Pain is immediate and searing but remains a deep mystery for sufferers, their physicians, and researchers. As neuroscientific research shows, even the immediate sensation of pain is shaped by psychological state and interpretation. At the same time, many individuals and cultures find meaning, particularly religious meaning, even in chronic and inexplicable pain.
This ambitious interdisciplinary book includes not only essays but also discussions among a wide range of specialists. Neuroscientists, psychiatrists, anthropologists, musicologists, and scholars of religion examine the ways that meditation, music, prayer, and ritual can mediate pain, offer a narrative that transcends the sufferer, and give public dignity to private agony. They discuss topics as disparate as the molecular basis of pain, the controversial status of gate control theory, the possible links between the relaxation response and meditative practices in Christianity and Buddhism, and the mediation of pain and intense emotion in music, dance, and ritual. The authors conclude by pondering the place of pain in understanding--or the human failure to understand--good and evil in history.
Chronic pain is the leading cause of disability in the United States, affecting as many as 48 million people in this country alone. It can demoralize and depress both patient and family, especially when there is no effective pain control and no hope for relief. Improperly managed, chronic pain can lead to substance abuse (usually painkillers) and to acute psychological and emotional distress. Pain begets stress and stress begets pain in a wretched downward spiral.
Silver reviews the causes and characteristics of chronic pain and explores its impact on individual family relationships and on the extended family, covering such issues as employment, parenting, childbearing and inheritance, and emotional health. Silver treats aspects of chronic pain not covered in a typical office visit: how men and women differ in their experience of chronic pain, the effect of chronic pain on a toddler's behavior or an older child's performance in school, the risks of dependence on and addiction to pain medications, and practical ways for relatives beyond the immediate family circle to offer help and support to the person in pain.
A masterful synthesis of literary readings and poetic reflections, making profound contributions to our understanding of chronic pain
At the intersection of queer theory and disability studies, acclaimed theorist Michael D. Snediker locates something unexpected: chronic pain. Starting from this paradigm-shifting insight, Snediker elaborates a bracing examination of the phenomenological peculiarity of disability, articulating a complex idiom of figuration as the lived substance of pain’s quotidian. This lexicon helps us differently inhabit both the theoretical and phenomenal dimensions of chronic pain and suffering by illuminating where these modes are least distinguishable.
Suffused with fastidious close readings, and girded by a remarkably complex understanding of phenomenal experience, Contingent Figure resides in the overlap between literary theory and lyric experiment. Snediker grounds his exploration of disability and chronic pain in dazzling close readings of Herman Melville, Emily Dickinson, Henry James, and many others. Its juxtaposition of these readings with candid autobiographical accounts makes Contingent Figure an exemplary instance of literary theory as a practice of lyric attention.
Thoroughly rigorous and anything but predictable, this stirring inquiry leaves the reader with a rich critical vocabulary indebted to the likes of Maurice Blanchot, Gilles Deleuze, D. O. Winnicott, and Eve Kosofsky Sedgwick. A master class in close reading’s inseparability from the urgency of lived experience, this book is essential for students and scholars of disability studies, queer theory, formalism, aesthetics, and the radical challenge of Emersonian poetics across the long American nineteenth century.
Pain and Profits tells the story of how a common ailment—the headache—became the center of a multibillion dollar pharmaceutical industry in the United States. Despite the increasing authority of the medical profession in the twentieth century, treatment of this condition has remained largely in the hands of the public. Using the headache as a case study, and advertising as a significant source of information, Jan McTavish traces the beginnings of the modern over-the-counter industry.
The American pharmaceutical industry developed from nineteenth-century suppliers of plant-derived drugs for both professional and home care. Two branches of the industry evolved over time—the ethical branch, which sold products only with prescriptions, and the nostrum branch, which was noted for its energetic marketing techniques. At the end of the century, they were joined by German companies that combined a strong commitment to science with aggressive salesmanship. Since German drugs were both highly effective in treating headaches and commonly available, sufferers wanting quick relief could easily obtain them. The result was a new kind of “legitimate” pharmaceutical industry that targeted consumers directly.
Historians of medicine as well as more general readers interested in the history of the headache will enjoy this fascinating account of the creation of the modern pharmaceutical industry.
During the past few decades, high-profile cases like that of Terry Schiavo have fueled the public debate over forgoing or withdrawing artificial nutrition and hydration from patients in a persistent vegetative state (PVS). These cases, whether involving adults or young children, have forced many to begin thinking in a measured and careful way about the moral legitimacy of allowing patients to die. Can families forgo or withdraw artificial hydration and nutrition from their loved ones when no hope of recovery seems possible?
