Showing papers in "Medical Humanities in 2012"

Graphic medicine: comics as medical narrative

Abstract: Among the growing number of works of graphic fiction, a number of titles dealing directly with the patient experience of illness or caring for others with an illness are to be found. Thanks in part to the Medical Humanities movement, many medical schools now encourage the reading of classic literature to gain insight into the human condition. Until recently, the medium of comics (the term is used in the plural to refer to both the physical objects and the attendant philosophy and practice surrounding them) has received little attention from healthcare scholars, even though some authors argue that graphic fiction is, in fact, a form of literature. This paper suggests that it is time that the medium was examined by healthcare professionals and studies some acclaimed comic works. Drawing on the principles of narrative medicine, this paper will ask whether comics and graphic novels could be used as a resource for health professionals, patients and carers.

A systematic review and thematic analysis of cinema in medical education.

Abstract: The use of cinema in medical education has the potential to teach students about a variety of subjects, for instance by illustrating a lecture on communication skills with a clip of Sir Lancelot Spratt (Doctor In The House, 1954) demonstrating a paternalistic, doctor-centred approach to medicine or nurturing an ethical discussion around palliative care and dying using the cinematic adaptation of American playwright Margaret Edson's Wit (2001). Much has been written about this teaching method across several medical academic disciplines. It is the aim of this review to assimilate the various experiences in order to gain an insight into current expertise. The results are presented by the following headings under which the articles were examined: the source journal, year of publication, article type, theme, content, target, authors, if a clip or the entire film was used, and if any feedback was documented. This is followed by a chronological account of the development of the literature. Such an approach will allow the reader to gather specific information and contextualise it. This review does not critically appraise the quality of the evidence nor does it determine its validity, rather it is hoped that having read the review educators will know where to locate previous accounts of work that will help them develop more engaging pedagogy.

Get into Reading as an intervention for common mental health problems: exploring catalysts for change.

Abstract: There is increasing evidence for the efficacy of non-medical strategies to improve mental health and well-being. Get into Reading is a shared reading intervention which has demonstrable acceptability and feasibility. This paper explores potential catalysts for change resulting from Get into Reading. Two weekly reading groups ran for 12 months, in a GP surgery and a mental health drop-in centre, for people with a GP diagnosis of depression and a validated severity measure. Data collection included quantitative measures at the outset and end of the study, digital recording of sessions, observation and reflective diaries. Qualitative data were analysed thematically and critically compared with digital recordings. The evidence suggested a reduction in depressive symptoms for Get into Reading group participants. Three potential catalysts for change were identified: literary form and content, including the balance between prose and poetry; group facilitation, including social awareness and communicative skills; and group processes, including reflective and syntactic mirroring. This study has generated hypotheses about potential change processes of Get into Reading groups. Evidence of clinical efficacy was limited by small sample size, participant attrition and lack of controls. The focus on depression limited the generalisability of findings to other clinical groups or in non-clinical settings. Further research is needed, including assessment of the social and economic impact and substantial trials of the clinical effectiveness and cost-effectiveness of this intervention.

A review of qualitative methodologies used to explore patient perceptions of arts and healthcare.

Abstract: Although the importance of the arts in healthcare is increasingly recognised, further research is needed to investigate the mechanisms by which arts and health programmes achieve their impact. An overview of the qualitative methods used to explore patients' perceptions of these interventions is lacking. We reviewed the literature to gain insights into the qualitative methods used to explore patients' perceptions of the role of arts in healthcare with a view to identifying the most common methodologies used and to guide researchers embarking on research regarding patients' perceptions of arts in healthcare. Our results indicate a paucity of qualitative studies, a variety of methods used and variability of methodological rigour. Grounded theory and phenomenology were the most common approaches adopted, mixed methods approaches were relatively frequent, and versions of 'thematic' or 'content' analysis were commonly cited. Semi-structured interviews were the most popular data collection method. The emphasis of all of the studies was on active or participative arts engagement, with no focus on receptive engagement with the arts and aesthetics. It was concluded that careful consideration of appropriate methodology is important when researching such an exploratory and sensitive area. Individual interviews were most popular and might be appropriate when exploring personal, sensitive experiences. Mixed method studies possibly provide a comprehensive approach which might satisfy both the arts and healthcare settings need for evidence. It seems important to pay attention to rigour in any methodology chosen and a greater focus on receptive engagement with the arts might be encouraged in future research.

