Showing 71 - 80 of 496 annotations tagged with the keyword "History of Medicine"
In 1877, the widowed Sarah Bell writes to the New York Children’s Aid Society to explain that poverty has driven her to leave her daughter Lily May in its care. Mr Bassett writes to the same office that he and his wife would like to adopt a little girl. They are given Lily May and change the baby’s name to Mabel.
Over the years, Sarah keeps writing to ask for news of her child; when she remarries she begs to have her daughter back. With evident alarm, the Bassetts tell of the good care they have given the girl; they love her and will not relinquish her. Lily/Mabel has no idea that she is adopted and will never be told.
The great French actress Sarah Bernhardt (1844-1923) conducted an affair with her doctor, gynecologist Samuel Pozzi (1846-1918) in the decade before he married. They remained friends, and she always called him her Docteur Dieu (doctor god).
The handsome physician was a leading light in French gynecology and in the Paris arts community. Clad in his red dressing gown, Pozzi was the subject of John Singer Sargent's wonderful portrait (1881), which spawned erotic legends about him.
At first happy, Pozzi’s marriage degenerated into coldness, but his wife would not grant him a divorce. He then established a long-standing, public relationship with Emma Fischhof. During the Dreyfus affair, which unmasked the horror of entrenched anti-Semitism in France, physician and actress both fought against the ill treatment of the Jewish officer.
In 1915 and at Sarah’s insistence, Pozzi amputated her painful leg. Three years later, he was shot and killed by a disgruntled and delusional patient who blamed him for a minor illness.
The author was the first blind physician to be licensed in Canada. Her autobiography is also an autopathography.
From her anger over developing severe diabetes as a teenager, through her relentless pursuit of a scientific degree and medical school, through a brief failed marriage – followed by the tragedy of completely losing her sight while still in training, to a rewarding and responsible career as a palliative care physician and educator.
Sustained by her religious faith and by loyal family members and friends, Poulson explains choices, compromises and supports that allowed her to continue studying and working in Montreal and later in Toronto.
Her complications from diabetes were numerous, and included heart disease for which she required surgery. Then she developed breast cancer, which eventually metastasized. In closing her narrative, she knows it will likely take her life.
In 1904, the 19 year-old Russian Jewish Sabina Spielrein (Keira Knightley) is admitted to Burgholzi clinic under the care of Dr. Carl Jung (Michael Fassbender) who is beginning to adopt the talk-therapy methods of psychoanalysis promoted by Sigmund Freud (Viggo Mortensen).
She is hysterical and difficult to control, but she is also bright and has been studying to become a doctor. Jung slowly breaks through her resistence using dream interpretation and word association; eventually she reveals that her mental distress has its origin in her relationship with her father. He would punish her physically and she found it sexually exciting.
The married Jung is obsessed with his patient and seduces her. They conduct a heated affair that entails sessions of bondage and beating, that they pursue almost like a scientific experiment.
On this background, Jung is becoming the protégé and anticipated heir of Freud—but they disagree over whether or not psychotherapy can cure. Spielrein recovers and goes on to become a physician and psychiatrist who develops her own methods of therapy. Freud comes to admire her and Jung is torn by jealousy.
Summary:In her reflections on the vocation of nursing Robinson explores many myths and archetypes that give shape and energy to the identity of the nurse as it has evolved in Western culture, including the stories of Hygeia, Baubo, Hermes, Hecate, Cassandra, and the Dionysian Maenad. The ancient stories of each of these figures and others articulate particular constraints, conventions, and conflicts involved in caregiving, especially in the ways women assume the role of caregiver. She explains at the outset that she deals particularly with women in nursing, though now many men are nurses, since traditionally it has been a profession deeply shaped by cultural notions of female roles. Another layer of this exploration is a chapter on the nurse in popular culture that considers ways in which the figure of the nurse has been both elevated and debased, made comic or tragic, sidelined or sexualized. The multidimensionality of the nursing vocation and, consequently, the challenge it poses to women who enter it, is strongly emphasized throughout the six chapters, which together depict the work of nursing as a soul journey. This journey challenges nurses in new ways to work within institutions that suppress important aspects of their power to do healing work at a level of intimacy generally not accessed by doctors.