Many Catholics know that Catholic moral theology has formulated a well-developed and well-reasoned position on this and other end-of-life issues, one that distinguishes between "ordinary" and "extraordinary" treatment. But recent events have caused uncertainty and confusion and even acrimony among the faithful. In his 2004 allocution, Pope John Paul II proposed that artificial nutrition and hydration is a form of basic care, thus suggesting that the provision of such care to patients neurologically incapable of feeding themselves should be considered a moral obligation. The pope's address, which seemed to have offered a new development to decades of Catholic health care ethics, sparked a contentious debate among the faithful over how best to treat permanently unconscious patients within the tenets of Catholic morality.
In this comprehensive and balanced volume, Ronald Hamel and James Walter present twenty-one essays and articles, contributed by physicians, clergy, theologians, and ethicists, to reflect the spectrum of perspectives on the issues that define the Catholic debate. Organized into six parts, each with its own introduction, the essays offer clinical information on PVS and feeding tubes; discussions on the Catholic moral tradition and how it might be changing; ecclesiastical and pastoral statements on forgoing or withdrawing nutrition and hydration; theological and ethical analyses on the issue; commentary on Pope John Paul II's 2004 allocution; and the theological commentary, court decisions, and public policy resulting from the Clarence Herbert and Claire Conroy legal cases.
A valuable resource for students and scholars, this teachable volume invites theological dialogue and ethical discussion on one of the most contested issues in the church today.
AIDS. Ebola. "Killer microbes." All around us the alarms are going off, warning of the danger of new, deadly diseases. And yet, as Nancy Tomes reminds us in her absorbing book, this is really nothing new. A remarkable work of medical and cultural history, The Gospel of Germs takes us back to the first great "germ panic" in American history, which peaked in the early 1900s, to explore the origins of our modern disease consciousness.
Little more than a hundred years ago, ordinary Americans had no idea that many deadly ailments were the work of microorganisms, let alone that their own behavior spread such diseases. The Gospel of Germs shows how the revolutionary findings of late nineteenth-century bacteriology made their way from the laboratory to the lavatory and kitchen, with public health reformers spreading the word and women taking up the battle on the domestic front. Drawing on a wealth of advice books, patent applications, advertisements, and oral histories, Tomes traces the new awareness of the microbe as it radiated outward from middle-class homes into the world of American business and crossed the lines of class, gender, ethnicity, and race.
Just as we take some of the weapons in this germ war for granted--fixtures as familiar as the white porcelain toilet, the window screen, the refrigerator, and the vacuum cleaner--so we rarely think of the drastic measures deployed against disease in the dangerous old days before antibiotics. But, as Tomes notes, many of the hygiene rules first popularized in those days remain the foundation of infectious disease control today. Her work offers a timely look into the history of our long-standing obsession with germs, its impact on twentieth-century culture and society, and its troubling new relevance to our own lives.
The human genome is the key to what makes us human. Composed of the many different genes found in our cells, it defines our possibilities and limitations as members of the species. The ultimate goal of the pioneering project outlined in this book is to map our genome in detail—an achievement that will revolutionize our understanding of human development and the expression of both our normal traits and our abnormal characteristics, such as disease. The Code of Codes is a collective exploration of the substance and possible consequences of this project in relation to ethics, law, and society as well as to science, technology, and medicine.
The many debates on the Human Genome Project are prompted in part by its extraordinary cost, which has raised questions about whether it represents the invasion of biology by the kind of Big Science symbolized by high-energy accelerators. While addressing these matters, this book recognizes that far more than money is at stake. Its intent is not to advance naive paeans for the project but to stimulate thought about the serious issues—scientific, social, and ethical—that it provokes. The Code of Codes comprises incisive essays by stellar figures in a variety of fields, including James D. Watson and Walter Gilbert and the social analysts of science Dorothy Nelkin and Evelyn Fox Keller. An authoritative review of the scientific underpinnings of the project is provided by Horace Freeland Judson, author of the bestselling Eighth Day of Creation.
The book’s broad and balanced coverage and the expertise of its contributors make The Code of Codes the most comprehensive and compelling exploration available on this history-making project.
What if your father had Alzheimer's disease? And what if there was a test to tell you if, as you grew older, you might develop it, too? Would you have the test? And if you did, how would the results affect the way you live your life? How would they affect your family? Your job? Your medical insurance?
Breast cancer, sickle-cell anemia, Huntington disease, muscular dystrophy--every day, people have to face the fact that a hereditary disorder runs in their family. The painful knowledge that they or their children might be at risk for a genetic disorder influences all their decisions about the future. They ask, "Is there a genetic test to let us know if we are really at risk? If there is such a test, do we really want to have it done?"
