Showing 101 - 110 of 338 annotations tagged with the keyword "Acculturation"
In dire financial straits, the physician-researcher, Dr. Malcolm Sayres (Robin Williams), accepts a clinical job for which he is decidedly unsuited: staff physician in a chronic-care hospital. His charges include the severely damaged, rigid, and inarticulate victims of an epidemic of encephalitis lethargica. Sayres makes a connection between their symptoms and Parkinson’s disease. With the hard-won blessing of his skeptical supervisor, he conducts a therapeutic trial using the new anti-Parkinson drug, L-Dopa.
The first patient to "awaken" is Leonard Lowe (Robert De Niro) who, despite being "away" for many years, proves to be a natural leader, with a philosophical mind of his own. Other patients soon display marked improvement and their stories are told in an aura of fund-raising celebration marked by happy excursions.
Gradually, however, problems develop: patients have trouble adapting to the radical changes in themselves and the world; Leonard grows angry with the imperfection of his rehabilitation; the horrifying side effects of L-Dopa appear; and Leonard’s mother (Ruth Nelson), initially happy for her son’s recovery, is later alienated by the concomitant arousal of his individuality, sexuality, and independence. The film ends with "closure of the therapeutic window" and marked regression in some patients, but not before they have awakened clinical commitment and a new ability to express feelings in their shy doctor.
Worlds Apart is a set of four documentary videos designed to stimulate thought and discussion about the effects of culture on communication and medical decision-making. Each video encapsulates the story of a real patient and his or her interactions with physicians and family.
The four videos are: (1) Kochi Story--an Afghan man, diagnosed with stomach cancer, decides about chemotherapy amidst miscommunication due to translation issues and religious convictions; (2) Chitsena Story--the mother of a four-year-old girl from Laos is caught between physicians who tell her that her daughter needs surgery to correct an atrial septal defect, and her mother who upholds the traditional Khmu beliefs that scars, including surgical scars, are injurious to a person in future lives; (3) Phillips Story--an African-American man on dialysis discusses the prejudices against black people in the health care system, particularly the decreased chances for receiving a renal transplant; (4) Mercado Story--a 60-year-old Puerto Rican woman who lives in Hell's Kitchen, New York City, explains the complex social situation which affects her ability to take care of her chronic health problems, such as diabetes and hypertension.
The films depict the patients and families in various settings--in doctors' offices, at other health care facilities, at home or work, during religious ceremonies. Phillips Story is different in that only the patient speaks during the film--in the other three stories we hear family members, translators, and physicians. The pitfalls of translation by a family member or friend are discussed, as well as the need for the physician to elicit information from patients about the social contexts that may affect their health and decisions.
For example, Mr. Kochi's religious beliefs contravene the use of continuous infusion chemotherapy, but not other regimens--this distinction is not elucidated for many months. Hence cultural competency in health care requires that the provider not assume reasons for patients' behaviors and decisions but rather emphasizes communication to understand the particulars of the situation.
Summary:In Dirty Details, Marion Deutsche Cohen writes about the unrelenting labor entailed in caring for her husband Jeffrey at home as multiple sclerosis turns his symptoms from "mere inconveniences" (11) to extraordinary demands, which can disturb her sleep as frequently as twenty times a night. The premise of her unsparing narrative is that "we have got to spill the dirty details" (26) of such arrangements before the endurance-draining responsibilities of home care such as hers can be understood and redressed. In a culture that favors narratives of seemingly heroic individual effort, Cohen's brutally forthright descriptions of the effects of Jeff's needs on her life can be mistaken for a self-pitying complaint, rather than an urgent, revelatory, political call to action. Like her husband, a well-published physicist at the University of Pennsylvania when diagnosed with MS at age 36 in 1977, Cohen is an accomplished professional. With a PhD in mathematics, Cohen teaches college students as well as publishes poetry and prose. She and her husband also shared, with increasing asymmetry, the parenting of their four children.
Summary:This volume belongs in the category of cross-cultural studies of medicine and the humanities. Its main audience is scholars of nineteenth-century American psychiatry and culture. The author divides his study into six chapters, each with a topic, including the simultaneous emergence of nineteenth-century public debate about improving the treatment of insanity and the movement to abolish slavery; cultural activities in asylums directed toward humanizing the patients; bardolatry in British and American medical circles; discussions of Emerson, Hawthorne, Poe, and Melville in the context of their literary and personal relationship with madness; a chapter on captivity narratives and popular novels by former female and male patients; and an epilogue.
