Why women evolved to have orgasms--when most of their primate relatives don't--is a persistent mystery among evolutionary biologists. In pursuing this mystery, Elisabeth Lloyd arrives at another: How could anything as inadequate as the evolutionary explanations of the female orgasm have passed muster as science? A judicious and revealing look at all twenty evolutionary accounts of the trait of human female orgasm, Lloyd's book is at the same time a case study of how certain biases steer science astray.

Over the past fifteen years, the effect of sexist or male-centered approaches to science has been hotly debated. Drawing especially on data from nonhuman primates and human sexology over eighty years, Lloyd shows what damage such bias does in the study of female orgasm. She also exposes a second pernicious form of bias that permeates the literature on female orgasms: a bias toward adaptationism. Here Lloyd's critique comes alive, demonstrating how most of the evolutionary accounts either are in conflict with, or lack, certain types of evidence necessary to make their cases--how they simply assume that female orgasm must exist because it helped females in the past reproduce. As she weighs the evidence, Lloyd takes on nearly everyone who has written on the subject: evolutionists, animal behaviorists, and feminists alike. Her clearly and cogently written book is at once a convincing case study of bias in science and a sweeping summary and analysis of what is known about the evolution of the intriguing trait of female orgasm.

Although cerebral dominance, the specialization of each side of the brain for different functions, was discovered in the 1860s, almost nothing was known for many years about its biological foundations, the study of which has undergone what can only be described as a revolution in the past decade and a half.

Norman Geschwind and Albert Galaburda, two of the leaders of this new field, have assembled a distinguished group of investigators, each a pioneer in some aspect of the biology of dominance. The authors document human brain asymmetry at gross and microscopic levels in both adults and fetuses, its visualization in life by radiological methods, and its manifestation in brain waves. The evolutionary history of brain asymmetry over more than 300,000 years is shown in fossil skulls of humans and apes. In a dramatic reversal of older beliefs, asymmetry of anatomy, function, and chemistry has been demonstrated in many nonhuman species, and experiments have shown the role of hormones and other prenatal influences in the production of asymmetry. The surprising associations of non-right-handedness with twinning and immune disorders are discussed, as well as the asymmetrical malformation of the cortex in childhood dyslexia.

This volume, combining scholarly authority and the excitement of the birth of a new discipline, will be welcomed by those to whom the implications of dominance are becoming evident—neuroscientists, neurologists, linguists, psychologists, experts in learning disorders, speech pathologists—and by specialists in nearly every branch of biology, medicine, and psychology.

Of his friend of many years, Dr. John Fothergill, Benjamin Franklin wrote: "I can hardly conceive that a better man has ever existed." Fothergill's letters provide a fascinating perspective of his time--a totally different view from that given by his contemporaries Horace Walpole and Dr. Johnson.

The "Quaker internationalist" (as his editors aptly call him) was during the middle decades of the eighteenth century one of the half dozen leading physicians of London, a horticulturist of great distinction, an educational reformer, a patron of many philanthropic causes, and a tireless friend of Americans and the cause of American rights. He was exceedingly generous as a patron of scientific undertakings and of young Americans abroad. He founded a famous Quaker school for boys and girls which is still flourishing; he helped found various benevolent and educational institutions in America and he continually subsidized worthy books and gave them to worthy recipients.

All these activities and others are recorded in the some two hundred letters here selected for publication. They throw light on Quaker history on both sides of the Atlantic, on advances in medical science and institutional care of the sick, on discoveries in natural history, and on political developments from the Jacobite Rebellion through the American Revolution. From the beginnings of the rift between colonies and mother country, Fothergill served as a vigorous advocate of conciliatory measures and commonwealth status for America, speaking with equal frankness and impartiality to leaders on both sides until well after hostilities began.

A few weeks before he died (at the end of 1780), he wrote Franklin in France to say that with all Europe leagued against England nothing could be hoped for her from this war, but that the world might hope for the establishment of a tribunal to settle disputes among nations and preclude war as an instrument of policy.

This edition includes a substantial introduction, and the letters have been annotated with great skill and authority. Lyman Butterfield, well known editor of the Adams Papers, says, "I have never encountered annotation on bibliographical, biographical, medical, botanical, and topographical matters that is more unfailingly readable per se. The transatlantic combination of editors was obviously just right. Toward understanding one prominent strand in the cultural history of the 18th century, this book is a uniquely valuable contribution."

