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.
After World War II, the United States and Canada, two countries that were very similar in many ways, struck out on radically divergent paths to public health insurance. Canada developed a universal single-payer system of national health care, while the United States opted for a dual system that combines public health insurance for low-income and senior residents with private, primarily employer-provided health insurance—or no insurance—for everyone else. In National Health Insurance in the United States and Canada, Gerard W. Boychuk probes the historical development of health care in each country, honing in on the most distinctive social and political aspects of each country—the politics of race in the U.S. and territorial politics in Canada, especially the tensions between the national government and the province of Quebec.
In addition to the politics of race and territory, Boychuk sifts through the numerous factors shaping health policy, including national values, political culture and institutions, the power of special interests, and the impact of strategic choices made at critical junctures. Drawing on historical archives, oral histories, and public opinion data, he presents a nuanced and thoughtful analysis of the evolution of the two systems, compares them as they exist today, and reflects on how each is poised to meet the challenges of the future.
When did the West discover Chinese healing traditions? Most people might point to the "rediscovery" of Chinese acupuncture in the 1970s. In Needles, Herbs, Gods, and Ghosts, Linda Barnes leads us back, instead, to the thirteenth century to uncover the story of the West's earliest known encounters with Chinese understandings of illness and healing. A medical anthropologist with a degree in comparative religion, Barnes illuminates the way constructions of medicine, religion, race, and the body informed Westerners' understanding of the Chinese and their healing traditions.
Needless Suffering offers a sociological examination of a complex medical problem: chronic pain and the inability of doctors and other health professionals to understand and manage it in their patients. People in pain, writes Dr. David Nagel, are the poor of the medical world. Like the poor, they are stigmatized and left at the mercy of powerful social actors who tend to work in their own self-interest, frequently at the expense of those they propose to serve. This leaves those who suffer with little control over their own destinies and creates a dysfunctional status quo that harms instead of helps. Drawing on his own experience witnessing his mother’s chronic pain and numerous clinical stories from over thirty years’ expertise as a pain management specialist, Nagel looks first at patients, their families, and their doctors (usually not trained in pain management), and then broadens his canvas to elaborate a pain power structure that includes the entire healthcare community, insurers, lawyers, government regulators, employers, politicians, law enforcement agencies, and painkilling drugs. Concluding with concrete reforms to create more effective and compassionate pain care, this book is designed for pain patients and their families, healthcare providers, legislators and other public policymakers, judges, personal injury and other attorneys, insurers, government regulators, law enforcement personnel, and health care businesspeople.
Neither Donkey nor Horse tells the story of how Chinese medicine was transformed from the antithesis of modernity in the early twentieth century into a potent symbol of and vehicle for China’s exploration of its own modernity half a century later. Instead of viewing this transition as derivative of the political history of modern China, Sean Hsiang-lin Lei argues that China’s medical history had a life of its own, one that at times directly influenced the ideological struggle over the meaning of China’s modernity and the Chinese state.
Far from being a remnant of China’s premodern past, Chinese medicine in the twentieth century coevolved with Western medicine and the Nationalist state, undergoing a profound transformation—institutionally, epistemologically, and materially—that resulted in the creation of a modern Chinese medicine. This new medicine was derided as “neither donkey nor horse” because it necessarily betrayed both of the parental traditions and therefore was doomed to fail. Yet this hybrid medicine survived, through self-innovation and negotiation, thus challenging the conception of modernity that rejected the possibility of productive crossbreeding between the modern and the traditional.
By exploring the production of modern Chinese medicine and China’s modernity in tandem, Lei offers both a political history of medicine and a medical history of the Chinese state.
Joseph Loscalzo Harvard University Press, 2017 Library of Congress R858.N48 2016 | Dewey Decimal 610.285
Big data, genomics, and quantitative approaches to network-based analysis are combining to advance the frontiers of medicine as never before. With contributions from leading experts, Network Medicine introduces this rapidly evolving field of research, which promises to revolutionize the diagnosis and treatment of human diseases.
As the United States rushed toward industrial and technological modernization in the late nineteenth century, people worried that the workplace had become too competitive, the economy too turbulent, domestic chores too taxing, while new machines had created a fast-paced environment that sickened the nation. Physicians testified that, without a doubt, modern civilization was causing a host of ills—everything from irritability to insomnia, lethargy to weight loss, anxiety to lack of ambition, and indigestion to impotence. They called this condition neurasthenia.
