Medical Humanities最新文献

{"title":"'Mrs. Don't Care': refusing modern Black motherhood in Nella Larsen's <i>Quicksand</i>.","authors":"Matty Hemming","doi":"10.1136/medhum-2023-012833","DOIUrl":"10.1136/medhum-2023-012833","url":null,"abstract":"<p><p>This essay examines the portrayal of modern Black motherhood in Nella Larsen's Harlem Renaissance novel, <i>Quicksand</i> (1928). Writing in a cultural landscape dominated by discourses of racial uplift, scientific motherhood and eugenics, I argue that Larsen critiques and ultimately refuses the limited literary, medical and political terms available for representing Black motherhood in the early twentieth century. My readings centre Larsen's understudied career as a nurse; prior to becoming a writer, Larsen worked as Head Nurse at the Tuskegee Institute in Alabama and as a public health nurse for the Department of Health in the Bronx. I consider how this professional experience informed her fictional depiction of modern Black motherhood, drawing on archival materials to demonstrate how her novel complicates contemporaneous medical and cultural attitudes towards Black motherhood and resists the eugenic demands delineating what constitutes 'good' and 'bad' motherhood. Engaging contemporary Black feminist theories of refusal and Black motherhood, I show how <i>Quicksand</i> is not only a critique of racist stigmatising discourses and practices but also of how racism limits the ways in which Black mothers' complexity has historically been represented.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"276-284"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The reckoning table, the periodoscope and the shaping of modern pregnancy in nineteenth-century print forms.","authors":"Mary Elizabeth Leighton, Lisa Surridge","doi":"10.1136/medhum-2023-012841","DOIUrl":"10.1136/medhum-2023-012841","url":null,"abstract":"<p><p>How did Victorian print forms shape experiences of pregnancy? This article focuses on pregnancy calendars, a form that rose to prominence in nineteenth-century Britain and Europe. Such calendars appeared in tabular as well as circular formats and were printed in books, periodicals and pocketbooks designed for both medical practitioners and fertile women. These calendars shaped the nebulous period of human gestation, giving pregnancy narrative form by dividing it temporally into stages and highlighting key events and medical interventions. In the nineteenth century, these printed pregnancy calendars mediated between women's personal experiences and gestational body time as well as medical management of that time. During this period, such calendars-which included the columnar reckoning table as well as the circular periodoscope-functioned as instruments of both medical control and female agency. Although they did not enable pregnant women to critique the medicalisation of pregnancy, they nevertheless accorded to such women some power in managing their reproductive bodies.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"201-210"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the art of audio description: Naomi Kawase's <i>Radiance</i>.","authors":"Aleksandra Glos, Felipe Toro Franco","doi":"10.1136/medhum-2023-012802","DOIUrl":"10.1136/medhum-2023-012802","url":null,"abstract":"<p><p>Audio description improves access to visual culture for people who are unable to fully participate in it due to visual impairments. Because of this direct benefit to disabled people, it is usually defined as an accommodation or inclusion service. Rather than adopting this view, we see disability as a creative force, arguing that it can engender a new dimension of art: audio description as a form of cinematic ekphrasis. This claim is made by drawing on the 2017 movie <i>Radiance</i>, by Japanese director Naomi Kawase. This movie puts audio description in the spotlight and stimulates discussion on this underdeveloped and under-recognised art. <i>Radiance</i> is structured around the process of making the audio description, thus offering good insight into the artistry and main challenges of this process. Between the words of this meditation on the art of audio description, Kawase also challenges the dominant ocular normative narrative on blindness as a deficiency and provokes a discussion on the contribution that blindness-with its different, still culturally unexplored modes of perception-could make to the interpretation of visual arts. <i>Radiance</i> can thus be treated as an artful argument for the greater recognition of disabled people's right to participate in cultural life.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"392-407"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lanka Mahila Samiti, Mary Rutnam and girls' education.","authors":"Jessica Annette Albrecht","doi":"10.1136/medhum-2023-012837","DOIUrl":"10.1136/medhum-2023-012837","url":null,"abstract":"<p><p>This article engages with the maternal education politics in late colonial Sri Lanka by looking at the implementation of maternal health in the gendered syllabus of middle-class girls' schools. After decades of gender-specific education, the 1930s saw a homogenisation of teachings in these schools through the impact of Mary Rutnam's health manuals. Rutnam was a Canadian doctor who had been living in Sri Lanka for most of her adult life and was seen as a local. She was also active in establishing women's and girls' organisations and political groups. Especially the Lanka Mahila Samiti (LMS) was greatly influential and still is today. The LMS specifically aims at educating the rural women in maternal health and other forms of hygiene with the goal to increase their political and cultural agency. This article examines the relationship between Rutnam's handbooks for girls' schools and the globality of the discourse of motherhood, on the one hand, and the hierarchical divide between the urban middle-class woman and the rural woman, on the other hand. I will argue that by applying the classist discourse of eugenics and hygiene, the teaching of maternal health was transformed in Sri Lanka to create a notion of motherhood that was detached from religion, as it previously was so often framed by it but was highly racialised and classist. This notion of motherhood continues to exist and informs the teaching of sexuality in contemporary Sri Lankan middle-class girls' schools.