Chinese Medicine and Healing is a comprehensive introduction to a rich array of Chinese healing practices as they have developed through time and across cultures. Contributions from fifty-eight leading international scholars in such fields as Chinese archaeology, history, anthropology, religion, and medicine make this a collaborative work of uncommon intellectual synergy, and a vital new resource for anyone working in East Asian or world history, in medical history and anthropology, and in biomedicine and complementary healing arts.

This illustrated history explores the emergence and development of a wide range of health interventions, including propitiation of disease-inflicting spirits, divination, vitality-cultivating meditative disciplines, herbal remedies, pulse diagnosis, and acupuncture. The authors investigate processes that contribute to historical change, such as competition between different types of practitioner—shamans, Daoist priests, Buddhist monks, scholar physicians, and even government officials. Accompanying vignettes and illustrations bring to life such diverse arenas of health care as childbirth in the Tang period, Yuan state-established medical schools, fertility control in the Qing, and the search for sexual potency in the People’s Republic.

The two final chapters illustrate Chinese healing modalities across the globe and address the challenges they have posed as alternatives to biomedical standards of training and licensure. The discussion includes such far-reaching examples as Chinese treatments for diphtheria in colonial Australia and malaria in Africa, the invention of ear acupuncture by the French and its worldwide dissemination, and the varying applications of acupuncture from Germany to Argentina and Iraq.

Free and informed consent is one of the most widespread and morally important practices of modern health care; competence to consent is its cornerstone. In this book, Becky Cox White provides a concise introduction to the key practical, philosophical, and moral issues involved in competence to consent.

The goals of informed consent, respect for patient autonomy and provision of beneficent care, cannot be met without a competent patient. Thus determining a patient's competence is the critical first step to informed consent. Determining competence depends on defining it, yet surprisingly, no widely accepted definition of competence exists. White identifies nine capacities that patients must exhibit to be competent. She approaches the problem from the task-oriented nature of decision making and focuses on the problems of defining competence within clinical practice. Her proposed definition is based on understanding competence as occurring in a special rather than a general context; as occurring in degrees rather than at a precise threshold; as independent of consequential appeals; and as incorporating affective as well as cognitive capacities.

Combining both an ethical overview and practical guidelines, this book will be of value to health care professionals, bioethicists, and lawyers.

At the edge of mortality there is a place where the seriously ill or dying wait—a place where they may often feel vulnerable or alone. For over forty years, bioethicist cum philosopher Richard Zaner has been at the side of many of those people offering his incalculable gift of listening, and helping to lighten their burdens—not only with his considerable skills, but with his humanity as well.

The narratives Richard Zaner shares in Conversations on the Edge are informed by his depth of knowledge in medicine and bioethics, but are never "clinical." A genuine and caring heart beats underneath his compassionate words. Zaner has written several books in which he tells poignant stories of patients and families he has encountered; there is no question that this is his finest.

In Conversations on the Edge, Zaner reveals an authentic empathy that never borders on the sentimental. Among others, he discusses Tom, a dialysis patient who finally reveals that his inability to work—encouraged by his overprotective mother—is the source of his hostility to treatment; Jim and Sue, young parents who must face the nightmare of letting go of their premature twins, one after the other; Mrs. Oland, whose family refuses to recognize her calm acceptance of her own death; and, in the final chapter, the author's mother, whose slow demise continues to haunt Zaner's professional and personal life.

These stories are filled with pain and joy, loneliness and hope. They are about life and death, about what happens in hospital rooms—and that place at the edge—when we confront mortality. It is the rarest of glimpses into the world of patients, their families, healers, and those who struggle, like Zaner, to understand.

As David Kelly writes, "Catholic moral theology has not been completely constant over the centuries; it has learned and developed." In Contemporary Catholic Health Care Ethics he demonstrates how Catholic health care ethics can—and should—evolve similarly in response to the lightning speed of modern medical advances. Kelly draws on and analyzes the Catholic tradition of medical ethics—but he does not shy away from criticizing it as well, giving health care professionals, hospital ethics committees, and students a fresh treatment of Catholic health care ethics emphasizing theology, methodology, and application.

First discussing the Catholic understanding of the human person, Kelly proposes a Catholic Christian approach to the meaning of human life as it applies specifically to health care. He includes a brief history of the relationship between religion and medicine, and makes strong claims about how theology ought and ought not to be applied in health care ethics. Drawing from the terminology and approaches used by secular bioethics, he suggests how a Catholic perspective on health care can utilize certain secular moral-philosophical positions, even as they apply to the issues of birth control, and end-of life concerns. As practitioners, patients, and families face the difficult decision to continue or stop treatment for dying patients, Kelly compassionately, but practically, explores their concerns in light of American law and ethics. Finally, he provides measured insight on pain management, hospital ethics committees, stem cell research, genetic engineering, and allocation of health care resources.