Neurasthenic Nation investigates how the concept of neurasthenia helped doctors and patients, men and women, and advertisers and consumers negotiate changes commonly associated with “modernity.” Combining a survey of medical and popular literature on neurasthenia with original research into rare archives of personal letters, patient records, and corporate files, David Schuster charts the emergence of a “neurasthenic nation”—a place where people saw their personal health as inextricably tied to the pitfalls and possibilities of a changing world.
Neurofilaments was first published in 1983. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.
Neurofilaments are fibrous organelles that serve as one of the main structural elements of neurons. Synthesized in the perikaryon ,or nerve cell body, neurofilaments are transported along the axon, where they help to maintain the neuronal architecture. Recent research has shown that neurofilaments are biochemically distinct from other kinds of cellular filaments and that they play a special role in the health and functioning of neurons. Although their existence has been recognized for over a century, scientists have only recently started to apply the methods of cellular and molecular biology to the study of neurofilaments, aided by the use of the electron microscope. The study of neurofilaments has raised a number of interesting biological questions with implications for our understanding of neurophysiology, neuroanatomy, and neurology. This book is the first to provide, in one place, reports by specialists on the most significant areas of research on these neuronal organelles.
The book opens with a historical background to current research, followed by chapters dealing with the neuronal cytoskeleton; the biochemistry of neurofilaments; neurofilaments of the mammalian peripheral nerve; the functional role of neurofilaments in axonal transport; the metabolism of neurofilaments; experimental models of abnormal neurofilamentous pathology; and the relation of these abnormal structures to Alzheimer's disease. Editor Charles Marotta's closing chapter surveys current and future neurofilament research.
The field of research related to neurocritical care has grown significantly in recent years, and the clinical demands for current and dependable expertise has followed suit. It can be a challenge for the neurocritical practitioner to keep up with cutting-edge evidence-based research and best practices, especially regarding the role of pharmacotherapeutics.
In the treatment of neurocritical disease states, pharmacotherapeutic strategies are increasingly relevant. Neuropharmacotherapy in Critical Illness is the first book that provides this information in a high-yield format for the busy healthcare provider. Edited and authored by leading experts in the field, this book provides practitioners with clinical pearls on neuropharmacology, dosing strategies, monitoring, adverse events, drug interactions, and evidence-based pharmacotherapy.
Neuroscience, Psychology, and Religion is the second title published in the new Templeton Science and Religion Series. In this volume, Malcolm Jeeves and Warren S. Brown provide an overview of the relationship between neuroscience, psychology, and religion that is academically sophisticated, yet accessible to the general reader.
The authors introduce key terms; thoroughly chart the histories of both neuroscience and psychology, with a particular focus on how these disciplines have interfaced religion through the ages; and explore contemporary approaches to both fields, reviewing how current science/religion controversies are playing out today. Throughout, they cover issues like consciousness, morality, concepts of the soul, and theories of mind. Their examination of topics like brain imaging research, evolutionary psychology, and primate studies show how recent advances in these areas can blend harmoniously with religious belief, since they offer much to our understanding of humanity's place in the world. Jeeves and Brown conclude their comprehensive and inclusive survey by providing an interdisciplinary model for shaping the ongoing dialogue.
Sure to be of interest to both academics and curious intellectuals, Neuroscience, Psychology, and Religion addresses important age-old questions and demonstrates how modern scientific techniques can provide a much more nuanced range of potential answers to those questions.
The Neuroscientific Turn brings together 19 scholars from a variety of fields to reflect on the promises of and challenges facing emergent "neurodisciplines" such as neuroethics, neuroeconomics, and neurohistory. In the aftermath of the Decade of the Brain, neuroscience has become one of the hottest topics of study---not only for scientists but also, increasingly, for scholars from the humanities and social sciences. While the popular press has simultaneously lauded and loathed the coming "neurorevolution," the academy has yet to voice any collective speculations about whether there is any coherence to this neuroscientific turn; what this turn will and should produce; and what implications it has for inter- or transdisciplinary inquiry.
