Showing 91 - 100 of 217 annotations tagged with the keyword "Public Health"

An Uncertain Grace

Salgado, Sebastiao

Last Updated: May-17-2007
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Photography

Genre: Photography

Summary:

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.]

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In this account of early practitioners and advocates of 'inoculation,' or the use of tiny amounts of smallpox contagion to induce a mild case of smallpox and immunity, author Carrell weaves prodigious historical research with fictionalized dialogue to create a tale of two prominent figures: Lady Mary Wortley Montagu of London and Dr. Zabdiel Boylston of Boston. Both Lady Mary and Boylston suffered scarring from smallpox, and, by living in the early 18th century, both witnessed the devastation of epidemics in terms of public health and private loss.

Both were also aware of the use of inoculation to prevent severe disease in Turkey (Lady Mary visited with her ambassador husband) and in Africa (on the advice of Cotton Mather, Boylston interviewed Africans, slave and freemen, living in Boston). Both faced formidable challenges and risked personal security to promote the use of this technique. Both proved their belief in the technique by the inoculation of their own children. And both, perhaps, met. At the behest of the Royal Society, Boylston traveled to London, witnessed numerous inoculations, and presented his Boston experience to the Society.

The book also chronicles the natural course of the disease, its various symptoms, forms and popular treatments, and the political impact of smallpox on the royal families of Europe and business interests in Boston. The medical research of various doctors is detailed. In particular, selected Newgate prisoners were offered pardon in return for participation in an experiment conducted by Mr. Maitland, who also inoculated Lady Mary's children. These experiments were used to test the safety and efficacy of inoculation prior to royal inoculation.

Ultimately, detractors of inoculation ceased their vitriolic attacks, as the risks of inoculation were proven to be far lower than exposure without such protection. The success of inoculation paved the way for Edward Jenner, often called 'the father of immunology,' to successfully use cowpox to induce smallpox immunity later in the 18th century.

View full annotation

The Killing Sea

Lewis, Richard

Last Updated: May-13-2007
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Sarah and Peter Bedford are sailing with their parents off the coast of Indonesia when the tsunami strikes. As they attempt to escape, their father breaks his leg. Their mother insists the children run ahead, so they do, up the hills into the jungle. Sarah later finds her mother, dead, on the beach, but not her father. Peter is soon running a fever and Sarah embarks on an arduous overland journey to try to get him help. At the same time Ruslan, an Indonesian boy, has taken his own escape route out of his village, and is looking for his father, along with many who are searching for missing relatives. Ruslan and Sarah recognize one another when their paths cross, as he had waited on her family on an earlier stop in his village. Together, with a few other refugees, they make their way to another village where Peter may be able to receive help in a makeshift hospital. Ruslan is threatened by an additional danger, since his family are partisans in a local conflict, and he is suspected of activity on behalf of the rebels.

At the hospital, lack of personnel and supplies throws Peter's survival into doubt, as well as the prospect of finding the children's father. Eventually Ruslan finds his own father, and Sarah and Peter are rescued by the military and taken to a base where more adequate care may be provided. Once there, Sarah finds herself swarmed by journalists, but realizes that the international attention their own case has incited is lopsided, given the many locals whose stories of loss and suffering are not being told. The story ends with the fates of Peter and their father unresolved; clearly part of the story is that no "end" is in sight, and that it will be a long, long time before anything that looks like "normality" will be restored.

View full annotation

Summary:

The authors analyze developments in the scientific article in Europe from the seventeenth century to the present. They devote a chapter to "style and presentation" in each century, and a separate chapter to "argument" more specifically in each century, in French, German, and English examples. They find a remarkable similarity of style already evident in seventeenth-century examples, demonstrating that scientific authors were already addressing an international audience. Seventeenth-century articles show an "impression of objectivity" and "a movement toward a more impersonal style" (47), although the English examples were somewhat more personal, less quantitative, and less interested in explanation than were the French examples, and the prose overall is hardly what we would currently expect from a scientific article.

