Relevant bibliographies by topics / Doctor Faustu

Academic literature on the topic 'Doctor Faustu'

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Published: 11 March 2023

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Journal articles on the topic "Doctor Faustu"

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Kojoyan, Ani. "Damnable Lives? The Inter-Textual Relations between Marlowe’s “Doctor Faustus” and “The English Faust” Book." Armenian Folia Anglistika 10, no. 1-2 (12) (October 15, 2014): 131–41. http://dx.doi.org/10.46991/afa/2014.10.1-2.131.

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Christopher Marlowe’s play Doctor Faustus is a problematic work in regards to the issues of its date and authorship, but one thing can be stated with certainty: it was inspired by The History of the Damnable Life and Deserved Death of Doctor John Faustus which is commonly known as the English Faust Book. The present article observes inter-textual dimensions between Marlowe’s tragedy Doctor Faustus and its prose source-book – the English Faust Book. The article discusses intertextual relations both at paradigmatic and syntagmatic levels. According to the analysis, it becomes obvious that despite several similarities between the two texts, certain differences also exist which are conditioned by political and religious factors of time and social-historical factors of space.
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Spencer, Matthew, Christopher Marlowe, and David Wootton. "Doctor Faustus with the English Faust Book." Sixteenth Century Journal 37, no. 4 (December 1, 2006): 1152. http://dx.doi.org/10.2307/20478179.

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Baron, Frank, William Empson, and John Henry Jones. "Faustus and the Censor. The English Faust-Book and Marlowe's Doctor Faustus." German Studies Review 12, no. 2 (May 1989): 354. http://dx.doi.org/10.2307/1430100.

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Celestini, Federico. "Musikpolitische Konstellationen in Thomas Manns Doktor Faustus." Archiv für Musikwissenschaft 75, no. 3 (2018): 193–215. http://dx.doi.org/10.25162/afmw-2018-0011.

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Eggensperger, Klaus. "„Den Bösen sind sie los“ Überlegungen zu Mephistopheles und zum Bösen in Goethes Faust." Pandaemonium Germanicum, no. 8 (December 19, 2004): 189. http://dx.doi.org/10.11606/1982-8837.pg.2004.68421.

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Por que o Mefistófeles no Fausto de Goethe, ao contrário de todas as expectativas, não apresenta uma natureza realmente má? Partindo desta pergunta, neste artigo discute-se a figura do diabo no imaginário europeu no sec. XVI e no Doctor Faustus de Christopher Marlowe. Em seguida são analisados alguns traços principais do diabo goethiano secularizado. O Mefistófeles de Goethe não é o demônio da mitologia cristã e tão pouco representa o grande vilão da peça. Seu autor deixa claro que a responsibilidade pelo mal produzido nas duas partes do Fausto é dos seus personagens humanos.
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Mathieu, Jeanne. "Doctor Faustus." Cahiers Élisabéthains: A Journal of English Renaissance Studies 103, no. 1 (November 2020): 157–60. http://dx.doi.org/10.1177/0184767820946175q.

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Parameswaran, Uma, and Vasant A. Shahane. "Doctor Fauste: An Indian Version of the Legend of Faustus." World Literature Today 61, no. 4 (1987): 676. http://dx.doi.org/10.2307/40143971.

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Elder, R. Bruce. "Goethe’s Faust, Gertrude Stein’s Doctor Faustus Lights the Lights, and Stan Brakhage’s Faust Series." Canadian Journal of Film Studies 14, no. 1 (March 2005): 51–68. http://dx.doi.org/10.3138/cjfs.14.1.51.

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SÜMBÜL, Feride, and Selmin SÖYLEMEZ. "İncil ile İlgili ve Tarihi Anıştırmaların Çevirisi: Christopher Marlowe’un Doktor Faustus’u Üzerine Bir Çalışma." Cankaya University Journal of Humanities and Social Sciences 16, no. 1 (June 6, 2022): 27–42. http://dx.doi.org/10.47777/cankujhss.937402.

