A SCHOLARLY BOOK REPOSITORY68 start with R start with R
Peard shows how the Tropicalistas adapted Western medicine and challenged the Brazilian medical status quo in order to find new answers to the old question of whether the diseases of warm climates were distinct from those of temperate Europe. They carried out innovative research on parasitology, herpetology, and tropical disorders, providing evidence that countered European assumptions about Brazilian racial and cultural inferiority. In the face of European fatalism about health care in the tropics, the Tropicalistas forged a distinctive medicine based on their beliefs that public health would improve only if large social issues—such as slavery and abolition—were addressed and that the delivery of health care should encompass groups hitherto outside the doctors’ sphere, especially women. But the Tropicalistas’ agenda, which included biting social critiques and broad demands for the extension of health measures to all of Brazil’s people, was not sustained. Race, Place, and Medicine shows how imported models of tropical medicine—constructed by colonial nations for their own needs—downplayed the connection between socioeconomic factors and tropical disorders.
This study of a neglected episode in Latin American history will interest Brazilianists, as well as scholars of Latin American, medical, and scientific history.
Scholars exploring the history of science under the Nazis have generally concentrated on the Nazi destruction of science or the corruption of intellectual and liberal values. Racial Hygiene focuses on how scientists themselves participated in the construction of Nazi racial policy. Robert Proctor demonstrates that the common picture of a passive scientific community coerced into cooperation with the Nazis fails to grasp the reality of what actually happened—namely, that many of the political initiatives of the Nazis arose from within the scientific community, and that medical scientists actively designed and administered key elements of National Socialist policy.
The book presents the most comprehensive account to date of German medical involvement in the sterilization and castration laws, the laws banning marriage between Jews and non-Jews, and the massive program to destroy “lives not worth living.” The study traces attempts on the part of doctors to conceive of the “Jewish problem” as a “medical problem,” and how medical journals openly discussed the need to find a “final solution” to Germany’s Jewish and gypsy “problems.”
Proctor makes us aware that such thinking was not unique to Germany. The social Darwinism of the late nineteenth century in America and Europe gave rise to theories of racial hygiene that were embraced by enthusiasts of various nationalities in the hope of breeding a better, healthier, stronger race of people. Proctor also presents an account of the “organic” health movement that flourished under the Nazis, including campaigns to reduce smoking and drinking, and efforts to require bakeries to produce whole-grain bread. A separate chapter is devoted to the emergence of a resistance movement among doctors in the Association of Socialist Physicians. The book is based on a close analysis of contemporary documents, including German state archives and more than two hundred medical journals published during the period.
Proctor has set out not merely to tell a story but also to urge reflection on what might be called the “political philosophy of science”—how movements that shape the policies of nations can also shape the structure and priorities of science. The broad implications of this book make it of consequence not only to historians, physicians, and people concerned with the history and philosophy of science, but also to those interested in science policy and medical ethics.
Although chemotherapy harms the immune system and is increasingly demonstrated to be an ineffective long-term cure for the vast majority of cancers, it remains the standard treatment for most cancer patients. Ruzic, a former scientific magazine publisher and originator of a science center, refused to accept this status quo, and instead plunged into the world of cutting-edge treatments, exploring the frontiers of cancer science with revolutionary results.
Ruzic went on the offensive: visiting scores of laboratories, gathering information, talking to researchers, and effectively becoming his own patient-care advocate. This book presents his findings. A scathing critique of the chemotherapy culture as well as unscientific "alternative" therapies, the book endorses state-of-the-art molecularly based technologies, making it an illuminating and necessary read for anyone interested in cancer research, especially patients and their families and physicians.
Neil Ruzic was expected to die within two years of his initial diagnosis. Five years later he has been declared cancer-free and considers himself cured.
This book raises important questions about medical experimentation and the so-called Golden Rule of medical ethics, issues of safety and professional identity, and the temptation of a powerful therapeutic tool that also posed significant risks in its formative years. In this cautionary tale of technological medical progress, Jeffrey Womack reveals how practitioners and their patients accepted uncertainty as a condition of their therapy in an attempt to alleviate human suffering.
Designed for busy medical students, The Radiology Handbook is a quick and easy reference for any practitioner who needs information on ordering or interpreting images.
The book is divided into three parts:
- Part I presents a table, organized from head to toe, with recommended imaging tests for common clinical conditions.
- Part II is organized in a question and answer format that covers the following topics: how each major imaging modality works to create an image; what the basic precepts of image interpretation in each body system are; and where to find information and resources for continued learning.
- Part III is an imaging quiz beginning at the head and ending at the foot. Sixty images are provided to self-test knowledge about normal imaging anatomy and common imaging pathology.
Published in collaboration with the Ohio University College of Osteopathic Medicine, The Radiology Handbook is a convenient pocket-sized resource designed for medical students and non radiologists.
Raising the Living Dead is a history of Puerto Rico’s carceral rehabilitation system that brings to life the interactions of incarcerated people, their wider social networks, and health care professionals. Alberto Ortiz Díaz describes the ways that multiple communities of care came together both inside and outside of prisons to imagine and enact solution-oriented cultures of rehabilitation from the 1930s to the 1960s. Scientific and humanistic approaches to well-being were deliberately fused to raise the “living dead,” an expression that reemerged in the modern Caribbean to refer to prisoners. These reform groups sought to raise incarcerated people physically, mentally, socially, spiritually, and civically.
The book is based on deep, original archival research into the Oso Blanco (White Bear) penitentiary in Puerto Rico, yet it situates its study within Puerto Rico’s broader carceral archipelago and other Caribbean prisons. The agents of this history include not only physical health professionals, but also psychologists and psychiatrists, social workers, spiritual and religious practitioners, and, of course, the prisoners and their families. By following all these groups and emphasizing the interpersonal exercise of power, Ortiz Díaz tells a story that goes beyond debates about structural and social control.
The book addresses key issues in the history of prisons and the histories of medicine and belief, including how prisoners’ different racial, class, and cultural identities shaped their incarceration and how professionals living in a colonial society dealt with the challenge of rehabilitating prisoners for citizenship.
Raising the Living Dead is not just about convicts, their immediate interlocutors, and their contexts, however, but about how together these open a window into the history of social uplift projects within the (neo)colonial societies of the Caribbean. There is no book like this in Caribbean historiography; few examine these themes in the larger literature on the history of prisons.
Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. Rationing Sanity is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care.
How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. Rationing Sanity integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care—the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill—but also how we may find more just and humane treatment for those afflicted.
