[Problems of medical deontology in Tolstoy's short story "The Death of Ivan Il'ich" (on the centenary of its publication)].
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Each of these three works focused on indelible memories of its writer's medical education. Thomas Browne spoke about autopsies, medical theories, religion. Tobias Smollett exposed the horrendous conditions aboard naval vessels and some of the problems facing young physicians. John Brown depicted surgery before anesthesia and antisepsis. Uniformly, the events and circumstances that seemed to have affected them were on the forefront of medical and social history. Religio Medici, Roderick Random, and "Rab and His Friends" were each the first major literary work of the authors discussed; each achieved instant success, yet somehow their popularity waned. Perhaps, the evolution of medicine has eclipsed what was once sensational, disturbing, interesting, and marketable, leaving only the dry and lifeless bones of stories--remnants of what once they were.
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This is a report on the development of a curriculum designed to meet the need to teach residents a caring model of medicine for effective management of the growing chronically ill population. A central unifying theme in this curriculum is the use of nonmedical literature, specifically Heartsounds, to provide a common experience and focus for discussion. The goal of the curriculum is to help residents increase their understanding of the meaning of chronic illness to the patient, family, and physician. Objectives and a structured conference series are described, including the use of nonmedical literature as required reading. Long-term evaluation of the effect of the curriculum on attitude and behavior is in progress.