Medical Humanities最新文献

{"title":"Traumatic narrative and medical care: clinical treatment in <i>The Vegetarian</i>.","authors":"Jenna Xinyi Niu","doi":"10.1136/medhum-2025-013236","DOIUrl":"https://doi.org/10.1136/medhum-2025-013236","url":null,"abstract":"<p><p>The Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-V) (American Psychiatric Association) provides clinical guidance for psychiatrists on mental disorders. It emphasises both clinical utility and the concern of sociocultural context but does not specify how to balance the need for practicability and the openness of culture. Attempting to address this conflict, I focus on the narration of trauma in Han Kang's <i>The Vegetarian</i> (2015) and discuss how traumatic narrative enables us to understand traumatised patients' mental states. In addition, allowing other family members to take part in the patient's narrative supplements the 'Cultural Formulation Interview' proposed in DSM-V. The analysis of the latest methodology in psychopathology and <i>The Vegetarian</i> demonstrates that while standardised medical care can provide medical guidance to common cases, literature, as a form of expression, is more powerful in presenting the internal life of traumatised people. This study argues that Han's novel has practical meaning in enlightening psychiatrists to refine therapies for psychopathological symptoms.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040898","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":"<b>\"</b>It's like The Matrix. You have all the numbers, all the information, but no touch, no feeling\": South African teachers' experiences of teaching oral hard-of-hearing learners (HoHL) during COVID-19 restrictions.","authors":"Victor Manuel de Andrade, Tashira Bava","doi":"10.1136/medhum-2024-013205","DOIUrl":"https://doi.org/10.1136/medhum-2024-013205","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 drastically impacted access to teaching worldwide. Furthermore, for children who are hard-of-hearing (HoH), these challenges were exacerbated, especially within contexts of infrastructural and resource constraints. Necessary COVID-19 protocols had implications for teaching HoH learners (HoHL) online and in-person, where, for example, connectivity and facemask-muffled speech impacted on teaching. Moreover, the reliance on technology during COVID-19 South African level 5 to level 1 restrictions revealed particular challenges for teachers of HoHL and the learners themselves.</p><p><strong>Methodology: </strong>This qualitative, cross-sectional study explored the experiences of teachers of oral HoHL in South Africa during the COVID-19 pandemic. 11 teachers of grades 1-7 oral HoHL who were recruited through purposive and snowball sampling participated in individual, online, semi-structured interviews. Thereafter, interview transcriptions underwent thematic analysis.</p><p><strong>Findings: </strong>Participants reported that infrastructural constraints, information and communication technology resource limitations, interruptions in the continuity of education and COVID-19 precautions amplified challenges when teaching oral HoHL. Teachers reported behavioural and emotional challenges in the children whom they taught. Moreover, there seemed to be limited access to medical services for HoHL. Participants reported attempting to bridge the gap between the human and technology interfaces, notwithstanding the inconsistent and limited support services.</p><p><strong>Conclusion: </strong>This study revealed that, as a consequence of COVID-19, South African teachers had to amend their teaching and assessment methodologies which emphasised the inequality in access to education in South Africa, especially the particular challenges related to education for HoHL. Teachers had to navigate an unknown terrain using modified methodologies and were reliant on technology within the constrained South African context where structural limitations further complicated the teaching of HoHL. COVID-19 highlighted that the confluence of disability, constrained resources and poor support mechanisms in South Africa threatens educational provision for learners with special needs.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987541","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":"Of shopping bags and shame: issues of identity in palliative care social work in South Africa.","authors":"Michelle Petersen-Damon","doi":"10.1136/medhum-2024-013161","DOIUrl":"https://doi.org/10.1136/medhum-2024-013161","url":null,"abstract":"<p><p>Central to social work practice are issues of privilege and guidelines for its management. What is less considered, though, is how privilege is experienced, subverted and enacted, even in contexts where, from a policy perspective, dismantling privilege is central. I report here on my personal journey of growing up within the apartheid system and currently holding a senior position in a hospice organisation, a role which would have been unlikely for a person of colour during the apartheid era. I discuss the dynamics of identity, privilege