O’Connor focuses on how four particularly troubling physical conditions were represented in a variety of literature. She begins by exploring how Asiatic cholera, which reached epidemic proportions on four separate occasions between 1832 and 1865, was thought to represent the dangers of cultural contamination and dissolution. The next two chapters concentrate on the problems breast cancer and amputation posed for understanding gender. After discussing how breast cancer was believed to be caused by the female body’s intolerance to urban life, O'Connor turns to men’s bodies, examining how new prosthetic technology allowed dismembered soldiers and industrial workers to reconstruct themselves as productive members of society. The final chapter explores how freak shows displayed gross deformity as the stuff of a new and improved individuality. Complicating an understanding of the Victorian body as both a stable and stabilizing structure, she elaborates how Victorians used disease as a messy, often strategically unintelligible way of articulating the uncertainties of chaotic change. Over the course of the century, O’Connor shows, the disfiguring process of disease became a way of symbolically transfiguring the self. While cholera, cancer, limb loss, and deformity incapacitated and even killed people, their dramatic symptoms provided opportunities for imaginatively adapting to a world where it was increasingly difficult to determine not only what it meant to be human but also what it meant to be alive.
Raw Material will interest an audience of students and scholars of Victorian literature, cultural history, and the history of medicine.
In Reading for Health: Medical Narratives and the Nineteenth-Century Novel, Erika Wright argues that the emphasis in Victorian Studies on disease as the primary source of narrative conflict that must be resolved has obscured the complex reading practices that emerge around the concept of health. By shifting attention to the ways that prevention of illness and the preservation of well-being operate in fiction, both thematically and structurally, Wright offers a new approach to reading character and voice, order and temporality, setting and metaphor. As Wright reveals, while canonical works by Austen, Brontë, Dickens, Martineau, and Gaskell register the pervasiveness of a conventional “therapeutic” form of action and mode of reading, they demonstrate as well an equally powerful investment in the achievement and maintenance of “health”—what Wright refers to as a “hygienic” narrative—both in personal and domestic conduct and in social interaction of the individual within the community.
• Basic Concepts: mortality trends, concepts of disease, changes in medical therapy
• Public Health: AIDS, cigarette smoking, preventive medicine, fluoridation
• Health Care Professions: cardiology, pathology, women in medicine, nursing, podiatry, midwives
• Health Care Organizations: hospitals, HMOs
• Mental Illness
• Financing Health Care
• Medical Education
• Issues: abortion, ethical issues, cancer control, prenatal care, home care, the pharmaceutical industry
• Background Readings: American medicine from 1920 to midcentury.
The readings were chosen especially for course use in history, sociology, public health, and related fields, but can also provide useful background reading for anyone interested or involved in American health care. Each selection includes an introduction, questions for the reader, and a bibliography. Scholars and students alike will find the book an invaluable resource.
The Rebirth of the Clinic begins with a bold assertion: the doctor-patient relationship is sick. Fortunately, as this engrossing book demonstrates, the damage is not irreparable. Today, patients voice their desires to be seen not just as bodies, but as whole people. Though not willing to give up scientific progress and all it has to offer, they sense the need for more. Patients want a form of medicine that can heal them in body and soul. This movement is reflected in medical school curricula, in which courses in spirituality and health care are taught alongside anatomy and physiology. But how can health care workers translate these concepts into practice? How can they strike an appropriate balance, integrating and affirming spirituality without abandoning centuries of science or unwittingly adopting pseudoscience?
Physician and philosopher Daniel Sulmasy is uniquely qualified to guide readers through this terrain. At the outset of this accessible, engaging volume, he explores the nature of illness and healing, focusing on health care's rich history as a spiritual practice and on the human dignity of the patient. Combining sound theological reflection with doses of healthy skepticism, he goes on to describe empirical research on the effects of spirituality on health, including scientific studies of the healing power of prayer, emphasizing that there are reasons beyond even promising research data to attend to the souls of patients. Finally, Sulmasy devotes special attention and compassion to the care of people at the end of life, incorporating the stories of several of his patients.
Throughout, the author never strays from the theme that, for physicians, attending to the spiritual needs of patients should not be a moral option, but a moral obligation. This book is an essential resource for scholars and students of medicine and medical ethics and especially medical students and health care professionals.
Combining theory, history, and ethnography, the contributors to this volume ground today's clinic in a larger scheme of power relations, identifying the cultural, political, and economic pressures that frame clinical relationships, including the instrumentalist definition of health, actuarial-based medical practices, and patient self-help movements, which simultaneously hem in and create the conditions under which agents creatively change ideas of illness and treatment.
From threatened community health centers in poor African American locales to innovative nursing practices among the marginally housed citizens of Canada's poorest urban neighborhood, this volume addresses not just the who, what, where, and how of place-specific clinical practices, but also sets these local experiences against a theoretical backdrop that links them to the power of modern medicine in shaping fundamental life experiences.
In Recipes and Everyday Knowledge, Elaine Leong situates recipe knowledge and practices among larger questions of gender and cultural history, the history of the printed word, and the history of science, medicine, and technology. The production of recipes and recipe books, she argues, were at the heart of quotidian investigations of the natural world or “household science”. She shows how English homes acted as vibrant spaces for knowledge making and transmission, and explores how recipe trials allowed householders to gain deeper understandings of sickness and health, of the human body, and of natural and human-built processes. By recovering this story, Leong extends the parameters of natural inquiry and productively widens the cast of historical characters participating in and contributing to early modern science.
As a student, Sadger attended Freud's lectures from 1895 through 1904. Two years later Freud nominated Sadger to his Wednesday Psychological Society (later called the Viennese Psychoanalytic Society). Sadger, however, was not part of Freud's inner circle, but more a participant observer of the early years of the psychoanalytic movement and of Freud as teacher, therapist, and clinician.
Sadger was considered one of the most devoted followers of Freud and hoped to become one of Freud's "favorite sons." At the First Psychoanalytic Congress held in Salzburg in 1908, Sadger was chosen to be one of the principal speakers along with Freud, Jones, Alder, Jung, Prince, Rifkin, Abraham, and Stekel, an honor that bespeaks Sadger's early role in the movement. But Freud and many of his disciples were also openly critical of Sadger's work, calling it at various times overly simplistic, unimaginative, reductionist, orthodox, and rigid.
In 1930 Sadger published his memoir, Sigmund Freud: Persönliche Erinnerungen. With the rise of Nazism and World War II, the book became lost to the world of psychoanalytic history. Recently, Alan Dundes learned of its existence and mounted a search that led him around the world to one of the few extant copies—in a research library in Japan. The result of his fascinating quest is Recollecting Freud, a long-lost personal account that provides invaluable insights into Freud and his social, cultural, and intellectual context.
