Showing 51 - 60 of 203 annotations tagged with the keyword "Psycho-social Medicine"
This is a huge and wonderful book about cancer, the collection of diseases that sickens people all over the globe and kills many of them. An epigraph to the book states, “A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer,” but the book also describes medical advances that now heal, prevent, or palliate most forms of cancer.
Mukherjee, a cancer physician and researcher, has several strong themes. He sees cancer as an affliction with a long history, a story worthy of a biography; indeed recent discoveries show it to be rooted in our genes (although external factors such as viruses, asbestos, and tobacco smoke can cause genetic disruption). The story of cancer implies a surrounding triangle, the stories of sick people, treating physicians, and biological researchers, all of which Mukherjee artfully weaves across 472 pages. Cancer has Rohrschach blot qualities: depending on time, place, and role in life, humans have perceived different attributes of cancer. As the book ends, however, there is a coalescence of scientific understanding that is satisfying—although there is certainly more to be learned and we are all still vulnerable to genetic errors and, of course, we are intractably mortal.
Another strand is the nature of stories themselves, their twists and turns, presumed early solutions, and personal and social values embedded in them. Mukherjee threads throughout the book the case of a contemporary kindergarten teacher, Carla Reed, who has a leukemia. He bookends his text with ancient Persian Queen Atossa with (presumably) breast cancer. Reed, healed by the end of the book, was Mukherjee’s patient; Atossa was described by Herodotus: both suffered emotional turmoil because of their disease. Mukherjee understands the affective dimensions of disease for patients and caregivers alike; literature represents these in various ways, and he quotes in his chapter epigraphs and in his prose many writers who describe human experience deeply: Aleksandr Solzhenitsyn, Susan Sontag, Charles Dickens, Thomas Mann, William Carlos Williams, Carlo Levi, and Italo Calvino, to name a few.
The primary story, however, is the interplay of cancer and a large cast of observers, investigators, doctors, scientists, activists, and government officials. Sidney Farber and Mary Lasker dominate the first 100 pages with their two-decade war against cancer. While surgery—historically dramatic and disfiguring—had been a mainstay for treatment of cancer, Farber pursued a biochemical route, which elaborated into chemotherapy, the second major approach of the late 20th century.
Mukherjee also explains ancient views, Hippocrates’, Galen’s humors, Vasealius’ anatomy, Hunter’s stages, Lister’s antisepsis, and Röntgen’s X-rays, which became the third major approach. By 1980, however, the American “War on Cancer” had not been won.
Further advances in cellular biology and genetics would be needed to make targeted molecular therapy possible. Mukherjee tells this complicated story clearly and engagingly, showing the human investigators to be personable and dogged in their pursuits.
Another important approach is prevention. The biostatistical work of Doll and Hill, for example, showed the links between tobacco and lung cancer. Screening, such as Pap smears and mammograms, also saved lives, but the basic cellular understanding still eluded investigators.
The final 150 pages explain the search for and discovery of genetic factors, specifically oncogenes. Harold Varmus and J. Michael Bishop were the leaders, winning a Nobel Prize in 1989. Bert Vogelstein, Judah Folkman, Robert Weinberg and Douglas Hanahan took the work further, opening the doors for such drugs as Herceptin, Gleevec, and Avastin.
Sherwin Nuland has had a distinguished career as a surgeon on the faculty at Yale University and as an author with interests in history of medicine, medical ethics, and medical humanism. In this memoir we become acquainted with a different side of Nuland, that of son to a widowed, immigrant father with whom the author had a complex and difficult relationship.
We learn also that Nuland has suffered from depression on and off since he was preadolescent, experiencing a major breakdown in midlife. This book attempts to make sense out of the family dynamics and the depression. At the same time, it describes the insular world of Russian Jewish immigrants living in New York City's Lower East Side and Bronx in the first half of the 20th century.
Nuland explores, frankly and openly, his ambivalent relationship with his father, Meyer Nudelman, and contrasting adoration of his mother, who died when Nuland was 11. The young Sherwin (Sheppy) Nudelman lived in fear of his father's strict rules and unpredictable anger. Further, Sheppy was required to assist his father whenever he went out of the house because Meyer Nudelman had an unsteady gait that made walking difficult and that became increasingly severe. Although the boy initially enjoyed these neighborhood jaunts with his father, he was increasingly resentful of them as his father's condition deteriorated and as his own interests focused more on people and activities outside the home. His father's strong Yiddish accent, strange gait, and sloppy appearance were a major embarrassment.
The last third of Lost in America--chronologically the era of World War II, the Nazi atrocities, and after--concern Nuland's maturation and his path toward the profession of medicine. As he and his brother, Harvey, were contemplating a future in the world of Gentiles, they decided to change their last name from Nudelman to Nuland. Sherwin Nuland was accepted to medical school at "Waspy" Yale and chose to enroll there, deliberately distancing himself (on the surface) from his father and his culture.
In medical school Nuland realized that Meyer Nudelman's physical symptoms were caused by late stage syphilis. The initial shock and disbelief of that discovery dissipated; Meyer's growing helplessness and tremendous pride in the accomplishment of his son allowed for a measure of understanding and affection between the two.
