Title: Under the medical gaze: facts and fictions of chronic pain
Author: Greenhalgh, Susan
Published: University of California Press,  2001
Subjects: Anthropology | Folklore and Mythology | Medical Anthropology | Physical Anthropology | Cultural Anthropology | Medicine | Gender Studies | Sociology | Social Problems | Social Problems
Publisher's Description: This compelling account of the author's experience with a chronic pain disorder and subsequent interaction with the American health care system goes to the heart of the workings of power and culture in the biomedical domain. It is a medical whodunit full of mysterious misdiagnosis, subtle power plays, and shrewd detective work. Setting a new standard for the practice of autoethnography, Susan Greenhalgh presents a case study of her intense encounter with an enthusiastic young specialist who, through creative interpretation of the diagnostic criteria for a newly emerging chronic disease, became convinced she had a painful, essentially untreatable, lifelong muscle condition called fibromyalgia. Greenhalgh traces the ruinous effects of this diagnosis on her inner world, bodily health, and overall well-being. Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. Greenhalgh ultimately learns that she had been misdiagnosed and begins the long process of undoing the physical and emotional damage brought about by her nearly catastrophic treatment. In considering how things could go so awry, she embarks on a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical discourse and practice in the United States. She develops fresh arguments about the power of medicine to medicalize our selves and lives, the seductions of medical science, and the deep, psychologically rooted difficulties women patients face in interactions with male physicians. In the end, Under the Medical Gaze goes beyond the critique of biomedicine to probe the social roots of chronic pain and therapeutic alternatives that rely on neither the body-cure of conventional medicine nor the mind-cure of some alternative medicines, but rather a broader set of strategies that address the sociopolitical sources of pain.   [brief]
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Title: American medicine: the quest for competence
Author: Good, Mary-Jo DelVecchio
Published: University of California Press,  1995
Subjects: Medicine | Science | Medical Anthropology | Public Policy
Publisher's Description: What does it mean to be a good doctor in America today? How do such challenges as new biotechnologies, the threat of malpractice suits, and proposed health-care reform affect physicians' ability to provide quality care?These and many other crucial questions are examined in this book, the first to fully explore the meaning and politics of competence in modern American medicine. Based on Mary-Jo DelVecchio Good's recent ethnographic studies of three distinct medical communities - physicians in rural California, academics and students involved in Harvard Medical School's innovative "New Pathway" curriculum, and oncologists working on breast cancer treatment - the book demonstrates the centrality of the issue of competence throughout the medical world. Competence, it shows, provides the framework for discussing the power struggles between rural general practitioners and specialists, organizational changes in medical education, and the clinical narratives of high-technology oncologists. In their own words, practitioners, students, and academics describe what competence means to them and reveal their frustration with medical-legal institutions, malpractice, and the limitations of peer review and medical training.Timely and provocative, this study is essential reading for medical professionals, academics, anthropologists, and sociologists, as well as health-care policymakers.   [brief]
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Title: Just doctoring: medical ethics in the liberal state 
Author: Brennan, Troyen A
Published: University of California Press,  1991
Subjects: Philosophy | Ethics | Medicine
Publisher's Description: Just Doctoring draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way to a new, more aware and engaged medical ethics.The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems - from informed consent to care rationing and the repercussions of the HIV epidemic - and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century.   [brief]
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Title: Intensive care: a doctor's journal
Author: Murray, John F. (John Frederic) 1927-
Published: University of California Press,  2000
Subjects: Medicine | Aging
Publisher's Description: Intensive Care is an affecting view from the trenches, a seasoned doctor's minute-by-minute and day-by-day account of life in the Intensive Care Unit (ICU) of a major inner-city hospital, San Francisco General. John F. Murray, for many years Chief of the Pulmonary and Critical Care Division of the hospital and a Professor at the University of California, San Francisco, takes readers on his daily ward rounds, introducing them to the desperately ill patients he treats as well as to the young physicians and medical students who accompany him. Writing with compassion and knowledge accumulated over a long career, Murray presents the true stories of patients who show up with myriad disorders: asthma, cardiac failure, gastrointestinal diseases, complications due to AIDS, the effects of drug and alcohol abuse, emphysema. Readers will come away from this book with a comprehensive understanding of what an ICU is, what it does, who gets admitted, and how doctors and nurses make decisions concerning life-threatening medical problems. Intensive care