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The literary concept of intertextuality provides a new insight for translation studies. According to intertextual theory, texts are not isolated, they interact with each other in a way that a text is under the influence of preceding ones and it affects later writings (Allen 1). In translation, intertextual theory enables translators to take into consideration intertextual relations of a text to other texts which also means a translator should be aware of the literary and cultural tradition of the target culture. Allusions as one of the features of intertextuality hide a broader meaning and carry cultural implications in relation to other texts. To transfer them to the target culture effectively entails translators having cultural knowledge and experience of the target language. In the light of intertextual theory, this study focuses on the translation of biblical and historical allusions found in Doctor Faustus by Christopher Marlowe, which is a Renaissance play involving numerous allusions to mythology, the Bible, and history. In this study, biblical and historical allusions seen in Doctor Faustus and their Turkish renderings translated by T. Yılmaz Öğüt as Dr. Faustus (2018) have been analyzed in the light of Rita Leppihalme’s translation strategies concerning allusions. After detecting the allusions related to the Bible and history, they have been listed and compared to their Turkish allusions. Then, alluded references and their Turkish translations have been evaluated and the strategies adopted by the translator have been discussed according to the strategies proposed by Leppihalme in detail.
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Grenville, Anthony, Michael Beddow, and Hugh Ridley. "Thomas Mann: 'Doctor Faustus'." Modern Language Review 92, no. 1 (January 1997): 245. http://dx.doi.org/10.2307/3734780.

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Dissertations / Theses on the topic "Doctor Faustu"

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Eversberg, Gerd. "Doctor Johann Faust die dramatische Gestaltung der Faustsage von Marlowes "Doktor Faustus" bis zum Puppenspiel /." Köln : [s.n.], 1988. http://catalog.hathitrust.org/api/volumes/oclc/19807603.html.

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Matthews, Michelle M. "MAGICIAN OR WITCH?: CHRISTOPHER MARLOWE'S DOCTOR FAUSTUS." Connect to this title online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1143482826.

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黃國鉅 and Kwok-kui Wong. "Representing crises in German culture in Doctor Faustus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31220095.

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Jones, Louise. "Stage action as metaphor in Marlowe's Doctor Faustus." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/774755.

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The purpose of the study is to establish the critical need for stage action in order to understand fully the theme of Marlowe's Doctor Faustus. Marlowe's primary intent is to invert the morality play, illustrating the distortions and ambiguities of a systematized religion and to establish the human dilemma when man is faced with moral choices. To illustrate this inversion, Marlowe uses emblematic action for an effect opposite to that of the traditional moralities: Often this action goes beyond the emblem, becoming a metaphor for Marlowe's theme, man as a victim, conflicting within himself and within the system which governs his morality.Chapter one introduces this theme and the crucial need for staging Marlowe's ideas. The first chapter also establishes a compromise of the textual problems inherent within any study of Doctor Faustus. Since the study argues that audience reaction is important to Marlowe's intent, attention is paid to how audience response governs the play's interpretation.Chapter two is a critical review of the historical staging practices which must be considered when studying the dramatic text. Included are stage size, costuming, and special effects.Chapter three is the advancement of the thesis in a scene by scene analysis of the text with special attention to the action as metaphor. Considered is how audience reaction represents part of Marlowe's purpose; the increasing tension of the audience furthers Marlowe's concept of the ambiguities present when humans are faced with moral choices. This purpose is traced scene by scene with specific attention to how it is metaphorically portrayed on stage.Chapter four is separate as a director's book, with the text reproduced, together with the researcher's marginal notes on specific blocking and with footnotes emplacing and expanding on the metaphorical action as it appears in the text.
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Wong, Kwok-kui. "Representing crises in German culture in Doctor Faustus /." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2026317X.

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Stamenkovic, Zoran. "Culture-bound shifts in the first french and italian translations of Christopher Marlowe's Doctor Faustus." Thesis, Perpignan, 2018. http://www.theses.fr/2018PERP0052.

