Showing 11 - 20 of 106 annotations in the genre "Treatise"
Summary:This short but complex book assesses the many, current risks to all life on earth and considers some avenues for repair that may provide hope for the future. E. O. Wilson, a distinguished scientist, describes how all life on earth is inter-related. With a long view to the past and a wide view of the present—from microscopic creatures to humans—Wilson praises our planet’s biodiversity and warns of the dangers that may cause it to collapse; these dangers are human-related. Humans are an apex predator, smarter than all other creatures, but we are also too numerous, using too many resources, and causing various pollutions, including global warming. The health of the world and the health of all its creatures—humans included— are, for better or worse, interlinked forever.
Summary:The aim of these reflections on uncertainty in medicine is not to discredit evidence-based medicine or to incite suspicion of the careful and caring processes by which most clinicians arrive at the advice they give. Rather it is to change conversations among practitioners and between them and their patients in such a way as to raise everyone’s tolerance for the inevitable ambiguities and uncertainties we live with. If the public were more aware of the basic rules of mathematical probabilities, how statisticians understand the term “significance,” and of how much changes when one new variable is taken into account—when a new medication with multiple possible side-effects is added to the mix, for instance—they might, Hatch argues, be less inclined to insist on specific predictions. He goes on to suggest that there is something to be gained from the challenge of living without the solid ground of assurances. When we recognize the need to make decisions with incomplete information (a condition that seems, after all, to be our common lot) we may refocus on the moment we’re in and see its peculiar possibilities. Changing the conversation requires a critical look at medical education which, Hatch observes, “measures a certain type of knowledge essential to medical practice, but it consequently engenders a conception of medicine best described as overly certain . . . .”
Summary:The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.
Summary:Atul Gawande’s Being Mortal is both ambitious and synthetic, qualities that well suit his difficult subject, death. In Western culture, there are taboos against death because it fits neither into post-Enlightenment notions of progress and perfection nor into medical notions of control, even domination of human biology. A surgeon and an investigator, Gawande draws on his patients, his family, and travels to various hospitals and other caregiving places in order to confront death and see how approaches such as hospice and palliative care can improve our understanding, acceptance, and preparation for death.
Summary:Linden, a professor of neuroscience, has written a book for a general audience on the subject of touch. A synthetic thinker, he combines insights from science, anatomy, neurophysiology, psychology, and social behavior. He argues that touch pervades much of human experience: “From consumer choice to sexual intercourse, from tool use to chronic pain to the process of healing, the genes, cells, and neural circuits involved in the sense of touch have been crucial to creating our unique human experience” (p. 5). Case studies of medical oddities enliven his account.
Summary:The author of this long, compassionate and often startling treatise on identity interviewed over three hundred families to elicit stories about raising exceptional children, stories that also come from these exceptional children ('exceptional' is the term chosen to describe the children in the author's material about the book).
Jacob Needleman, a philosopher concerned with "applying philosophy to the questions of everyday life," taught medical ethics at San Francisco State University (SFSU). In this highly personal book he addresses what it means to be a "good doctor" and the role of physicians in contemporary society. The book is structured as a series of imaginary letters addressed to his childhood idol, the physician who treated him when he was 12 years old.
The aged Dr. Kaufman responds to these letters, although we see only the philosopher’s side of the correspondence. Toward the end of the book, Needleman makes a pilgrimage to Philadelphia to visit his ailing mentor. They talk for a while, then when the old man takes a nap, Needleman spends the rest of the day conversing with Dr. Kaufman’s daughter, a pediatrician who in some sense represents the "good" medicine of the future, just as her father represented the "good" medicine of the past.
In these letters the author addresses the deep questions of character and motivation in the form of a personal narrative. He recalls his experiences as a boy, his ambition to become a doctor, and several incidents from his life as an autopsy assistant and hospital orderly. For example, there is the bizarre story of the young man transporting an amputated leg by elevator; he accidentally drops the leg to the floor and the wrappings flip open, much to the astonishment of others on the elevator.
"People don’t trust science; people trust people." (p. 15) Similarly, Jacob Needleman writes, people don’t trust or distrust medicine as an institution; they trust or distrust doctors. "To be a good doctor, one must first of all be a good (person). And to be a good (person) one has to begin by discovering in oneself the desire for truth . . . truth is the only effective force." (p. 68)
To facilitate this quest for truth, Needleman describes in these letters a four-seminar sequence he teaches at SFSU: "To whom is the physician responsible?," "The art of living and the art of medicine," "Care," and "The financial disease of modern medicine." (pp. 71-72) Through these seminars the author hopes to re-awaken in prospective physicians the quest for truth, and the possibility of care, that he believes have been submerged by technology and infected by the financial disease. Dr. Kaufman’s daughter serves as a real-life example of the possibility of cultivating the contemporary version of the "good doctor."
Summary:Each chapter in this book explores the forms and effects of humor in healthcare, mostly in hospital settings, beginning with a touching account of a person who worked as a hospital clown, visiting patients, enlivening staff, haunting the halls of a hospital where she became a beloved and important reminder that the disruptions of illness can be reframed in ways that make them more tolerable and bring patients back into communities from which they often feel exiled. In subsequent chapters Carter, who himself went through cancer treatment, and writes from that experience as well as from his experience as a volunteer in an ER, draws from his compendious collection of medical jokes and stories to provide examples of the kinds of humor that help nurses and doctors, as well as patients and their families, get through the days. Some of it is edgy and ironic, some broad and slapstick, some wordplay that helps to domesticate the often alienating discourse of clinical medicine. His point is to provide some analytical categories and ways of understanding the kinds of humor that can be helpful-not simply to share a collection of jokes and stories, but the book does, especially in the final chapters, provide a sizeable collection of those, ranging from puns (including what he calls "groaners") to patient stories that in various ways turn medicine on its head.
Summary:In her reflections on the vocation of nursing Robinson explores many myths and archetypes that give shape and energy to the identity of the nurse as it has evolved in Western culture, including the stories of Hygeia, Baubo, Hermes, Hecate, Cassandra, and the Dionysian Maenad. The ancient stories of each of these figures and others articulate particular constraints, conventions, and conflicts involved in caregiving, especially in the ways women assume the role of caregiver. She explains at the outset that she deals particularly with women in nursing, though now many men are nurses, since traditionally it has been a profession deeply shaped by cultural notions of female roles. Another layer of this exploration is a chapter on the nurse in popular culture that considers ways in which the figure of the nurse has been both elevated and debased, made comic or tragic, sidelined or sexualized. The multidimensionality of the nursing vocation and, consequently, the challenge it poses to women who enter it, is strongly emphasized throughout the six chapters, which together depict the work of nursing as a soul journey. This journey challenges nurses in new ways to work within institutions that suppress important aspects of their power to do healing work at a level of intimacy generally not accessed by doctors.