Drawing on the controversial case of “Ashley X,” a girl with severe developmental disabilities who received interventionist medical treatment to limit her growth and keep her body forever small—a procedure now known as the “Ashley Treatment”—Reconsidering Intellectual Disability explores important questions at the intersection of disability theory, Christian moral theology, and bioethics.
What are the biomedical boundaries of acceptable treatment for those not able to give informed consent? Who gets to decide when a patient cannot communicate their desires and needs? Should we accept the dominance of a form of medicine that identifies those with intellectual impairments as pathological objects in need of the normalizing bodily manipulations of technological medicine?
In a critical exploration of contemporary disability theory, Jason Reimer Greig contends that L'Arche, a federation of faith communities made up of people with and without intellectual disabilities, provides an alternative response to the predominant bioethical worldview that sees disability as a problem to be solved. Reconsidering Intellectual Disability shows how a focus on Christian theological tradition’s moral thinking and practice of friendship with God offers a way to free not only people with intellectual disabilities but all people from the objectifying gaze of modern medicine. L'Arche draws inspiration from Jesus's solidarity with the "least of these" and a commitment to Christian friendship that sees people with profound cognitive disabilities not as anomalous objects of pity but as fellow friends of God. This vital act of social recognition opens the way to understanding the disabled not as objects to be fixed but as teachers whose lives can transform others and open a new way of being human.
Responding to the recent growth of illness and disability narratives in the United States—such works as Juliet Wittman’s Breast Cancer Journal, John Hockenberry’s Moving Violations, Paul Monette’s Borrowed Time: An AIDS Memoir, and Lou Ann Walker’s A Loss for Words: The Story of Deafness in a Family—Couser addresses questions of both poetics and politics. He examines why and under what circumstances individuals choose to write about illness or disability; what role plot plays in such narratives; how and whether closure is achieved; who assumes the prerogative of narration; which conditions are most often represented; and which literary conventions lend themselves to representing particular conditions. By tracing the development of new subgenres of personal narrative in our time, this book explores how explicit consideration of illness and disability has enriched the repertoire of life writing. In addition, Couser’s discussion of medical discourse joins the current debate about whether the biomedical model is entirely conducive to humane care for ill and disabled people.
With its sympathetic critique of the testimony of those most affected by these conditions, Recovering Bodies contributes to an understanding of the relations among bodily dysfunction, cultural conventions, and identity in contemporary America.
While solutions to these problems are complex and always have their roots in local circumstance, the essays in Recovery, Renewal, Reclaiming will inspire strategies that will clear blighted environments, deliver nourishing food, ease the lives of marginalized people, and lead to respect for all beliefs as we work together to bring balance to our environmental, physical, and spiritual health.
Challenging conventional ideas, Lawlor suggests that we look at Medicare as a contract between the federal government, the program's beneficiaries, and health care providers. Medicare reform, then, would involve rewriting this contract so that it more successfully serves the interests of both beneficiaries and taxpayers. To do this, Lawlor argues that we must improve the agency of the program—the informational, organizational, and incentive elements that assure Medicare program carries out beneficiary and taxpayer interests in providing the most appropriate, high-quality care possible. The book includes a chapter devoted solely to concepts and applications that give definition to this brand of agency theory. Lawlor's innovative agency approach is matched with lucid explanation of the more comprehensive groundwork in the history and politics of the Medicare program.
Lawlor's important and timely book reframes the Medicare debate in a productive manner and effectively analyzes alternatives for reform. Lawlor argues that effective policy design for Medicare requires greater appreciation of the vulnerability of beneficiaries, the complexity of the program itself, its wide geographical variations in services and financing, and the realistic possibilities for government and private sector roles. Tackling difficult problems like end-of-life and high-tech care—and offering sensible solutions—Redesigning the Medicare Contract will interest political scientists, economists, policy analysts, and health care professionals alike.
There are few issues more explosive than guns. "Guns don't kill people, people kill people," is an often-heard response to calls for firearm control. But are there ways to make guns safer without placing further restrictions on gun owners? Can guns be engineered to reduce the number and severity of injuries?
This book is about guns and new solutions for addressing problems they create. Trudy Karlson and Stephen Hargarten, two experts in public health and injury control, show readers how guns are products, designed to injure and kill, and how changes in the design, technology, and marketing of firearms can lead to reductions in the number of injuries and fatalities.
Just as innovations in the design and technology of motor vehicles succeeded in creating safer cars, Karlson and Hargarten describe how responsible changes to gun products can reduce the number of serious injuries and fatalities. The injury control perspective illustrates how the characteristics of guns and ammunition are associated with their ability to cause injury and death. It also provides options for how guns can be re-engineered to ensure a greater degree of safety and protection. Reducing Firearm Injury and Death teaches basic facts about guns and gun injuries, and by reframing the problem of firearms as a public health issue, offers hope for saving lives.
Sir Charles Scott Sherrington is credited with having single-handedly crystallized the field of neurophysiology. Judith Swazey’s study is the first book-length treatment of his early research, from the 1880s through the publication of The Integrative Action of the Nervous System in 1906. In this work he offered an experimentally documented account of how the nervous system, through the mechanism of reflex action, produces a coordinated motor organism. Swazey first analyzes the development of the concept of integrative action and then discusses the significance of the concept for neurophysiology and, on a broader level, for the nature of biological thought.
Focusing on the interests, events, and influences that shaped Sherrington’s career, the author surveys the relevant knowledge about reflex action and the functional anatomy of the spinal cord at the time he began his research. Continuing with a detailed analysis of the major lines of his work she covers such material and the anatomical studies of spinal degeneration, the mapping of sensory and motor root distribution in the macaque monkey, the role of sensory nerves in and from muscles, and the nature of reciprocal innervation.
The scope of Sherrington’s contributions—which included new and important techniques, apparatus, and methodological canons—clearly marks him as a major figure in the history of the neurosciences. The greater significance of his work, however, lies in his “synthetic attitude” in the fact that he perceived the interrelatedness of his varied researches. The integrative action concept and the data it embodied finally brought together the previously unconnected channels of neurophysiological, anatomical, and histological research. As a result of this unification, Sherrington was able to provide investigators of the nervous system with their first major paradigm and to establish guidelines which altered the course of scientific research after 1906.
The author has gathered a vast amount of material from published and unpublished sources for this comprehensive study of Sherrington’s life and work. Her analysis of his writings, her portrayal of his delightful and extraordinary personality, and her account of the scientific setting within which his work was carried out provide a model for historians of science.