Contemporary Catholic Health Care Ethics is informed, challenging, articulate, and bold—bringing to the extremely important field of Catholic health care ethics a much-needed and welcome voice, unafraid to speak to the most difficult issues of the 21st century.

Contemporary Catholic Health Care Ethics, Second Edition, integrates theology, methodology, and practical application into a detailed and practical examination of the bioethical issues that confront students, scholars, and practitioners. Noted bioethicists Gerard Magill, Henk ten Have, and David F. Kelly contribute diverse backgrounds and experience that inform the richness of new material covered in this second edition.

The book is organized into three sections: theology (basic issues underlying Catholic thought), methodology (how Catholic theology approaches moral issues, including birth control), and applications to current issues. New chapters discuss controversial end-of-life issues such as forgoing treatment, killing versus allowing patients to die, ways to handle decisions for incompetent patients, advance directives, and physician-assisted suicide. Unlike anthologies, the coherent text offers a consistent method in order to provide students, scholars, and practitioners with an understanding of ethical dilemmas as well as concrete examples to assist in the difficult decisions they must make on an everyday basis.

Since the 1970s health care costs in the United States have doubled, insurance premiums have far outpaced inflation, and the numbers of the uninsured and underinsured are increasing at an alarming rate. At the same time the public expects better health care and access to the latest treatment technologies. Governments, desperate to contain ballooning costs, often see a market-based approach to health care as the solution; critics of market systems argue that government regulation is necessary to secure accessible care for all.

The Catholic Church generally questions the market's ability to satisfy the many human needs intrinsic to any care delivery system yet, although the Church views health care as a basic human right, it has yet to offer strategies for how such a right can be guaranteed. Mary J. McDonough, a former Legal Aid lawyer for medical cases, understands the advantages and disadvantages of market-based care and offers insight and solutions in Can a Health Care Market Be Moral?

Drawing on Catholic social teachings from St. Augustine to Pope John Paul II, McDonough reviews health system successes and failures from around the world and assesses market approaches to health care as proposed by leading economists such as Milton Friedman, Regina Herzlinger, Mark Pauly, and Alain Enthoven. Balancing aspects of these proposals with Daniel Callahan's value-dimension approach, McDonough offers a Catholic vision of health care in the United States that allows for some market mechanisms while promoting justice and concern for the least advantaged.

Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty.

Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal balances theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions.

Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient.

Winner, Best Book Prize, LASA Ecuadorian Studies Section
The First English-Language Book on the History of Public Health in Ecuador during the Early and Mid-Twentieth Century 

The Ecuadorian Public Health Service was founded in 1908 in response to the arrival of bubonic plague to the country. A. Kim Clark uses this as a point of departure to explore questions of social history and public health by tracing how the service extended the reach of its broader programs across the national landscape and into domestic spaces. Delving into health conditions in the country—especially in the highlands—and efforts to combat disease, she shows how citizens’ encounters with public health officials helped make abstract ideas of state government tangible. By using public health as a window to understand social relations in a country deeply divided by region, class, and ethnicity, Conjuring the State examines the cultural, social, and political effects of the everyday practices of public health officials. 

Chronic Condition provides a compelling analysis of the causes of the current health care crisis and of the shortcomings of reform proposals. It also offers an ingenious new framework for reform that, while minimizing government interference, would provide a means for financing care for the less affluent.

Sherry Glied shows that rising health care spending is consistent with a rising standard of living. Since we can, as a nation, afford more health care, reform must address not the overall level of health care costs but the distribution of health care spending.

Prior reform proposals, Glied argues, have failed to account for the tension between the clearly manifested desire for improving the quality of health care and the equally widespread interest in assuring that the less fortunate share in these improvements. After careful analysis of the ill-fated Clinton plan, Glied proposes a new solution that would make the willingness to pay for innovation the means of financing health care improvements for the less affluent. While rejecting the idea that the distribution of health care should be perfectly equal, Glied's proposal would enable all Americans to benefit from the dynamics of the free market.

In The Colonial Politics of Global Health, Jessica Lynne Pearson explores the collision between imperial and international visions of health and development in French Africa as decolonization movements gained strength.