Summary:Written by a psychiatrist and historian, American Melancholy: Constructions of Depression in the Twentieth Century looks at how culture, politics and, in particular, gender have played a role in the development of a diagnosis. Hirshbein moves between several different worlds, showing how they intercalate and, indeed, are very much part of the same world: psychiatric nosology and cultural attitudes to the gendered expression of emotion and feelings, medication trials and magazine advice to women about how they should deal with the blues, the relations between treatment paradigms and how society views suffering.
Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic: his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians. Members of his extended family were killed and his father’s home was destroyed. He straddled other boundaries: trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims. His perspective is both thoughtfully nationalistic and international.
Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable. Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes. Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.
Set against the backdrop of the violent post-Duvalier years in Haiti, this novel traces the development of Sophie, the product of a violent rape. Having been raised lovingly by her aunt in a village near Port-au-Prince for 12 years, Sophie is suddenly sent for by her mother (who had immigrated to the United States as an asylum seeker). Living in New York, Sophie discovers that her mother is haunted by violent nightmares, a remnant of the trauma she had suffered before fleeing Haiti.
Part Two opens as Sophie, now 18, falls in love with her neighbor, a musician named Joseph. Her mother, upon finding out about Sophie's love interest, begins the humiliating tradition of her mother, "testing" Sophie's virginity by inserting a finger in her vagina to make sure the hymen was not broken. After several "tests," Sophie painfully breaks her own hymen with a pestle and immediately runs off with Joseph.
Part Three of the novel opens about a year later, when Sophie has left her husband and returns to Haiti with her baby daughter. Here, she begins learning about her mother's past as well as telling her aunt and grandmother about her own current sexual dysfunction and her bulimia. Sophie and her mother reunite and reconcile in Haiti and later return to the States where Sophie returns to Joseph and begins a kind of therapy that includes rituals from Haitian, African, and Chicana traditions.
Meanwhile, Sophie's mother becomes pregnant (by her long time lover and friend) and increasingly agitated, finally committing suicide. At the funeral, in Haiti, Sophie runs into the cane field where her mother had been raped some 20 years earlier. As she is screaming her grief and rage, she tears at the cane stalks. Rather than attempting to stop her, Sophie's aunt and grandmother watch her, finally asking, "are you free?" and then insisting, "You are free!" (p. 233)
Summary:A memoir of raising a daughter with autism and an anthropological and historical investigation into autism around the world, Unstrange Minds: Remapping the World of Autism draws upon Grinker's own experiences, those of families of children with autism in the United States, Korea, India and South Africa, and a variety of experts and caregivers. Putting the story of autism into a historical, anthropological, and personal context, the book deals with hot-button topics - the question of an autism epidemic, of etiology, of treatments - with a careful, patient approach.
At fourteen, after marginally consensual sex with a boyfriend, Jane has a baby. She managed to keep her pregnancy a well-camouflaged secret until late in the process; both family and friends are still reeling from her late-breaking news. Her mother has died; her grandmother has moved from the tribal reservation to live with Jane, her father (a white Canadian), and Jane's two brothers. Though the school she attends has daycare for students' babies, Jane finds little emotional support, even among former friends, until a new girl, Dawna, takes an active, unpretentious interest in both Jane and the baby.
With Dawna's and her grandmother's help Jane decides to make the rather complicated arrangements required to allow her to audition for the school play and pursue a longstanding dream of singing and dancing on stage. She meets with fierce and aggressive competition from a much more privileged girl who does her best to discredit Jane's efforts on account of her unfitness as both a Native American who doesn't look the part, and as an unwed mother who, as one faculty member puts it, shouldn't "parade herself" in public. Nevertheless, Jane's skill and determination and soul-searching pay off; despite the steep learning curve required to care for a baby and the psychological cost of teen motherhood, she succeeds in making the accommodations and compromises necessary to retrieve old dreams on new terms.
Summary:South Africans, Paul and Andrea, are lovers living in France. Paul is fiftyish and white; Andrea is thirty and “coloured.” He has just asked her to marry him. She travels to Provence ostensibly to research sites for a film to be based on Paul’s endlessly forthcoming novel about fourteenth-century plague. But the real reason for the journey is to test her feelings about his proposal—she is leaning to ‘yes.’