The embodiment of lyricism in medicine and Homer

Abstract: Improving the quality of communication between doctors and their patients and colleagues is of vital importance. Poor communication, especially within and across clinical teams working around patients in pathways of care, leads to avoidable medical error, where an unacceptable number of patients are severely harmed or die each year. The figures from such iatrogenesis have now reached epidemic proportions, constituting one of the major killers of patients worldwide. Despite 30 years9 worth of explicit attention to teaching communication skills at undergraduate level, communication in medicine is failing to improve at an acceptable rate. The authors suggest a rather unusual approach to this dilemma of ‘communication hypocompetence’— thinking medicine lyrically —as an extension of thinking with Homer9s little-discussed lyrical aesthetic. A key part of the problem of communication hypocompetence is the well-researched phenomenon of ‘empathy decline’ in students, where ‘hardening’ and cynicism occur as over-determined ego defences. Empathy decline may be a symptom of the repression of the lyrical genre in medicine, where the epic, tragic and dark comic genres dominate. The lyrical genre emphasises coming to know the patient as a person and an individual. Importantly, central to performing the lyric genre is the heightened use of the senses in taking a history, physical examination and diagnostic work. Framing medicine as lyrical work challenges undue emphasis on ‘cure’ at the expense of humane ‘care’.

Plagued by kindness: contagious sympathy in Shakespearean drama

Abstract: This article considers Shakespeare's metaphors of transmission, contagion and infection in the light of period plague tracts, medical treatises and plague time literature. The author demonstrates how period conceptions of disease are predicated upon a notion of sympathetic transference and, consequently, how kindness, likeness and communication between characters in Shakespearean drama are complicated and fraught with period specific anxiety. This article situates Shakespearean literary texts within a precise historical and medical moment, considering how scientific conceptions contaminate dramatic text.

The war against bacteria: how were sulphonamide drugs used by Britain during World War II?

Abstract: Penicillin is often considered one of the greatest discoveries of 20th century medicine. However, the revolution in therapeutics brought about by sulphonamides also had a profound effect on British medicine, particularly during World War II (WWII). Sulphonamides were used to successfully treat many infections which later yielded to penicillin and so their role deserves wider acknowledgement. The sulphonamides, a pre-war German discovery, were widely used clinically. However, the revolution brought about by the drugs has been either neglected or obscured by penicillin, resulting in less research on their use in Britain during WWII. By examining Medical Research Council records, particularly war memorandums, as well as medical journals, archives and newspaper reports, this paper hopes to highlight the importance of the sulphonamides and demonstrate their critical role in the medical war effort and their importance in both the public and more particularly, the medical, sectors. It will present evidence to show that sulphonamides gained importance due to the increased prevalence of infection which compromised the health of servicemen during WWII. The frequency of these infections led to an increase in demand and production. However, the sulphonamides were soon surpassed by penicillin, which had fewer side-effects and could treat syphilis and sulphonamide-resistant infections. Nevertheless, despite these limitations, the sulphonamides drugs were arguably more important in revolutionising medicine than penicillin, as they achieved the first real success in the war against bacteria.

Performance and palliative care: a drama module for medical students

Abstract: This paper describes an innovative 2 weeks module for medical students facilitated by drama educators and a palliative medicine doctor. The module incorporates drama, end-of-life care, teamwork and reflective practice. The module contents, practical aspects of drama teaching and learning outcomes are discussed. Various themes emerged from a study of Harold Pinter9s play, The Caretaker , which were relevant to clinical practice: silence, power, communication, uncertainty and unanswered questions. Drama teaching may be one way of enhancing students’ confidence, increasing self- awareness, developing ethical thinking and fostering teamworking.