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La présente thèse compare le drame Le Docteur Faust de Christopher Marlowe (1604, 1616) avec la première traduction française faite par Jean-Pierre Antoine Bazy (1850) et la première traduction italienne faite par Eugenio Turiello (1898) en visant à identifier les changements textuels révélateurs du contexte culturelle et idéologique au moment où se produisent les deux textes cibles. Le Docteur Faust est un exemple emblématique de l’instabilité du texte dramatique source. Il nous est parvenu en deux versions (le texte A et le texte B) différentes du point de vue structurel, thématique et doctrinal. En revanche, aucune version ne permet pas une interprétation cohérente. Ce travail a pour propos d’examiner si les traductions de Bazy et de Turiello, qui proviennent de contextes géographiques, historiques et littéraires différents mais étroitement liés, multiplient les lectures plausibles ou bien si elles aboutissent à une vision plus constante. En outre, on s’interroge sur la cause des variations textuelles, généralement dénommées en traductologie les glissements. Tout d’abord, j’ai identifié une régularité des glissements qui se manifestent dans deux traductions en question. Puis, j’ai analysé les effets des glissements sur la structure et la signification générales des textes. Enfin, en adoptant une approche socioculturelle de l’analyse des traductions, j’ai exploré la manière dont les changements sont déterminés par l’idéologie des traducteurs et leur interprétation de l’original. Cela explique leur position au sein de l’espace politique et idéologique de chaque culture d’arrivée, ainsi que les normes traductrices et culturelles adoptées au cours de la traduction
The aim of this research is to compare Christopher Marlowe’s play Doctor Faustus (1604, 1616) with the first French translation by Jean-Pierre Antoine Bazy (1850) and the first Italian translation by Eugenio Turiello (1898) in search of the changes that are symptomatic of the cultural and ideological context of translation production. The case of Doctor Faustus represents the epitome of the instability of a dramatic source text. Two main versions of the play (the A-text and the B-text) differ in structural, thematic and doctrinal terms. At the same time, neither version delivers a coherent vision. The research seeks to examine whether Bazy’s and Turiello’s translation, belonging to different yet related geographical, historical and literary traditions, further multiply the potential readings of the original or whether they display a more consistent framework. In addition, we will analyse the causes of textual variation, commonly labelled in Translation Studies as shifts. First, we identified a pattern of shifts manifested in the target texts in question. Then, we discussed the ways in which the identified patterns of shifts affect the general meaning and the structure of the texts. Finally, adopting a socio-cultural approach, we showed how certain shifts are conditioned by the translators’ ideology and their interpretation of the original. This in turn reveals the positions they occupy within the political and ideological space of each target culture and the main cultural and translation norms operating in the recipient systems
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Collovini, Alessandra <1992&gt. "Il patto col diavolo. Un'indagine sul Doctor Faustus di Thomas Mann." Master's Degree Thesis, Università Ca' Foscari Venezia, 2020. http://hdl.handle.net/10579/17421.

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L'elaborato si propone di analizzare il tema del patto col diavolo, attraverso le interpretazioni di alcuni autori che si sono interessati alla figura di Faust. Il percorso trova la sua origine nell'opera "Storia del Dottor Faust, ben noto mago e negromante" di Spies. In questo libretto popolare del 1587, per la prima volta si parla della figura di Faust e del suo diabolico patto con Satana, volto a superare i limiti intrinseci dell'essere umano; un patto che però lo condurrà alla dannazione eterna. Thomas Mann, rifacendosi in particolare alla leggendaria "Storia" di Spies, rielabora il celebre mito di Faust, inserendolo nel contesto storico-politico della Germania della prima metà del Novecento, nella sua opera matura "Doctor Faustus. La vita del compositore tedesco Adrian Lerverkuhn narrata da un amico". Attraverso l'analisi e la descrizione del comportamento e delle scelte dei due protagonisti, Adrian Leverkuhn e Serenus Zeitblom, Mann rende collettivo un mito che fino ad allora era stato sottoscritto dal singolo. L'autore allarga così lo spettro del patto individualmente stipulato in un patto che il popolo tedesco stringe con il nazismo. L'analisi del momento del diabolico accordo fa soprattutto riferimento alla recente traduzione ed interpretazione dell'opera a cura di Luca Crescenzi.
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Da, Silva Maia Alexandre. "Renaissance desire and disobedience, eroticizing human curiosity and learning in Doctor Faustus." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0026/MQ50508.pdf.