and power within the context of palliative care social work in South Africa. Providing a narrative account of a significant interaction with a patient's family, I share my personal reflections from my perspective as a privileged Coloured social worker navigating the complexities of race and socioeconomic disparities, which remain prevalent in South African postapartheid society. With a Woolworths shopping bag as metaphor, I reflect on my internal struggle with being perceived as an outsider despite my cultural background. The Woolworths shopping bag, a metaphor for privilege and aspiration, evokes the historical inequalities faced by my family and highlights the ongoing challenges faced by social workers in reconciling their professional roles with their racialised identities. Motivated by my reflections, I advocate for a deeper understanding of how privilege and oppression manifest for social workers working with those who have experienced generational disparities in the South African context, facilitating a critical engagement with their life experiences and the implications of privilege when working with diverse communities.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045869","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":"\"I have suffered something\": traumatic childbirth in 19th-century Britain.","authors":"Jessica Cox","doi":"10.1136/medhum-2023-012883","DOIUrl":"10.1136/medhum-2023-012883","url":null,"abstract":"<p><p>In 1994, the American Psychiatric Association revised its definition of trauma in relation to post-traumatic stress disorder (PTSD), enabling the recognition of childbirth as a potentially traumatic event leading to the development of symptoms of PTSD. This article considers clinical definitions of postpartum PTSD in relation to 19th-century case histories of difficult childbirth, and posits that the circumstances of some of these births-particularly in the context of higher infant and maternal mortality-mean they were likely to have been experienced as highly traumatic events, which may have led to the onset of symptoms today associated with postpartum PTSD. While resisting problematic retrospective diagnoses of postpartum PTSD, the article highlights the presence of the now widely recognised risk factors for the disorder in the experiences of these women, and demonstrates that birth in 19th-century Britain had significant potential to be experienced as a traumatic event for mothers. In doing so, it seeks to contribute to a wider conversation around-and expand our understanding of-women's (physical and emotional) experiences of childbirth at this time, as well as some of the medical practices commonly employed in the birthing room, and the ethical questions which emerge from some of these. The article begins by outlining the risk factors now associated with postpartum PTSD, before exploring these in relation to 19th-century birth narratives. It draws on medical case notes (primarily the case studies of Dr Robert Lee) and women's own accounts of childbirth, as well as advice literature for women on the subject of childbirth. The discussion focuses in particular on three issues: women's knowledge around childbirth and agency within the birthing room (including issues of consent); the use of interventions in childbirth; and infant loss. The final part of the article briefly considers 19th-century discourses around puerperal insanity, and notes an association between difficult deliveries and the onset of puerperal insanity in some cases.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732275","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":"Health beyond statistics: a capabilitarian revision of Daniels' theory of just health.","authors":"Enea Lombardi","doi":"10.1136/medhum-2025-013268","DOIUrl":"https://doi.org/10.1136/medhum-2025-013268","url":null,"abstract":"<p><p>This paper examines how the biostatistical theory (BST), as endorsed by Norman Daniels' account of just health, can be integrated with the capabilities approach to address the 'lowering functioning objection'. This objection argues that the BST could mistakenly define a population as healthier if the prevalence of a certain pathology increases and becomes the new statistical norm. To tackle this issue and offer a more coherent and normatively robust account of just health, the paper introduces a two-tiered model. The first tier retains the biostatistical model to provide a non-comprehensive, evidence-based foundation for health, focusing on the distribution of biological functionings within a population. The second tier introduces a capabilitarian survey that normatively assesses whether the new statistical norm supports or hinders the achievement of valuable capabilities. This integration enables a more holistic, flexible, pluralistic and context-sensitive understanding of health, framing it as a quasi-normative meta-capability-namely, a capability grounded in biological functionings but not reducible to them, which is essential for achieving other valuable capabilities. After explaining the rationale for this integration and outlining a Rawlsian-inspired approach to selecting valuable capabilities, I conclude by suggesting the implications of this model for Daniels' theory.