkins Medical school in Baltimore

Osler

Which of the following statements about the FOUR HUMORS is/are TRUE? - BLOOD was associated with SPRING and thought to be made by the SPLEEN - PHLEGM was thought to arise from the BRAIN and was associated with WINTER - BLACK BILE came form the LIVER and was associated with SUMMER - YELLOW BILE was associated with SUMMER and a MELANCHOLY personality - All of the above are true

PHLEGM was thought to arise from the BRAIN and was associated with WINTER

An illness narrative or story of a patient experience

Pathography

This physician was famous for his article "The Care of the Patient" in which he famously says that "the secret of caring for the patient is to care for the patient"

Peabody

"What it was about was dignity... that's all there was to it; I had offered to do a job that would have compromised my professional status, and by extension theirs since I was on the same career path as they. I don't mean to suggest that they actually thought it through. I think it was the instinct of professional self defense that prompted their response. ... Part of prestige is the jobs you do; The other part is the jobs you don't do."

Perri Klass "Baby Poop"

"At the beginning, before I could change my appliance myself, it was changed for me by nurse specialist(s)....These white coated professionals would enter my hospital room, put on an apron, mask and gloves, and then removed and replaced my appliance. The task completed, they would strip off all their protective clothing. Then they would carefully wash their hands. This elaborate ritual made things harder for me. I felt shamed. One day a woman about my age came to do this task. It was late in the day and she was not dressed in a white coat but in a silk dress, heels and stockings. In a friendly way she asked if I was ready to have my appliance changed...I doubt that she ever knew what her willingness to touch me in such a natural way meant to me. In 10 minutes she not only tended my body but healed my wounds and gave me hope. What is most professional is not always what is most healing."

Rachel Naomi Remen

"I first became interested in poetry as a means to explore the fracture I felt growing up here in the United States as a child of immigrant parents. My parents used to read me poetry as a way of connecting me to my Cuban heritage. Then I became aware of my sexual identity, so I felt another disconnect from the majority of my peers. But I found that through stories, through narrative, we can understand each other across differences. So poetry always was a source of healing for me."

Rafael Campo

In this story the main actor of the story is the illness and the person telling it is relatively passive

Restitution story

This type of story is the one in our culture most wants to tell

Restitution story

"A stillness settles in my heart and is carried to my hand. It is the quietude of resolve layered over fear. And it is this resolve that lowers us, my knife and me, deeper and deeper into the person beneath. It is an entry into the body that is nothing like a caress; still, it is among the gentlest of acts. Then stroke and stroke again and we are joined by other instruments, hemostats and forceps, until the wound blooms with strange flowers whose looped handles fall to the sides in steely array."

Richard Selzer "Confessions of a Knife"

"Having a sense of story and be able to recognize when someone is telling you a story...to receive it whole...to absorb them, to interpret them, to honor them and to be moved by them. And to be moved by them to action."

Rita Charon

The story is characterized by a pattern that goes like this: "this happened and then this happened and then this happened and then..."

chaos story

Pen name of the author of "house of god" — a satirical novel about residence training published in 1978

Samuel Shem

"To cover the vast field of medicine in four years is an impossible task. We can only instill principles, put the students in the right path, give him methods, teach him how to study, and early to discern between essentials and non-essentials."

Sir William Osler

What is the nationality of the painter of Science and Charity

Spanish

The following quote is taken form what document and date? "The practitioner deals with facts of two categories. Chemistry, physics, biology enable him to apprehend one set; he needs a different apperceptive and appreciative apparatus to deal with the other, more subtle elements. Specific preparation is in this direction much more difficult; one must rely for the requisite insight and sympathy on a varied and enlarging cultural experience. Such enlargement of the physician's horizon is otherwise important, for scientific progress has greatly modified his ethical responsibility"

The Flexner Report, 1910

Whitism

The belief that all of history is a progressive march to a utopian future

We talked extensively about the cult of Aesclepius and the Hippocratic school of medicine. Which ONE of the following statements below is FALSE? - hippocratic physicians practiced humoral medicine - the cult of aesclepius involved a practice known as incubation - Hippocratic physician carefully diagnosed, described, and documented case histories - the cult of Asclepius had died out by the time hippocratic physicians were practicing - Hippocratic referred to epilepsy as "the scared disease" in his writings

The cult of aesclepius had died out by the time Hippocratic physicians were practicing

Which one of the following is FALSE about the person who wrote this poem? This is just to say: I have eaten the plums that were in the icebox And which you were probably saving for breakfast Forgive me they were delicious so sweet and so cold - it was written by a physician who is credited for writing some of the very first modernist poems - the physician who wrote this also wrote plays and essays - the physician who wrote this was an internist and pediatrician who practiced in New Jersey - the physician who wrote this retired from the practice of medicine before he began to write - this was written by William Carlos Williams

The physician who wrote this retired from the practice of medicine before he began to write

Based on the description of the story and the excerpts from The Death of Ivan Ilych in which ONE of the following is TRUE? - the doctors in this story speak openly to Ivan and his wife about his upcoming death - We come to know that Ivan Ilych is dying of tuberculosis - two hours before his death, Ivan feels someone kissing his hand, opens his eyes, and sees his younger son - tragically, Ivan dies with great anger and resentment toward his wife - Ivan Ilych is accompanied only by a servant when he dies

Two hours before his death, Ivan feels someone kissing his hand, opens his eyes, and sees his younger son

This physician taught anatomy in Padua, was famous for doing his own anatomical dissection of executed criminals, and found many errors in Galen's works. His most important book was a masterpiece of medicine, art and printing.

Vesalius

This physician was German, was famous for his work in pathology, his saying "omnis cellula a cellula" and telling his students to "learn to think microscopically"

Virchow