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.

Parkinson’s disease is a movement disorder characterized by tremor, stiffness, and slow gait. It affects 500,000 people in the United States, with approximately 50,000 new cases diagnosed annually. But its impact is much wider. Family members with little understanding of the disease often find themselves struggling to help their loved one navigate the complexities of the health care system. Patients wonder, Which treatments are best for me? Will I be able to live on my own? Should I join a drug trial?

In this straightforward, compassionate guide, Nutan Sharma and Elaine Richman address these concerns and more. They provide a thorough review of the etiology, diagnosis, and current treatment of Parkinson’s, with special consideration given to the effect on family dynamics and routines—including the often neglected topics of long-term care and sexual function. The authors also review the pros and cons of various alternative therapies, including nutritional supplements, massage therapy, and traditional Chinese medicine.

“In this rigorous and beautifully researched volume, Milanich considers the tension between social and biological definitions of fatherhood, and shows how much we still have to learn about what constitutes a father.”
—Andrew Solomon, author of Far from the Tree: Parents, Children, and the Search for Identity

For most of human history, the notion that paternity was uncertain appeared to be an immutable law of nature. The unknown father provided entertaining plotlines from Shakespeare to the Victorian novelists and lay at the heart of inheritance and child support disputes. But in the 1920s new scientific advances promised to solve the mystery of paternity once and for all. The stakes were high: fatherhood has always been a public relationship as well as a private one. It confers not only patrimony and legitimacy but also a name, nationality, and identity.

The new science of paternity, with methods such as blood typing, fingerprinting, and facial analysis, would bring clarity to the conundrum of fatherhood—or so it appeared. Suddenly, it would be possible to establish family relationships, expose adulterous affairs, locate errant fathers, unravel baby mix-ups, and discover one’s true race and ethnicity. Tracing the scientific quest for the father up to the present, with the advent of seemingly foolproof DNA analysis, Nara Milanich shows that the effort to establish biological truth has not ended the quest for the father. Rather, scientific certainty has revealed the fundamentally social, cultural, and political nature of paternity. As Paternity shows, in the age of modern genetics the answer to the question “Who’s your father?” remains as complicated as ever.

It is rare indeed for one book to be both a first-rate classroom text and a major contribution to scholarship. The Pathway for Oxygen is such a book, offering a new approach to respiratory physiology and morphology that quantitatively links the two. Professionalism in science has led to a compartmentalization of biology. Function is the domain of the physiologist, structure that of the morphologist, and they often operate with vastly disparate concepts and procedures. Yet the performance of the respiratory system depends both on structural and on functional properties that cannot be separated.

The first chapter of The Pathway for Oxygen engages the student with the design and function of the vertebrate respiratory organs from a comparative viewpoint. The second chapter adds to that foundation the link between cell energetics and oxygen needs of the whole animal. With Chapter 3 the excitement begins—new ideas, fresh attacks on old problems, and a fuller account of the power of the quantitative approach Dr. Ewald Weibel has pioneered.

The Pathway for Oxygen will be read eagerly by medical students, graduate students, advanced undergraduates in zoology—and by their professors.

The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices.

According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient.

Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.

This book presents a careful analysis of pension data collected by the Health and Retirement Study, a unique survey of people over the age of fifty conducted by the University of Michigan for the National Institute on Aging. The authors studied pensions as they evolve over individuals’ work lives and into retirement: how pension coverage and plans change over a lifetime, how many pensions workers have by the time they retire and what these pensions are worth, what pensions contribute to individual retirement incomes, and how trends and policy changes affect retirement plans.

The book focuses on the major features of pensions, including plan type and participation, ages of eligibility for retirement, values of different pension types, how pension values are influenced by retirement age, how plans are settled when a worker leaves a firm, how well people understand their pensions, the importance of pensions in retirement saving and as a share of household wealth, and the vulnerability of the retirement age population to the current financial crisis.

This book provides readers with an invaluable look at the crucial but ever-changing role of pensions in supporting retirees.

