Six Kopeks or Your Life: Two Short Stories about Health Care Professionalism and Access
12/16/22 • 47 min
We draw from two short stories published long ago, but recently discovered, that help us discern whether current problems associated with professionalism in health care and access to health care are unique to our time, or whether they have always been with us in one form or another. One of the stories is Anton Chekhov’s At the Pharmacy, written in 1885 and found in the late 1990s, and the other story is Raymond Chandler’s It’s All Right – He Only Died, written in the late 1950s and found in 2017. A throughline from these stories led us to the classic, 1978 satirical novel, The House of God, by Samuel Shem. We consider its importance to health care professionalism at the time—including our own professional behavior—and whether its influence persists. We conclude musing about how the perspectives these sources offer can be used in modern-day health care.
Links:
See Russell Teagarden’s blog postings at According to the Arts for further analysis of the short stories featured in this podcast, At the Pharmacy (Chekhov) and It’s All Right – He Only Died (Chandler).
At the Pharmacy is included in the anthology, The Undiscovered Chekhov: Thirty-Eight New Stories, as is the story of how the translator, Peter Constantine, found these unpublished works more than a century after they were written. An online version of At the Pharmacy is published in the weekly newsletter, Falltide.
It’s All Right – He Only Died, was published in The Strand Magazine, along with the story of its discovery sixty years after it was first written.
The version of The House of God we referenced in the podcast is the Berkley trade paperback edition, 2010.
After the podcast was released, the New York Times published an investigative report concerning the operation of the New York University emergency department on December 22, 2022 indicating that what Chandler described in his short story is still in practice. And a Kaiser Family Foundation report published on December 21, 2022 concerning the policies and practices many individual hospitals apply in collecting money their patients owe them shows how the issues raised in Chekhov's story still exist.
Also:
Please send us comments, recommendations, and questions to: [email protected].
Thanks for listening, and please subscribe to The Clinic & The Person wherever you get your podcasts, or visit us at https://www.theclinicandtheperson.com.
Executive producer: Anne Bentley
We draw from two short stories published long ago, but recently discovered, that help us discern whether current problems associated with professionalism in health care and access to health care are unique to our time, or whether they have always been with us in one form or another. One of the stories is Anton Chekhov’s At the Pharmacy, written in 1885 and found in the late 1990s, and the other story is Raymond Chandler’s It’s All Right – He Only Died, written in the late 1950s and found in 2017. A throughline from these stories led us to the classic, 1978 satirical novel, The House of God, by Samuel Shem. We consider its importance to health care professionalism at the time—including our own professional behavior—and whether its influence persists. We conclude musing about how the perspectives these sources offer can be used in modern-day health care.
Links:
See Russell Teagarden’s blog postings at According to the Arts for further analysis of the short stories featured in this podcast, At the Pharmacy (Chekhov) and It’s All Right – He Only Died (Chandler).
At the Pharmacy is included in the anthology, The Undiscovered Chekhov: Thirty-Eight New Stories, as is the story of how the translator, Peter Constantine, found these unpublished works more than a century after they were written. An online version of At the Pharmacy is published in the weekly newsletter, Falltide.
It’s All Right – He Only Died, was published in The Strand Magazine, along with the story of its discovery sixty years after it was first written.
The version of The House of God we referenced in the podcast is the Berkley trade paperback edition, 2010.
After the podcast was released, the New York Times published an investigative report concerning the operation of the New York University emergency department on December 22, 2022 indicating that what Chandler described in his short story is still in practice. And a Kaiser Family Foundation report published on December 21, 2022 concerning the policies and practices many individual hospitals apply in collecting money their patients owe them shows how the issues raised in Chekhov's story still exist.
Also:
Please send us comments, recommendations, and questions to: [email protected].
Thanks for listening, and please subscribe to The Clinic & The Person wherever you get your podcasts, or visit us at https://www.theclinicandtheperson.com.