for critically ill patients is a new but well-established and growing branch of medicine. Estimates suggest that 15 to 20 percent of all hospitalized patients in the United States are treated in an intensive or coronary care unit during each hospital stay, so there is a real possibility that the reader will either be admitted to an ICU himself or herself or knows someone who will be. Murray not only offers a real-time account of the diagnosis, treatment, and progress of his patients over the course of one month but also conveys a wealth of information about various diseases and medical procedures in succinct and easy-to-understand terms. In addition, he elaborates on ethical dilemmas that he confronts on an almost daily basis: the extent of patient autonomy, the denial of ICU care, the withdrawal of life support, and physician-assisted suicide. Murray concludes that ICUs are doing their job, but they could be even better, cheaper, and--most important--more humane. His chronicle brings substance to a world known to most of us only through the fiction of television.   [brief]
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Title: From the fat of our souls: social change, political process, and medical pluralism in Bolivia
Author: Crandon-Malamud, Libbet
Published: University of California Press,  1991
Subjects: Anthropology | Latin American Studies | Politics | Medical Anthropology | Medicine
Publisher's Description: From the Fat of Our Souls offers a revealing new perspective on medicine, and the reasons for choosing or combining indigenous and cosmopolitan medical systems, in the Andean highlands. Closely observing the dialogue that surrounds medicine and medical care among Indians and Mestizos, Catholics and Protestants, peasants and professionals in the rural town of Kachitu, Libbet Crandon-Malamud finds that medical choice is based not on medical efficacy but on political concerns. Through the primary resource of medicine, people have access to secondary resources, the principal one being social mobility. This investigation of medical pluralism is also a history of class formation and the fluidity of both medical theory and social identity in highland Bolivia, and it is told through the often heartrending, often hilarious stories of the people who live there.   [brief]
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Title: Managing the medical arms race: public policy and medical device innovation 
Author: Foote, Susan Bartlett
Published: University of California Press,  1992
Subjects: Politics | Medicine | Public Policy | Economics and Business
Publisher's Description: The allure of medical innovation is powerful - it holds out the promise of perfect health, the end of pain, the deferral of death. Our insatiable appetite for costly new technologies, fed by a profusion of innovations and the profits they generate, has led to what has been dubbed the medical arms race. During the last several decades government has been called upon to manage the escalation of this race.Foote has written the first comprehensive examination of the profound influence of government policies on medical innovation. She explains how these policies have proliferated to affect every stage of the innovative process in medical device technology - from the first research idea to the patient's bedside. Drawing on case studies of technologies as diverse as lasers, cardiac pacemakers, CT scanners, and IUDs, she traces the interaction between the industry and government institutions, including the National Institutes of Health, the FDA, and the Medicare and Medicaid programs.Public policies during the 1950s and 1960s, Foote discovers, tended to promote innovation, while the regulation and cost controls of the 1970s and 1980s began to inhibit it. For the 1990s and beyond she proposes incremental policy improvements that will rationalize and streamline government intervention. She cautions that we must recognize the limits of medical technology and public policy to cure all ills.Medical innovation is a crucial part of health care reform, a subject of increasing complexity and controversy. Written clearly and accessibly, Managing the Medical Arms Race is an invaluable source for medical, industry, and policy professionals, but it also has much to say to anybody concerned with how we as a society choose to take care of our health.   [brief]
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Title: Paths to Asian medical knowledge
Author: Leslie, Charles M 1923-
Published: University of California Press,  1992
Subjects: Anthropology | Medical Anthropology | Asian Studies
Publisher's Description: Like its classic predecessor, Asian Medical Systems , Paths to Asian Medical Knowledge significantly expands the study of Asian medicine. These essays ask how patients and practitioners know what they know - what evidence of disease or health they consider convincing and what cultural traditions and symbols guide their thinking. Whether discussing Japanese anatomy texts, Islamic humoralism, Ayurvedic clinical practice, or a variety of other subjects, the authors offer an exciting range of information and suggest new theoretical avenues for medical anthropology.   [brief]
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Title: Life without disease: the pursuit of medical utopia 
Author: Schwartz, William B 1922-
Published: University of California Press,  1998
Subjects: Science | Medicine | Economics and Business | History and Philosophy of Science | Public Policy