Race, gender and the impossibilities of care.

Abstract: Informal care work is indispensible to healthcare but is often invisible. Using my own experience with carers who looked after my dying mother, I explore the submerged racial and gender politics of care work, issues which have a particular relevance in South Africa. I raise the question of whether it is possible for powerful professionals like myself to engage with care workers in ways which do not reproduce patterns of exclusion and exploitation. Telling of and thinking about 'private' stories which are intimate and visceral experiences may help us to think more clearly and more visibly about the politics of care work.

Manic depression in literature: the case of Virginia Woolf

Abstract: The steady growth of the discipline of medical humanities has facilitated better understanding of the symptoms and signs of mental health conditions and the feelings of the humans experiencing them. In this project, the arts have been seen as enabling re-engagement of the practitioner with the patient's own perceptions and feelings. With respect to the association between creativity and bipolar disorder in particular, work within medical humanities has meant that mentally ill creative individuals have been subject to scientific scrutiny and investigation, rather than continuing to be viewed as naively romanticised cases of mental illness. This paper is an attempt to supplement traditional literary criticism by examining Virginia Woolf's history of bipolar disorder through a medical humanities lens. I will provide an overview of Woolf's history of manic-depressive episodes, their symptoms and manifestation, look back on her circumstances during their occurrence, and observe the author's losing battle to salvage her identity in the throes of the disease. The aim is to offer further insight into Woolf's psychopathology and to gain some understanding of the causes and progression of the condition that led to her death by suicide.

Good grief: bereavement literature for young adults and A Monster Calls

Abstract: Recent years have seen a proliferation of critically acclaimed novels for young adults dealing with bereavement. This is part of a ‘bereavement turn’—a contemporary cultural movement to examine publicly our attitudes to death and grieving. This paper examines the narrative strategies in Patrick Ness's award-winning novel A Monster Calls to look at the ways in which the psychic burden of the impending loss of a parent through cancer is managed. The book draws on conventions of children's literature to create a sense of familiarity that helps to balance the emotional stress of the story. The Kubler-Ross stages of grief serve as a heuristic that helps the story deliver catharsis in spite of its inevitably traumatic subject matter. A Monster Calls is an important addition to the canon of fictional pathography.

Technics of touch in the neonatal intensive care

Abstract: Medical technologies, although often crucial for the provision of healthcare, may carry unintended significance for patients and their families. The highly technicised neonatal intensive care unit (NICU) is the place where parents of hospitalised baby have their early encounters with their child. The aim of this study is to investigate phenomenologically how the contact and relation between parent and child may be affected by the mediating presence and use of the techno-medical features and equipments of the NICU. Three common technologies are examined for the ways they condition the kinds of contact afforded between parents and child: the isolette, the feeding tube and the brain imaging equipment. The concluding recommendations speak of the need for understanding the relational experiences of parents of hospitalised babies, and the tactful sensitivities required of the healthcare teams who provide care to these families.

Narrating stroke: the life-writing and fiction of brain damage

Abstract: Cerebro-vascular events are, after neurodegenerative disorders, the most frequent cause of brain damage that leads to the patient9s impaired cognitive and/or bodily functioning. While the medico-scientific discourse related to stroke suggests that patients experience a change in identity and self-concept, the present analysis focuses on the patients9 personal presentation of their experience to, first, highlight their way of thinking and feeling and, second, contribute to the clinician9s actual understanding of the meaning of stroke within the life of each individual. As stroke ‘victims’ necessarily speak from the position of having undergone very abrupt degeneration followed by being confronted with a gradual relocation within their ‘recovery’, the present study addresses how narrative texts describe the condition, that is, the insult itself and its impairing consequences for body and mind, and how patients portray themselves within their illness. Furthermore, given that all illness narrative must remain non-representative, especially when exploring conditions that impair cognitive abilities, autobiographically inspired fiction, equally, contributes to neuroscientific perspectives on embodiment: it gives further insight into how the condition is perceived and alerts us to those aspects of the experience that are understood as particularly momentous.