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"285-291"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformational healing: the phenomenology of fulfilment in the face of adversity.","authors":"Drew Leder, Kevin Aho","doi":"10.1136/medhum-2024-012993","DOIUrl":"https://doi.org/10.1136/medhum-2024-012993","url":null,"abstract":"<p><p>In the last two decades, there has been an explosion of scholarship in the phenomenology of health and illness of great practical significance for clinicians and the allied health professions. 'Healing' has been distinguished from medical 'cure' insofar as it involves a process of existential re-integration even in the face of ongoing illness and incapacity. This article goes further than much existing literature in the field: it examines ways in which illness can trigger for some '<i>transformational</i> healing'-that is, not simply a return to previous functioning, but positive alterations that open one's life to enhanced fulfilment, authenticity and/or connection. Using philosophical resources and 'pathographies', first-person accounts of illness and healing, we examine six forms, often interconnected, of transformational healing. These involve, in turn: <i>vulnerability, intimacy, resilience, presence, gratitude and transcendence</i> In placing a spotlight on ways in which serious illness, injury and disability can inform positive transformations, we are not minimising the suffering often associated with such conditions. Nonetheless, many individuals experience life-enhancements despite, or even because of, the effects of suffering which can reveal personal strengths, deepened intimacy with others and heightened appreciation of life. The possibility of transformational healing, while far from a universal experience, has personal, philosophical and clinical significance not to be overlooked.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic challenges: picturing chronic disease by the World Health Organization.","authors":"Alexander Medcalf, Karl Atkin","doi":"10.1136/medhum-2023-012737","DOIUrl":"https://doi.org/10.1136/medhum-2023-012737","url":null,"abstract":"<p><p>Chronic diseases are among the leading causes of mortality in the world, the subject of major regional and international efforts to tackle shared risk factors, implement prevention and control measures and set national targets as part of the drive towards universal health coverage. Yet there is a growing conviction that chronic diseases suffer an image problem. It has been suggested that the terminology 'dulls the senses' to the problems, and in an age where the mass media affords unprecedented opportunities to inform and persuade people to care about their health and that of others, chronic disease representation remains a contested and much debated issue.This article investigates how WHO created and disseminated visual narratives to raise popular consciousness and build a visual vocabulary around chronic disease in the second half of the 20th century. It examines the measures taken to conceptualise, photograph and publicise chronic diseases, and considers who had control over their representation. In focussing predominantly on cancer, diabetes and cardiovascular disease, it reveals different narratives; the power of scientific and technological progress; individual and community action for health; promising utopian and parallel dystopian visions. It embeds these in a production context which reveals an intricate picturing process involving overcoming challenges of representation. It uses this historical background to discuss issues relating to how chronic disease and chronic pain have been narrated visually, such as the ideas of emotional response, moral failure, how people navigate the 'risk society' and ultimately the concerns regarding the intentional and unintentional influence that the media can have on the image of disease given to society.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In many voices: exploring end-of-life care through patient, caregiver and physician narratives.","authors":"Tracy Moniz, Carolyn Melro, Chris Watling","doi":"10.1136/medhum-2024-012926","DOIUrl":"https://doi.org/10.1136/medhum-2024-012926","url":null,"abstract":"<p><p>As the focus on end-of-life care intensifies, so too does the need to better understand the experiences of patients, caregivers and physicians. Delivering empathetic care requires a shared understanding of illness and its meaning and impact. The narratives of patients, caregivers and physicians each offer a distinct perspective on clinical experiences, yet comparative research is uncommon. This study compares written narratives about end-of-life illness and care by these groups.We created an archive of 332 first-person written narratives about end of life (patient=65, caregiver=156, physician=111) published between 1 January 2010 and 31 December 2019 through searching public domains (eg, national newspapers), personal blogs, and academic and literary journals in Canada. A comparative narrative analysis was conducted for patterns of content (eg, theme) and strategy (eg, characterisation).All three groups wrote about feeling gratitude. Patients also emphasised coping with change and carrying on. Caregivers further focused on grieving loss, and physicians most often wrote about valuing humanism. Physicians were most likely to ascribe agency to someone (ie, patients) or something (ie, death) other than themselves and to decentre themselves in the story. Patients and physicians most often made the patient the main character of their stories, while caregivers were as likely to centre the story on themselves as on the patient. Physicians were most likely to describe death as a source of tension, while patients and caregivers described the illness experience, often comparing it to battle. Physicians and caregivers tended to write testimonies, while patients wrote quests.Narrative research can illuminate unique aspects of end-of-life care. While death is a shared experience, each group approaches it differently. The disconnects have potential consequences for how end of life is experienced-whether patients' values are honoured, whether caregivers receive support, and whether physicians experience burn-out. We need to foster learning experiences that integrate these unique perspectives into medical education and practice, including leveraging the affordances of studying written narratives towards this end.