For an ever-growing number of disorders, testing is possible--but the existence of a test can raise new and troubling questions. In this book, geneticist and science policy expert Doris Teichler Zallen explains clearly and sympathetically how genetic disorders are passed along in families; which hereditary disorders can be tested for using genetic technology; how the new DNA tests for genetic disorders work; what genetic tests can and can't reveal, and why the tests often do not give clear-cut answers; what questions one should ask doctors and genetic counselors; how the health care system, government policies, and insurance companies influence our options; and what the resources are for obtaining more information and counseling.
Through the stories of real families and the choices they made about genetic testing, Zallen helps readers think through their own alternatives and discuss them with relatives. Does it Run in the Family? is essential reading for every family coping with inherited medical conditions and for the medical and genetics professionals involved in their decisions. It will also interest all readers who seek a clear explanation of the new DNA tests and the issues surrounding them.
The secrets locked in our genes are being revealed, and we find ourselves both enthused and frightened about what that portends. We look forward to curing disease and alleviating suffering—for our children as well as for ourselves—but we also worry about delving too deeply into the double helix. Abuses perpetrated by eugenicists—from involuntary sterilization to murder—continue to taint our feelings about genetic screening.
Yet, as Ruth Schwartz Cowan reveals, modern genetic screening has been practiced since 1960, benefiting millions of women and children all over the world. She persuasively argues that new forms of screening—prenatal, newborn, and carrier testing—are both morally right and politically acceptable. Medical genetics, built on the desire of parents and physicians to reduce suffering and increase personal freedom, not on the desire to “improve the human race,” is in fact an entirely different enterprise from eugenics.
Cowan’s narrative moves from an account of the interwoven histories of genetics and eugenics in the first half of the twentieth century, to the development of new forms of genetic screening after mid-century. It includes illuminating chapters on the often misunderstood testing programs for sickle cell anemia, and on the world’s only mandated premarital screening programs, both of them on the island of Cyprus.
Neither minimizing the difficulty of the choices that modern genetics has created for us nor fearing them, Cowan bravely and compassionately argues that we can improve the quality of our own lives and the lives of our children by using the modern science and technology of genetic screening responsibly.
To Test or Not to Test arms readers with questions that should be considered before they pursue genetic screening.
Determining the answers to these questions is no easy task. In this highly readable book, Doris Teichler Zallen provides a template that can guide individuals and families through the decision-making process and offers additional resources where they can gain more information. She shares interviews with genetic specialists, doctors, and researchers, as well as the personal stories of nearly 100 people who have faced genetic-testing decisions. Her examples focus on genetic testing for four types of illnesses: breast/ovarian cancer (different disorders but closely connected), colon cancer, late-onset Alzheimer's disease, and hereditary hemochromatosis. From the more common diseases to the rare hereditary conditions, we learn what genetic screening is all about and what it can tell us about our risks.
Given that we are now bombarded with ads in magazines and on television hawking the importance of pursuing genetic-testing, it is critical that we approach this tough issue with an arsenal of good information. To Test or Not to Test is an essential consumer tool-kit for the genetic decision-making process.
This is a landmark introduction to the facts and hopes of gene therapy: an exciting, albeit controversial, technique that could bring about a new age in medical treatment. Modern medicine has had relatively little to offer children with disorders such as thalassemia and severe combined immune deficiency. Many of these young patients still face repeated hospitalizations and, often, an early death. In gene therapy, a child with life-threatening genetic disease caused by a defect in a single gene will he treated with the gene’s normal counterpart. Successful development of somatic cell gene therapy is potentially the most effective new therapeutic approach to helping these children lead normal lives.
With unusual clarity of style, Eve K. Nichols (author of the acclaimed Mobilizing Against AIDS) explores the potential for gene therapy and identifies those who are candidates for it. She reviews methods for diagnosing genetic diseases and evaluates current forms of therapy. Having provided a biomedical background for understanding somatic cell gene therapy, Nichols takes a thoughtful look at complex and sensitive issues surrounding ethical, economic, and policy aspects of manipulating human genes. A straightforward analysis of the current limitations and future potential of gene therapy concludes her broadly accessible account.
This book is is derived from the annual session of the prestigious Institute of Medicine. Distinguished participants in this meeting, such as Leon Rosenberg (Dean of the Yale Medical School), Philip Leder (Harvard Medical School), David Martin (Vice President, Genentech, Inc.), James Wyngaarden (Director of the National Institutes of Health), and LeRoy Walters (Director of the Center for Bioethics, Georgetown University), have contributed expert perspectives that will establish this book as a standard of excellence for future studies. A preface by Frank Press, President of the National Academy of Sciences, provides an insightful overview of this promising new therapy.