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789098","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":"'Some people talk about children as though they're completely different': hospital art, architecture and design for children in modern Britain.","authors":"Victoria Bates","doi":"10.1136/medhum-2025-013234","DOIUrl":"https://doi.org/10.1136/medhum-2025-013234","url":null,"abstract":"<p><p>Children's hospitals are often thought to be special places, marked by particular attention to emotions and careful consideration of inclusive design. Photographs of children's hospitals, or design for children within general hospitals, often showcase primary colours and playfulness. Such aesthetic qualities are, at first glance, exceptional for healthcare environments and reinforce the idea that children's hospitals are special or unique. This article, however, reconsiders this notion of exceptionalism in two ways. First, it uses the history of modern British hospitals to show that some of these qualities-such as bright colour and playfulness-might have once been a special feature of design for children, but were qualities of some adult hospital design by the end of the twentieth century. It makes this point, further, through a collection of interviews with professionals working in hospital art, architecture and design. In so doing, it places greater emphasis on process; interviews show the general expansion of person-centred design, and indicate that it has closed the gap between design for children and adults in both process and outcome.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774587","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":"Understanding the pandemic: self and other alignment with COVID poetry.","authors":"Marcello Giovanelli, Polina Gavin","doi":"10.1136/medhum-2025-013239","DOIUrl":"https://doi.org/10.1136/medhum-2025-013239","url":null,"abstract":"<p><p>This article examines how readers in an empirical study of COVID poetry make sense of the events and experiences depicted in a COVID poem. We draw on data generated through pre-reading questions, reading group discussions and post-reading journals to analyse how readers in our study both align their reading with their own pandemic experiences and demonstrate empathetic alignment with the experiences of others. Our findings demonstrate that reading COVID poetry triggers powerful responses in readers that may help them better understand the impact of the pandemic. These findings have implications for the medical humanities' use of poetry for well-being, in health contexts, with those affected by the pandemic, as well as more broadly for researchers and practitioners interested in the role of literature as a tool for remembering and reflection.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765307","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":"Performance and making material histories of racialising violence in medicine.","authors":"Laura Elizabeth Smith","doi":"10.1136/medhum-2024-013103","DOIUrl":"https://doi.org/10.1136/medhum-2024-013103","url":null,"abstract":"<p><p>This article argues that gynaecology has historically understood Black women's reproductive organs as a site of resource extraction, not healing and that contemporary performance offers a way to make the power relations entailed in this abstract visible. The histories of the transatlantic slave trade and gynaecology are intertwined and inform how the medical system interacts with Black women today. 'Father of gynaecology' and 19th-century American physician J. Marion Sims (1813-1883) was dependent on slavery in order to conduct experiments on enslaved Black women's reproductive organs-notably for developing a cure for vesicovaginal fistula that later benefitted wealthy white women. Turning to three recent performances, Black Youth Project 100's (BYP100) performance protests, Charly Evon Simpson's <i>Behind the Sheet</i> and Mojisola Adebayo's <i>Family Tree</i>, I analyse how performance can reveal medicine's history of using the bodies of Black women as the raw material to develop medical innovations that prolong white life. BYP100's performance protests at the statue of Sims in New York City made visible the racial violence he enacted on enslaved Black women's bodies. The play <i>Behind the Sheet</i> gives voice to the enslaved Black women omitted from the archive. The play <i>Family Tree</i> draws connections between Sims and instances of medical racism in the 20th and 21st centuries, including Henrietta Lacks (1920-1951), whose cervical cells were taken for medical research without her consent, and Black nurses who died during the COVID-19 pandemic working for the UK's National Health Service. Through performance, these three works draw attention to how the drive to read medical innovations as strictly positive 'advancements' often requires the erasure of coloniality's racialising function within the production of knowledge.