Prevention of tetanus during the First World War

Abstract: The emergence of tetanus in wounded soldiers during the first months of the First World War (WWI) resulted from combat on richly manured fields in Belgium and Northern France, the use of modern explosives that produced deep tissue wounds and the intimate contact between the soldier and the soil upon which he fought. In response, routine prophylactic injections with anti-tetanus serum were given to wounded soldiers removed from the firing line. Subsequently, a steep fall in the incidence of tetanus was observed on both sides of the conflict. Because of fatal serum anaphylaxis associated with administration of serum at a time when purification methods still needed to be improved, it must be presumed that tens to hundreds of men might have died as a result of the routine administration of anti-tetanus serum during WWI. Yet anti-tetanus serum undoubtedly prevented life threatening tetanus among several hundred thousands of wounded men, making it one of the most successful preventive interventions in wartime medicine. After the abrupt fall in tetanus incidence in 1914 due to introduction of anti-tetanus serum, the incidence of the disease tended to become even lower as the war went on. This was probably due to earlier and more thorough surgical treatment, consisting of opening, cleaning, excision and drainage of wounds as early as possible. In this overview, recent battlefield findings from the Meuse-Argonne offensive in 1918 are used to illustrate common practices employed in the prevention of tetanus during WWI.

A happy doctor's escape from narrative: reflection in Saturday

Abstract: The humanities have, in their application to medicine, become almost synonymous with narrative. When medical education turned to ‘reflection’ as a means to nurture coherent and ethical professional identity, interventions tended to take narrative as their primary form. Even while promoting ‘mindfulness’ as complete engagement in the present moment, proponents of reflection sometimes subsume reflection under the category ‘narrative’. The author offers a reading of Ian McEwan9s novel Saturday , the account of the thoughts of a London surgeon over the course of one day, attending to the novel9s reflective and lyrical as well as its narrative passages, in order to suggest that, rather than grouping the various forms that constitute ‘literature’ into a single instrumental method for producing more professional and ethical doctors, it might be valuable to attend to the various modes that constitute literary discourse, of which narrative is only one.

Illness as a condition of our existence in the world: on illness and pathic existence

Abstract: This paper seeks to find different ways of addressing illness as an experience essential to the understanding of being a human being. As a conceptual point of departure, we suggest the notion of ‘pathic existence’ as developed by the German physician and philosopher Viktor von Weizsacker (1886–1957). Through an analysis of his conceptualisation of the pathic and of pathic categories, we demonstrate how this auxiliary typology may be of help in unveiling different modes of ill-being, or Kranksein . Furthermore, we show how illness plays a paradigmatic role in this type of existence. We discuss how von Weizsacker9s claim of illness as “a way of being human” indicates how such a view of the illness existence both differs from and touches upon other streams of thought within the philosophy of medicine and medical ethics. Finally, we highlight some of the normative implications emerging from this perspective of relevance in today9s medicine.

Gendered spaces, gendered pages: Union women in Civil War nurse narratives.

Abstract: This interdisciplinary analysis joins literary and culture studies with history using Daphne Spain's theory of gendered spaces. Specifically, we examine the reconfiguration of the spaces of military medical work and of book publishing that produced popular literary representations of those medical spaces. As a social historian of nursing and a scholar of American literature and culture, we argue that the examination of Civil War narratives by or about Northern female nurses surveys a landscape in which women penetrated the masculine spaces of the military hospital and the literary spaces of the wartime narrative. In so doing, these women transformed these spaces into places acknowledging and even relying upon what had been traditionally considered male domains. Like many historiographical papers written about nurses and the impact of their practice over time, this work is relevant to those practicing nursing today, specifically those issues related to professional authority and professional autonomy.

A lost decade: exploring F Scott Fitzgerald's contribution to the illness canon through the doctor-nurse series and other healthcare stories of the 1930s.