Executive producer: Anne Bentley
Previous Episode
Sweet Sand of Time: James Dickey’s poem Diabetes with Guest Dr. Jack Coulehan
We feature James Dickey’s poem, Diabetes, with our guest, the renowned physician-poet Dr. Jack Coulehan. We discuss insights the poem offers about the trajectory of type 2 diabetes from the time of symptom onset until the time a balance is achieved between maximum compliance with disease management requirements and the compromises an acceptable lifestyle can necessitate for many individuals. In addition to providing his perspectives on how the poem expands on the biomedical components of diabetes in recognizing effects such as fear, anxiety, frustration, and oppression, Dr. Coulehan recounts how he has used this poem and others in teaching medical students and residents. He also tells stories of particular instances in which he used poetry as part of the care he provided certain patients, and as a way to connect with them.
Links:
Dr. Jack Coulehan’s bio at Stonybrook University is here.
The poem, Diabetes, and the comparative biomedical text discussed can be seen here in Russell Teagarden’s blog, According to the Arts.
Dr. Coulehan’s poem, I’m Gonna Slap Those Doctors, which was central to one of the stories he told, can be accessed here. And, his poem, The Man with Stars Inside Him, which was central to another story he told, can be accessed here.
In this episode, we make a distinction between illness as the subjective perceptions of a health problem and disease as the pathological basis of a health problem. This distinction is explained in much greater depth here in According to the Arts.
The Literature, Arts and Medicine Database at the New York University Grossman School of Medicine, a great source for Humanities works related to disease, illness, and health care, is found here.
Please send us comments, recommendations, and questions to [email protected].
Thanks for listening, and please subscribe to The Clinic & The Person wherever you get your podcasts, or visit us at our website.
Executive producer: Anne Bentley
Next Episode
Beautifier or Destroyer: Tuberculosis in Two Paintings
We explore two paintings, each rendering one of two different perspectives on tuberculosis (TB). We first take a close look at Alice Neel’s 1940 painting, T.B. Harlem, and focus on how it depicts the suffering and destruction TB caused, and reveals some of the social determinants of TB at the time. We then examine Thomas Lawrence’s 1794 painting, Portrait of Catherine Rebecca Grey, Lady Manners, and work through how it conveys the convergence of TB clinical manifestations with beauty ideals at the time.
Links:
Here are the links for the paintings we discuss:
T.B. Harlem, Alice Neel, 1940, oil on canvas
Portrait of Catherine Rebecca Grey, Lady Manners, Thomas Lawrence (1794), oil on canvas
The Sick Child, Edvard Munch, 1907, oil on canvas
Background sources:
JAMA issue featuring cover with Alice Neel painting, T.B. Harlem, and William Barclay commentary.
Russell Teagarden’s According to the Arts blog piece on T.B. Harlem.
Hoban P. Alice Neel: The Art of Not Sitting Pretty. New York, St. Martin’s Press, 2010. Day, C. Consumptive Chic. London, Bloomsbury Visual Art; 2017, 189 pages.
Russell Teagarden’s According to the Arts blog piece on Carolyn Day’s book, Consumptive Chic.
Day C, Rauser A. Thomas Lawrence’s Consumptive Chic: Reinterpreting Lady Manners’s Hectic Flush in 1794, Eighteenth-Century Studies, vol. 49, no. 4 (2016) pp. 455–74. (Not open access)
Russell Teagarden’s According to the Arts blog pieces on The Sick Child, and on Munch’s approach to his painting, and podcast episode with Øystein Ustvedt, curator and Munch expert on Munch's paintings rendering illness, suffering, and grief.
Here's an image representative of the 1990s fashion trend known as “Heroin Chic” that we referred to during the podcast.
Please send us comments, recommendations, and questions to: [email protected].
Thanks for listening, and please subscribe to The Clinic & The Person wherever you get your podcasts, or visit our website.
Executive producer: Anne Bentley
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