Summary:"Propofol" is a 20 line poem of five quatrains each with an a-b-a-b rhyming scheme. Appearing in the June 30, 2008 New Yorker magazine, it is a description of the Classical allusions and hallucinatory experience surrounding the administration of the hypnosedative, propofol, to the speaker-patient for an undescribed medical procedure.
Summary:This book describes San Francisco’s Laguna Honda Hospital, where Victoria Sweet worked as a doctor for 20 years. In the tradition of the Hôtel-Dieu in Paris (literally “God’s Hotel”), Laguna Honda cares for the sickest and poorest patients, many staying there indefinitely because there is no alternative for them. Sweet learns from her long experience at Laguna Honda that “Slow Medicine” has benefits, that a holistic or unified view of patients works best, and that the reductionism and specialization of modern medicine has limitations and costs. During these years Sweet becomes fascinated by the medieval abbess Hildegard of Bingen and earns a Ph.D. focusing on medieval medicine. At the same time (and increasingly) various forces—economic, legal, political, bureaucratic—cause many changes at Laguna Honda, mostly contrary to Sweet’s vision of medicine.
Part history, part memoir, part social criticism, the book is informative, entertaining, and important for its discussion of the care of our least-well-off citizens and for its perspectives on modern, Western medicine.
There are three intertwining strands to this engaging book: Sweet’s medical evolution as a physician, the changes in Laguna Honda, and her investigations of Hildegard of Bingen and other spiritual matters.
Sweet joins up with Laguna Honda initially for only two months, but she finds the hospital and her work there so fascinating that she stays for 20 years. As an almshouse, Laguna Honda takes care of indigent patients, most with complicated medical conditions, including mental illness and dependencies on alcohol and/or drugs. Many of these cases come from the County Hospital with continuing (but not carefully reviewed) drug treatments. Every 15 or 20 pages, Sweet describes the dilemmas of a particular patient, and her medical (and personal) attention to that patient. The cases are vivid and instructive.
Clearly Laguna Honda is a major figure on the book; we can even consider it (or “her”) a beloved character and a teacher to the young Dr. Sweet, who learns three principles from her work there: hospitality, community, and charity.
Because Laguna Honda is old-fashioned in many ways, Sweet reads her own X-rays, goes the to lab to see results, and spends large amounts of time with each patient. Laguna Honda has an aviary, a farm with barnyard, and a solarium; such features help to heal the whole person. While respectful of modern medicine, Sweet slowly learns that a careful review of a patient through Slow Medicine is more accurate and more cost-efficient than standard, reductionist, high-tech medicine. She comes to respect approaches from “premodern” medicine, including that of Hippocrates and Hildegard.
The second strand is the evolution of Laguna Honda itself. Sweet describes a variety of pressures: the recommendations of consulting firms, rulings from the Department of Justice, a lawsuit, financial difficulties (including fiscal mismanagement), administrators focused on a narrow concept of efficiency, a utilization review board, forms and more forms, and a pervasive sense that modern (including Evidence Based Medicine) is always good. All these and more create a “relentless pressure squeezing the hospital’s Old Medicine into the New Health Care” (p. 322). Sweet demonstrates that her Slow Medicine can actually save money in the long run. Confident that her way is better, she proposes an “ecomedicine unit” that she would match against the modern, “efficient” units in a two-year experiment. (For more information on her concept of ecomedicine proposal, see http://www.victoriasweet.com/.)
As the hospital is “modernized,” many important features of the old place are gone and many “new and improved” aspects don’t work. Somehow there are no rooms for physicians in the new building while there is plenty of space for administrators and managers. A sophisticated computer system doesn’t work. Sweet doesn’t say “I told you so” directly, but we get the picture.
The third strand is Sweet’s investigations of spirituality and pilgrimage. She is fascinated by Hildegard’s notions of the healing power of nature, the ability of the body to heal itself, and wholeness as an aim for a person and for a community. Sweet attends a Swiss conference on Hildegard. She hikes the pilgrimage route from France to Santiago de Compostela in four installments and considers notions of pilgrimage. She feels called to pursue her ecomedicine project and to write this book.
By the end of the book, both Sweet and Laguna Honda have changed and are now headed in different directions.
Hillel D. Braude, a physician and a philosopher, has written an important, albeit dense and narrowly circumscribed, study. While “Intuition in Medicine” is the main title, the subtitle, “A Philosophical Defense of Clinical Reasoning” is a more accurate description of the book, which originated as a doctoral dissertation. While some of the prose will appeal only to specialists, there are important and thoughtful analyses of such topics as Evidence-Based Medicine, modern dehumanized medicine, the relation of beneficence and automony, and principalist ethics in general.