The cerebral cortex, occupying over 70 percent of our brain mass, is key to any understanding of the workings--and disorders--of the human brain. offering a comprehensive account of the role of the cerebral cortex in perception, this monumental work by one of the world's greatest living neuroscientists does nothing short of creating a new subdiscipline in the field: perceptual neuroscience.

For this undertaking, Vernon Mountcastle has gathered information from a vast number of sources reaching back through two centuries of investigation into the intrinsic operations of the cortex. His survey includes phylogenetic, comparative, and neuroanatomical studies of the neocortex; studies of the large-scale organization of the neocortex, of neuronal histogenesis and the specification of cortical areas, of synaptic transmission between neurons in cortical microcircuits, and of rhythmicity and synchronization in neocortical networks; and inquiries into the binding problem--how activities among the separate processing nodes of distributed systems coalesce in a coherent activity that we call perception.

The first book to summarize what is known about the physiology of the cortex in perception, Perceptual Neuroscience will be a landmark in the literature of neuroscience.

A leading neuroscientist argues that the peripheral nervous system, long understood to play a key role in regulating basic bodily functions, also signals the onset of illness.

The central nervous system, consisting of the brain and the spinal cord, has long been considered the command center of the body. Yet outside the central nervous system, an elaborate network of nerve cells and fibers extends throughout our bodies, transmitting messages between the brain and other organs. The peripheral nervous system, as it’s known, regulates such vital functions as heart rate, digestion, and perspiration and enables us to experience the barrage of sounds, tastes, smells, and other sensory information that surrounds us. But beyond these crucial roles, the peripheral nervous system might do even more: it might warn us of diseases in our future.

As Moses Chao argues in Periphery, from Parkinson’s disease to autism to dementia, many neurological conditions emerge not in the brain but rather within the peripheral nervous system, in the dense network of nerves that wrap around the gastrointestinal tract. What’s more, dysfunctions of the peripheral nervous system can signal the onset of disease decades before symptoms like tremor or memory loss occur. Fortunately, unlike nerves in the brain and spinal cord, peripheral nerves can heal and regenerate in response to injury and aging. The therapeutic implications are remarkable. Chao shows how, with a better understanding of the peripheral nervous system, we could not only predict and treat neurological diseases long before their onset, but possibly prevent them altogether.

Full of new ideas and bold interpretations of the latest data, Periphery opens exciting avenues for medical research while deepening our understanding of a crucial yet underappreciated biological system.

Modern psychological and political theory meet head-on in this powerful re-evaluation of America's contradictory and sometimes dangerous addiction to individualism. Best-selling author Gaylin and co-author Jennings investigate the contentious intersections of interdependence and autonomy, rights and public responsibility. They examine the painful abrasion occurring between America's tradition of personal freedom and privacy, as it rubs against the still valuable if almost vanishing ideals of sacrifice and social order.

Our current culture of autonomy—championed by both liberals on the left and libertarians on the right—is based on the idea of rationality as the motivation for human conduct. But, as the authors remind us, people are not simply rational creatures—appeals to emotions are always far more effective than logical argument in changing our behavior.

This timely edition includes a new preface; updated examples and illustrations throughout; and new coverage of contemporary social critics and their work since the publication of the first edition. Two essential new chapters, one on the movement to forgo life-sustaining treatment and the other on physician-assisted suicide, particularly clarify the authors' arguments. Drawing on these and numerous other illustrations—with significant emphasis on the state of American health care—Gaylin and Jennings demonstrate that society has not just the right but the duty to occasionally invoke fear, shame, and guilt in order to motivate humane behavior.

As cases of AIDS are once again on the upswing, as the dangerously mentally ill are allowed to wander free and untreated, as starvation and poverty still hold too many in its grip in the richest nation on the planet, this controversial book, considerably revised and expanded, is needed more than ever. If we are to indeed preserve and nurture a genuinely free—and liberal—society, the authors suggest that these "coercions" may be essential for the health and the maturity of a nation where we all too often avert our eyes, not seeing that our neighbor is in pain or trouble and needs our help.