Although the eighteenth-century examples should, perhaps, be considered part of a larger period that included the seventeenth century, Gross et al do track a movement from impersonal to personal style, nominal to verbal style, and minimal presentation to more elaborate presentation during this period. Also, the French examples continue to approximate more closely to twentieth-century norms of scientific style, reflecting their more professionalized community. Overall, the authors characterize much of the eighteenth century as a period of "consolidation and altered emphasis," with "relative stability" of style (116), although the last quarter of the eighteenth century showed a sharp rise in standardization and standards for accuracy and precision.

Gross et al note that nineteenth-century prose still addresses amateurs as well as professionals, and they comment on its persistent difference from "the highly compressed, neutral, monotonal prose" of late-twentieth-century science(137). However, the English and German examples do become more professional in their use of impersonal style, and examples demonstrate a consolidation toward a more "homogeneous communicative style" (138). They also note that the nineteenth century exhibits a "master presentation system approaching maturity," with "title and author credits, headings, equations segregated from text, visuals provided with legends, and citations standardized as to format and position," as well as standardized introductions and conclusions (138).

They find that the combination of an increasing "passion for factual precision" and systematization produces more careful theorizing generally in science during this period, even as individual sciences specialize and diverge (158). Increased attention is given to the process by which facts are linked to theory, and to the role of evidence, governed by an "overriding need for explicitness" (160).

Twentieth-century examples include shorter sentences with more information packed into each by way of "complex noun phrases with multiple modifications in the subject position, noun strings, abbreviations, mathematical expressions, and citations" (186). The scientific article is now generally marked by high incidence of passive voice and low incidence of personal reference, along with a "master finding system" made up of "headings, graphic legends, numbered citations, numbered equations, and so on" (186). They argue that the current state of the scientific article reflects an evolutionary process whereby "current practices are a consequence of the selective survival of practices that were, persistently, better adapted to the changing environments of the various scientific disciplines over time" (212).

 

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The book opens with a thought "exercise": thirteen short essays, each in a different national voice and beginning "We, the people of a nation . . . " The honest, intelligent "speakers" love their countries and traditions; however, they try to express the ugly truths about their homelands as challenges for the future.

For example, American smugness over its know-how and wealth combines with American failure to recognize the resentment sparked elsewhere by these same attributes. Similarly, the mutual intolerance of Canada's linguistic and religious duality is portrayed as a grotesque irony. The U.S.S.R. has exchanged an old tyranny for a new; Japan must face the issue of controlling its population, if it is to control its impulse to aggression.

Chisholm then returns to his role as a socially committed psychiatrist who hopes to avert a war that could annihilate the human species. World aggression, he writes, is caused by the "anxiety" that emerges from intolerance typifying narrow parental guidance and even narrower systems of education and religion. People must learn to be comfortable with differences in population, race, language, and wealth. The message is simple: "anxiety" leads to "aggression." The book ends with a ideal curriculum for "world citizenship," surprisingly different from any currently in use.

View full annotation

The Citadel

Cronin, A. J. (Archibald Joseph)

Last Updated: Feb-15-2007
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1921, the twenty-four year-old Scottish medical graduate, Andrew Manson, takes up an assistant’s position in a small Welsh mining town. He is idealistic, but he quickly learns that his training is inadequate and that his hemiplegic employer will never return to practice. Manson must do all the work for a pittance and bad food. He befriends another assistant, the surgeon Phillip Denny, whose fatal flaw is devotion to drink. Together they solve the town’s problem with typhoid by blowing up the sewer.

Manson’s escape comes in a new job in a larger town and marriage to the equally idealistic Christine. She encourages him to continue his studies and to conduct research on the relationship between dust inhalation and tuberculosis. The results include higher degrees and international recognition, but they also bring about the wrath of the town’s antivivisectionists. To add to the gloom, Christine looses a much wanted pregnancy and the ability to have children.