Publisher's Description: The chaotic state of today's health care is the result of an explosion of effective medical technologies. Rising costs will continue to trouble U.S. health care in the coming decades, but new molecular strategies may eventually contain costs. As life expectancy is dramatically extended by molecular medicine, a growing population of the aged will bring new problems. In the next fifty years genetic intervention will shift the focus of medicine in the United States from repairing the ravages of disease to preventing the onset of disease. Understanding the role of genes in human health, says Dr. William B. Schwartz, is the driving force that will change the direction of medical care, and the age-old dream of life without disease may come close to realization by the middle of the next century. Medical care in 2050 will be vastly more effective, Schwartz maintains, and it may also be less expensive than the resource-intensive procedures such as coronary bypass surgery that medicine relies on today.Schwartz's alluring prospect of a medical utopia raises urgent questions, however. What are the scientific and public policy obstacles that must be overcome if such a goal is to become a reality? Restrictions on access imposed by managed care plans, the corporatization of charitable health care institutions, the increasing numbers of citizens without health insurance, the problems with malpractice insurance, and the threatened Medicare bankruptcy - all are the legacy of medicine's great progress in mastering the human body and society's inability to assimilate that mastery into existing economic, ethical, and legal structures. And if the average American life span is 130 years, a genuine possibility by 2050, what social and economic problems will result?Schwartz examines the forces that have brought us to the current health care state and shows how those same forces will exert themselves in the decades ahead. Focusing on the inextricable link between scientific progress and health policy, he encourages a careful examination of these two forces in order to determine the kind of medical utopia that awaits us. The decisions we make will affect not only our own care, but also the system of care we bequeath to our children.   [brief]
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Title: When a doctor hates a patient, and other chapters in a young physician's life 
Author: Peschel, Richard E
Published: University of California Press,  1988
Subjects: Medicine | Science
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Title: The blood of strangers: stories from emergency medicine
Author: Huyler, Frank 1964-
Published: University of California Press,  1999
Subjects: Medicine | American Literature | Autobiography
Publisher's Description: Reminiscent of Chekhov's stories, The Blood of Strangers is a visceral portrayal of a physician's encounters with the highly charged world of an emergency room. In this collection of spare and elegant stories, Dr. Frank Huyler reveals a side of medicine where small moments - the intricacy of suturing a facial wound, the bath a patient receives from her husband and daughter - interweave with the lives and deaths of the desperately sick and injured. The author presents an array of fascinating characters, both patients and doctors - a neurosurgeon who practices witchcraft, a trauma surgeon who unexpectedly commits suicide, a wounded murderer, a man chased across the New Mexico desert by a heat-seeking missile. At times surreal, at times lyrical, at times brutal and terrifying, The Blood of Strangers is a literary work that emerges from one of the most dramatic specialties of modern medicine. This deeply affecting first book has been described by one early reader as "the best doctor collection I have seen since William Carlos Williams's The Doctor Stories ."   [brief]
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Title: Writing at the margin: discourse between anthropology and medicine
Author: Kleinman, Arthur
Published: University of California Press,  1997
Subjects: Anthropology | Medical Anthropology | Sociology | Medicine | Asian Studies | Social Problems
Publisher's Description: One of the most influential and creative scholars in medical anthropology takes stock of his recent intellectual odysseys in this collection of essays. Arthur Kleinman, an anthropologist and psychiatrist who has studied in Taiwan, China, and North America since 1968, draws upon his bicultural, multidisciplinary background to propose alternative strategies for thinking about how, in the postmodern world, the social and medical relate. Writing at the Margin explores the border between medical and social problems, the boundary between health and social change. Kleinman studies the body as the mediator between individual and collective experience, finding that many health problems - for example the trauma of violence or depression in the course of chronic pain - are less individual medical problems than interpersonal experiences of social suffering. He argues for an ethnographic approach to moral practice in medicine, one that embraces the infrapolitical context of illness, the responses to it, the social institutions relating to it, and the way it is configured in medical ethics.Previously published in various journals, these essays have been revised, updated, and brought together with an introduction, an essay on violence and the politics of post-traumatic stress disorder, and a new chapter that examines the contemporary ethnographic literature of medical anthropology.   [brief]
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Title: The unvarnished truth: personal narratives in nineteenth-century America
Author: Fabian, Ann
Published: University of California Press,  2000
Subjects: American Studies | United States History | American Literature