Examining the health care market in a historical framework, Drake analyzes the forces and events that have shaped American health care in the twentieth century and sheds new light on why and how our health care system has dampened competitive market forces and failed to provide sound value for much of our health care expenditures. He examines the roles that physicians, hospitals, insurance companies, businesses, individual consumers, and government legislation have played in creating a provider-dominated market in which the cost of care has been concealed from consumers. Comparing U.S. health care expenditures with those of other developed countries, he concludes that a significant part of our health care problem is the style of medicine practiced in the United States, which is much more specialized and high tech than in other developed nations.
Drake develops proposals for health care financing reform that consider the political and economic difficulties involved. He first examines the Clinton health care reform plan and makes specific recommendations for revisions that would improve its likelihood of controlling costs. He then offers an alternative proposal that would both maintain the principle of universal, noncancelable coverage and eliminate the flaws in the market for health care services by giving consumers a financial stake in cost containment.
This timely argument, combining economic and historical analysis with thoughtful consideration of the motivating humanitarian and political concerns, will be of interest to everyone seeking to understand and to reform our ailing health care system.
The Supreme Court has ruled that states may prohibit physician-assisted suicide. Expressing the views of his fellow justices, Chief Justice Rehnquist wrote, "Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide. Our holding permits this debate to continue." Regulating How We Die is certain to be a landmark contribution to that debate.Dr. Linda Emanuel--one of America's most influential medical ethicists--has assembled leading experts to provide not only a clear account of the arguments for and against physician-assisted suicide and euthanasia but also historical, empirical, and legal perspectives on this complicated issue. These contributors include Marcia Angell, George Annas, Susan Wolf, and many others.
The important questions are addressed here, including: What does mercy dictate? Does physician-assisted suicide honor or violate autonomy? Is it more dignified than natural death? Is this decision purely a private matter? Will legalizing physician-assisted suicide put us on a slippery slope toward involuntary euthanasia? And, in an analysis of data not available in any other book, what can we learn from Holland, the only country in which physician-assisted suicide and euthanasia are legal?
Regulating How We Die will be essential reading for anyone who has been handed a terminal diagnosis, for people close to those facing such a diagnosis, for professionals, including physicians, nurses, pastors, lawyers, legislators--indeed, for anyone who has considered the moral and political debate over doctor-assisted suicide.
In Reinventing Food Banks and Pantries, Katie Martin argues that if handing out more and more food was the answer, we would have solved the problem of hunger decades ago. Martin instead presents a new model for charitable food, one where success is measured not by pounds of food distributed but by lives changed. The key is to focus on the root causes of hunger. When we shift our attention to strategies that build empathy, equity, and political will, we can implement real solutions.
Martin shares those solutions in a warm, engaging style, with simple steps that anyone working or volunteering at a food bank or pantry can take today. Some are short-term strategies to create a more dignified experience for food pantry clients: providing client choice, where individuals select their own food, or redesigning a waiting room with better seating and a designated greeter. Some are longer-term: increasing the supply of healthy food, offering job training programs, or connecting clients to other social services. And some are big picture: joining the fight for living wages and a stronger social safety net.
These strategies are illustrated through inspiring success stories and backed up by scientific research. Throughout, readers will find a wealth of proven ideas to make their charitable food organizations more empathetic and more effective. As Martin writes, it takes more than food to end hunger. Picking up this insightful, lively book is a great first step.
There are more psychoanalytic theories today than anyone knows what to do with, and the heterogeneity and complexity of the entire body of psychoanalytic though have become staggering. In Relational Concepts in Psychoanalysis, Stephen A. Mitchell weaves strands from the principal relational-model traditions (interpersonal psychoanalysis, British school object-relations theories, self psychology, and existential psychoanalysis) into a comprehensive approach to many of the knottiest problems and controversies in theoretical and clinical psychoanalysis.
Mitchell’s earlier book, Object Relations in Psychoanalytic Theory, co-authored with Jay Greenberg, set the stage for this current integration by providing a broad comparative analysis of important thinking on the nature of human relationships. In that classic study Greenberg and Mitchell distinguished between two basic paradigms: the drive model, in which relations with others are generated and shaped by the need for drive gratifications, and various relational models, in which relations themselves are taken as primary and irreducible. In Relational Concepts in Psychoanalysis, Mitchell argues that the drive model has since outlived its usefulness. The relational model, on the other hand, has been developed piecemeal by different authors who rarely acknowledge and explore the commonality of their assumptions or the rich complementarity of their perspectives.
In this bold effort at integrative theorizing, Mitchell draws together major lines of relational-model traditions into a unified framework for psychoanalytic thought, more economical than the anachronistic drive model and more inclusive than any of the singular relational approaches to the core significance of sexuality, the impact of early experience, the relation of the past to the present, the interpenetration of illusion and actuality, the centrality of the will, the repetition of painful experience, the nature of analytic situation, and the process of analytic change. As such, his book will be required reading for psychoanalytic scholars, practitioners, candidates in psychoanalysis, and students in the field.
Sasaks, a people of the Indonesian archipelago, cope with one of the country's worst health records by employing various medical traditions, including their own secret ethnomedical knowledge. But anxiety, in the presence and absence of illness, profoundly shapes the ways Sasaks use healing and knowledge. Hay addresses complex questions regarding cultural models, agency, and other relationships to conclude that the ethnomedical knowledge they use to cope with their illnesses ironically inhibits improvements in their health care.
M. Cameron Hay is a NSF Advance Fellow and an Assistant Adjunct Professor at the UCLA Center for Culture and Health.
The Renewal of Generosity evokes medicine as the face-to-face encounter that comes before and after diagnostics, pharmaceuticals, and surgeries. Frank calls upon the Roman emperor Marcus Aurelius, philosopher Emmanuel Levinas, and literary critic Mikhail Bakhtin to reflect on stories of ill people, doctors, and nurses who transform demoralized medicine into caring relationships. He presents their stories as a source of consolation for both ill and professional alike and as an impetus to changing medical systems. Frank shows how generosity is being renewed through dialogue that is more than the exchange of information. Dialogue is an ethic and an ideal for people on both sides of the medical encounter who want to offer more to those they meet and who want their own lives enriched in the process.
The Renewal of Generosity views illness and medical work with grace and compassion, making an invaluable contribution to expanding our vision of suffering and healing.