A leading researcher provides a comprehensive review of the basic physiology of the hemostatic system, offering a solid foundation for understanding the pathological events leading up to thrombosis and abnormal bleeding. An introductory chapter, intended for the nonspecialist, outlines the whole hemostatic process and leads the reader carefully into the detailed information that follows. The first section of the book describes basic components of platelet structure and function, the coagulation system, and fibrinolytic enzyme system. The second is a unique discussion of the changes in these components induced by physiological parameters—hormones, sex, environment, nutrition, stress, and activity.

Derek Ogston performs an invaluable service in reviewing pertinent studies that show both positive and negative results and examining conflicting data and conclusions. His work will be a source of insight and data for practicing hematologists as well as researchers in this rapidly growing field.

The great Swiss psychologist and theorist Jean Piaget (1896–1980) had much to say about the developing mind. He also had plenty to say about his own development, much of it, as Fernando Vidal shows, plainly inaccurate. In the first truly historical biography of Piaget, Vidal tells the story of the psychologist’s intellectual and personal development up to 1918. By exploring the philosophical, religious, political, and social influences on the psychologist’s early life, Vidal alters our basic assumptions about the origins of Piaget’s thinking and his later psychology.

The resulting profile is strikingly dissimilar to Piaget’s own retrospective version. In Piaget’s own account, as an adolescent he was a precocious scientist dedicated to questions of epistemology. Here we find him also—and increasingly—concerned with the foundations of religious faith and knowledge, immersed in social and political matters, and actively involved in Christian and socialist groups. Far from being devoted solely to the classification of mollusks, the young Piaget was a vocal champion of Henri Bergson’s philosophy of creative evolution, an interest that figured much more prominently in his later thinking than did his early work in natural history. We see him during World War I chastising conservatism and nationalism, espousing equality and women’s rights, and advocating the role of youth in the birth of a new Christianity.

In his detailed account of Jean Piaget’s childhood and adolescence—enriched by the intellectual and cultural landscape of turn-of-the-century Neuchâtel—Vidal reveals a little-known Piaget, a youth whose struggle to reconcile science and faith adds a new dimension to our understanding of the great psychologist’s life, thought, and work.

Dean of the Harvard Medical School and School of Public Health in the 1920's and '30's,David Edsall was one of the leaders in a period of great change and progress in medicine. At the beginning of Edsall's career, a doctor's chief weapons were his informed mind and trained senses. By the end of it, the permanent alliance of the sciences and medicine had profoundly altered the doctor's practice and his education. It was a time of struggle, of conflict, and of enduring accomplishment.

Edsall was at the center of this revolutionary effort in three leading schools of medicine: the University of Pennsylvania, Washington University in St. Louis, and Harvard. He began his career in Pennsylvania as recording clerk to the famous Dr. William Pepper, Jr., at the same time making scientific contributions in metabolism through his work in the Pepper Laboratory of Clinical Medicine. By 1907 he had become Professor of Therapeutics and Pharmacology. In 1910 and '11, for one stormy year, he was the school's Professor of Medicine. This was a key year -in 1910 the publication of Abraham Flexner's Medical Education in the United States and Canada had led to the eradication of one quarter of U. S. medical schools and radical reform of many others.

From Pennsylvania Edsall went to St. Louis as Professor of Preventive Medicine, and his part in the reform of that medical school is both controversial and fascinating.

,Edsall's appointment in 1912 to a double post at Harvard and the Massachusetts General Hospital brought him to Boston -the field of his major contributions. This remarkable period was the day of such people as Harvard's Walter Cannon, Otto Folin, Harvey Cushing, Alice Hamilton, L. J. Henderson. It saw the founding of the School of Public Health, the major endowment of the Medical School. In his ten years at the hospital and his seventeen years as dean, as in his influence as a trustee of the Rockefeller Foundation, Edsall gave direction to many developments in American medicine which bear his mark to this day.

A mere "symbol" of medicine--the sugar pill, saline injection, doctor in a white lab coat--the placebo nonetheless sometimes produces "real" results. Medical science has largely managed its discomfort with this phenomenon by discounting the placebo effect, subtracting it as an impurity in its data through double-blind tests of new treatments and drugs. This book is committed to a different perspective--namely, that the placebo effect is a "real" entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin.

