Showing 41 - 49 of 49 annotations contributed by Carter, III, Albert Howard
This is a collection of 91 poems on medical topics by medical students, physicians in training, and attending physicians; two are Canadian and the rest American. The poems are organized by six traditional groups of medical training and advancement in the profession: Medical Student, First Year; Medical Student, Second Year, Medical Student, Clinical Years; Intern; Resident; and Attending. There are no sections for pre-meds, retired doctors, or other programs (naturopath, chiropractor).
The editors have done a good job of picking well crafted and evocative poems. A dozen have been previously published. For the most part, the poems are short, easily fitting on one page. Almost all are in free verse, although there is one group of haiku, one prose poem, and an impressive sequence of ten Shakespearean sonnets “Breughel at Bellevue” by Anna Reisman.
Many poems treat dramatic moments in training: the anatomy lab, first gynecological exams, physician-patient relationships, especially when a patient is gravely ill or dying. Several poems in the first three sections comment on the differences between the normal social world and the intense medical world of the hospital. Throughout there are references to the pressures of high-tech, unfeeling medicine. Indeed Jack Coulehan sounds this theme in his introduction; he writes that "steadiness and tenderness" are both needed in medical practice.
As an anthropologist with training in comparative biology, Jablonski is particularly interested in the natural history of humans: how did humans evolve to gain the varied appearances we see today? In particular, she investigates how our skin developed into a covering that is unique among animals in three ways: (1) it is naked--effectively hairless--and sweaty, (2) we come in a wide array of colors (not just the traditional four), and (3) we use our skin as a surface for decoration, a "social placard," which we cover or bare at will, and on which we put make-up, tattooes, scarifications, and piercings, all ways of expressing cultural and personal values.
Our ability to sweat allowed us to cast off the usual mammalian fur coat and to be active even in the heat of the day (when many creatures take shelter). Humans, therefore, could do more and be more as thinkers, builders, and social creatures.
As to our color variations, Jablonski argues that the main root of modern humans came out of East Africa; these people were black, because a lot of melanin in their skin was the best way to avoid too much ultraviolet radiation, although some is needed to create Vitamin D. As humans migrated to the north and the south, Darwinian selection favored lighter skin pigmentation in order to use the lower levels of sunlight.
Jablonski writes, "Dark skin or light skin, therefore, tells us about the nature of the past environments in which people lived, but skin color itself is useless as a marker of racial identity" (p. 95). And, noting an irony: "Naturally dark people in many parts of the world are increasingly seeking ways to lighten their skin, while the naturally light-skinned are trying to find new ways to darken theirs" (p. 159).
We often take our skin and all its functions for granted; our consciousness can change quickly, however, if we experience a skin disease, a sunburn, or a thermal burn (see Carter and Petro, Rising from the Flames: The Experience of the Severely Burned). Jablonski discusses a variety of illnesses, including burns, dermatitis, and skin cancers. Other topics include the importance of touch, how skin relates to emotion and sex, and experiments in artificial skin, useful for covering patients with severe burns.
Jablonski presents a dozen color plates, 44 figures, and maps to enliven her text.
Fraser’s subtitle is accurate; this book tells about a middle-aged woman rediscovering her difficult past of incest from her father and abuse, as a child, from another man. She tells her life story of growing up in a working-class neighborhood in Hamilton, Ontario, Canada, going to university, marrying, and becoming a journalist. All the while, anger and rage fuel her, but it is only after surgery (for fibroids) and psychotherapy that she can recall the abuse and has it corroborated by others. Fraser understands that her personality split into three personae; she uses her dreams, her writing (including six novels), and her childhood drawings to understand what happened to her. Finally she is able to forgive her father (although after his death) and continue with her successful career as a writer.
Sims sees his book in the tradition of blazons anatomiques, “poetic tributes to the individual parts of the female body” originating in France in the mid-sixteeenth century. He adds, of course, men, including Adam. Working from head to toe, Sims assembles a very wide variety of scientific facts, cultural perceptions, and representations of the human body by artists, writers, and scientists.
Sims sticks to the outside of the body—no internal organs, nor, it follows, no sense of the integrated body. After a brief Overture (on skin), Part One, Headquarters, treats hair, face, eye, ear, nose, and smile (mouth). Part Two, The Weight of the World, discusses arms, hands, breasts, and the navel. Part Three, “A Leg to Stand On” (but no mention of Oliver Sacks), deals with “Privy Members” (the genitals), the buttocks, legs, and feet. There is no concluding chapter.
Sims draws on sources as diverse as Greek myth, Darwin, Lombroso, French painters, movies, popular culture, Jane Goodall’s chimps, the Bible, feminist writers, William Blake, etymologies, anthropologists, and modern science writers. There are some references to Native American cultures, Africa, and the East, but he stays mostly in the Western tradition.