After World War II, French officials viewed health improvements as a way to forge a more equitable union between France and its overseas territories. Through new hospitals, better medicines, and improved public health, French subjects could reimagine themselves as French citizens. The politics of health also proved vital to the United Nations, however, and conflicts arose when French officials perceived international development programs sponsored by the UN as a threat to their colonial authority. French diplomats also feared that anticolonial delegations to the United Nations would use shortcomings in health, education, and social development to expose the broader structures of colonial inequality. In the face of mounting criticism, they did what they could to keep UN agencies and international health personnel out of Africa, limiting the access Africans had to global health programs. French personnel marginalized their African colleagues as they mapped out the continent’s sanitary future and negotiated the new rights and responsibilities of French citizenship. The health disparities that resulted offered compelling evidence that the imperial system of governance should come to an end.

Pearson’s work links health and medicine to postwar debates over sovereignty, empire, and human rights in the developing world. The consequences of putting politics above public health continue to play out in constraints placed on international health organizations half a century later.

This is the first book to examine challenges in the healthcare sector in the six Gulf Cooperation Council (GCC) countries (Saudi Arabia, Oman, the United Arab Emirates, Qatar, Kuwait, and Bahrain). These countries experienced remarkably swift transformations from small fishing and pearling communities at the beginning of the twentieth century to wealthy petro-states today. Their healthcare systems, however, are only now beginning to catch up.

Rapid changes to the population and lifestyles of the GCC states have completely changed—and challenged—the region’s health profile and infrastructure. While major successes in combatting infectious diseases and improving standards of primary healthcare are reflected in key health indicators, new trends have developed; increasingly “lifestyle” or “wealthy country” diseases, such as diabetes, heart disease, and cancer, have replaced the old maladies. To meet these emerging healthcare needs, GCC states require highly trained and skilled healthcare workers, an environment that supports local training, state-of-the-art diagnostic laboratories and hospitals, research production and dissemination, and knowledge acquisition. They face shortages in most if not all of these areas. This book provides a comprehensive study of the rapidly changing health profile of the region, the existing conditions of healthcare systems, and the challenges posed to healthcare management across the six states of the GCC.

The challenges to health, wellness, and health equity in the United States are massive. No matter what side of the discussion health care leaders are on, insufficient mental health care, adverse childhood experiences, substance use disorders, high infant mortality rate, and declining life expectancy for women are issues that leadership can rally around. The second volume in the Interdisciplinary Community-Engaged Research for Health series explores hands-on approaches that leaders can take in their community. Creating Culture through Health Leadership focuses on the practitioner’s view of community engagement and how health care leaders can build a culture of health through community-grown solutions. Volume editor Lina Svedin invites contributors from the Robert Wood Johnson Foundation’s Culture of Health Leaders program to share transformative leadership skills that advance health and equity for all. Svedin’s contributors span the fields of business, technology, architecture, education, urban farming, and the arts, and represent subject matter experts, mentors, and coaches in the private, public, nonprofit, and social sectors. The volume is a collection of innovative, engaging case studies that illuminate how health care administrators and managers can collaborate to lead change within their organization, in their regional system, and throughout the nation.
 
 

In the 1978 Love Canal toxic waste crisis, concerned citizens "did a far better job of evaluating the health of the community than did the professionals of the New York Health Department," asserts Marvin Legator. In Chemical Alert! A Community Action Handbook, he and coeditor Sabrina Strawn offer a step-by-step guide that can be used by any lay person or citizens' group to determine whether a health risk exists in their area.

Writing for the general reader with no scientific expertise, environmental, medical, and legal professionals instruct communities on the organizational and investigative techniques that will produce a valid, scientific case study. With these tools, citizens living near petrochemical plants or waste disposal areas—or who may have simply noticed a high incidence of certain health problems in their community—can determine for themselves whether a problem really exists and seek remediation. Given the reality that government agencies often lack the resources—or the will—to detect health hazards before they affect a community, an informed citizenry should be its own best environmental watchdog.

An in-depth analysis of why COVID-19 warnings failed and how to avert the next disaster

Epidemiologists and national security agencies warned for years about the potential for a deadly pandemic, but in the end global surveillance and warning systems were not enough to avert the COVID-19 disaster. In The COVID-19 Intelligence Failure, Erik J. Dahl demonstrates that understanding how intelligence warnings work—and how they fail—shows why the years of predictions were not enough.

In the first in-depth analysis of the topic, Dahl examines the roles that both traditional intelligence services and medical intelligence and surveillance systems play in providing advance warning against public health threats—and how these systems must be improved for the future. For intelligence to effectively mitigate threats, specific, tactical-level warnings must be collected and shared in real time with receptive decision makers who will take appropriate action. Dahl shows how a combination of late and insufficient warnings about COVID-19, the Trump administration’s political aversion to scientific advice, and decentralized public health systems all exacerbated the pandemic in the United States. Dahl’s analysis draws parallels to other warning failures that preceded major catastrophes from Pearl Harbor to 9/11, placing current events in context.