In Replacement Parts, internationally recognized bioethicist Arthur L. Caplan and coeditors James J. McCartney and Daniel P. Reid assemble seminal writings from medicine, philosophy, economics, and religion that address the ethical challenges raised by organ transplantation. Caplan's new lead essay explains the shortfalls of present policies. From there, book sections take an interdisciplinary approach to fundamental issues like the determination of death and the dead donor rule; the divisive case of using anencephalic infants as organ donors; the sale of cadaveric or live organs; possible strategies for increasing the number of available organs, including market solutions and the idea of presumed consent; and questions surrounding transplant tourism and "gaming the system" by using the media to gain access to organs.
Timely and balanced, Replacement Parts is a first-of-its-kind collection aimed at surgeons, physicians, nurses, and other professionals involved in this essential lifesaving activity that is often fraught with ethical controversy.
Residents of Haiti-one of the poorest and most unstable countries in the world-face a grim reality of starvation, violence, lack of economic opportunity, and minimal health care. For years, aid organizations have sought to alleviate the problems by creating health and family planning clinics, including one modern (and, by local standards, luxurious) center in the heart of Cit Soleil. During its height of service in the 1980s and 1990s, the clinic boasted nineteen staff members, an array of modern contraceptives, an accessible location, and convenient hours-but very few clients.
Why did this initiative fail so spectacularly despite surveys finding that residents would like to have fewer children? Why don't poor women heed the message of family planning, when smaller families seem to be in their best interest? In Reproducing Inequities, M. Catherine Maternowska argues that we too easily overlook the political dynamics that shape choices about family planning. Through a detailed study of the attempt to provide modern contraception in the community of Cit Soleil, Maternowska demonstrates the complex interplay between local and global politics that so often thwarts well-intended policy initiatives.
Medical anthropologists, she argues, have an important role to play in developing new action plans for better policy implementation. Ethnographic studies in desperate, dangerous locations provide essential data that can point the way to solutions for the dilemmas of contraception in poor communities worldwide.
A North Carolina woman dies of a flesh-eating bacterial disease. Thousands of people in West Africa are suffering from cholera. And antibiotics are rapidly becoming less and less effective at fighting what were once mild infections. The biggest threat to the future of human society may not be terrorist attacks or nuclear war, but rather microscopic bacteria. Immunologist Norbert Gualde explains in Resistance the dangers we face from bacterial resistance, asserting that we must confront the reality awaiting us--the next fatal plague may occur sooner than we think.
Over the course of the twentieth century, incredible advances in medicine inspired a utopian belief among many that all common infectious diseases would eventually be eradicated. But Resistance shows that this dream is an impossible one. The book’s riveting narrative reveals how new infectious agents and diseases are being discovered every day and how bacteria previously thought to have been destroyed are returning with a vengeance. Drawing upon the history of past epidemics, Gualde explores how new outbreaks might be predicted and controlled. He also investigates the potentially devastating social and political impact of such public health disasters, particularly in underdeveloped countries in the southern hemisphere. He ultimately argues that the constant interaction between man and microorganisms will inevitably catalyze future epidemics similar to the horrific ones of centuries past.
Global outbreak monitoring and medical research on the human body’s immune system are beginning to produce effective strategies against bacterial resistance. But the most important weapon is awareness of the crisis, and this engrossing and brilliantly translated study will serve as a wake-up call for us all.
Presenting bioethics as a practical, educational activity rather than an abstract intellectual exercise, this important volume shows how dialogue between patients and health care providers can clarify both medical and ethical issues, promoting patient autonomy and advancing health care.
Yet, more are noticing and research confirms that self-care is needed, not only for personal sanity but also for quality of work. Unwell medical professionals are not the best at treating others. And this self-care includes not just rest, food, and water, but a deeper care, one that tends the spiritual side as well.
To both the spiritually active and the spiritually resistant, hospital chaplain William Dorman offers a guide to understand a more comprehensive, full-bodied self-care. Each chapter begins with case studies, concrete experiences that help unpack abstract concepts which bring much needed peace to stressed individuals. Dorman also structures each chapter to end with prayers and action steps, which offer more concrete ways to care for the self.
From working as a hospital chaplain for over 18 years, and serving as the director of chaplaincy services for the largest integrated health care system in New Mexico, Rev. Dorman recognizes the stresses that come to those who have made it their profession to heal others. Healers need healing too—and this guide is the first step.
States are increasingly important players in the current efforts to reform U.S. health care, as the federal government withdraws from this responsibility. Robert B. Hackey analyzes the varied routes states have taken in reformulating health care policy and provides a road map of what specific strategies work and why.
In this comparative case study, Hackey focuses on four states—Massachusetts, New Hampshire, New York and Rhode Island—that have had markedly different experiences with regulating health care over the past two decades. Hackey's detailed comparisons show how the states' policies changed over time, moving from regulatory to market-oriented solutions, and examines which policy programs appear best poised to meet the future.
Hackey uses regime theory to explain how the states' policy choices concerning cost control and entry regulation were shaped by the prevailing political culture and institution of each state. He concludes that the autonomy of state government form special interests is vital to the successful adoption, implementation and outcome of state initiatives.
Rethinking Health Care Policy offers policymakers, planners and specialists useful insights into the politics of state regulation and into future directions for health care reform.
Hypothyroidism, also commonly referred to as Hashimoto’s disease, affects millions in the United States alone. It occurs when the thyroid—the butterfly-shaped gland that sits in your neck right above the front of your shirt collar—malfunctions or after thyroid surgery, causing thyroid hormone levels in circulation to drop below normal. Thus, treatment is aimed at bringing these hormone levels back to normal. This is done with daily tablets of thyroxine or T4. Because hypothyroidism is so common, we likely know someone who is on this type of medication. While most patients respond well to this standard treatment, about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing these symptoms to be unrelated to the thyroid disease. In Rethinking Hypothyroidism, Dr. Antonio C. Bianco, a physician and a scientist who has studied hypothyroidism and thyroid hormones for decades, offers an accessible overview of the disease’s treatment and the role of big pharma in shaping it, making the case that the current approach is failing many patients. But more than this, Bianco calls for alternatives to improve lives, and he equips patients and their families with the tools to advocate for other treatments.
In this primer for patients, their families, and their doctors, a leading physician and scientist explains why the standard treatment for hypothyroidism fails many—and offers an empowering call for change.