The Mansons leave Wales for London, where Manson hopes to extend his research within a government agency. Quickly disillusioned by bureaucracy, he is lured into society practice and slowly abandons his ideals in exchange for prestige and wealth. Christine is increasingly unhappy, but his response is annoyance with her and an affair with a married woman. When one of his new associates botches an elective operation on a trusting patient, he realizes the colleague is nothing more than a society abortionist and that he and his new friends are little better.

He decides to sell his practice and renews contact with Denny to establish a group consulting practice "on scientific principles" in a carefully chosen Midland town. He also helps the tubercular daughter of an old friend to an unorthodox (but effective) pneumothorax in a clinic run by Stillman, an American who does not have an MD. Just as he and Christine have rediscovered joy in each other and their future together, she is killed in a freak accident. Only days later in the depths of grief, he is brought before the General Medical Council on charges of unprofessional conduct laid by his former associates. He acquits himself brilliantly and leaves with his old friend Denny for work in the Midlands.

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Canadian surgeon Norman Bethune, 1890-1939, (Donald Sutherland) journeys 1500 miles into China to reach Mao Zedong's eighth route army in the Wu Tai mountains where he will build hospitals, provide care, and train medics. Flashbacks narrate the earlier events of his life: a bout with tuberculosis at the Trudeau sanatorium; the self-administration of an experimental pneumothorax; the invention of operative instruments; his fascination with socialism; a journey into medical Russia; and the founding of a mobile plasma transfusion unit in war-torn Spain.

Bethune twice married and twice divorced his wife, Frances (Helen Mirren) who chooses abortion over child-rearing in her unstable marriage. By 1939, Bethune had been dismissed from his Montreal Hospital for taking unconventional risks and from his volunteer position in Spain for his chronic problems of drinking and womanizing. As his friend states: "China was all that was left." Even there, Bethune confidently ignores the advice of Chinese officials, until heavy casualties make him realize his mistake and lead him to a spectacular apology. The film ends with his much-lamented death from an infected scalpel wound.

View full annotation

Summary:

The first seven episodes in the made-for-TV series tracing the remarkably credible story of a woman physician in 1890s London. Newly graduated in medicine, Eleanor Bramwell (Jemma Redgrave) is the daughter of Robert (David Calder), a distinguished physician. He would like her to join him in his private practice, but she has other plans. Bright and ambitious, she is well qualified to pursue her goal of surgery; however, these qualities do not protect her from the chauvinism of her male superiors, including the influential and basically well-meaning Sir Herbert Hamilton (Robert Hardy). In anger and frustration, she leaves the academic hospital, garners philanthropic support from Lady Cora Peters (Michele Dotrice Dotrice) and opens the charitable "Thrift Infirmary,"

In a poverty stricken district. There she is joined by the quiet Scots surgeon Dr. Joe Marsham (Kevin McMonagle) and competent Nurse Carr (Ruth Sheen) of crusty exterior and soft core. Together they encounter a series of clinical problems that clearly document not only the medicine and social values of the late Victorian era, but the troubles of those who live and work in poverty.

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Idealistic, nervous, and rigid, Andrew Manson (Robert Donat) takes his first medical job as an assistant to a doctor in a Welsh mining community. The greedy wife of his invalid employer obliges Manson to hand over most of his earnings. But he finds a local kindred spirit in the outspoken Dr. Denny (Ralph Richardson). In a drunken prank, they blow up the town sewer forcing the unwilling government to repair a notorious source of typhoid.

Manson marries a beautiful school teacher (Rosalind Russell) who leaves her beloved classroom to follow him to an even larger mining town. There he is employed by a group practice run on a capitation basis by the miners. In their evenings, the Mansons investigate the problem of chronic cough in miners, linking it to tuberculosis and coal dust--a discovery that they publish. But suspicious miners destroy their laboratory and force them to London and poverty.