Melissa M. Littlefield and Jenell M. Johnson provide an initial framework for this most recent of "turns" by bringing together 14 original essays by scholars from the humanities, social sciences, and neurosciences. The resulting collection will appeal to neuroscientists curious about their colleagues' interest in their work; scholars and students both in established neurodisciplines and in disciplines such as sociology or English wondering about how to apply neuroscience findings to their home disciplines; and to science, technology, and society scholars and students interested in the roles of interdisciplinarity and transdisciplinarity in the construction of knowledge.
Extraordinary advances in neurochemistry are both transforming our understanding of human nature and creating an urgent problem. Much is now known about the ways that neurotransmitters influence normal social behavior, mental illness, and deviance. What are these discoveries about the workings of the human brain? How can they best be integrated into our legal system?
These explosive issues are best understood by focusing on a single neurotransmitter like serotonin, which is associated with such diverse behaviors as dominance and leadership, seasonal depression, suicide, alcoholism, impulsive homicide, and arson. This book brings together revised papers from a conference on this theme organized by the Gruter Institute for Law and Behavioral Research, supplemented with articles by leading scholars who did not attend. Contributors include psychiatrists, neurologists, social scientists, and legal scholars.
The Neurotransmitter Revolution presents a unique survey of the scientific and legal implications of research on the way serotonin combines with other factors to shape human behavior. The findings are quite different from what might have been expected even a decade ago.
The neurochemistry of behavior is not the same thing as genetic determinism. On the contrary, the activity of serotonin varies from one individual to another for many reasons, including the individual’s life experience, social status, personality, and diet. And there are a number of major neurotransmitter systems, each of which interacts with the other. Behavior, culture, and the social environment can influence neurochemistry along with inheritance. Nature and nurture interact—and these interactions can be understood from a vigorously scientific point of view.
The fact that our actions are heavily influenced by neurotransmitters like serotonin is bound to be disquieting. A sophisticated understanding of law and human social behavior will be needed if our society is to respond adequately to these rapid advances in our knowledge. This book is an essential step in that direction, providing the first comprehensive survey of the biochemical, social, and legal considerations arising from research on the behavioral effects of serotonin and related neurotransmitters.
In 1850, a group of reformist male Quaker physicians and allies founded the Female Medical College of Pennsylvania to offer formal medical training to women. By the 1890s, the renamed Woman's Medical College of Pennsylvania (WMC) had matured into a solid and progressive institution that would outlast other, younger women's medical schools that had arisen in the United States. Steven J. Peitzman describes how WMC survived periods of instability and crises as it became a remarkable experiment in single-sex professional education, and a rare early example of female-male collaboration in science and medicine. Its unique survival provided scarce opportunities for women physicians and scientists to teach and perform research, while maintaining the assurance of medical education free from gender discrimination, Yielding to complex forces, it became the coeducational Medical College of Pennsylvania in 1970 and found another new course to pursue
The productivity slowdown of the 1970s and 1980s and the resumption of productivity growth in the 1990s have provoked controversy among policymakers and researchers. Economists have been forced to reexamine fundamental questions of measurement technique. Some researchers argue that econometric approaches to productivity measurement usefully address shortcomings of the dominant index number techniques while others maintain that current productivity statistics underreport damage to the environment. In this book, the contributors propose innovative approaches to these issues. The result is a state-of-the-art exposition of contemporary productivity analysis.
Charles R. Hulten is professor of economics at the University of Maryland. He has been a senior research associate at the Urban Institute and is chair of the Conference on Research in Income and Wealth of the National Bureau of Economic Research. Michael Harper is chief of the Division of Productivity Research at the Bureau of Labor Statistics. Edwin R. Dean, formerly associate commissioner for Productivity and Technology at the Bureau of Labor Statistics, is adjunct professor of economics at The George Washington University.