Anne Harrington's introduction and a historical overview by Elaine Shapiro and the late Arthur Shapiro, which open the book, review the place of placebos in the history of medicine, investigate the current surge in interest in them, and probe the methodological difficulties of saying scientifically just what placebos can and cannot do. Combining individual essays with a dialogue among writers from fields as far-flung as cultural anthropology and religion, pharmacology and molecular biology, the book aims to expand our ideas about what the placebo effect is and how it should be seen and studied. At the same time, the book uses the challenges and questions raised by placebo phenomena to initiate a broader interdisciplinary discussion about our nature as cultural animals: animals with minds, brains, and bodies that somehow manage to integrate "biology" and "culture," "mechanism" and "meaning," into a seamless whole.

This is an auto-narrated audiobook edition of this book.

In 1992, Dr. Ross A. Slotten signed more death certificates in Chicago—and, by inference, the state of Illinois—than anyone else. As a family physician, he was trained to care for patients from birth to death, but when he completed his residency in 1984, he had no idea that many of his future patients would be cut down in the prime of their lives. Among those patients were friends, colleagues, and lovers, shunned by most of the medical community because they were gay and HIV positive. Slotten wasn’t an infectious disease specialist, but because of his unique position as both a gay man and a young physician, he became an unlikely pioneer, swept up in one of the worst epidemics in modern history.

Plague Years is an unprecedented first-person account of that epidemic, spanning not just the city of Chicago but four continents as well. Slotten provides an intimate yet comprehensive view of the disease’s spread alongside heartfelt portraits of his patients and his own conflicted feelings as a medical professional, drawn from more than thirty years of personal notebooks. In telling the story of someone who was as much a potential patient as a doctor, Plague Years sheds light on the darkest hours in the history of the LGBT community in ways that no previous medical memoir has.

Poisoning occurs in over half of Agatha Christie's many novels and stories. In fact, she used a larger number and broader selection of poisons and medicines, for a wider variety of purposes, with greater frequency, ingenuity, and scientific accuracy than any other detective fiction writer. Yet very little has been written on the use of drugs, poisons, and chemicals in Christie's fiction.

The Poisonous Pen of Agatha Christie entertainingly and authoritatively fills this gap. Michael Gerald explores the use of poisons and drugs in Christie's fiction not only to commit murder and suicide but also to incapacitate a victim, alter behavior, treat disease, or support addiction. He also analyzes her views, as expressed in her fiction and autobiography, on drug addiction, the health professions, the value of medicines, and scientific discoveries.

Especially valuable is Gerald's exhaustive listing of all drugs, poisons, and chemicals mentioned in Christie's novels and stories, with references to the work(s) in which each appears and the ways in which each is used. Other tables list all the novels and short stories and the chemicals that are used in each. Throughout, the properties of all drugs are clearly explained so that the reader needs no special scientific or medical knowledge.

The Poisonous Pen of Agatha Christie illuminates the fictional uses Christie made of her real-life experiences as a hospital drug dispenser and as a provider of nursing care. It will be of interest to fans and scholars alike.

It was not long ago that scientists proclaimed victory over polio, the dread disease of the 1950s. More recently polio resurfaced, not conquered at all, spreading across the countries of Africa. As we once again face the specter of this disease, along with other killers like AIDS and SARS, this powerful book reminds us of the personal cost, the cultural implications, and the historical significance of one of modern humanity's deadliest biological enemies. In Polio and Its Aftermath Marc Shell, himself a victim of polio, offers an inspired analysis of the disease. Part memoir, part cultural criticism and history, part meditation on the meaning of disease, Shell's work combines the understanding of a medical researcher with the sensitivity of a literary critic. He deftly draws a detailed yet broad picture of the lived experience of a crippling disease as it makes it way into every facet of human existence.

Polio and Its Aftermath conveys the widespread panic that struck as the disease swept the world in the mid-fifties. It captures an atmosphere in which polio vied with the Cold War as the greatest cause of unrest in North America--and in which a strange and often debilitating uncertainty was one of the disease's salient but least treatable symptoms. Polio particularly afflicted the young, and Shell explores what this meant to families and communities. And he reveals why, in spite of the worldwide relief that greeted Jonas Salk's vaccine as a miracle of modern science, we have much more to fear from polio now than we know.