Every year, millions of healthy women undergo a variety of screening tests without understanding why or the meaning of the outcome. If you are among those women, overwhelmed by information and baffled by results, this is the book you've been waiting for. In straightforward, personable prose, A Woman's Concise Guide to Common Medical Tests surveys a wide variety of standard tests commonly suggested by doctors.
Using the recommendations of the U.S. Preventative Health Services Task Force as a starting point, physicians Michele C. Moore and Caroline M. de Costa describe and explain screening tests for STDs and other communicable diseases, diabetes, thyroid disease, bone loss, various genetic tests, pregnancy, and cancer (including breast, colon, and skin). A section on common blood tests demystifies the numerical results that can be virtually impossible to interpret for women outside the medical profession. The authors detail what is considered "normal" as well as what's not-to help women make sense of their results.
As practicing physicians, both authors have fielded patients' questions about standard screening tests and understand what women should know but often feel afraid to ask about. For each test, there is an explanation of why it may be ordered, how it is done, what sort of preparation may be involved, and what risks may be incurred.
As the health-care industry continues to evolve, the amount of medical information available to women about their health can be overwhelming and confusing. Without being encyclopedic or intimidating, A Woman's Concise Guide to Common Medical Tests offers all the facts you need about screening tests, all in one place.
This new edition of Fundamentals of Radiology brings up to date the consummate, classic work by Lucy Frank Squire and Robert A. Novelline that has introduced generations of medical students to radiology.
The standard introductory text for more than thirty years, Fundamentals of Radiology is a model of clarity and comprehensiveness. Robert Novelline continues that tradition by thoroughly updating and expanding this edition to reflect the latest types and uses of imaging techniques. Complementing the text are many superb reproductions of plain film, computed tomography, magnetic-resonance, and ultrasound images--hundreds of them new to this edition. In addition, Novelline has added five important chapters. A new chapter near the beginning of the book provides an atlas of drawings and images that allows the reader to review normal plain film and CT anatomy. Another new chapter is devoted to vascular imaging, including CT angiography, MR angiography, and vascular ultrasound, especially full-color Doppler ultrasound images. The chapter on interventional radiology covers therapeutic procedures performed by radiologists, such as angioplasty, embolization, and percutaneous biopsy. To address the different medical conditions of males, females, and children, another new chapter examines the imaging of obstetrical, gynecological, testicular, prostate, and urethral disorders, and considers a variety of childhood ailments and problems, including child abuse. Finally, a new chapter on TB and AIDS shows how radiology can track the course of a single disease over time and trace the depredations of a multisystem disease.
Medical students preparing for a career in clinical practice must become familiar with a wide range of diagnostic imaging techniques and image-guided interventions. They must learn to identify the indications for radiological examination and recognize the role each procedure plays in the workup, diagnosis, and therapeutic management of patients. That is why Squire’s Fundamentals of Radiology has been such an important, long-standing resource for medical students, physicians, and other professionals at all stages of their careers. It teaches essential topics in the radiology curriculum and features hundreds of illustrative cases clinicians can turn to again and again in practice.
In this long-awaited seventh edition, Robert Novelline provides more than 600 new high-resolution images representing the current breadth of radiological procedures: conventional x-rays, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), angiography, radioisotope scanning, positron emission tomography (PET), and molecular imaging. This edition’s expanded coverage addresses dual energy CT, breast tomosynthesis, PET-MR scanning, and tractography brain imaging, along with best practices for managing patient experiences during and after examination. All new images were produced at a major teaching hospital using state-of-the-art imaging technologies.
Squire’s Fundamentals of Radiology is designed to be read cover to cover by students, with concepts, principles, and methods progressing in a logical, cumulative manner. It also serves as an invaluable tool for teachers and an indispensable reference for seasoned practitioners. Written by a radiologist who has trained thousands of medical students and residents, this textbook is the clear choice for excelling in the general practice of radiology.
For thousands of years, horror of the dead, superstition, and oppressive decrees prevented our ancestors from looking inside the human body; in ancient civilizations, diagnostics were based on imagination and theory, with only limited observation. So people developed suppositions about health and disease without knowing how the liver, heart, brain, and blood vessels looked or functioned. In tracing the history of medical imaging, Doby and Alker establish that it was not until the Renaissance and the detailed drawings of human anatomy by da Vinci and Vesalius that successful internal imaging of the human body was born.