A chance encounter with a wealthy hysteric and an old mate (Rex Harrison) raises Manson’s social standing. He opens a Harley Street practice and makes a fortune. His wife regrets the loss of his ideals and the death of his research. She begs him to remember how happy they were in poverty when each day was a noble challenge to take "the citadel" of life. Denny returns to entice Manson into a new group practice funded by community insurance, but Manson flatly refuses. Denny’s accidental death and a blunder by an elite, unethical Harley Street surgeon bring Andrew back to his idealistic senses.

The film closes with his eloquent self defense against charges of irregular practice for having intervened (successfully) in the case of a little girl with tuberculosis. Manson assists as the child is treated gratis with the controversial new pneumothorax operation administered by an American who does not hold a medical degree. Whether or not Manson keeps his license, the audience is confident that his sense of purpose has been restored and that his wife loves him more than ever. He will return both to the comfortably compatible pursuits of research and serving the sick poor.

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

As a medical student, Martin Arrowsmith (Ronald Colman) approaches the revered Professor Gottlieb (A. E. Anson) wishing to accelerate his studies into bacteriology research. Gottlieb insists that he complete his clinical training first. But Arrowsmith meets the cheeky nurse Leora (Helen Hayes) and throws over his plans for science in order to earn a marriage-sustaining living as a general practitioner in her native South Dakota.

Assuaging his undying passion for research (in the family kitchen), he takes on the problem of an epidemic of black leg disease of cattle and earns the animus of a veterinarian and the admiration of the Swedish farmers by single-handedly disproving the efficacy of a government serum, developing his own serum, and conducting a controlled trial to prove its worth. His frustrated and unemployed wife--now displaced from her own kitchen--continues to support him, answering always "Yes, Martin. No, Martin. Whatever you say, Martin."

The couple move to New York City where Arrowsmith intends to devote himself full time to science at the side of his old hero Gottlieb in the McGurk Institute (a thinly disguised Rockefeller Institute). In his new laboratory, Arrowsmith utters a prayer for clear vision and humility--a prayer that seems to go unanswered.

Late one snowy night after two years of fruitless work, he discovers that "something" (in the novel, it is bacteriophage) has killed the bacteria he has been incubating. "Is it important, Martin?" asks Leora. He is brutal in his zealous response, his eyes gleaming with the promise of promotion, fame, and fortune. But after days of exhausting labour, he learns that he has been scooped by Felix D’Herelle a (real) researcher at the Pasteur Institute.

Arrowsmith quickly finds a new passion and travels to the Caribbean to conduct research into the effect of a serum on bubonic plague. Gottlieb makes him promise to act like a scientist (not a G.P. or a quack) and to withhold the remedy from half his patients. He tries to convince the colonial authorities of the importance of controlled testing, but is rebuffed with accusations of turning humans into guinea pigs. A black medical graduate of Howard University invites him to a different island where the epidemic is so thick that the people willingly cooperate with the controlled trial.

Leora, who had refused to remain in New York, is now left behind. The film implies clumsily that the now solitary Arrowsmith--ecstatic to be back in the research trenches--has a romantic encounter with Joyce, a beautiful stranded tourist (Myrna Loy). Meanwhile, Leora contracts plague from a cigarette, which has absorbed plague germs from Martin’s sloppy lab technique, and which she smokes because of Martin’s inattention and abandonment. She dies miserably and alone.

Crazed with remorse, Arrowsmith abandons his scientific principles and allows the entire population to be treated with the serum after all. The epidemic is arrested. But Martin knows that his success does not justify his scientific sin. Still grieving for Leora, he returns to New York to much fanfare, but is unable to find absolution from Gottlieb who has just had a stroke. He runs out on his lover, his institute, and a press conference to join a friend who is establishing a Walden-like institute dedicated to pure research in Vermont.

View full annotation