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Humanities workbookfor Birmingham Conference 2005, as part of workshop: Educating For Ritas’–Developing A Curriculum In Medical Humanities For Doctors In TrainingDr. Mike Deighan Curriculum Development group Royal College of General Practitioners Dr. Kay Mohanna Principal Lecturer in Medical Education Staffordshire University Dr. Steve Walter Primary Care Medical Educator West Midlands Deanery
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LOSS
By Wendy Cope
The day he moved out was terrible – That evening she went through hell. His absence wasn’t a problem. But the corkscrew had gone as well.
Facilitators notes –
Wendy Cope suffered from many failed relationships and uncertain sexuality in her early life. Seemingly humorous but sardonic tone Is that all there was to say about the end of the relationship – rather desolate What has not been said? Importance of small nuisances in traumatic situations Need for alcohol in stressful situation
GROUP ONE Excerpts From 1. Dead Poets Society - A different view Scene: Charismatic English professor John Keating arrives at a strict boarding school. His unconventional teaching methods breathe new life into the curriculum and inspires his students to pursue their individuality. 2. Educating Rita Scene 13 ‘New found independence’ Rita has been to Summer School and is well advanced with her studies. In the meantime Frank’s personal and professional life is in free fall. The pupil has outgrown the teacher, but have her ultimate goal, aims and values been a mirage?
GROUP TWO Excerpt From About a Boy Background Will is a single man with plenty of money but no sense of direction. He befriends Marcus in his attempt to curry favour with a woman he fancies. Marcus lives with his mother who is a single parent and suffers with recurrent bouts of depression. This culminates in an attempted suicide she was found by Marcus and Will. Scene 7 ( 26:08 – 28:19) Marcus’s mother returns home from hospital following the overdose.
Facilitator's notes This scene illustrates the unforeseen and unexpected consequences of a failed suicide attempt when you are confronted with those who would have been left behind. Marcus feels he is responsible for supervising his mother. He feels vulnerable at the prospect of being left alone. His mother feels guilty and has to regain his trust. She is unable to explain her feelings to him.
Dead Poets Society Charismatic English professor John Keating arrives at a strict boarding school. His unconventional teaching methods breathe new life into the curriculum and inspires his students to pursue their individuality. Scene 7 Find you own walk.
Facilitator's notes This scene exemplifies his exhortations to be your own person and not feel compelled to conform. It is also OK to exercise your right not to do so.
GROUP THREE Excerpt From Shine Background True story of child prodigy David Helfgott. The film examines his journey from a childhood dominated by an overbearing father to his nervous breakdown as a young adult Scene 4 ‘A difficult piece’ David has been entered by his father into a competition with an inappropriately difficult piece. The scene examines the tense family dynamics on his return home
Facilitator's notes Explore the undertones of pressure in the family. His sister can tell from his walk home that ’he is for it’ His father's exhortation to Win, Win.. His father's resentment at the treatment by his own father His mother's fearful reticence His sister's anger that David has lost at chess and so made his father angry. His father's reluctance to allow anyone else to teach him His dismissal of his prize ‘for losing’.
Shine Scene 10 ‘Deranged’ David has been accepted at the Royal College of Music and wants to leave home to further the ambition that his father has created for him. It erupts into a full – blown domestic violence.
Facilitator's notes Lying in wait for him Physical violence Emotional blackmail that he will destroy the family. Psychological abuse of disowning and rejection Some show of remorse at violence Family reaction – ‘frozen watchfulness’ Not Waving But DrowningStevie SmithNobody heard him, the dead man,But still he lay moaning:I was much further out than you thoughtAnd not waving but drowning.Poor chap, he always loved larkingAnd now he's deadIt must have been too cold for him his heart gave way,They said.Oh, no no no, it was too cold always(Still the dead one lay moaning)I was much too far out all my lifeAnd not waving but drowning.
Facilitator's notes How often do we see people who have been ‘too far out all their lives’ and struggling to cope? How do we recognise the distress signals? What are the causes of it being ‘too cold always’? Larking – external mask of the clown to hide the tears?
An Excerpt from The Curious Incident of the Dog in the Night Mark Haddon
My name is Christopher John Francis Boone. I know all the
countries of the world and their capital cities and every prime number up to
7,057.
Facilitator's notes The path as a common metaphor for life Only one traveller – we only have one life How far can we see down . Both look the same – we are unable to predict the future We have to make choices and are unlikely to get a second chance It is the journey itself that matters We should do it our own way
Where would a doctor be standing in the woods? What could he / she be doing?
from Cause of Death Jane Rogers Jim Richardson hated religion. He hated bullshit, hypocrisy, fatalism, bigotry. He hated the passivity it induced and the wars it fuelled and the weakness – the weakness the need of it revealed. He was a great, good, humane, honest atheist. He has carcinoma of the pancreas. Inoperable. He told me cheerfully he’d got about a month to go. ‘Did you diagnose yourself?’ I asked. He smiled. ‘First symptom – jaundice’. He used to do this routine with me. He was the senior in the practice where I did my first spell of GP training, I think he was really the reason I decided to become a GP. ‘First symptom, constipation.’ First symptom, stiff neck.’ ‘First symptom, blurred vision.’ When I didn’t guess what he was thinking of from the first symptom, he’d go to the second, third, fourth, until I did: if I made a plausible guess but it wasn’t what he had in mind, it counted as wrong. ‘40% medical knowledge, 60% telepathy to be a good doctor,’ he said. ‘Your telepathy needs practice, Christine.’ He was a great teacher, he made things simple. The first symptom, like the first fact, is simple. It’s the accretion of facts, the multiplicity of symptoms, the symptoms’ symptoms, which lead to confusion and mask the true nature of the case. I had a baby die last week. Viral pneumonia, I wrote on the certificate. But the real cause of death? I could have put manslaughter. Neglect. If the mother’d brought him in 24 hours earlier we could have saved him. I don’t know why she didn’t. Unhappiness, ignorance, maybe she didn’t have the bus fare. I could have put social causes; poverty. The flat was hot and damp as a sauna when I took her back from the hospital; the windows’d been nailed shut, and there was a thick grey fungus right up the wall next to the child’s cot. Where was the health visitor – had she ever called? I could have put, failure of health education (my failure; I was her GP). She hadn’t wanted another baby – but never came to family planning, never came at all till she was 7 months gone. Really, the child’s conception was the cause of its death. Cause of death: life. Then I want to know why, and have to grasp with shaking hands at the plank a man like Jim Richardson could pull from the wreck; at least get the social workers in, at least give the other kids a chance, push the family to the top of a list somewhere and get them rehoused. Fight, get angry, don’t take no for an answer, call the inspectors, get the whole block condemned. Cause of death; life.
BUT, REMEMBER –
Sometimes Sheenagh Pugh
Sometimes things don't go, after all,
A people sometimes will step back from war;
Sometimes our best efforts do not go
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