Hypothyroidism, also commonly referred to as Hashimoto’s disease, affects millions in the United States alone. It occurs when the thyroid—the butterfly-shaped gland that sits in your neck right above the front of your shirt collar—malfunctions or after thyroid surgery, causing thyroid hormone levels in circulation to drop below normal. Thus, treatment is aimed at bringing these hormone levels back to normal. This is done with daily tablets of thyroxine or T4. Because hypothyroidism is so common, we likely know someone who is on this type of medication. While most patients respond well to this standard treatment, about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing these symptoms to be unrelated to the thyroid disease. In Rethinking Hypothyroidism, Dr. Antonio C. Bianco, a physician and a scientist who has studied hypothyroidism and thyroid hormones for decades, offers an accessible overview of the disease’s treatment and the role of big pharma in shaping it, making the case that the current approach is failing many patients. But more than this, Bianco calls for alternatives to improve lives, and he equips patients and their families with the tools to advocate for other treatments.
This intimate memoir—tenuous, shifting, sometimes humorous—demonstrates Skloot’s considerable literary skill honed as an award-winning essayist, memoirist, novelist, and poet. His recollections of a strange, spinning world prompt further musings on the forces of uncertainty, change, and displacement that have shaped him from childhood to late middle age, repeatedly knocking him awry, realigning his hopes and plans, even his perceptions. From the volatile forces of his mercurial, shape-shifting early years to his obsession with reading, acting, and writing, from the attack of vertigo to a trio of postvertigo (but nevertheless dizzying) journeys to Spain and England, and even to a place known only in his mother’s unhinged fantasies, Skloot makes sense of a life’s phantasmagoric unpredictability.
Finalist, Sarah Winnemucca Award for Creative Nonfiction, Oregon Book Awards
Revolutionizing Women’s Healthcare is the story of a feminist experiment: the self-help movement. This movement arose out of women’s frustration, anger, and fear for their health. Tired of visiting doctors who saw them as silly little girls, suffering shame when they asked for birth control, seeking abortions in back alleys, and holding little control over their own reproductive lives, women took action. Feminists created “self-help groups” where they examined each other’s bodies and read medical literature. They founded and ran clinics, wrote books, made movies, undertook nationwide tours, and raided and picketed offending medical institutions. Some performed their own abortions. Others swore off pharmaceuticals during menopause. Lesbian women found “at home” ways to get pregnant. Black women used self-help to talk about how systemic racism affected their health. Hannah Dudley-Shotwell engagingly chronicles these stories and more to showcase the creative ways women came together to do for themselves what the mainstream healthcare system refused to do.
2016 CCCC Best Book Award in Technical and Scientific Communication
In the past ten years, we have seen great changes in the ways government organizations and media respond to and report on emerging global epidemics. The first outbreak to garner such attention was SARS (severe acute respiratory syndrome). In Rhetoric of a Global Epidemic, Huiling Ding uses SARS to explore how various cultures and communities made sense of the epidemic and communicated about it. She also investigates the way knowledge production and legitimation operate in global epidemics, the roles that professionals and professional communicators, as well as individual citizens, play in the communication process, points of contention within these processes, and possible entry points for ethical and civic intervention.
Focusing on the rhetorical interactions among the World Health Organization, the United States, China, and Canada, Rhetoric of a Global Epidemic investigates official communication and community grassroots risk tactics employed during the SARS outbreak. It consists of four historical cases, which examine the transcultural risk communication about SARS in different geopolitical regions at different stages. The first two cases deal with risk communication practices at the early stage of the SARS epidemic when it originated in southern China. The last two cases move to transcultural rhetorical networks surrounding SARS.
With such threats as SARS, avian flu, and swine flu capturing the public imagination and prompting transnational public health preparedness efforts, the need for a rhetoric of global epidemics has never been greater. Government leaders, public health officials, health care professionals, journalists, and activists can learn how to more effectively craft and manage transcultural risk communication from Ding’s examination of the complex and varied modes of communication around SARS. In addition to offering a detailed case study, Rhetoric of a Global Epidemic provides a critical methodology that professional communicators can use in their investigations of epidemics and details approaches to facilitating more open, participatory risk communication at all levels.
As psychoanalysis approaches its second century, it seems no closer to being a science than when Freud first invented the discipline. All the clinical experience of the past hundred years, Donald Spence tells us in this trenchant book, has not overcome a tendency to decouple theory from evidence. Deprived of its observational base, theory operates more like shared fantasy. In support of this provocative claim, Spence mounts a powerful critique of the way psychoanalysis functions—as a clinical method and as a scholarly discipline or “science.” In the process, he prescribes an antidote for the uncontrolled rhetoric that currently governs psychoanalytic practice.
The reliance on rhetoric is the problem Spence identifies, and he attributes the troubling lack of progress in psychoanalysis to its outmoded method of data collection and its preference for fanciful argument over hard fact. Writing to Jung in 1911, Freud admitted that he “was not at all cut out to be an inductive researcher—I was entirely meant for intuition.” His intuitive approach led him to retreat form traditional Baconian principles of inductive investigation and to move toward a more Aristotelian approach that emphasized choice specimens and favorite examples, played down replication, and depended on arguments based on authority. Detailing this development, with particular attention to the role of self-analysis in the Freudian myth and the evidential drawbacks of the case study genre, Spence shows how psychoanalysis was set on its present course and how rhetorical maneuvers have taken the place of evidence.
With this diagnosis, Spence offers a remedy—an example of the sort of empirical research that can transform clinical wisdom into useful knowledge. His book holds out the hope that, by challenging the traditions and diminishing the power rhetoric, psychoanalysis can remain a creative enterprise, but one based on a solid scientific foundation.
This is a historical review of the development of our knowledge of the clinical picture, etiology, pathogenesis, and prevention of rheumatic fever and rheumatic heart disease over the past four centuries. Benedict Massell examines the major contributions of both clinicians and investigators to our current understanding of rheumatic fever as a separate disease form.
Elucidating many facts about this dread disease, Massell examines the frequent epidemics in training camps during World War II, discusses our growing understanding of the pathogenesis and mechanisms by which streptococcal infections cause the disease, and shows the important progress made in prevention through the use of penicillin and other antibiotics. He includes a discussion of the many problems which can hinder our understanding and control of this disease, as well as recent promising developments in the clarification of the molecular structure of the streptococcal protein and the possible application of this information to the development of a safe and effective vaccine for the prevention of streptococcal infection.
Rheumatic Fever in America and Britain is the first book to examine comprehensively a disease that has been a moving target for physicians and health care workers. A disease of skin, brain, heart, connective tissue, blood, tonsils, and joints bound to a member of the streptococcus family of bacteria, this illness has practically disappeared from the present-day scene. Yet in 1940 more than one million Americans suffered from the heart disease that followed the ravages of rheumatic fever. It struck nearly 2 percent of all school-aged children, filling hospitals, convalescent homes, and special schools.