Publisher's Description: The practice of selling one's tale of woe to make a buck has long been a part of American culture. The Unvarnished Truth: Personal Narratives in Nineteenth-Century America is a powerful cultural history of how ordinary Americans crafted and sold their stories of hardship and calamity during the nineteenth century. Ann Fabian examines the tales of beggars, convicts, ex-slaves, prisoners of the Confederacy, and others to explore cultural authority, truth-telling, and the nature of print media as the country was shifting to a market economy. This well-crafted book describes the fascinating controversies surrounding these little-read tales and returns them to the social worlds where they were produced.Drawing on an enormous number of personal narratives - accounts of mostly poor, suffering, and often uneducated Americans - The Unvarnished Truth analyzes a long-ignored tradition in popular literature. Historians have treated the spread of literacy and the growth of print culture as a chapter in the democratization of refinement, but these tales suggest that this was not always the case. Producing stories that purported to be the plain, unvarnished truth, poor men and women edged their way onto the cultural stage, using storytelling strategies far older than those relying on a Renaissance sense of refinement and polish. This book introduces a unique collection of tales to explore the nature of truth, authenticity, and representation.   [brief]
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Title: Healing the masses: Cuban health politics at home and abroad
Author: Feinsilver, Julie Margot
Published: University of California Press,  1993
Subjects: Latin American Studies | Politics | Medicine | Public Policy
Publisher's Description: How has Cuba, a small, developing country, achieved its stunning medical breakthroughs? Hampered by scarce resources and a long-standing U.S. embargo, Cuba nevertheless has managed to provide universal access to health care, comprehensive health education, and advanced technology, even amid desperate economic conditions. Moreover, Cuba has sent disaster relief, donations of medical supplies and technology, and cadres of volunteer doctors throughout the world, emerging, in Castro's phrase, as a "world medical power."In her significant and timely study, Julie Feinsilver explores the Cuban medical phenomenon, examining how a governmental obsession with health has reaped medical and political benefits at home and abroad. As a result of Cuba's forward strides in health care, infant mortality rates are low even by First World standards. Cuba has successfully dealt with the AIDS epidemic in a manner that has aroused controversy and that some claim has infringed on individual liberties - issues that Feinsilver succinctly evaluates.Feinsilver's research and travel in Cuba over many years give her a unique perspective on the challenges Cuba faces in this time of unprecedented economic and political uncertainty. Her book is a must-read for everyone concerned with health policy, international relations, and Third World societies.   [brief]
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Title: Big doctoring in America: profiles in primary care 
Author: Mullan, Fitzhugh
Published: University of California Press,  2002
Subjects: Medicine | Health Care | Sociology
Publisher's Description: The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan - a pediatrician, writer, and historian - argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners - family physicians, internists, pediatricians, nurse practitioners, and physician assistants - asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine, Big Doctoring in America provides an engrossing and illuminating look at those in the trenches of the profession.   [brief]
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Title: A flourishing Yin: gender in China's medical history, 960-1665
Author: Furth, Charlotte
Published: University of California Press,  1999
Subjects: History | Asian History | Asian Studies | Women's Studies | China | Medicine
Publisher's Description: This book brings the study of gender to Chinese medicine and in so doing contextualizes Chinese medicine in history. It examines the rich but neglected tradition of fuke , or medicine for women, over the seven hundred years between the Song and the end of the Ming dynasty. Using medical classics, popular handbooks, case histories, and belles lettres , it explores evolving understandings of fertility and menstruation, gestation and childbirth, sexuality, and gynecological disorders.Furth locates medical practice in the home, where knowledge was not the monopoly of the learned physician and male doctors had to negotiate the class and gender boundaries of everyday life. Women as healers and as patients both participated in the dominant medical culture and sheltered a female sphere of expertise centered on, but not limited to, gestation and birth. Ultimately, her analysis of the relationship of language, text, and practice reaches beyond her immediate subject to address theoretical problems that arise when we look at the epistemological foundations of our knowledge of the body and its history.   [brief]
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Title: The making of rehabilitation: a political economy of medical specialization, 1890-1980
Author: Gritzer, Glenn
Published: University of California Press,  1989
Subjects: Anthropology | Cultural Anthropology
Publisher's Description: Focusing on the history of one medical field - rehabilitation medicine - this book provides the first systematic analysis of the underlying forces that shape medical specialization, challenging traditional explanations of occupational specialization.