Chapter 8, “The Monkey’s Paw,” is a good example of Sims's method. He discusses (in this order) handshakes, carpal tunnel problems, Michelangelo’s God and Adam on the Sistine ceiling, the “phalangeal formula” of handbones in mammals, Jesus’s crucifixion, Robert Schumann’s hand troubles, the importance of the thumb for humans, fingerprints, palmistry, and handedness (Ben Franklin was left-handed) and more in 40 pages. The interesting facts keep coming, but there is no basic theme or concluding overview.
Nisbett, a professor of psychology at the University of Michigan, argues that thinking is not universally the same, in time or around the globe. Specifically, Asians and Westerners vary in what they perceive, how they process it, and what action they might take. Nisbett has studied seminal figures such as Aristotle and Confucius, the geographical and social origins of Greece and China, and clues from the languages involved.
He explains a series of polarities, which can be quickly sketched (Eastern first/then Western): relationships/action, choice; feelings/logic; interdependence/independence; circularity, cycles/linearity; field dependence/divisible categories; harmony/debate; ground/figure; context/focal object; setting/outcome; and multiple causes/single cause and effect. Nisbett has also conducted experiments with students of Eastern and Western backgrounds to demonstrate that such differences are still real.
Finally, he argues that, with globalization, the two traditions will merge.
This is an exhibition catalogue for a show of 16 photographers who documented major topics in health over the last century. Carol Squiers, curator of the show, provides ten essays, amply illustrated by photos, on critical topics such as child labor, domestic violence, environmental pollution, AIDS, veterans of war, and aging. Some 80 per cent of the images treat American subjects.
Lewis Wickes Hine's photographs of child labor are dramatic and disturbing; these document children in coal mines, cotton mills, glass works, etc. in the first part of the 20th century. The Farm Security Administration sponsored photographers (including Dorothea Lange) to represent the New Deal Health Initiatives. Topics include farm labor, poverty in the South and Southwest, and inoculations. W. Eugene Smith created a photographic essay for Life magazine about Maude Callen, an African-American nurse-midwife in 1950s rural South Carolina.
Donna Ferrato documented domestic violence in the U.S. in powerful, personal shots, including a series of an actual attack. David T. Hanson created triptychs about environmental pollution: one panel shows a map of the area, a middle panel gives descriptive text, the last panel is an aerial shot in color. Eugene Richards spent time in the 1980s in Denver General's Emergency Room. Eleven black and white photos show the turmoil and drama.
Gideon Mendal documented HIV/AIDS in several African countries. Lori Grinker took photos of army veterans (some without hands) but also noncombatants harmed by war, including children. Ed Kashi presents images of aging Americans, rich and poor, urban and rural. Sebastião Salgado provides photos of vaccination in Africa and Asia.
This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.
Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.
Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.
Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?
One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).
This densely packed book follows Oschman's Energy Medicine: The Scientific Basis (2000, see annotation) with applications to medical treatment and--very briefly--human performance (athletics, dance, music). Oschman, a cell biologist, shows how electroencephalograms, electrocardiograms, and pulsing electromagnetic fields (which can heal broken bones) are accepted medical technologies, while theoretically related Healing Touch, Therapeutic Touch, Qi Gong, Reiki, Reflexology, massage, etc. are widely used and effective but generally (and inaccurately) considered to be alternative medicine.
According to Oschman, contributions from quantum physics explain that the energies of the body are subtle, instantaneous, and highly efficient in regulation and healing at the cellular level. The body is best understood as a living crystal, which can semiconduct energy, translate physical energy (such as touch) to piezoelectricity, and maintain coherence and continuity. Given our evolutionary heritage, we can sense from healers their intention, empathy, and healing energy. Our bodies heal themselves with energy provided by both standard and nonstandard medicine.
Moller is a sociologist who takes us into the world of the urban poor; he focuses on half a dozen individuals, giving intimate and moving portraits of them. An opening character is called Cowboy (a pseudonym); he lives under a bridge with his dog Cowgirl and dies a slow death of lung cancer. In an Epilogue (pp. 163-184) Moller calls him "an urban Thoreau." This respect for the dying poor pervades the book.
Besides descriptions of the characters, there is much dialogue, including extended quotations, but also some 100 small photographs, usually close-ups, inserted into the text. One photo shows a man in his coffin. Clearly Moller gets close to his characters, and so does the reader.
Moller argues that the dominant society--to its shame--neither supplies adequate care for this sector of society nor even recognition that such people exist. He calls the dying poor "an invisible world." It's a disturbing world, with the pain and neglect, but also an inspiring one, because of the caregivers such as social workers and nurses and the heroism and dignity of the patients presented.