Rheumatic fever rose in prevalence throughout the nineteenth century, reaching its peak in that century's last decades, and then steadily declined-both in occurrence and severity-throughout the twentieth century. In the nineteenth century, acute rheumatic fever was largely a disease of children and young adults. Another remarkable epidemiological change occurred during the twentieth century; rheumatic fever shifted its character, became milder, and in doing so allowed its victims to live longer, if disabled lives. As this disease so altered, adults increasingly became its victims.
Dr. Peter C. English explores both the shifting biological nature of this disease and the experiences of physicians and patients who fought its ravages. Using insights from biology, epidemiology, and social history, Dr. English-both a physician and medical historian-is uniquely suited to unravel this disease's epidemiological and cultural complexities.
Anderson provides the context from which Selzer’s writing grows and a concept of language adequate to his purposes and accomplishments. He takes a careful look at Selzer’s writing to demonstrate that these abstract considerations do tell us why a surgeon would write. The works Anderson examines are "Jonah and the Whale" (an important early short story) and the first three essays in Mortal Lessons. These examples show the reader exactly how the symbols of literature interact directly with the world and the everyday communications of both writer and reader. According to Anderson, Mortal Lessons is also Selzer’s most artistic statement of his own sense of why and how he became a writer.
Selzer’s books include Rituals of Surgery, Mortal Lessons, Confessions of a Knife, Letters to a Young Doctor, and Taking the World in for Repairs.
More than ten million children suffer from severe acute malnutrition globally each year. In Uganda, longstanding efforts to understand, treat, and then prevent the condition initially served to medicalize it, in the eyes of both biomedical personnel and Ugandans who brought their children to the hospital for treatment and care. Medicalization meant malnutrition came to be seen as a disease—as a medical emergency—not a preventable condition, further compromising nutritional health in Uganda.
Rather than rely on a foreign-led model, physicians in Uganda responded to this failure by developing a novel public health program known as Mwanamugimu. The new approach prioritized local expertise and empowering Ugandan women, blending biomedical knowledge with African sensibilities and cultural competencies.
In The Riddle of Malnutrition, Jennifer Tappan examines how over the course of half a century Mwanamugimu tackled the most fatal form of childhood malnutrition—kwashiorkor—and promoted nutritional health in the midst of postcolonial violence, political upheaval, and neoliberal resource constraints. She draws on a diverse array of sources to illuminate the interplay between colonialism, the production of scientific knowledge, and the delivery of health services in contemporary Africa.
There are few issues more divisive than what has become known as “the right to die.” One camp upholds “death with dignity,” regarding the terminally ill as autonomous beings capable of forming their own judgment on the timing and process of dying. The other camp advocates “sanctity of life,” regarding life as intrinsically valuable, and that should be sustained as long as possible. Is there a right answer?
Raphael Cohen-Almagor takes a balanced approach in analyzing this emotionally charged debate, viewing the dispute from public policy and international perspectives. He offers an interdisciplinary, compelling study in medicine, law, religion, and ethics. It is a comprehensive look at the troubling question of whether physician-assisted suicide should be allowed. Cohen-Almagor delineates a distinction between active and passive euthanasia and discusses legal measures that have been invoked in the United States and abroad. He outlines reasons non-blood relatives should be given a role in deciding a patient’s last wishes. As he examines euthanasia policies in the Netherlands and the 1994 Oregon Death with Dignity Act, the author suggests amendments and finally makes a circumscribed plea for voluntary physician-assisted suicide.
In 1988, a new health care system, the Sistema Único de Saúde (Unified Health Care System or SUS) was formally established in Brazil. The system was intended, among other goals, to provide universal access to health care services and to redefine health as a citizen’s right and a duty of the state. A Right to Health explores how these goals have unfolded within an urban peripheral community located on the edges of the northeastern city of Fortaleza. Focusing on the decade 1998–2008 and the impact of health care reforms on one low-income neighborhood, Jessica Jerome documents the tensions that arose between the ideals of the reforms and their entanglement with pervasive socioeconomic inequality, neoliberal economic policy, and generational tension with the community.
Using ethnographic and historical research, the book traces the history of political activism in the community, showing that, since the community’s formation in the early 1930s, residents have consistently fought for health care services. In so doing, Jerome develops a multilayered portrait of urban peripheral life and suggests that the notion of health care as a right of each citizen plays a major role not only in the way in which health care is allocated, but, perhaps more importantly, in how health care is understood and experienced.
As April R. Haynes shows, the crusade against female masturbation was rooted in a generally shared agreement on some major points: that girls and women were as susceptible to masturbation as boys and men; that “self-abuse” was rooted in a lack of sexual information; and that sex education could empower women and girls to master their own bodies. Yet the groups who made this education their goal ranged widely, from “ultra” utopians and nascent feminists to black abolitionists. Riotous Flesh explains how and why diverse women came together to popularize, then institutionalize, the condemnation of masturbation, well before the advent of sexology or the professionalization of medicine.
In Risk and Adaptation in a Cancer Cluster Town, Laura Hart examines another understudied dimension of community inaction: the role of emotion and its relationship to community experiences of social belonging and inequality. Using a cancer cluster community in Northwest Ohio as a case study, Hart advances an approach to risk that grapples with the complexities of community belonging, disconnect, and disruption in the wake of suspected industrial pollution. Her research points to a fear driven not only by economic anxiety, but also by a fear of losing security within the community—a sort of pride that is not only about status, but connectedness. Hart reveals the importance of this social form of risk—the desire for belonging and the risk of not belonging—ultimately arguing that this is consequential to how people make judgements and respond to issues. Within this context where the imperative for self-protection is elusive, affected families experience psychosocial and practical conflicts as they adapt to cancer as a way of life. Considering a future where debates about risk and science will inevitably increase, Hart considers possibilities for the democratization of risk management and the need for transformative approaches to environmental justice.
Exploring the transformation of health care over the last several decades that has led doctors to become more attentive to treating risk than treating symptoms or curing disease, Aronowitz shows how many aspects of the health system and clinical practice are now aimed at risk reduction and risk control. He argues that this transformation has been driven in part by the pharmaceutical industry, which benefits by promoting its products to the larger percentage of the population at risk for a particular illness, rather than the smaller percentage who are actually affected by it. Meanwhile, for those suffering from chronic illness, the experience of risk and disease has been conflated by medical practitioners who focus on anticipatory treatment as much if not more than on relieving suffering caused by disease. Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz argues that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty.
