Showing 411 - 420 of 740 Nonfiction annotations
In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.
Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.
His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.
This lively volume of medical history chronicles the forms of suffering, illness, injury, and treatment endured by the members of the Lewis and Clark expedition of 1805. Beginning with three chapters of political and medical history to set the context, the story follows the adventures of the extraordinarily fortunate "Corps of Discovery" among whom Lewis was the most trained in the medicine of the time (having studied in preparation for the trip under Dr. Benjamin Rush of Philadelphia), and he only an amateur. Even professional medicine of the time was approximate and largely ineffectual, limited mostly to purgatives, opiates and laudanum for pain relief, bleeding, and topical applications of various compounds or herbal substances.
The story chronicles the main events of the trip based on the extensive journals of Lewis and Clark as well as other historical account, maintaining focus in each chapter on the medical incidents including gastrointestinal distress from parasites and contaminated water; effects of overexposure like hypothermia and exhaustion; infections from wounds and scratches; syphilis; dislocations; muscular spasms; mosquitoes and other insect bites; snakebites and other animal attacks.
Along the way Peck pauses to explain the rather rudimentary medical theories upon which treatments were based, the effects of particular known treatments, and what Lewis and others likely knew, guessed at, or didn’t understand about lead, mercury, opium, and certain herbal substances they used. He speculates about the contexts of their medical decisions and offers occasional contemporary analogies to help readers imagine the circumstances and tradeoffs the explorers faced.
Schiebinger’s historical analysis looks at the role of women and female nature in modern science in four places. These are: institutional organizations (when and how did medical schools and fraternities allow or disallow female participation?), individual biographies (who were trendsetters in the history of science?), scientific determinations of female nature (how did scientists decide what makes woman woman?), and cultural meanings of gender.
Chapter Seven is an especially disruptive chapter, analyzing drawings of female skeletons at the turn into the nineteenth century. Earlier, female skeletons had been drawn in the same way as male skeletons. At this point, however, they became thin-boned and wide-hipped. Sexual difference became far more central.
One morning in the shower Joyce Wadler, "a journalist, forty-four, Jewish, never married," discovers a lump in her left breast. In this brief, bright, and very readable account, Wadler describes what happened next, taking us through medical examination, diagnosis, and successful lumpectomy and chemotherapy.
But this is much more than a simple patient’s story. For one thing, Wadler is an intrepid researcher, and we learn a good deal about breast cancer and the often agonizing therapeutic choices its victims face. For another, she does not separate her medical adventure from the rest of her life, which includes a day job as a writer for People magazine, a book project, a semi-functional relationship, and a Jewish mother.
Finally, Wadler uses her ironic-sardonic sense of humor to great advantage--remarking, for instance, that through her post-diagnosis impulse to live in the present and not worry about her lover’s monogamy, cancer had made her "the dream girl of every uncommitted man in Manhattan"!
The New Medicine and the Old Ethics, in Albert Jonsen’s own words, is a "secular aggadah." Jonsen explains that one Talmud reviewer defined aggadah as "a magical rabbinic mode of thought in which myth, theology, poetry and superstition robustly mingle" (4). The book begins with a personal essay entitled "Watching the Doctor." Jonsen establishes his premise that the moral history of Western medicine is best understood as a paradox between altruism and self-interest, a paradox alive and well entering the 21st Century.
He then takes the reader on his "secular aggadah," blending history, myths, and stories that trace important moral developments in the practice of Western medicine. In "Askelepios as Intensivist," we learn of the early Greek values of competence in shaping medical practice. Through the influence of the Church in the medieval period, Western medicine incorporates the value of compassion through the Biblical Good Samaritan, struggles with problems of justice in the care of the poor, and further elaborates the meaning of benefit.
In "The Nobility of Medicine," Jonsen describes the contribution of Sir William Osler and other knighted medical men of the 19th Century who established the ethics of noblesse oblige in the medical profession. He traces this noble tradition to the medieval Knights Hopitallers of Saint John of Jerusalem, a group of religious who provided hostels for pilgrims to the Holy Land and cared for the sick. With essays on John Locke and Jeremy Bentham, Jonsen brings us to the 20th Century and the play of individual rights and utilitarian values in the moral life of Western medicine.