Abstract: F Scott Fitzgerald spent the 1930s writing about illness themes while he struggled with tuberculosis, insomnia, alcoholism, heart disease and the mental illness of his wife Zelda. During this decade, Fitzgerald published six stories that prominently feature hospitals and healthcare professionals. These stories, the 'doctor-nurse stories', along with nine additional published stories that touch upon medical themes have not previously been investigated as a thematic grouping. This paper explores the 1930s stories in the context of Fitzgerald's life and career in order to highlight his significant yet previously undervalued contribution to the canon of illness literature and his work's relevance to the field of literature and medicine.

At the end of life: true stories about how we die

Abstract: Edited by Lee Gutkind. Published by Underland Press, 2012, paperback, 288 pages. ISBN 9781937163044, £10.99. This book is a collection of essays about dying. The essays were all first published in 2011 by a different publisher, the Southern Methodist University Press, under a different title, Twelve Breaths a Minute: End of Life Essays. They are reissued under the new title as part of ‘a series of narrative books on science and medicine supported by the Jewish Healthcare Foundation’. The phrase ‘How We Die’ in the new title is no doubt intended to recall Sherwin B Nuland's book, How We Die: Reflections on Life's Last Chapters (1994) which was a New York Times bestseller, and won the National Book Award for Nonfiction. The message of that book is that most of us will die in hospital, from a heart attack, stroke or cancer, or some combination of the above. We will probably die in our old age, by which time our bodies will no longer be able to cope with some of the treatments intended to keep us alive. For Nuland, dying is ‘a messy business’, ‘a series of destructive events that involve by their very nature the disintegration of the dying person's humanity. I have not seen much dignity in the process by which we die.’ ‘Dying badly,’ he goes on to say, is not ‘a judgment upon the many that are fated to die badly, simply the nature of the thing that kills them’. How We Die, explained to the lay reader in biological terms, the dehumanising work of the most common terminal illnesses; but it also used real-life examples to show how hi-tech medicine often made the moment of death less dignified. Nuland was, of course, writing in the shadow of another classic book, whose shade also hovers over the present volume: Elisabeth Kubler-Ross's On Death and Dying (1969). A psychiatrist by training, …

Ethical reflections on the thoughts and lives of Kurosawa's doctors

Abstract: The year 2010 marked the centenary of the birth of Akira Kurosawa (1910-1998), whose works have been reassessed favourably in the last couple of years in Japan. During his lifetime, Kurosawa directed and produced three films whose chief characters are medical doctors: Drunken Angel (1948), The Quiet Duel (1949) and Red Beard (1965). This paper discusses these three films and examines the thoughts and lives of the three protagonists from the perspective of modern medical ethics. The films depict contemporary ethical and social problems, and deal with paternalism, a healthy professional life and the proper place for human reason in medicine, all of which still give rise to debate in modern medical settings. They are very impressive in their portrayal of extreme paternalism, excessively professional lives and disproportionate reliance on rationality. The doctors are role models in certain situations and are examples of how not to behave in other situations. On the one hand, they are devoted to helping their patients, with their self-sacrifice firmly based on humanity and medical ethics. On the other hand, they perform unwelcome favours and are unhealthy role models who might harm others through narrow-minded attitudes about human beings, a fixed view of life and inflexible ideas about medicine. In this sense, they can be regarded as a rather mixed blessing. These films provide us with an opportunity to simultaneously recognise the importance of modern ethical principles and the significance of 'old' ethical values.

The epileptic singers of belle époque Paris

Abstract: In late 19th century Paris, people with epilepsy were treated alongside those with hysteria in the now famous Salpetriere Hospital, where both conditions were deemed to have a neurological basis. When Jean Martin Charcot became chief physician at the Salpetriere Hospital in 1862, he described himself 'in possession of a kind of museum of living pathology whose holdings were virtually inexhaustible'. He opened the doors of his 'living museum' and exhibited his prize specimens to all of Paris. By putting his patients on display, Charcot introduced a vogue for pathology that permeated well beyond the world of medical enquiry and into the public psyche and vernacular. Not only did Charcot's demonstrations provide the inspiration for high culture in the form of operas, plays and novels, they also provided the inspiration for the 'gommeuses epileptiques' (epileptic singers), who entertained the masses at the cafe concerts. This paper explores the foundations of our current medical approaches to mental illness and epilepsy, with a particular focus on the boundaries that emerged between hysteria and epilepsy in 19th century Paris. These clinical boundaries were both shaped by and reflected in the popular entertainments in the city.