New Organs Within Us is a richly detailed and conceptually innovative ethnographic analysis of organ transplantation in Turkey. Drawing on the moving stories of kidney-transplant patients and physicians in Istanbul, Aslihan Sanal examines how imported biotechnologies are made meaningful and acceptable not only to patients and doctors, but also to the patients’ families and Turkish society more broadly. She argues that the psychological theory of object relations and the Turkish concept of benimseme—the process of accepting something foreign by making it one’s own—help to explain both the rituals that physicians perform to make organ transplantation viable in Turkey and the psychic transformations experienced by patients who suffer renal failure and undergo dialysis and organ transplantation. Soon after beginning dialysis, patients are told that transplantable kidneys are in short supply; they should look for an organ donor. Poorer patients add their names to the state-run organ share lists. Wealthier patients pay for organs and surgeries, often in foreign countries such as India, Russia, or Iraq. Sanal links Turkey’s expanding trade in illegal organs to patients’ desires to be free from dialysis machines, physicians’ qualms about declaring brain-death, and media-hyped rumors of a criminal organ mafia, as well as to the country’s political instability, the privatization of its hospitals, and its position as a hub in the global market for organs.
This study focuses on the staff who provide direct patient care, viewing hospital personnel in interaction with patients and in their own work groups. It examines the psychosocial needs characteristic of most workers and suggests ways to meet them to encourage increased staff motivation and competence.
Emphasizing the importance of the psychosocial and cultural background of the individual patient, the final study suggests methods of acquiring this information and the ways in which the staff can then utilize these findings to best advantage both in initial contact and in planning comprehensive patient care.
This first study considers patients' frequent complaints about anxiety, frustration, loneliness, boredom, and uselessness. It suggests changes, some of an almost obvious nature, which might be made in the physical and social environment of the wards to reduce the sense of strangeness and the cold, impersonal atmosphere that aggravate these discomforts.
AIDS, tuberculosis, hepatitis, chickenpox, malaria, Lyme disease, salmonella, strep throat-no matter where you go or where you live, you are at risk from infectious disease. But there are ways you can protect yourself and your family!
The revised and expanded edition of this classic guide explains what you need to know to keep the germs away. From the infections of daily life, like the common cold and traveler's diarrhea, to dangerous, rare diseases such as plague, hantavirus, and invasive strep bacteria, to recent threats of mad cow disease, West Nile virus, SARS, and bioterrorism, this unique guide tells you:
your chances of getting sick
simple precautions you can take
which vaccinations and shots are worthwhile
how to avoid catching infections in the hospital
special precautions to take if you are pregnant
how to ward off infections even if you have chronic health problems or are HIV positive
how to keep well while traveling
what to eat-and not eat-on the road
symptoms that signal trouble
what illnesses you can get from bug bites and animals
how to prevent sexually transmitted diseases
who should get flu shots and why
why you should see your doctor before you get sick
Dr. Winkler G. Weinberg lets you know what you need to worry about and what you don't.
Co-Winner of the 2004 Colorado Endowment for the Humanities Publication Prize
From burying scurvy victims up to their necks in the earth to drinking kerosene mixed with sugar to treat influenza, mid-nineteenth century medicine in the mining communities of the West usually consisted of home remedies that were often remarkable for their inventiveness but tragically random in their effectiveness. Only as a desperate last resort would people turn to the medical community, which had developed a deplorable reputation for quackery and charlatanism because of its lack of licensing regulations and uniform educational standards. No One Ailing Except a Physician takes readers back to those free-wheeling days in the mining towns and the dark recesses of the mines themselves, a time when illness or injury was usually survived more due to sheer luck than the interventions of medicine.
In this important new contribution to both mining and medical history, historians Duane A. Smith and Ronald C. Brown present a detailed analysis of the ailments that confronted the miners and the methods with which they and their doctors attempted to "cure" them. The occupational hazards of mining, with its strenuous labor and exposure to the elements, contributed to the miners' vulnerability to disease and injury, which was further worsened by the typical miner's refusal to heed prevailing medical wisdom and common sense, often leading to easily preventable diseases such as scurvy. And because medical science of the era had not progressed much beyond that of the ancient Greeks, such debilitating diseases such as cholera, influenza, dysentery, and malaria proved to be virtual death sentences, to say nothing of occupational accidents with fires and explosions, mine collapses, and safety cage mishaps.
Normality: A Critical Genealogy
Peter Cryle and Elizabeth Stephens University of Chicago Press, 2017 Library of Congress B105.N65C79 2017 | Dewey Decimal 302.1
The concept of normal is so familiar that it can be hard to imagine contemporary life without it. Yet the term entered everyday speech only in the mid-twentieth century. Before that, it was solely a scientific term used primarily in medicine to refer to a general state of health and the orderly function of organs. But beginning in the middle of the twentieth century, normal broke out of scientific usage, becoming less precise and coming to mean a balanced condition to be maintained and an ideal to be achieved.