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701775","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":"Beyond medical xenophobia: Congolese and Somali refugees' struggles, perceptions and responses to the COVID-19 pandemic in South Africa.","authors":"Dostin Mulopo Lakika, Tackson Makandwa","doi":"10.1136/medhum-2024-013172","DOIUrl":"https://doi.org/10.1136/medhum-2024-013172","url":null,"abstract":"<p><p>The COVID-19 pandemic was an unprecedented crisis characterised by widespread disruption and significant loss of life. Governments worldwide responded with a myriad of containment measures aimed at curbing the spread of this deadly virus. In South Africa, a nation accommodating migrants from diverse backgrounds, COVID-19 mitigation protocols were authorised but met with criticism not limited to local citizens. Cross-border migrants decried these measures as manifestations of medical xenophobia and 'migrantcide', engendering reluctance among many, particularly migrants, to seek medical treatment from public healthcare facilities.This article delves into the perspectives and beliefs of Congolese and Somali asylum seekers and refugees living in South Africa, with a particular emphasis on their perceptions of COVID-19 within an immigration landscape often fraught with hostility. The central argument posits that animosity and state negligence in a time of socioeconomic difficulty exacerbated migrants' misconceptions regarding COVID-19, contributing to their hesitancy in using South African public healthcare facilities during the pandemic. The profound deficit in trust between refugees and healthcare practitioners, stemming from inadequate communication channels, further exacerbates existing tensions and mistrust.Based on extensive fieldwork conducted in 2021 among Congolese and Somali communities in Yeoville and Mayfair-two suburbs of Johannesburg, South Africa populated by migrants-this paper explores the various meanings, perceptions and beliefs surrounding the COVID-19 pandemic. It examines how these factors contributed to rising anxiety and fear, as well as the diverse responses adopted to address the deadly disease. The hesitancy of migrant groups to seek medical assistance from public healthcare facilities led them to explore alternative means of managing COVID-19 symptoms. While some of these approaches occasionally yielded positive outcomes, they often fell short of achieving the desired results, potentially resulting in an increased number of infections and fatalities that remained untested and unreported.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701762","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":"Alder Hey's heart of gold: charity, cardiac surgery and the distortion of paediatric provision in a nationalised health service, 1948-91.","authors":"Michael Lambert","doi":"10.1136/medhum-2024-013133","DOIUrl":"https://doi.org/10.1136/medhum-2024-013133","url":null,"abstract":"<p><p>Liverpool is perceived as exceptional, a city apart from the nation, and its health services are no different. Alder Hey, the city's children's hospital, reaffirms this perspective. Its name is inseparable from the scandal surrounding the unlawful removal and retention of thousands of organs, mostly hearts, from children for research purposes over decades culminating in the 2001 Redfern report. This paper contextualises these events by reconstructing how paediatric cardiac surgery, as an emerging subspecialty, disproportionately shaped the development of children's hospital services for the city and its region. Such cumulative, compounding impacts are invisible in the historiography, focused on national trends and high politics. Recognising but eschewing established policy narratives, the paper follows enduring tensions between teaching and research, service and specialty, centre and periphery, managers and clinicians and patients and professional prestige, which remained unresolved from the inception of the National Health Service (NHS) in 1948 to the Royal Liverpool Children's Hospital becoming a self-governing trust in 1991. Using archival documents to reconstruct complex organisational and clinical decision-making within the shifting architecture of the NHS at national, regional and local levels over time, this paper shows how children's hospital services in Liverpool were distorted by another heart. One of gold: charity. Public appeals and philanthropic support for paediatric provision outweighed competing claims for compassionate giving in Liverpool. The availability of alternative funding to develop highly specialised paediatric cardiac surgery, and to lever further statutory resources at the expense of competing specialties, impacted the shape of nationalised health services in the city and its wider region. Ultimately, the paper demonstrates how children's care, clinicians and charity confounded efforts to organise universal, nationalised health services.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693882","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}