Showing 141 - 150 of 396 annotations tagged with the keyword "Cross-Cultural Issues"
This collection of essays by surgeon-writer Atul Gawande (author of Complications: A Surgeon's Notes on an Imperfect Science --see annotation) is organized into three parts (Diligence, Doing Right, and Ingenuity) and includes an introduction, an afterword entitled "Suggestions for becoming a positive deviant," and reference notes. Each part is comprised of three to five essays, which illustrate, as Gawande explains in the introduction, facets of improving medical care - hence the title of the collection: Better: A Surgeon's Notes on Performance. In typical Gawande style, even the introduction contains tales of patients - a woman with pneumonia who would have fared far worse had the senior resident not paid close and particular attention to her well-being, and a surgical case delayed by an overcrowded operating room schedule. Such tales are interwoven with the exposition of themes and the detailing of the medical and historical contexts of the topic at hand.
The essays, though loosely grouped around the improvement theme, can easily be read as individual, isolated works. The concerns range widely both geographically (we travel to India and Iraq as well as roam across the United States) and topically. For instance, we learn about efforts to eradicate polio in rural south India and the dedicated people who devise and implement the program. Another essay, far flung from the plight of paralyzed children, is "The doctors of the death chamber," which explores the ethical, moral and practical aspects of potential physician involvement in the American system of capital punishment (from formulating an intravenous cocktail ‘guaranteed' to induce death to the actual administration of such drugs and pronouncement of death).
In sum, the topics of the eleven essays are: hand washing, eradicating polio, war casualty treatments, chaperones during physical examinations, medical malpractice, physician income, physicians and capital punishment, aggressive versus overly-aggressive medical treatment, the medicalization of birth, centers of excellence for cystic fibrosis treatment, and medical care in India. The afterword comprises five suggestions Gawande offers to medical students to transform themselves into physicians who make a difference, and by including this lecture in the book, what the reader can do to lead a worthy life.
Summary:Katie Takeshima, the narrator of this coming-of-age novel, moved with her immigrant family from Iowa to Georgia when she was in kindergarten. As her parents work long hours in a poultry processing plant with other exploited non-union immigrant workers, she and her older sister Lynn, and her little brother, Sammy, enjoy a loving and fairly free childhood. Lynn is Katie's primary teacher. Among her most important lessons is to see everything around her as "kira kira"--a Japanese word meaning something like "glittering"--moving and alive. When Lynn sickens and then dies of lymphoma, Katie has to do some fast growing up, and in her mourning develops a sharper sense of the glittering, mysterious presence of spirit and life in a world full of prejudice, poverty, and loss.
In this collection, twenty-two medical students and young physicians across the United States eloquently recount the process of medical education for those who do not believe they fit standard measures of student demographics. The editors, Takakuwa, an emergency medicine resident physician; Rubashkin, a medical student; and Herzig, who holds a doctorate in health psychology, group the essays into three sections: Life and Family Histories, Shifting Identities, and Confronted.
Each section is prefaced by an essay explicating the essay selection process, the history of medical school admissions policies and requirements, the basic progression of medical education and the reasons for this collection, such as "putting a human face" (p. xx) on the changing characteristics of admitted medical students: "With their diversity and through their self-reflections, we hope that these students will bring new gifts and insights to the practice of medicine and that they might one day play an important role in transforming American medical education into a fairer and more responsive system." (p. 141)
Additionally, a foreword by former Surgeon General Joycelyn Elders outlines her experience as a black woman entering medical school in 1956, including eating in the segregated cafeteria. The book concludes with recommendations for further reading and improvements to the medical education process as well as with brief biographies of the contributors and editors.
The range of essays is impressive: diversity itself is given a new meaning by the variety of narrative voices in this volume. Contributors include people from impoverished backgrounds, both immigrant (Vietnamese, Mexican) and not. One student, marginalized by his academic difficulties, began a homeless existence during his first clinical year. Others were made to feel different because of being African or Native American.
In two essays, mothers defy labels placed on them (pregnant black teen; lesbian) and describe the trials and triumphs of their situations. Students write of being subjected to ridicule, ignorance and prejudice due to their gender, interest in complementary medicine, political and advocacy views, or religious beliefs. Due to pressures to conform, even students from what might be considered more mainstream in American culture (e.g., growing up in a small town, or being Christian) can experience the effects of being "different" when in medical school.
A number of essays communicate the difficulties of illness, disability and bodily differences. Issues include recovered alcoholism (rather tellingly, this is the only essay that is anonymous), obsessive compulsive disorder, sickle cell anemia, Tourette Disorder, attention deficit hyperactivity disorder, chronic pain, and obesity. The authors balance their narratives of hardship with insights into how their struggles improve their opportunities for empathy, perspective and fulfillment as physicians.
In this poem, a young male patient receives stitches in an emergency room for a face wound from an alleyway knife fight. It seems the violence involved drugs, as a "broken syringe" is involved in the fight. However, more telling is the label that the ER doctor uses to describe the patient. The narrator of the poem, apparently an exhausted physician-in-training, is told by the ER doctor to quickly "Stitch up the faggot in bed 6."
The narrator meticulously sews his patient's wound, empathizing completely with him: "Each suture thrown reminded me I would never be safe / in that town." He too, could be ripped open "to see the dirty faggot inside." Furthermore, he ruminates that when the perpetrators of such violence themselves become victims, he would also stitch their wounds--silently, carefully, passively, "like an old woman."