Looking into the neonatal isolette

Abstract: In my everyday professional life, I encounter the medical isolette as a structural unit that houses a single sick or premature child within an acrylic glass enclosure. The unit is designed so as to incubate the developing child by providing warmth, quiet, humidity and security. Small openings allow wires or tubes to hook up the child to technological instruments, monitors and specialised medicine dispensers. Larger portholes allow limited access for the hands of those who take care of the child. The baby is enclosed in a dwelling place in the sense that an isolette may be regarded as the child's bedroom. But it is a place of limited room, for no …

Some of my friends

Abstract: > Some of my friends > > are becoming concerned. > About lumps where there > > were none before. > > Some thing which > > does not …

Notes from the 56th BFI London Film Festival, 10–21st October 2012

Abstract: When the London Film Festival (LFF) began in the late fifties, it was labelled ‘The festival of festivals’ because audiences got to view the best of world films screened at other international film festivals such as Cannes and Venice. This year the LFF deserves that title more than ever. Under a new artistic director, the festival has changed its format subtly but significantly. Featuring no less than 333 films from all over the world including feature films, short films, documentaries, animated films, treasures from the archives and experimental films, the public is truly spoilt for choice. The films are arranged under headings designed to attract a broad range of audiences, such as Journey, Cult, Thrill, Laugh, Dare, Debate and Love. Does the Festival have much to offer health professionals? The answer to that question is an emphatic ‘Yes’. Plenty of films, with an emphasis on the ageing population, provide food for thought—‘older people’ being an emerging demographic in the developed world both as the subject of films and potential film …

Cinema: a two-dimensional artform plus

Abstract: As film reviews editor of this journal, I like to strike a balance in what we cover between the recondite and the recognised as well as between history and contemporaneity In the past 3 years, we have featured new films by arthouse marquee names like Haneke1 and Almodovar2; but also reviewed a reissued DVD of a Clark Gable star vehicle from the early ‘30s that helped set a template for doctor movies to come3 and a strikingly unusual full-length ‘clay-mation’ film by young Australian director Adam Elliott called Mary and Max 4 In some ways, it would be wonderful if reviews could always be up-to-the-minute and topical; and we're very pleased to have a report (see page xxx) freshly filed from the frontline of the London Film Festival, which is taking place just as this issue is being put to bed Of the numerous films being premiered that looked likely, Khalid Ali has focussed on those that deal with ageing5 This case of fortuitous timing notwithstanding, the intrinsic nature of a journal that comes out twice a year is, ipso facto , different to a monthly or weekly magazine, or a daily newspaper, let alone an updated-hourly website or blog The slow turnaround time of our reviews might be a cause for frustration—you'll be reading this at least 2 months after the Festival's closing gala—but it's a question of perception: in a world that seems to be spinning ever faster, it is surely advantageous to give a reviewer more time to reflect and a more generous word-count to explore ideas at greater length As all parents know, tweets are fine, but they don't replace a proper meal Time and space, then, are valuable commodities; and I was reminded of this when I attended a masterclass by …

Flame proof: The Skin I Live In (2011)

Abstract: Toledo, Spain is the first object of director Pedro Almodovar's gaze in ‘The Skin I Live In’. The reclining cityscape is branded with the title ‘Toledo 2012’—although the film was released to audiences in 2011. The credit roll implies that a sci-fi nightmare gestates in the audience's blind spot and it will be born within the next blink of an eye. True to the body horror genre, ‘The Skin I Live In’ grafts the seed of its ending to the beginning. Blink—and Vera appears (played by Elena Anaya, the coma victim in Almodovar's earlier ‘Talk to Her’), vital and perfectly formed, her flesh-coloured body stocking stretched in a yoga backbend. By the film's midpoint, we come to know Vera by the name she was called 6 years earlier when she was free, before she embodied an experiment more warped than the average mind (and the average male) would dream of conceiving. Vera, truth and spring in Latin, is the genetically modified germ of the mad scientist's demise. Almodovar's veteran, Antonio Banderas plays Dr Ledgard, a menacingly suave surgeon, who devotes his life to fortifying flesh. Ledgard …