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Da, Silva Maia Alexandre. "Renaissance desire and disobedience : eroticizing human curiosity and learning in Doctor Faustus." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=21205.

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Focusing on the A-text (1604) version of Marlowe's Doctor Faustus , this study further assesses biographical information on the poet and intellectual currents of the Counter Reformation, so as to investigate the play's relation to emergent trends of individualism in the Renaissance, recovery of the pagan past, and intellectual aspirations that could readily collide with orthodoxy. Clearly reflecting anxieties of the period about individual deviance from social norms through intellectual overreaching, Doctor Faustus powerfully testifies to the potential dangers of human aspiration and the scholarly spirit of unbounded learning. While thus exploring the exotic temptations of forbidden knowledge, the play resurrects and interrogates traditional taboos which related intellectual appetite to wrongful lust. Marlowe stages an explosive conflict between the conservative tradition of intellectual inquiry, which distrusted the unorthodox scholarship and Neoplatonic magic that some widely influential thinkers promoted in the Italian Renaissance, and Faustus's own creative desires, ambitions, and imagination. The tension between proscribed and prescribed knowledge climaxes in the invocation of Helen of Troy. While Helen's significance is complex, we find that, in relation to the play's concern with dissent from orthodoxy, she focuses the power of intellectual longing to seduce and ravish the mind. Apart from being a superior play, Doctor Faustus encapsulates Marlowe's awareness of his period's uneasy perception of unconventional thinking, and urges the importance of challenging restrictions on how much one is permitted to know.
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Andersson, Love. ""The Devil to pay" : Temptation and desire in Christopher Marlowe's Doctor Faustus." Thesis, Högskolan i Halmstad, Akademin för lärande, humaniora och samhälle, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-43851.

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The Faustian myth may not have started with Christopher Marlowe and the staging of his play The Tragical tale of Dr. Faustus, but few adaptions have managed to become as prominent as Marlowe’s in passing on the Faustian myth. Psychoanalyst Jacques Lacan highlights the presence of a more or less conscious catalyst behind each desire, the objet a (the lost object of desire), thus indicating that desiring is not a straight path but rather a constant filling of the void that comes with being human. In an eerie mirroring of this tendency, the play eloquently paints the picture of Faustus’ incessant search for his true desire -his objet a-, by veiling it in other desires (omnipotence and omniscience). This quest ultimately culminates in the demonic pact with Mephistopheles, which, as will be explored and argued in the analysis is what locks Faustus out from achieving his true desire: salvation. Hence, the main investigative aim of this essay is to asses how Lacan’s objet a can be used to explore the development of the theme of unfilled desire displayed by Marlowe’s protagonist Faustus.
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Books on the topic "Doctor Faustu"

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Marlowe, Christopher. Doctor Faustus with the English Faust book. Indianapolis, IN: Hackett Pub. Co., 2005.

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Henry, Jones John, ed. Faustus and the censor: The English Faust-book and Marlowe's Doctor Faustus. Oxford, UK: B. Blackwell, 1987.

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Leñero, Carmen. Las transmigraciones de Fausto. México: Universidad Nacional Autónoma de México, 2014.

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Doctor Faustus. Deddington: Philip Allan Updates, 2010.

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Williams, Guy R. Doctor Faustus. Studio City, CA: Players Press, 1992.

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Mann, Thomas. Doctor Faustus. New York: A.A. Knopf, 1997.

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Rudall, Nicholas. Doctor Faustus. Chicago: I.R. Dee, 1991.

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Marlowe, Christopher. Doctor Faustus. London: Routledge, 1988.

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Marlowe, Christopher. Doctor Faustus. New York: Signet Classic, 2001.

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Marlowe, Christopher. Doctor Faustus. London: Nick Hern, 1996.

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Book chapters on the topic "Doctor Faustu"

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Sales, Roger. "Doctor Faustus." In Christopher Marlowe, 133–60. London: Macmillan Education UK, 1991. http://dx.doi.org/10.1007/978-1-349-21577-5_7.