Summary:Edited by Victoria Tischler (a psychologist in the Division of Psychiatry at The University of Nottingham), with forewords by Dinesh Bhugra (Professor of Mental Health and Cultural Diversity at King's College London) and Allan D. Peterkin (who founded ARS MEDICA: A Journal of Medicine, The Arts and Humanities), this handbook is intended to provide guidance on medical humanities teaching in the field of mental health. After a short, familiar introduction to the need for such teaching, Tischler offers concrete guidance on how to begin establishing a medical humanities course. The subsequent chapters deal with topics, perspectives, and forms of art one might include in such a course. There is a "brief history of psychiatry through the arts" by Allen Beveridge which is, as we are warned in the title, somewhat cursory, but also well-written and thought-provoking.
Summary:On July 5, 1998, physics Professor Alan Cromer suffered a heart attack on a plane, and survived after almost an hour of resuscitation efforts, but sustained brain injury from lack of oxygen. In this chronicle of caregiving, his wife, a psychiatric nurse by training, gives a very personal, detailed account of the radical adaptations his disability required of both of them. Her story includes reflection on his and her own emotional adjustments to loss of parity in communication and awareness, practical adjustments to physical limitations, and social adjustments to family, friends and professional colleagues.
Wit takes place in a University Hospital Comprehensive Cancer Center. The main character, Vivian Bearing, Ph.D., is a John Donne scholar who has stage IV ovarian cancer. Much of the action takes place in the last few days/hours of her life, although flashback scenes to weeks, months, even years before are interspersed effectively throughout the performance.
Bearing has lived an isolated life. Her love is her teaching and research. She is a stern taskmaster, perhaps "non-humanistic" in her approach. Similarly, she faces doctors and a medical system that emphasize technique over caring. She does find, in the end, compassion from a nurse who prevents the medical team from carrying out a CPR (cardiopulmonary resuscitation) attempt that she did not want.
Attorney Rebecka Martinsson returns to her northern Swedish home to recover from a traumatic experience. She becomes involved in the investigation of the murder of Mildred, a woman priest who was found hanging from a beam in her own church. The investigating police office, Anna Maria Mella, meets opposition, especially from the local organization of hunters, who clearly resented Mildred for having offered shelter on the church lands to a stray wolf.
It is clear that Nalle, a large, mentally challenged boy, was close to the dead priest, and that his single parent father Lars-Gunnar did not appreciate their friendship. Nalle begins to trust Rebecka, as he trusted Mildred, and he appears to know something. But Anna Maria learns that Mildred had another enemy in her jealous, male colleague; moreover, some of the women in town resented her freedoms.
The many historical and personal ways in which the members of this isolated community are entwined becomes part of the investigation, but before it is complete Mella is confronted with two more murders and two suicides.
Summary:The book's chapters derive from a conference entitled "Representing Autism: Writing, Cognition, Disability" held in 2005. Contributors are scholars of English, communication studies, psychology, and other disciplines; some are on the autism spectrum themselves or are parents of autistic people. The book attempts to address what editor Mark Osteen in his introduction cites as a deficit in the field of disability studies, namely that the field has ignored cognitive disabilities. Osteen notes that autism is a spectrum not only among people but within individuals: "any given autistic person's abilities will occupy different locations on [the spectrum] at different times" (7) but a severely autistic person is not merely "different." The editor also addresses the question of self- representation, arguing that "we must strive to speak not for but with those unable or unwilling to communicate through orthodox modes" (7).
This is an imaginative documentary film by director-producer Su Friedrich, of her experiences with health problems, physicians, the health-care system, and how these affected her relationship with her female partner over a period of more than two decades. The narrator-subject takes us through her numerous surgeries, hormonal (prolactin) imbalance, and her growing disenchantment with the traditional health-care system.
She films herself: getting dressed into the "humiliating" paper garb prior to being examined by her physician; in exchanges with her various physicians; reading from medical texts and self-help books as she tries to understand her condition(s); taking t'ai chi classes and preparing herbal potions; gardening and doing needle work. As the film ends, she is grappling with the prospect of menopause, but she feels that she has taken charge of her body and of her own care, that she tends herself as she tends her garden.
Summary:The film opens on the Coeur d'Alene Indian Reservation -- called "the rez" by its inhabitants -- in 1998. Immediately there is a flashback to July 4, 1976 when the community was celebrating "white man's Independence Day" in drunken abandon. Accidentally Arnold Joseph (Gary Farmer) sets an uncontrollable fire to his neighbor's house, killing the couple who live there. But Joseph catches the baby, Thomas, when he is thrown out of a second story window from the burning house. The rescued Thomas (Evan Adams) is brought up by his grandmother and along side of Victor (Adam Beach), Arnold Joseph's son of about the same age. Joseph keeps on drinking but is in despair about the conflagration and its consequences.
Summary:This is an anthology of 32 pieces, many directly relating to war and its aftermath, or, in general, kinds of violence humans inflict upon each other and the ensuing suffering: hence the title, "echoes of war." The pieces include short fiction, essay, a dozen poems, and a photo collection. Since none are lengthy, this is a good reader to supplement other longer texts or to serve as an anthology for a reading group. A short essay, "Suggested Longer Readers," mentions some three dozen pivotal topics, including "homecoming" and "sense of identity."