The COVID-19 Intelligence Failure is a wake-up call for the United States and the international community to improve their national security, medical, and public health intelligence systems and capabilities.

As the coronavirus ravages the globe, its aftermaths have brought gender inequalities to the forefront of many conversations. Countries in the Middle East and North Africa have been slow to prepare for, adapt to, and mitigate the COVID-19 health crisis and its impacts on governance, economics, security, and rights. Women’s physical well-being, social safety nets, and economic participation have been disproportionately affected, and with widespread shutdowns and capricious social welfare programs, women are exiting the workplace and the classroom, carrying the caregiving burden.

With feminist foregrounding, Rita Stephan's collection COVID and Gender in the Middle East gathers an impressive group of local scholars, activists, and policy experts. The book examines a range of national and localized responses to gender-specific issues around COVID’s health impact and the economic fallout and resulting social vulnerabilities, including the magnified marginalization of Syrian refugees; the inequitable treatment of migrant workers in Bahrain; and the inadequate implementation of gender-based violence legislation in Morocco. An essential global resource, this book is the first to provide empirical evidence of COVID’s gendered effects.

Poor health habits (drinking, smoking, lack of exercise) obviously take their toll on individuals and their families. The costs to society are less obvious but certainly more far-reaching. This investigation is the first to quantify the financial burden these detrimental habits place on American taxpayers. Willard Manning and his colleagues measure the direct costs of poor health habits (fire damage, motor vehicle accidents, legal fees), as well as collectively financed costs (medical care, employee sick leave, group health and life insurance, nursing home care, retirement pensions, liability insurance). Consider two co-workers covered by their employer's health plan: both pay the same premium, yet if one drinks heavily, the other--through their mutual insurance program--involuntarily funds the resulting health problems.

After laying out their conceptual framework, methods, and analytical approach, the authors describe precisely how and to what extent drinking, smoking, and lack of exercise are currently subsidized, and make recommendations for reducing or reallocating the expense. They present, for example, a persuasive case for raising excise taxes on alcohol. The authors correlate their data to make costs comparable, to avoid double counting, and to determine the exact costs of each of these poor health habits and some of their findings are quite surprising.

This unique study will be indispensable to public health policy specialists and researchers, as well as to health economists.

In Collective Biologies, Emily A. Wentzell uses sexual health research participation as a case study for investigating the use of individual health behaviors to aid groups facing crisis and change. Wentzell analyzes couples' experiences of a longitudinal study of HPV occurrence in men in Cuernavaca, Mexico. She observes how their experiences reflected Mexican cultural understandings of group belonging through categories like family and race. For instance, partners drew on collective rather than individualistic understandings of biology to hope that men's performance of “modern” masculinities, marriage, and healthcare via HPV research would aid groups ranging from church congregations to the Mexican populace. Thus, Wentzell challenges the common regulatory view of medical research participation as an individual pursuit. Instead, she demonstrates that medical research is a daily life arena that people might use for fixing embodied societal problems. By identifying forms of group interconnectedness as “collective biologies,” Wentzell investigates how people can use their own actions to enhance collective health and well-being in ways that neoliberal emphasis on individuality obscures.

Nothing about Homer G. Phillips Hospital came easily. Built to serve St. Louis’s rapidly expanding African-American population, the grand new hospital opened its doors in 1937, toward the end of the Great Depression.  “Homer G.,” as many called it, joined a burgeoning group of black hospitals amid a national period of institutional segregation and strong racial prejudice nationwide.

When the beautiful, up-to-date hospital opened, it attracted more black residents than any other such program in the United States. Patients also flocked to the hospital, as did nursing students who found there excellent training, ready employment, and a boost into the middle class. For decades, the hospital thrived; by the 1950s, three-quarters of African-American babies in St. Louis were born at Homer G.

But the 1960s and 1970s brought less need for all-black hospitals, as faculty, residents, and patients were increasingly welcome in the many newly integrated institutions. Ever-tightening city budgets meant less money for the hospital, and in 1979, despite protests from the African-American community, HGPH closed. Years later, the venerated, long-vacant building came to life again as the Homer G. Phillips Senior Living Community.