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Meyers, Jeffrey. "Mann: Doctor Faustus." In Disease and the Novel, 1880–1960, 62–82. London: Palgrave Macmillan UK, 1985. http://dx.doi.org/10.1007/978-1-349-17783-7_5.

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Schiller, Robert. "Ignorant Doctor Faust." In Between One Culture, 43–46. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-20538-6_8.

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Loehlin, James N. "The Text and Early Performances." In Christopher Marlowe Doctor Faustus, 1–11. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_1.

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Loehlin, James N. "Commentary: The Play in Performance." In Christopher Marlowe Doctor Faustus, 12–77. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_2.

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Loehlin, James N. "Intellectual and Cultural Context." In Christopher Marlowe Doctor Faustus, 78–92. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_3.

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Loehlin, James N. "Key Performances and Productions." In Christopher Marlowe Doctor Faustus, 93–123. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_4.

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Loehlin, James N. "The Play on Screen." In Christopher Marlowe Doctor Faustus, 124–30. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_5.

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Loehlin, James N. "Critical Assessments." In Christopher Marlowe Doctor Faustus, 131–48. London: Macmillan Education UK, 2016. http://dx.doi.org/10.1007/978-1-137-42635-2_6.

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Franklin, Peter. "The Problem of Doctor Faustus." In The Idea of Music, 35–53. London: Palgrave Macmillan UK, 1985. http://dx.doi.org/10.1007/978-1-349-17996-1_3.

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Conference papers on the topic "Doctor Faustu"

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Selezneva, E. ""AS A LIGHT IN THE NIGHT" ("THE LAMENTATION OF DOCTOR FAUSTUS": AN INTERPRETATION)." In 6th SGEM International Multidisciplinary Scientific Conferences on SOCIAL SCIENCES and ARTS Proceedings. STEF92 Technology, 2019. http://dx.doi.org/10.5593/sgemsocial2019v/6.1/s11.015.

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Xu, Bingfeng, Zhiqiu Huang, Jun Hu, Ou Wei, and Yu Zhou. "Minimal cut sequence generation for state/event fault trees." In the 2013 Middleware Doctoral Symposium. New York, New York, USA: ACM Press, 2013. http://dx.doi.org/10.1145/2541534.2541592.

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Sun, Biao, Peter B. Luh, Zheng O'Neill, and Fangting Song. "Building energy doctors: SPC and Kalman filter-based fault detection." In 2011 IEEE International Conference on Automation Science and Engineering (CASE 2011). IEEE, 2011. http://dx.doi.org/10.1109/case.2011.6042429.

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Turner, Cameron J. "Diagnosis via NURBs Metamodel." In ASME 2010 International Mechanical Engineering Congress and Exposition. ASMEDC, 2010. http://dx.doi.org/10.1115/imece2010-38323.

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In vivo tissue condition diagnosis is a challenging engineering problem. The goal is to develop a technology that can eliminate tissue removal and external examination and enable less invasive surgical techniques to be used with a precision provided by a knowledge of the tissue within the body. Particularly challenging is the task of automating the diagnosis of the tissue condition. In this work, a metamodeling technique based on Non-Uniform Rational B-splines is used to analyze and automate the diagnosis of human tissue conditions. The resulting diagnoses are compared to results from medical doctors and the challenges in such data analysis are discussed. The technique has implications for both biomedical and electromechical system fault diagnosis and diagnostics.
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Marques, Marco A., Marcos A. Simplício Jr., and Charles Christian Miers. "Event2Ledger: Container traceability using Docker Swarm and consortium Hyperledger blockchain." In Simpósio Brasileiro de Segurança da Informação e de Sistemas Computacionais. Sociedade Brasileira de Computação - SBC, 2022. http://dx.doi.org/10.5753/sbseg_estendido.2022.227013.