Throughout, intuition is narrowly conceived and in the service of clinical reasoning, as it applies to standard, Western physicians and not to other healers (or nurses), and the emphasis is on interventive medicine to cure illness and relieve suffering more than on health promotion.
Braude writes in the introduction that intuition has long been understood to be “a direct perception of things,” but he resists a more precise definition: “Rather than defining and using a single concept of intuition—philosophical, practical, or neuroscientific—this study examines intuition as it occurs at different levels and in different contexts of clinical reasoning” (xviii).
Eight chapters explore these different levels in such topics as moral intuitionism, Aristotle’s phronesis (or practical reason), the rise of statistics (a basis for Evidence-Based Medicine), and C. S. Peirce’s notion of abduction. Braude’s careful analysis traces historical and theoretical developments in analytic philosophy and how these may be applied to clinical reasoning. He uses an impressive range of thinkers: Achenwall, Albert, Allan, Andre, Ashcroft, Aristotle, Bacon, Barrow, Barton, Beauchamp, Bergson, Bernard, Bichat, Black, Bottero, Bourdieu, Brody, Browne—just to take names headed by A or B.
Throughout, Braude puts in dialectic two poles on a spectrum arguing that they both have contributions to make. He believes that between them is an “ethical space,” where discoveries and applications can be made, but he clearly favors all the concepts from the lefthand list for medicine. In tabular form, we can list aspects of the two poles:
Aristotelian practical reasoning Kantian abstraction
Naturalist approaches Nonnaturalist approaches
Primacy of beneficence Primacy of autonomy
Fact and value joined Fact and value separated
Case-based Evidence-Based Medecine
Individual patients Large groups of patients
Narrative experience Statistical correlations
Anthropocentric focus Mechanist, positivist foci
Tacit, organic knowledge (Polanyi) Dualism (Descartes)
Braude believes intuition is a cognitive process but has other dimension, the corporeal and the social. While these provide a grounding, intuition for him is generally rational. He also argues for medical care at the personal, face-to-face level, not through applications of algorithms.
A brief conclusion, “Medical Ethics beyond Ontology” clarifies some of the arguments and sketches some valuable notions from Husserl and Levinas. He writes “intuition . . . does appear to be fundamental for human judgment” because “an intuition faculty” can “extract universals from the particular” (p. 170). Drawing on Husserl, he defines phenomenological intuition as “the primary means through which objects are presented to consciousness.” This affirmation includes the basic human, which is also the focus for medicine. For Levinas (and my summary is much too brief), “interhuman solidarity” is a source for medical care, a form of responsibility that is different from Foucaultian power relationships, ethical rules and priniciples, or “an uncritical acceptance of medical authority” (p. 177).
Summary:Tora lived happily on a mountain farm in Norway until her beloved mother's death and her own subsequent diagnosis with leprosy, an illness common in early 19th-century Norway and one that drove her mother to suicide. Upon diagnosis (at the age of 13) she is taken to the leprosarium in Bergen, from which very few emerge. Most are left there by families whose fear of the disease leads them to abandon even much-loved children, parents, and spouses. There, despite the misery of living among many who consider themselves the living dead, she finds a friend in Marthe, the chief cook and general caregiver, a woman of almost boundless kindness; and the "Benefactor," a pastor who is remarkably unafraid of the disease from which most flee, and who befriends Tora as she grows into an unpromising early adulthood. Another unlikely friend is a noblewoman who has languished, embittered, behind a closed door with a trunk full of her old gowns and several cherished books, including the Bible, The Divine Comedy, Gulliver's Travels, and a popular Norwegian epic about the adventures of Niels Klim at the center of the earth. She gradually softens toward Tora, who cares for her tenderly as the older woman teaches her to read. Reading becomes not only Tora's consolation, but that of many of her fellow inmates. Near the end of her own short, but surprisingly rich life, Tora's father shows up after years of neglect. Forgiving him, almost against her will, she reaches a new level of acceptance of her own mysterious fate. The book includes a short afterword about the actual leprosarium in which the story is situated and about Gerhard Armauer Hansen who in 1873 discovered the bacillus responsible for leprosy, the first bacterium proved to be the cause of a chronic human disease.