The isolation, loneliness and helplessness of being homeless

Abstract: One of the hotly debated questions, at the journal's recent editorial board meeting, was how to communicate, to our readers, the clinical relevance of the papers we publish. It is an interesting question, and one moreover that begs several others, not least amongst them being whether it is appropriate to expect a medical humanities scholarship to be directly, or indirectly relevant to patient care and clinical practice. Laying that old bugbear to one side, I would like to argue that one of the strengths of medical humanities is its ability to shine a light into some of the darker, and more neglected corners of medicine and social care, and thereby revealing what can be uncomfortable truths. Take, for example, the cover image for this issue, featuring Homeless 1 , by medical student Rory Hutchinson, one of the winners of the inaugural MDU Mark Brennan Prize (Visual Arts category). Rory's work was ‘inspired by the treatment of homeless patients within the medical system’, and aims to ‘raise awareness …

Furry friend or foe

Abstract: The Beaver . Directed by Jodie Foster, USA, 2011 ![Graphic][1] The Beaver is a dark, complex and well-made film about bipolar disorder, that also explores the inevitability of its inheritance across three generations of men in a middle-class American family. Directed by Jodie Foster, who also co-stars with off-screen friend Mel Gibson, it tells two stories: that of Walter Black, father and CEO of a failing toy company and that of Porter, his teenage son, who is struggling to deal with the negative feelings he has towards his depressed father, while facing the fear that he is becoming just like him. In the opening scenes, we discover that Walter is a middle-aged married father of two, who has lacked energy and has been sleeping excessively for the past 2 years. Depressed in mood and without motivation, he is described as “like a dead man who didn't have the good manners to leave his body”. His prescribed medications ren't helping and his father's toy company, which he inherited and now runs, is failing badly. Walter's father committed suicide when Walter was a boy of 7—the same age as … [1]: /embed/inline-graphic-1.gif

Together and waiting

Abstract: > The people in the waiting room at the hospital > > cannot help but wonder just what is wrong > > with everyone else. > The old woman in the borrowed wheelchair. > > The man with the bandaged …

Golden holocaust: origins of the cigarette catastrophe and the case for abolition

Abstract: Authored by Robert N Proctor. Published by University of California Press, 2011, hardback, 779 pages, £34.95. ISBN 9780520270169. Robert Proctor is an American historian and the author of Cancer Wars and The Nazi War on Cancer . In the latter book, published in 1999, he discussed pioneering research in the Third Reich on the connection between smoking and lung cancer and the strong Nazi emphasis on antismoking policies, a precursor of the wider focus on antismoking postwar. Prior to Proctor's work, the Nazi interest in antismoking had been discussed in the UK by historically minded epidemiologists writing in the Journal of Epidemiology and Community Health in 1994. Proctor's tone in his earlier book was measured. He was at pains to stress at the outset that discussion of Nazi antismoking interests did not imply approval of other Nazi policies. The fact that he was drawing our attention to a ‘good’ Nazi policy did not mean that he approved of their other actions. That approach, a typically historical one, has changed in the intervening years. The tone of this book, and its title, is quite different. This is advocacy history. Proctor is part of the antismoking action with a clear policy agenda promoted through historical research. Cigarette smoking is a ‘Golden Holocaust’ and the book aims to show how the cigarette became an item of mass culture, how its risks were revealed by research, and then hidden by manufacturers. Proctor sets out a political agenda for the future, one where the aim is prohibition and the elimination of the cigarette. The methodology of the current book differs from the historical norm. Proctor has acted as an expert witness in one of the many US legal cases against the tobacco industry and has used material from the online industry archives released as part of legal settlements and now available …