Candace O’Connor draws upon contemporary newspaper articles, institutional records, and dozens of interviews with former staff members to create the first, full history of the Homer G. Phillips Hospital. She also brings new facts and insights into the life and mysterious murder (still an unsolved case) of the hospital’s namesake, a pioneering Black attorney and civil rights activist who led the effort to build the sorely needed medical facility in the Ville neighborhood.

In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority.

At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

A surprising look at how hospitals affect and are affected by their surrounding communities.
 
An enduring paradox of urban public health is that many communities around hospitals are economically distressed and, counterintuitively, medically underserved. In The City and the Hospital two sociologists, Jonathan R. Wynn and Berkeley Franz, and a political scientist, Daniel Skinner, track the multiple causes of this problem and offer policy solutions.
 
Focusing on three urban hospitals—Connecticut’s Hartford Hospital, the flagship of the Hartford Healthcare system; the Cleveland Clinic, which coordinates with other providers for routine care while its main campus provides specialty care; and the University of Colorado Hospital, a rare example of an urban institution that relocated to a new community—the authors analyze the complicated relationship between a hospital and its neighborhoods. On the one hand, hospitals anchor the communities that surround them, often staying in a neighborhood for decades. Hospitals also craft strategies to engage with the surrounding community, many of those focused on buying locally and hiring staff from their surrounding area. On the other hand, hospitals will often only provide care to the neighboring community through emergency departments, reserving advanced medical care and long-term treatment for those who can pay a premium for it. In addition, the authors show, hospitals frequently buy neighborhood real estate and advocate for development programs that drive gentrification and displacement.
 
To understand how urban healthcare institutions work with their communities, the authors address power, history, race, and urbanity as much as the workings of the medical industry. These varied initiatives and effects mean that understanding urban hospitals requires seeing them in a new light—not only as medical centers but as complicated urban forces.
 

In this report on one of the first continuing care departments in the country, Dr. Harold Willard describes how he set up and directed a program in Thayer Hospital, Waterville, Maine, to provide the personnel and services necessary for improved care of patients with chronic illnesses. The community hospital, he maintains, must be the center for developing methods for health maintenance and care of the chronically ill. Two chapters by Dr. Stanislav Kasl provide a theoretical background for continuing care and discuss the importance of information from the behavioral sciences in the development and operation of continuing care programs.

Maligned by the public and manipulated by politicians, today's city hospitals often cannot keep pace with the rising costs of medical technology. But while the urban landscape decays around them and city officials debate their continued existence, these institutions provide primary care for many of the nation's poor, and technically advanced care for some. They also serve as training grounds for many health professionals. How city hospitals have progressed so far, only to face such an uncertain future, is the subject of this clearly written and meticulously researched history.

Drawing on his personal experience as a physician and administrator, Harry F. Dowling shows that many problems facing city hospitals in the 1980s can be traced to their bleak beginnings as adjuncts to the poorhouse. Occasionally they provided satisfactory custodial care for the indigent sick, along with medical treatment comparable to the best private hospitals; more often their wards were scantily staffed with incompetent, careless attendants and characterized by filth, overcrowding, and epidemics that turned hospitals into death houses. Dr. Dowling describes how the gradual affiliation of city hospitals with medical schools, as well as the professionalization of nursing and administration, brought about the transition from almshouse to modern medical center. But by the 1960s deteriorating buildings and dwindling budgets again raised questions about the city hospital's role in today's medical establishment.

This book discusses a number of issues that will have a direct bearing on the future viability of these hospitals. Of particular significance will be their willingness to respond creatively to the needs of the surrounding community through emphasis on preventive medicine, family services, and care of the chronically ill.

Chronic pain is the leading cause of disability in the United States, affecting as many as 48 million people in this country alone. It can demoralize and depress both patient and family, especially when there is no effective pain control and no hope for relief. Improperly managed, chronic pain can lead to substance abuse (usually painkillers) and to acute psychological and emotional distress. Pain begets stress and stress begets pain in a wretched downward spiral.

Silver reviews the causes and characteristics of chronic pain and explores its impact on individual family relationships and on the extended family, covering such issues as employment, parenting, childbearing and inheritance, and emotional health. Silver treats aspects of chronic pain not covered in a typical office visit: how men and women differ in their experience of chronic pain, the effect of chronic pain on a toddler's behavior or an older child's performance in school, the risks of dependence on and addiction to pain medications, and practical ways for relatives beyond the immediate family circle to offer help and support to the person in pain.