In Normality, Peter Cryle and Elizabeth Stephens offer an intellectual and cultural history of what it means to be normal. They explore the history of how communities settle on any one definition of the norm, along the way analyzing a fascinating series of case studies in fields as remote as anatomy, statistics, criminal anthropology, sociology, and eugenics. Cryle and Stephens argue that since the idea of normality is so central to contemporary disability, gender, race, and sexuality studies, scholars in these fields must first have a better understanding of the context for normality. This pioneering book moves beyond binaries to explore for the first time what it does—and doesn’t—mean to be normal.
Helmut Illbruck traces the concept of nostalgia from the earliest uses of the term in the seventeenth century to today as it evolves with different meanings and intensities in the discourses of medicine, literature, philosophy, and aesthetics. Following nostalgia’s troubled relations to the philosophical project of the Enlightenment, Illbruck’s study builds a cumulative argument about nostalgia’s modern significance that often revises and thoroughly enriches our understanding of cultural, literary, and intellectual history. Illbruck concludes with an attempt at a reinterpretation and defense of nostalgia, which seduces us to read and think with, rather than against, nostalgia’s wistful yearning for the past. Nostalgia: Origins and Ends of an Unenlightened Disease is a comprehensive, insistent, and profound interdisciplinary investigation of the history of an idea. It should appeal to readers interested in the cultural makings of the Enlightenment and modernity or in the histories of medicine, literature, and philosophy.
This book tells how the Department of Family Medicine was established at the University of Michigan in 1978 and how it has evolved since then. The forty years of stories paint a detailed picture of the department leaders, faculty, staff, and learners who coped with setbacks, challenges, and accomplishments in establishing this specialty at a nationally renowned medical school.
In Not Quite a Cancer Vaccine, medical anthropologist S.D. Gottlieb explores how the vaccine Gardasil—developed against the most common sexually-transmitted infection, human papillomavirus (HPV)—was marketed primarily as a cervical cancer vaccine. Gardasil quickly became implicated in two pre-existing debates—about adolescent sexuality and pediatric vaccinations more generally.
Prior to its market debut, Gardasil seemed to offer female empowerment, touting protection against HPV and its potential for cervical cancer. Gottlieb questions the marketing pitch’s vaunted promise and asks why vaccine marketing unnecessarily gendered the vaccine’s utility, undermining Gardasil’s benefit for men and women alike. This book demonstrates why in the ten years since Gardasil’s U.S. launch its low rates of public acceptance have their origins in the early days of the vaccine dissemination. Not Quite a Cancer Vaccine addresses the on-going expansion in U.S. healthcare of patients-as-consumers and the ubiquitous, and sometimes insidious, health marketing of large pharma.
In Nursing Civil Rights, Charissa J. Threat investigates the parallel battles against occupational segregation by African American women and white men in the U.S. Army.
As Threat reveals, both groups viewed their circumstances with the Army Nurse Corps as a civil rights matter. Each conducted separate integration campaigns to end the discrimination they suffered. Yet their stories defy the narrative that civil rights struggles inevitably arced toward social justice. Threat tells how progressive elements in the campaigns did indeed break down barriers in both military and civilian nursing. At the same time, she follows conservative threads to portray how some of the women who succeeded as agents of change became defenders of exclusionary practices when men sought military nursing careers. The ironic result was a struggle that simultaneously confronted and reaffirmed the social hierarchies that nurtured discrimination.
"This book is a manual of nursing procedures originally prepared for the students of the University of Minnesota School of Nursing, written to obviate the necessity of note-taking by the students during the presentation of demonstration by the instructor . . . On the whole the manual is excellent. An instructor would find it of great value in planning her demonstration. It would be difficult to improve upon the simplicity and clarity with which the steps of the procedures are given." —Pacific Coast Journal of Nursing
Nursing Procedures was first published in 1929. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.