In the final essays, Jonsen describes the mingling of these traditions as a means to establish a moral frame for Western medicine in our current times where technology and science have achieved and threatened so much. Ethics, he argues, "is disciplined reflection on ambiguity" (130). In the last essay, "Humanities Are the Hormones," Jonsen brings his "secular aggadah" full circle.
He argues that the paradox of altruism and self-interest that runs through the moral history of Western medicine must continually be vitalized and examined through the Humanities. The Humanities are "the chemical messengers that course through the complicated institution of medicine and enable it to respond to the constantly changing scientific, technological, social, and economic environment" (147).
An extraordinary phenomenon began to emerge a century or so ago, which, as it proceeded, allowed us a glimpse into what a society would look like when most of its members, rather than a select few, lived to, or more precisely, near, the limit of the human lifespan. Now we are facing the possibility of extending the upper limit of the human lifespan. How we live within this new world will be the result of numerous individual as well as corporate (in its fullest sense--business, professional societies, religious organizations, political bodies) decisions.
Stephen Hall, through compelling and clear writing takes us behind the scenes and into the lives and labs of the researchers and entrepreneurs who are seeking to slow down, stop, or reverse the aging process--those who intend to bring about, if not actual, then practical immortality. Figuring prominently throughout the book are Leonard Hayflick, early pioneering researcher on aging cells, and the charismatic (and former creationist) researcher-entrepreneur, Michael West. Rounding out the narrative are commentaries by noted ethicists and the chronicling of the political responses to these scientific and business developments, especially in regard to stem cell research.
Summary:This is a selection from "The Call of Stories" in which Robert Coles argues for a medical ethics rooted in particular lives and particular situations, rather than (or to supplement) the ethics of abstract rules and principles. He tells the tale of an "uppidy nigger" in Clarksdale, Mississippi, in 1967 who took issue with her clinic doctor because he was insulting and condescending toward his patients: "I told him I expected more of him. Isn’t he a doctor? If he can lord it over people, being a doctor, then he ought to remember how our Lord, Jesus Christ behaved . . . did He go around showing how big and important He was . . . ?"
Laqueur argues that in the course of medical history there has been a shift from the one-sex to the two-sex model. Prior to the seventeenth century, scientists of all kinds believed that there was only one kind of human body. Men and women were the same.
In drawings made during dissections, for example, scientists from Aristotle to Galen identified female genitalia as male genitalia which were simply inside the body rather than outside of it. Thus, the vagina was identified as penis and the uterus as testes. Women’s organs were internal, it was believed, because they were colder (and therefore inferior). It was possible for a woman to turn into a man if she over-exerted herself and became hot. After the seventeenth century, this one-sex model slowly transformed into the two-sex model popular today according to which men and women have different bodies and different attributes that follow from those bodies.
Laqueur does not think that earlier scientists were mistaken. They carefully performed dissections and recorded what they saw. Their drawings are correct. However, because their world view did not allow for two sexes, the parts are identified differently. In later centuries it became politically necessary to create a greater, natural distinction between men and women, a distinction that could not be remedied by greater heat. The material evidence of the body was thus interpreted differently.
Dr. Slocum leads his readers through some of the high (and low) points of his 34 years of general medical practice in the Hell’s Kitchen neighborhood of Manhattan. The work opens as he and his wife and nurse of as many years close the office they have shared for the last time. Then moving backward for a few chapters, the author discusses briefly his training, including a critical four-month period in Vienna in the year 1932. Slocum was awaiting the results of his Medical board examination and while doing some advance study, experienced first hand the early stages of Nazi activity against Jews in Austria.
After their return to the states and the doctor’s completion of his internship, the young couple located office and home in Manhattan. The remainder of the book is devoted to descriptions of critical events and important professional encounters in more than three decades, organized by chapter, most of which encapsulate a patient and, when present, his or her family.
This is a story of injury in the midst of exuberant good health, followed by a progressively darkening journey. The writer experiences a period of isolation from normal life by his hospitalization, isolation from a part of his body by neurosensory damage to the injured leg, isolation from the security of medical colleagues by their insensitivity to his anguish. Sacks reaches a psychological nadir before beginning his return. He chronicles, retrospectively, the stages of this trip. As in the classical journey myths, the traveler returns with new insight and an altered vision of the meaning of disease.