The human genome is the key to what makes us human. Composed of the many different genes found in our cells, it defines our possibilities and limitations as members of the species. The ultimate goal of the pioneering project outlined in this book is to map our genome in detail—an achievement that will revolutionize our understanding of human development and the expression of both our normal traits and our abnormal characteristics, such as disease. The Code of Codes is a collective exploration of the substance and possible consequences of this project in relation to ethics, law, and society as well as to science, technology, and medicine.

The many debates on the Human Genome Project are prompted in part by its extraordinary cost, which has raised questions about whether it represents the invasion of biology by the kind of Big Science symbolized by high-energy accelerators. While addressing these matters, this book recognizes that far more than money is at stake. Its intent is not to advance naive paeans for the project but to stimulate thought about the serious issues—scientific, social, and ethical—that it provokes. The Code of Codes comprises incisive essays by stellar figures in a variety of fields, including James D. Watson and Walter Gilbert and the social analysts of science Dorothy Nelkin and Evelyn Fox Keller. An authoritative review of the scientific underpinnings of the project is provided by Horace Freeland Judson, author of the bestselling Eighth Day of Creation.

The book’s broad and balanced coverage and the expertise of its contributors make The Code of Codes the most comprehensive and compelling exploration available on this history-making project.

Winner, 2022 Outstanding Academic Title, CHOICE Awards

Mao Zedong’s Great Leap Forward campaign organized millions of Chinese peasants into communes in a misguided attempt to rapidly collectivize agriculture with disastrous effects. Catastrophic famine lingered as the global cholera pandemic of the early 1960s spread rampantly through the infected waters of southeastern coastal China. Confronted with a political crisis and the seventh global cholera pandemic in recorded history, the communist government committed to social restructuring in order to affirm its legitimacy and prevent transmission of the disease. Focusing on the Wenzhou Prefecture in Zhejiang Province, the area most seriously stricken by cholera at the time, Xiaoping Fang demonstrates how China’s pandemic was far more than a health incident; it became a significant social and political influence during a dramatic transition for the People’s Republic.

China and the Cholera Pandemic reveals how disease control and prevention, executed through the government’s large-scale, clandestine anticholera campaign, were integral components of its restructuring initiatives, aimed at restoring social order. The subsequent rise of an emergency disciplinary health state furthered these aims through quarantine and isolation, which profoundly impacted the social epidemiology of the region, dividing Chinese society and reinforcing hierarchies according to place, gender, and socioeconomic status.

"The author's multiple voices--scholar, sociologist, victim--provide an academic, yet personal, professional, yet poignant, story....Readers face...the 'contradictory meanings' that an especially articulate woman brings to the final chapter of her life." --Women and Health In 1988, Marianne Paget published the Unity of Mistakes: A Phenomenological Interpretation of Medical Work (Temple) in which she argued that error is an intrinsic feature in medicine--an experimental and uncertain activity. Her subsequent research focused on medical negligence and on miscommunication and silence a as cause and product of error in medicine. While pursuing her research on negligence, she found out that she was an example of it. Chronic back pain that had been misdiagnosed as muscle spasms turned out to be a symptom of a rare and fatal cancer that claimed Paget's life in December 1989. This collection of her personal and professional writings on the phenomenon of error in medicine chronicles a young scholar's courageous struggle to make sense of a tragic coincidence. Discovering that she was living the charges and painful topic that she had studied so deeply, Paget write poignantly and analytically until the last week of her life about this uncanny parallel. "It is very tricky to come to terms with the reality of death without becoming trapped in that reality," wrote "Tracy" Paget to her friends. In this book, she describes "the odd way my life began to mirror my work"; her search for "life rites" when face with tasks involving wills, last rites, and farewells; and her indomitable and forthright attempt to remain intensely alive in the face of death. A Complex Sorrow, her final project, comprises essays, letters, and a journal recording her last year. Ever critical of the distanced and dispassionate stance taken in much social analysis, Paget had experimented with performance as a form for enlivening social science research. The script for her play, "The Work of Talk," about communication problems between a physician and his cancer patient, is also included. Her compelling life-text speaks to those living with illness and those who care for and about them, as the investigation and representation of lived experience. Excerpt Excerpt available at www.temple.edu/tempress "Strangely, my knowledge of error has helped me deal with the errors in my care. Had I not known about the prevalence of error in medicine I would not have been able to process what has happened to me without bitterness. But I had thought these matters through already, and more than once. I now live out the complex sorrow I have before described." --Marianne A. Paget Reviews "Paget's book is stunning. It's a tribute to the invulnerable human spirit. The woman burned like a flame; obviously she died well, because she lived well; she was loved because she was loving. The book is tremendously sad, but it isn't depressing; somehow, one is left with a sense of human possibility." --Joan Cassell, author of Expected Miracles: Surgeons at Work