In the evolution of the nursing profession, the phrases nursing care, therapeutic care, caring for others, and related expressions are used by nurses to describe their professional service to others. Members of our society have different thoughts and role expectations about these phrases in relation to the kind of care they receive from nurses. Furthermore, these expressions hold different meanings for nurses in their various care-giving roles, such as to individual clients, families, and community groups they serve. Care-giving and care-receiving roles of nurses have different sets of expectations and behaviors. It is well, there, that members of the nursing profession begin systematically to clarify the diverse functions and cultural values related to the concepts of care, caring, and nursing care.
The concept of care is probably one of the least understood ideas used by professional and nonprofessional people, yet it is probably one of the most important concepts to be understood by human groups. It is a word with multiple social usages in the American culture, and has other meanings in other world cultures. The terms care, caring, and nursing care have both symbolic and functional meanings as they are used by caregivers and care-recipients. Nursing care also has a general, special meaning to nurses, and is often taken for granted in nurses' thoughts and action patterns. It is time that we study the implicit and explicit meanings associated with the concepts of care and caring so that we can reduce their ambiguities. Furthermore, the humanistic, scientific, and linguistic meanings related to nursing care and caring behaviors in any culture remain a most fascinating area of study for nurses.
Jean Watson's first edition of Nursing, now considered a classic, introduced the science of human caring and quickly became one of the most widely used and respected sources of conceptual models for nursing. This completely new edition offers a contemporary update and the most current perspectives on the evolution of the original philosophy and science of caring from the field's founding scholar.
A core concept for nurses and the professional and non-professional people they interact with, "care" is one of the field's least understood terms, enshrouded in conflicting expectations and meanings. Although its usages vary among cultures, caring is universal and timeless at the human level, transcending societies, religions, belief systems, and geographic boundaries, moving from Self to Other to community and beyond, affecting all of life.
This new edition reflects on the universal effects of caring and connects caring with love as the primordial moral basis both for the philosophy and science of caring practices and for healing itself. It introduces Caritas Processes, offers centering and mediation exercises on an included audio CD, and provides other energetic and reflective models to assist students and practitioners in cultivating a new level of Caritas Nursing in their work and world.
Mandated by the Affordable Care Act, public health demonstration projects have been touted as an innovative solution to the nation’s health care crisis. Yet, such projects actually have a long but little-known history, dating back to the 1920s. This groundbreaking new book reveals the key role that these local health programs—and the nurses who ran them—influenced how Americans perceived both their personal health choices and the well-being of their communities.
Nursing with a Message transports readers to New York City in the 1920s and 1930s, charting the rise and fall of two community health centers, in the neighborhoods of East Harlem and Bellevue-Yorkville. Award-winning historian Patricia D’Antonio examines the day-to-day operations of these clinics, as well as the community outreach work done by nurses who visited schools, churches, and homes encouraging neighborhood residents to adopt healthier lifestyles, engage with preventive physical exams, and see to the health of their preschool children. As she reveals, these programs relied upon an often-contentious and fragile alliance between various healthcare providers, educators, social workers, and funding agencies, both public and private. Assessing both the successes and failures of these public health demonstration projects, D’Antonio also traces their legacy in shaping both the best and worst elements of today’s primary care system.
The rise of the nurse practitioner as a new kind of health care professional has blurred the traditional distinction between physicians and nurses. Nurse practitioners argue that they combine both the traditionally male health care delivery of the M.D. and the traditionally female caring attention of the R.N. In her previous work Sue Fisher has analyzed the difficulties that women patients have in getting doctors to listen to their medical concerns. Now she asks whether women fare any better with nurse practitioners.
Nursing Wounds takes us into the examining rooms of nurse practitioners and doctors to listen to how health care professionals and women patients communicate. The nurse practitioners, unlike the doctors, go beyond the medical problem to ask about the social context of the patients' lives. In these exchanges the doctors insist on reinforcing both their professional status and dominant cultural assumptions about women. While the nurse practitioners sometimes do this, they also distance themselves from their professional identities, respond to their patients woman to woman, and undermine traditional understandings about gender arrangements.These differences have important consequences for the delivery of health care.
This compelling and complex analysis employs a range of theoretical perspectives–-from sociolinguistic to postmodern and materialist. Fisher concludes by urging a health care policy that capitalizes on the special strengths of nurse practitioners as providers of primary care who pay real attention to what their patients are saying and who support an alternative, even oppositional, understanding of women's lives.