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of task shifting on power relations in healthcare: the case of clinical officers at public hospitals in Malawi.","authors":"Paliani Chinguwo","doi":"10.1136/medhum-2023-012867","DOIUrl":"https://doi.org/10.1136/medhum-2023-012867","url":null,"abstract":"<p><p>In Malawi, there exists a group of medical professionals known as clinical officers (COs) who assume responsibilities typically carried out by doctors due to the current scarcity of the latter. This paper seeks to explain how the introduction of COs as part of implementing task shifting in healthcare, unintentionally became a terrain for the contestation of power between COs and physicians. The research from which this paper originates used a qualitative research approach. It was carried out in state-owned facilities, encompassing four district hospitals and one central hospital in Malawi. This paper develops a conceptual framework on power and then uses it to demonstrate that task shifting through the introduction of COs as substitutes for physicians, became a source of interprofessional conflicts. The paper argues that unequal power relations between COs and physicians in healthcare contribute to interprofessional conflicts. The paper further demonstrates that unequal power relations between COs and physicians are manifested through differences in educational backgrounds and work experiences as well as unequal responsibility and authority. The paper concludes that the interprofessional conflicts between COs and physicians arising from unequal power relations ultimately aggravate poor psychosocial well-being among COs.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disruption, transformation and silos: medical humanities and the management gurus","authors":"Gavin Miller","doi":"10.1136/medhum-2024-012928","DOIUrl":"https://doi.org/10.1136/medhum-2024-012928","url":null,"abstract":"To disrupt, to transform and to break through silos are common sense aims for the medical humanities and other interdisciplinary endeavours. These keywords arise because of the influence upon the academy of management and business gurus, reputed experts who arose in response to the economic crises of the 1980s. Despite the noted analytic deficiencies in the concept of disruption, and its association with product innovation, the term has been extended to academic research, where it connotes radical novelty in research practice, typically accompanied by profound organisational and managerial change. ‘Disruption’ has become wedded to the word ‘transformation’ as national funders seek to support more radically innovative research that will maintain Western economic hegemony. A distorted version of Kuhn’s model of scientific revolutions underpins the discourse of transformation, which fits humanities research to a template in which revolutionary, transformative shifts can be instrumentally favoured by funders, at the expense of inferior ‘incremental’ progress. Disruptive and transformative research are, according to funders, more readily produced in organisations that have broken through silos between disciplines. The silo metaphor misleadingly models academic disciplines as if they were essentially unitary entities, akin to the functionally specialised units of a business organisation. The discourse of silos arises from the guru doctrine of the learning organisation. This theory supposes that the organisation—including the university—is literally a living organism, and thereby susceptible to corporate sickness, mortality, infection and disability. Medical humanity researchers should be aware of, and reject, this vitalist metaphysic in which the optimal organisation is a culturally homogeneous supra-personal organism whose immense capacities are harnessed by visionary leaders. Moreover, a new vocabulary should be developed for research evaluation, superseding the supposed hierarchical opposition between transformative and incremental research. Data sharing is not applicable as no datasets generated and/or analysed for this study. No applicable.","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":"31 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141587751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health treatments and the influence of culture: portrayals of hypnotherapy and electroconvulsive therapy in Singaporean television dramas.","authors":"Graham Matthews, Melissa Ho","doi":"10.1136/medhum-2023-012854","DOIUrl":"https://doi.org/10.1136/medhum-2023-012854","url":null,"abstract":"<p><p>Stigma is one of the chief reasons for treatment-avoidant behaviour among people with mental health conditions. Stigmatising attitudes are spread through multiple determinants, including but not limited to: (i) individual beliefs; (ii) interpersonal influences; (iii) local cultural values and (iv) shared culture such as depictions in television shows. Our research indicates that popular television shows are currently understudied vectors for narratives that alternately reify or debunk assumptions and stereotypes about people with mental health conditions. Although such shows are fictional, they influence perception by normalising 'common sense' assumptions over extended periods of time. Consequently, representations of patients, psychiatrists and treatments influence knowledge and understanding of mental health and treatment-seeking behaviour. While storytelling about sickness can inspire possibilities and bestow meaning on traumatic experiences, fictional narratives written without sufficient care can have the inverse effect of curtailing horizons and limiting expectations. Problematic portrayals of patients, mental health professionals and psychological interventions are often reductive and may increase stigma and prevent treatment-seeking behaviour. This article analyses the representation of hypnotherapy and electroconvulsive therapy (ECT) in Singaporean television dramas that attract a wide, mainstream audience. Our diverse team investigated dramas in all four of the official languages of Singapore: English, Mandarin Chinese, Bahasa Melayu and Tamil. We found that depictions of hypnotherapy tend to produce problematic images of mental health professionals as manipulative, able to read minds, engaging in criminal behaviour, lacking in compassion and self-interested. Meanwhile, representations of ECT typically focus on the fear and distress of the patient, and it is primarily depicted as a disciplinary tool rather than a safe and effective medical procedure for patients whose condition is severe and refractory to pharmacotherapy and behavioural interventions. These depictions have the potential to discourage treatment-seeking behaviour-when early intervention has found to be crucial-among vulnerable populations.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}