Between 1990 and 1993, breast cancer activism became a significant political movement. The issue began to receive extensive media attention, and federal funding for breast cancer research jumped dramatically. Describing the origins of this surge in interest, Maureen Hogan Casamayou attributes it to the emergence of politically potent activism among breast cancer survivors and their supporters. Exploring the creation and development of the National Breast Cancer Coalition (NBCC), she shows how many of its key leaders were mobilized by their own traumatic experiences with the disease and its treatments.

Casamayou details the NBCC’s meteoric rise and impressive lobbying efforts, explaining how—in contrast to grassroots movements founded by dedicated individuals—the coalition grew from the simultaneous efforts of a network of women who invested their time, energy, money, and professional skills in the fight for increased funding for breast cancer research. This multiple leadership—or collective entrepreneurialism, says Casamayou—was crucial to the NBCC’s success framing the issue in the minds of the public and policymakers alike.

In 1927 the first bill to secure government support in the search for a cure for cancer was introduced to Congress. In 1971 Congress passed the Conquest of Cancer Act, which initiated a new and enlarged effort in the fight against cancer, including possible annual expenditures of up to one billion dollars. The forty-four years between these two dates have witnessed the evolution of medical research from a limited, private endeavor to a major national enterprise commanding substantial support from the federal government.

In this first historical analysis of national policy in biomedical research, Stephen Strickland examines the rise of the National Institutes for Health, tells of the recurrent struggle between elected public officials and science administrators over the pace and direction of cancer and heart disease research; analyzes the roles that key members of Congress have played in the development of medical research; and discusses the medical research lobby and its founder, Mrs. Albert D. Lasker. What emerges is a clear picture of how government officials actually formulate national policy, not only in medical research but in other areas as well.

A call to reform Catholic health care ethics, inspired by the teachings of Pope Francis

Since its first edition in 1948, the US Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services (ERD) has guided Catholic institutions in the provision of health care that reflects both the healing ministry of Jesus and the Church’s understanding of human dignity. However, while the papacy of Pope Francis and the clerical sex-abuse scandal both profoundly impacted the Catholic Church, the latest edition of the ERD does not address or reflect these transformations.

Now for the first time, Todd A. Salzman and Michael G. Lawler present an extended critical commentary on the 2018 ERD. They argue that it is problematic in a number of ways. First, the revised ERD continues to prioritize a rule-based over a personalist-based ethical method, with an emphasis on absolute norms that proscribe specific medical acts. Further, it does not take into account Pope Francis’s transforming ecclesiological, methodological, and anthropological visions, neither internally in Catholic health care institutions nor externally in collaborations between Catholic and non-Catholic health care institutions. Finally, the revised ERD provides no evidence that the bishops grasp how the clerical sex-abuse scandal and its cover-up have fundamentally undermined episcopal authority and credibility.

Salzman and Lawler propose new ways forward for US Catholic health care ethics that prioritize human dignity as their guiding principle. As there is pluralism in Catholic definitions of human dignity, there must be pluralism in the norms and directives that facilitate realizing human dignity. Pope Francis’s emphasis on the virtues of mercy and care should move the ERD forward from a focus on absolute norms in medical ethics to a focus on virtues and principles to guide both patients and health care professionals in their discerned conscientious health care decisions.

Law plays a crucial role in protecting the health of populations. Whether the public health threat is bioterrorism, pandemic influenza, obesity, or lung cancer, law is an essential tool for addressing the problem. Yet for many decades, courts and lawyers have frequently overlooked law’s critical importance to public health. Populations, Public Health, and the Law seeks to remedy that omission. The book demonstrates why public health protection is a vital objective for the law and presents a new population-based approach to legal analysis that can help law achieve its public health mission while remaining true to its own core values.

By looking at a diverse range of topics, including food safety, death and dying, and pandemic preparedness, Wendy E. Parmet shows how a population-based legal analysis that recalls the importance of populations and uses the tools of public health can enhance legal decision making while protecting both public health and the rights and liberties of individuals and their communities.