Risky Medicine is a timely call for a skeptical response to medicine’s obsession with risk, as well as for higher standards of evidence for risk-reducing interventions and a rebalancing of health care to restore an emphasis on the actual curing of and caring for people suffering from disease.
Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing is the first book-length study of the rhetoric inherent in and surrounding HIV testing. In addition to providing a history of HIV testing in the United States from 1985 to the present, J. Blake Scott explains how faulty arguments about testing’s power and effects have promoted unresponsive and even dangerous testing practices for so-called healthy subjects as well as those deemed risky.A new afterword to the paperback edition discusses changes in testing technology, treatments, and public health responses in the last ten years. The ultimate goal of Risky Rhetoric is to offer strategies to policy makers, HIV educators and test counselors, and other rhetors for developing more responsive and egalitarian testing-related rhetorics and practices.
Winner of the Ellii Kongas-Maranda Prize from the Women's Section of the American Folklore Society, 2003.
Ritual Medical Lore of Sephardic Women preserves the precious remnants of a rich culture on the verge of extinction while affirming women's pivotal role in the health of their communities. Centered around extensive interviews with elders of the Sephardic communities of the former Ottoman Empire, this volume illuminates a fascinating complex of preventive and curative rituals conducted by women at home--rituals that ensured the physical and spiritual well-being of the community and functioned as a vital counterpart to the public rites conducted by men in the synagogues.
Isaac Jack Lévy and Rosemary Lévy Zumwalt take us into the homes and families of Sephardim in Turkey, Israel, Greece, the former Yugoslavia, and the United States to unravel the ancient practices of domestic healing: the network of blessings and curses tailored to every occasion of daily life; the beliefs and customs surrounding mal ojo (evil eye), espanto (fright), and echizo (witchcraft); and cures involving everything from herbs, oil, and sugar to the powerful mumia (mummy) made from dried bones of corpses.
For the Sephardim, curing an illness required discovering its spiritual cause, which might be unintentional thought or speech, accident, or magical incantation. The healing rituals of domesticated medicine provided a way of making sense of illness and a way of shaping behavior to fit the narrow constraints of a tightly structured community. Tapping a rich and irreplaceable vein of oral testimony, Ritual Medical Lore of Sephardic Women offers fascinating insight into a culture where profound spirituality permeated every aspect of daily life.
At the center of the debate over complementary and alternative medicine—from acupuncture and chiropractic treatments to homeopathy and nutritional supplements—is how to scientifically measure the effectiveness of a particular treatment. Fourteen scholars from the fields of medicine, philosophy, sociology, and cultural and folklore studies examine that debate, and the clash between growing public support and the often hostile stance of clinicians and medical researchers.
Proponents and critics have different methodologies and standards of evidence—raising the question of how much pluralism is acceptable in a medical context—particularly in light of differing worldviews and the struggle to define medicine in the modern world. The contributors address both the methodological problems of assessment and the conflicting cultural perspectives at work in a patient's choice of treatment. Sympathetic to CAM, the contributors nonetheless offer careful critiques of its claims, and suggest a variety of ways it can be taken seriously, yet subject to careful scrutiny.
In Romancing the Sperm, Diane Tober explores the intersections between sperm donation and the broader social and political environment in which “modern families” are created and regulated. Through tangible and intimate stories, this book provides a captivating read for anyone interested in family and kinship, genetics and eugenics, and how ever-expanding assisted reproductive technologies continue to redefine what it means to be human.
This journal issue explores the political dimensions of the rollout of the ACA and the attendant backlash. Contributors Helen Levy, Andrew Ying, and Nicholas Bagley argue that despite repeated efforts at repeal, over 80 percent of the Act has been implemented as it was originally intended. Julianna Pacheco, Jake Haselswerdt, and Jamila Michener show that when Republican governors support Medicaid expansion, Republican voters become more favorable toward the ACA, and polarization between Republican and Democrat voters decreases. Yet Charles Courtemanche, James Marton, and Aaron Yelowitz find little impact of the ACA on voter participation. Lisa Beauregard and Edward Miller examine states’ adoption of the ACA’s home and community-based care services for the elderly and people with disabilities, finding that states with more liberal elected officials and more fiscal capacity were more likely to adopt these provisions. Paul Shafer, David Anderson, Seciah Aquino, Laura Baum, Erika Franklin Fowler, and Sarah Gollust probe the role of different types of health insurance and political advertising on insurance enrollment. Richard Fording and Dana Patton explain the emergence of contentious Medicaid work requirements and patient co-pays that limit access to Medicaid.
Other contributors address how the ACA affects marginalized populations. Carrie Fry, Thomas McGuire, and Richard Frank link Medicaid expansion to lower rates of recidivism among the formerly incarcerated. Radhika Gore, Ritu Dhar, Sadia Mohaimin, Priscilla Lopez, Anna Divney, Jennifer Zanowiak, Lorna Thorpe, and Nadia Islam study primary care practices serving South Asian immigrants in New York City and highlight the importance of social context and organizational constraints in designing population health interventions. The issue also examines the economic effects of the ACA, especially on access to private and public health insurance. Both Mark Hall and Jean Abraham study instability in ACA health insurance markets, with Hall focusing on uncertainty arising from political factors and Abraham examining the factors that lead local markets to face high premiums and low insurer participation. Philip Rocco and Andrew Kelly explore the mechanisms included in the ACA to try to spur innovations in care delivery that both improve health and generate long-term cost savings.
As the COVID-19 pandemic affects healthcare in unprecedented ways, affordable healthcare access is critical. This RSF journal issue offers a timely, thoughtful consideration of one of the most pressing issues in American life.
In Rum Maniacs, Matthew Warner Osborn reveals how and why pathological drinking became a subject of medical interest, social controversy, and lurid fascination in the early American republic. At the heart of that story is the disease that Poe suffered: delirium tremens. First described in 1813, delirium tremens and its characteristic hallucinations inspired sweeping changes in how the medical profession saw and treated the problems of alcohol abuse. Based on new theories of pathological anatomy, human physiology, and mental illness, the new diagnosis founded the medical conviction and popular belief that habitual drinking could become a psychological and physiological disease. By midcentury, delirium tremens had inspired a wide range of popular theater, poetry, fiction, and illustration. This romantic fascination endured into the twentieth century, most notably in the classic Disney cartoon Dumbo, in which a pink pachyderm marching band haunts a drunken young elephant. Rum Maniacs reveals just how delirium tremens shaped the modern experience of alcohol addiction as a psychic struggle with inner demons.
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