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Title: Whitman and the romance of medicine
Author: Davis, Robert Leigh 1956-
Published: University of California Press,  1997
Subjects: American Studies | American Literature | Gender Studies
Publisher's Description: In this compelling, accessible examination of one of America's greatest cultural and literary figures, Robert Leigh Davis details the literary and social significance of Walt Whitman's career as a nurse during the American Civil War. Davis shows how the concept of "convalescence" in nineteenth-century medicine and philosophy - along with Whitman's personal war experiences - provide a crucial point of convergence for Whitman's work as a gay and democratic writer.In his analysis of Whitman's writings during this period - Drum-Taps, Democratic Vistas, Memoranda During the War , along with journalistic works and correspondence - Davis argues against the standard interpretation that Whitman's earliest work was his best. He finds instead that Whitman's hospital writings are his most persuasive account of the democratic experience. Deeply moved by the courage and dignity of common soldiers, Whitman came to identify the Civil War hospitals with the very essence of American democratic life, and his writing during this period includes some of his most urgent reflections on suffering, sympathy, violence, and love. Davis concludes this study with an essay on the contemporary medical writer Richard Selzer, who develops the implications of Whitman's ideas into a new theory of medical narrative.   [brief]
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Title: The corporate practice of medicine: competition and innovation in health care
Author: Robinson, James C 1953-
Published: University of California Press,  1999
Subjects: Politics | Public Policy | Medicine | Economics and Business
Publisher's Description: One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy.The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing.In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine - overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions - factors often overlooked when newer organizational models are criticized.Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful - and optimistic - view of a future health care system, one in which physician entrepreneurship is a dynamic component.   [brief]
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Title: Lives at risk: public health in nineteenth-century Egypt 
Author: Kuhnke, LaVerne
Published: University of California Press,  1990
Subjects: Anthropology | Medical Anthropology
Publisher's Description: Lives at Risk describes the introduction of Western medicine into Egypt. The two major innovations undertaken by Muhammad Ali in the mid-nineteenth century were a Western-style school of medicine and an international Quarantine Board. The ways in which these institutions succeeded and failed will greatly interest historians of medicine and of modern Egypt. And because the author relates her narrative to twentieth-century health issues in developing countries, Lives at Risk will also interest medical and social anthropologists.The presence of the quarantine establishment and the medical school in Egypt resulted in a rudimentary public health service. Paramedical personnel were trained to provide primary health care for the peasant population. A vaccination program effectively freed the nation from smallpox. But the disease-oriented, individual-care practice of medicine derived from the urban hospital model of industrializing Europe was totally incompatible with the health care requirements of a largely rural, agrarian population.   [brief]
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Title: The elusive embryo: how women and men approach new reproductive technologies
Author: Becker, Gaylene
Published: University of California Press,  2000
Subjects: Anthropology | Cultural Anthropology | Sociology | Gender Studies | Medical Anthropology | Medicine | Women's Studies | Science
Publisher's Description: In the first book to examine the industry of reproductive technology from the perspective of the consumer, Gay Becker scrutinizes the staggering array of medical options available to women and men with fertility problems and assesses the toll - both financial and emotional - that the quest for a biological child often exacts from would-be parents. Becker interviewed hundreds of people over a period of years; their stories are presented here in their own words. Absorbing, informative, and in many cases moving, these stories address deep-seated notions about gender, self-worth, and the cultural ideal of biological parenthood. Becker moves beyond people's personal experiences to examine contemporary meanings of technology and the role of consumption in modern life. What emerges is a clear view of technology as culture, with technology the template on which issues such as gender, nature, and the body are being rewritten and continuously altered. The Elusive Embryo chronicles the history and development of reproductive technology, and shows how global forces in consumer culture have contributed to the industry's growth. Becker examines how increasing use of reproductive technology has changed ideas about "natural" pregnancy and birth. Discussing topics such as in vitro fertilization, how men and women "naturalize" the use of a donor, and what happens when new reproductive technologies don't work, Becker shows how the experience of infertility has become increasingly politicized as potential parents confront the powerful forces that shape this industry. The Elusive Embryo is accessible, well written, and well documented. It will be an invaluable resource for people using or considering new reproductive technologies as well as for social scientists and health professionals.   [brief]
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