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Cloud computing employing container-based virtualization enables dynamic allocation of computational resources, providing scalability and fault tolerance, etc. However, this flexibility could imply a drawback: container environment monitoring is highly challenging due to the large flow of calls and (de)allocations. In this work, we present event2ledger, a blockchain-based solution that implements a distributed log with data sent by authorized and customized collectors to a permissioned consortium blockchain, responsible for ordering and storage in a distributed and auditable manner. A proof-of-concept is implemented with a Hyperledger Fabric consortium blockchain, composed and maintained by the scenario actors (i.e., Providers, Users, and Developers), which stores signed container life cycle events.
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Rey, Javier, Matias Cogorno, Sergio Nesmachnow, and Luiz Angelo Steffenel. "Efficient Prototyping of Fault Tolerant Map-Reduce Applications with Docker-Hadoop." In 2015 IEEE International Conference on Cloud Engineering (IC2E). IEEE, 2015. http://dx.doi.org/10.1109/ic2e.2015.73.

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Marques, Marco, Maurício Pillon, Guilherme Koslovski, and Charles Miers. "Rastreabilidade de alocação e desalocação de contêineres usando Docker Swarm com base em blockchain Hyperledger consorciado." In Computer on the Beach. Itajaí: Universidade do Vale do Itajaí, 2020. http://dx.doi.org/10.14210/cotb.v11n1.p066-067.

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Container-based virtualization technology enables dynamic allocation,addressing needs of scalability and fault tolerance. This featureprovides flexibility in the use of computing resources, but turnsmonitoring a challenge due to the large flow of calls and allocations.Recording these operations in a Blockchain allows to not only auditthe resources employed but also the chronology analysis of theperformed operations. In addition, the use of blockchain distributesthe credibility of record veracity between provider, end user, anddeveloper of the container-based solution.
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Ioan, Augustin. "POSSIBILITIES OF PLAY ACTIONS EVALUATION IN VOLLEYBALL." In eLSE 2015. Carol I National Defence University Publishing House, 2015. http://dx.doi.org/10.12753/2066-026x-15-228.

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The purpose of this writing was that one of testing the working instruments, which are to be used within the doctor paper. To evaluate the play actions it has been used the evaluation scale of the International Volleyball Federation (Manual for Statistical Match Records). The results have been graphically presented and centralized. Every actionis evaluated by using a scale of 5 degrees based on the effect on the score or further control of the ball by the team that plays the ball or by the opposite team: ACE (4) won point, EXCELLENT (3) - full control either won or maintained, GOOD (2) - limited control, won or maintained, WEAK (1) - lost control or without control, FAULT (MISTAKE) - 0 - lost point. "Ace" (evaluated 4) is used just for the following actions: service, attack, blockage. "Full control" (evaluated 3) is being used when all possibilities are created for further play constructions. "Limited control" (evaluated 2), in case if the further attack preparation can not be done by using all options. "Without control" (evaluated 1) is used when the attack. construction is not possible, but however the ball remains in play. The research was developed throughout the period August-November 2014, all game video recordings of a female junior team (15-16 years of age) participating in the national championships were processed. The results are graphically presented and centralized on games and highlight features different game model, the efficiency of one or more processes, inclinad balance to the winning team, this data can be used for personalizing, individualization of sports training and automatically increase efficiency training. As is clear from the statistics each technical element rated highlight strengths or weaknesses of a team.
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An, Kyoungho. "Resource management and fault tolerance principles for supporting distributed real-time and embedded systems in the cloud." In the 9th Middleware Doctoral Symposium of the 13th ACM/IFIP/USENIX International Middleware Conference. New York, New York, USA: ACM Press, 2012. http://dx.doi.org/10.1145/2405688.2405692.

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Usama, Muhammad, Hazlie Mokhlis, Nurulafiqah Nadzirah Mansor, Mahmoud Moghavvemi, and Li Wang. "Optimal FCL Placement and Sizing Incorporate DOCR Settings to mitigate Escalated Fault Stresses in Distribution Network." In 2022 6th International Conference on Electrical, Telecommunication and Computer Engineering (ELTICOM). IEEE, 2022. http://dx.doi.org/10.1109/elticom57747.2022.10037958.

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Reports on the topic "Doctor Faustu"

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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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Abstract:
As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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