This short novel tells the story of a Japanese-American family’s internment during World War II. They are living comfortably in Berkeley, California, when their nightmare begins. Soon after Pearl Harbor the husband/father is arrested by the FBI--taken away in his housecoat and slippers. We learn of this through the narration of the eight-year-old son, his ten-year-old sister, and their mother--who are rounded up several months later and sent to a camp in Utah. The father remains shadowy--a figure of memory, wishful thinking, and censored letters stamped "Detained Alien Enemy Mail." The reason for his arrest is never explained, as if there is no reason to question the man’s loyalty.
After her husband’s arrest, the mother is left to take care of her children and the house. A few months later she must pack up the household belongings, give away the family cat, kill and bury the family dog, tell her daughter to let loose the pet macaw. They are allowed to bring with them--where to they do not know--only what they can carry. They take an endless train ride through the Nevada desert to reach an internment camp in Utah, "a city of tar-paper barracks behind a barbed-wire fence on a dusty alkaline plane high up in the desert" (49).
Here they remain until the war ends, some three and a half years later. They learn to live in one room with a single light bulb; to stand on line for everything; to eat in the mess hall; to avoid rattlesnakes, scorpions, and the sun; and to "never say the Emperor’s name out loud" (52). They are unable to avoid the desert dust that covers and gets into everything. The children attend makeshift classes, play cards, are bored, lonely, and confused. The boy misses and has fantasies about his father, the girl reaches adolescence and becomes cynical, the mother is too depressed to eat or read.
At the end of the war, the three are allowed to go home "with train fare and twenty-five dollars in cash" (117). Their house has been vandalized; neighbors, teachers, and classmates either ignore them or are openly hostile. Finally their father is released from detention in New Mexico, a changed man both in appearance and spirit.
Born in Vienna, Alma Rosé (1906-1944) was a gifted violinist with an illustrious concert career. Her mother was the sister of composer, Gustav Mahler, and her famous father, Arnold, conducted orchestras. All the family members were non-observant Jews. Alma was talented, beautiful, audacious, and arrogant. After an unhappy early marriage to Czech violinist Vása Príhoda, she established a remarkable orchestra for women that toured Europe.
As the German Third Reich consolidated its power, her only brother, Alfred, fled to the USA. She managed to bring their widowed father to England, but displaced musicians crowded London making work difficult to find. Alma left her father and returned to the continent, living quietly as a boarder in Holland and giving house concerts when and where she could. She took lovers.
Despite the urging of her family and friends, she kept deferring a return to safety in England. In early 1943, she was arrested and transported to Drancy near Paris, thence to Auschwitz six months later. Initially sent to a barrack for sterilization research, she revealed her musical brilliance and was removed to marginally better accommodations and allowed to assemble an orchestra of women players.
The hungry musicians were granted precarious privileges, but Alma became obsessed with their progress and insisted on a grueling schedule of rehearsal and perfection. Some said that she believed that survival depended on the quality of their playing; others recognized that the music, like a drug, took her out of the horror of her surroundings.
In April 1944, she died suddenly of an acute illness thought to have been caused by accidental food poisoning. In a bizarre and possibly unique act of veneration for Auschwitz, her body was laid "in state" before it was burned. Most members of her camp orchestra survived the war.
Summary:This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.
Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.
In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.
The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.
This powerful book of black and white photographs contains four sections labeled: I. The End of Manual Labor, 1986-, II. Diverse Images 1974-87, III. Famine in the Sahel, 1984-85, and IV. Latin America, 1977-84. In addition, photographs accompany the prose-poetry opening essay, "Salgado, 17 Times," by Uruguayan writer Eduardo Galeano and the concluding essay, "The Lyric Documentarian," by former New York Times picture editor Fred Ritchin. This oversize book concludes with a list of captions for the photographs and a detailed two-page biography of Salgado. Essentially the photographs cover Salgado’s impressive work from 1974-89.
Every image is of a person or people. Many are suffering, many are starving, grieving, keening, dying, displaced. Many are children. Many are laboring under impossibly harsh conditions such as the teeming, mud-coated manual laborers of the Brazilian Serra Pelada gold mine. An Ethiopian father anoints the corpse of his famine starved, skin and bone child with oil. An old man, squinting in the sun, leans over to touch the arm of an equally thin and weak man in a Sudanese refugee camp. Rarely, the people are smiling or celebrating.
The photographs are global: Angola, Bangladesh, Bolivia, Brazil, Chad, Cuba, Ecuador, Eritrea, Ethiopia, Mali, Mexico, Portugal, Sudan, Thailand, and more. As Galeano notes, "This much is certain: it would be difficult to look at these figures and remain unaffected. I cannot imagine anyone shrugging his shoulder, turning away unseeing, and sauntering off, whistling." (p. 7) [156 pp.]
Japanese American artist, Henry Sugimoto, depicted life in the Arkansas internment camps into which he and his entire family (including wife and child) and many others of Japanese descent were forced, following the Japanese attack on Pearl Harbor in 1941. Sugimoto's life and his painting were profoundly influenced by his incarceration experience during World War II. During and after this period his subject changed from landscapes to scenes of camp life and the Japanese emigration/immigration experience; these works often had social and political purpose.
Dominating this picture are five brown-skinned, black-haired babies clad only in diapers, who are sitting or standing on a white sheet. Remarkably, the babies are featureless, although one appears to be crying. Another is standing, waving a tiny American flag. Looming in the lower left of the picture is an MP (military police), also brown-skinned, but with Caucasian features. He stands guard, not facing the children, and prominently holding a rifle to which a bayonet is attached.
Separating the babies from the MP is the barbed wire fence that stretches along the painting's foreground. In the background is the watch tower often depicted in Sugimoto's paintings, more barbed wire fences that enclose the children, and a menacing dark brown sky.