Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Scourge of Cardiogenic Shock

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RECOGNITIONS

Arvind Bhimaraj, MD, MPH, Guides Issue on Cardiogenic Shock

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REVIEW ARTICLES See More

Pathophysiology and Advanced Hemodynamic Assessment of Cardiogenic Shock

Cardiogenic Shock in the Setting of Acute Myocardial Infarction

Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Acute Mechanical Circulatory Support for Cardiogenic Shock

Management of Cardiogenic Shock in a Cardiac Intensive Care Unit

Physiological Concepts of Cardiogenic Shock Using Pressure-Volume Loop Simulations: A Case-Based Review

Systems of Care in Cardiogenic Shock

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

CASE REPORTS See More

Repair of Extent III Thoracoabdominal Aneurysm in the Presence of Aortoiliac Occlusion

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 16, Issue 1 (2020)

Article Full Text

POET'S PEN

“No man is an island entirely of itself”

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Article Citation:

Young JB. “No man is an island entirely of itself”. Methodist DeBakey Cardiovasc J. 2018;14(4):308.



Pick up any edition of Earnest Hemingway’s masterpiece For Whom the Bell Tolls, first copyrighted in 1940, and you will see on a front piece the John Donne work from which his title came:

No man is an iland, intire of it selfe; everyman

Is a peece of the Continent, a part of the maine; if a

Clod bee washed away by the Sea, Europe is the lesse,

as well as if a Promontorie were, as well as if a Mannor

of thy friends or of thine owne were; any mans death

diminishes me, because I am involved in Mankinde; And

therefore never send to know for whom the bell tolls;

It tolls for thee.

The “poem” is, more accurately, several lines from a prose work titled Devotions Upon Emergent Occasions and severall steps in my Sickness written in 1624 for Prince Charles, the son of King James the First. Donne was the Dean of St. Paul’s and had been very ill with “spotted fever.” Fearing death as he heard church bells tolling on the occasion of others’ deaths, Donne penned his meditations. Hemingway used the “for whom the bell tolls” line to entitle, and set the stage, for a major philosophical work that has become one of his most famous. The story line, as noted on the jacket of the used 1993 Book-of-the-Month club edition I bought some years ago as a re-read, was about “…love, death, honor, and betrayal.” And so it was. But recently I used the short poetic lines in a different manner. Yes, the poem is deeply steeped in our mortality and that of the patients we care for, but there is a much less sobering message here as well. The words serve to provoke us into contemplating our daily lives as healthcare providers, as part of that experience.

The wide audience of healthcare providers has morphed from a gladiatorial mano-a-mano sport into a complex intertwining of teams-of-teams. Certainly there have always been teams of one sort or another. But no longer is the patriarchal, dominating, hubristic pyramid that once was the practice of medicine the best model. And so it is that no man is an island unto itself. Everyone is a piece of the healthcare continent and a part of the “main.” There is a new model of healthcare provision that requires embracing teams. And that is why I remember Houston Methodist (AKA “THE Methodist Hospital”) as so accomplished—it has always taken a team approach. Yes, we should ponder “for whom the bell tolls.” But let us also appreciate that “no man is an island entirely of itself.”

 

James B. Young, M.D.
Chief Academic Officer, Cleveland Clinic
Professor of Medicine & Vice-Dean for Cleveland Clinic Academic Affairs
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Section Editor, Poet’s Pen, Methodist DeBakey Cardiovascular Journal

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