During the late 1970s and 1980s, "cancer" underwent a remarkable transformation. In one short decade, what had long been a set of heterogeneous diseases marked by uncontrolled cell growth became a disease of our genes. How this happened and what it means is the story Joan Fujimura tells in a rare inside look at the way science works and knowledge is created. A dramatic study of a new species of scientific revolution, this book combines a detailed ethnography of scientific thought, an in-depth account of science practiced and produced, a history of one branch of science as it entered the limelight, and a view of the impact of new genetic technologies on science and society.

The scientific enterprise that Fujimura unfolds for us is proto-oncogene cancer research--the study of those segments of DNA now thought to make normal cells cancerous. Within this framework, she describes the processes of knowledge construction as a social enterprise, an endless series of negotiations in which theories, material technologies, and practices are co-constructed, incorporated, and refashioned. Along the way, Fujimura addresses long-standing questions in the history and philosophy of science, culture theory, and sociology of science: How do scientists create "good" problems, experiments, and solutions? What are the cultural, institutional, and material technologies that have to be in place for new truths and new practices to succeed?

Portraying the development of knowledge as a multidimensional process conducted through multiple cultures, institutions, actors, objects, and practices, this book disrupts divisions among sociology, history, anthropology, and the philosophy of science, technology, and medicine.

An innovative theory proposes a new therapeutic strategy to break the stalemate in the war on cancer. It is called cancer stem cell (CSC) theory, and Lucie Laplane offers a comprehensive analysis, based on an original interdisciplinary approach that combines biology, biomedical history, and philosophy.

Rather than treat cancer by aggressively trying to eliminate all cancerous cells—with harmful side effects for patients—CSC theory suggests the possibility of targeting the CSCs, a small fraction of cells that lie at the root of cancers. CSCs are cancer cells that also have the defining properties of stem cells—the abilities to self-renew and to differentiate. According to this theory, only CSCs and no other cancer cells can induce tumor formation.

To date, researchers have not agreed on the defining feature of CSCs—their stemness. Drawing from a philosophical perspective, Laplane shows that there are four possible ways to understand this property: stemness can be categorical (an intrinsic property of stem cells), dispositional (an intrinsic property whose expression depends on external stimuli), relational (an extrinsic property determined by a cell’s relationship with the microenvironment), or systemic (an extrinsic property controlled at the system level). Our ability to cure cancers may well depend upon determining how these definitions apply to different types of cancers.

In the half-century since his death, the Hungarian analyst Sándor Ferenczi has amassed an influential following within the psychoanalytic community. During his lifetime Ferenczi, a respected associate and intimate of Freud, unleashed widely disputed ideas that influenced greatly the evolution of modern psychoanalytic technique and practice. In a sequence of short, condensed entries, Sándor Ferenczi’s Diary records self-critical reflections on conventional theory—as well as criticisms of Ferenczi’s own experiments with technique—and his obstinate struggle to divest himself and psychoanalysis of professional hypocrisy. From these pages emerges a hitherto unheard voice, speaking to his heirs with startling candor and forceful originality—a voice that still resonates in the continuing debates over the nature of the relationship in psychoanalytic practice.

Over a century and a half ago, a French physician reported the bizarre behavior of a young aristocratic woman who would suddenly, without warning, erupt in a startling fit of obscene shouts and curses. The image of the afflicted Marquise de Dampierre echoes through the decades as the emblematic example of an illness that today represents one of the fastest-growing diagnoses in North America. Tourette syndrome is a set of behaviors, including recurrent ticcing and involuntary shouting (sometimes cursing) as well as obsessive-compulsive actions. The fascinating history of this syndrome reveals how cultural and medical assumptions have determined and radically altered its characterization and treatment from the early nineteenth century to the present.

A Cursing Brain? traces the problematic classification of Tourette syndrome through three distinct but overlapping stories: that of the claims of medical knowledge, that of patients' experiences, and that of cultural expectations and assumptions. Earlier researchers asserted that the bizarre ticcing and impromptu vocalizations were psychological--resulting from sustained bad habits or lack of self-control. Today, patients exhibiting these behaviors are seen as suffering from a neurological disease and generally are treated with drug therapy. Although current clinical research indicates that Tourette's is an organic disorder, this pioneering history of the syndrome reminds us to be skeptical of medical orthodoxies so that we may stay open to fresh understandings and more effective interventions.