At the turn of the nineteenth century, Roentgen’s discovery of the X-ray provided the first miraculous look into the living body. From that instant, medical imaging developed at an ever-increasing pace, evolving to more recent discoveries in nuclear medicine, CT scanning, and ultrasound and magnetic resonance imaging.
As Doby and Alker note, we can expect our efforts to be understood in the future only if we examine past events with an appreciation of the difficulties and challenges that faced our predecessors. Despite almost unbelievable advances in current medical technology, we must still rely on our own resources and common sense as human beings in understanding what technology can and cannot do for us.
A comprehensive set of appendixes pictorially depicting the history of imaging round out the volume.X-rays, fluoroscopy, ultrasound, CT, MRI, and PET scans--medical imaging has become a familiar part of modern health care today. A century ago, however, the idea of looking inside the living body seemed absurd. Wilhelm Roentgen's X-ray image of his wife's shadowy hand--with her wedding band "floating" around a white bone--convinced doctors to rush the new tool into use for diagnosis and treatment.
By the 1920s, the technology was a commonplace wonder: army recruits had routinely lined up for chest X-rays during World War I, and children delighted in seeing the bones of their feet in the green glow of shoestore fluoroscopes. By the late 1960s, the computer and television were linked to produce medical images that were as startling as Roentgen's original X-rays. Computerized tomography (CT) and magnetic resonance imaging (MR) made it possible to picture soft tissues invisible to ordinary X-rays. Ultrasound allowed expectant parents to see their unborn children. Positron emission tomography (PET) enabled neuroscientists to map the brain.
In this lively history of medical imaging, the first to cover the full scope of the field from X-rays to MR-assistant surgery, Bettyann Kevles explores the consequences of these developments for medicine and society. Through lucid prose, vivid anecdotes, and more than seventy striking illustrations, she shows how medical imaging has transformed the practice of medicine--from pediatrics to dentistry, neurosurgery to geriatrics, gynecology to oncology.
Despite their formidable power to reveal the inner secrets of the body, no form of medical imaging can claim to be the product of a technological imperative. As Kevles points out, few of these costly inventions made it easily to the marketplace, and all are vulnerable to the changing economics of the health-care system. In the early years of X-rays, many doctors, technicians, and patients died from overexposure to the invisible radiation. Although we may still find delayed repercussions from these newer technologies, a different kind of danger may lie in our conviction that an early diagnosis is equivalent to a cure.
Beyond medicine, Kevles describes how X-rays and the newer technologies have become part of the texture of modern life and culture. They helped undermine Victorian sexual sensibilities, gave courts new forensic tools, provided plots for novels and movies, and offered artists from Picasso to Warhol new ways to depict the human form.
Naked to the Bone offers readers an unparalled picture of a key technology of the twentieth century.
Saunders’s analyses are informed by strands of cultural history and theory including art historical critiques of realist representation, Walter Benjamin’s concerns about violence in “mechanical reproduction,” and tropes of detective fiction such as intrigue, the case, and the culprit. Saunders analyzes the diagnostic “gaze” of medical personnel reading images at the viewbox, the two-dimensional images or slices of the human body rendered by the scanner, methods of archiving images, and the use of scans as pedagogical tools in clinical conferences. Bringing cloistered diagnostic practices into public view, he reveals the customs and the social and professional hierarchies that are formulated and negotiated around the weighty presence of the CT scanner. At the same time, by returning throughout to the nineteenth-century ideas of detection and scientific authority that inform contemporary medical diagnosis, Saunders highlights the specters of the past in what appears to be a preeminently modern machine.
Let Them Go Free offers families a way to cope with a problem particular to our time: what to do when medical treatment sustains life but does not cure or resuscitate a critically ill loved one. This straightforward and empathic guide helps such families affirm that their choice to remove life support is morally acceptable, warranted, and made in the spirit of love and care for the patient.
With an emphasis on maintaining openness and trust among all involved in the decision-making process, this helpful guide skillfully addresses the questions that must be asked to assess the best course of care for a loved one:
• What is the patient’s medical condition?
• What are the medical options?
• Has the patient expressed any wishes regarding his or her treatment?
• What if the patient hasn’t expressed any wishes regarding treatment?
• Do we have to do everything possible to keep the patient alive?
• Do we have to use artificial means of feeding?
• How do we handle disagreements?
• What should we do about donating organs?
Let Them Go Free also includes an ecumenical prayer service to be conducted as life support is withdrawn. Woven with readings and prayers from Hebrew and Christian scripture, the service is intended to give family and friends a moment to express their love for the patient, to say goodbye, and to find a sense of closure as they embark on the first stage of the grieving process.
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