Search Results for: Medicine

Interview with a Torturer

S-21. Photo by lecercle

Rithy Panh with Christophe Bataille | Translated by John Cullen | The Elimination: A survivor of the Khmer Rouge confronts his past and the commandant of the killing fields | Other Press | February 2013 | 44 minutes (12,355 words)

Below is an excerpt from the book The Elimination, by Rithy Panh, as recommended by Longreads contributor Dana Snitzky. Read more…

A Very Naughty Little Girl

Illustration by Kjell Reigstad

Rose George | Longreads | March 2015 | 21 minutes (5,358 words)

 

 

She was a name on a plaque and a face on a wall. I ate beneath her portrait for three years and paid it little attention except to notice that the artist had made her look square. There were other portraits of women to hold my attention on the walls of Somerville, my Oxford college: Indira Gandhi, who left without a degree, and Dorothy Hodgkin, a Nobel prize-winner in chemistry. In a room where we had our French language classes, behind glass that was rumored to be bulletproof, there was also a bust of Margaret Thatcher, a former chemistry undergraduate. Somerville was one of only two women’s colleges of the University of Oxford while I was there, from 1988 to 1992, and the walls were crowded with strong, notable women. (The college has since gone co-ed.) Read more…

A Doctor with Terminal Cancer Writes to His Baby Daughter

Time for me is double-edged: Every day brings me further from the low of my last cancer relapse, but every day also brings me closer to the next cancer recurrence — and eventually, death. Perhaps later than I think, but certainly sooner than I desire. There are, I imagine, two responses to that realization. The most obvious might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions. Part of the cruelty of cancer, though, is not only that it limits your time, it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. But even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder, some days I simply persist.

Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described, hold so little interest: a chasing after wind, indeed.

Yet one thing cannot be robbed of her futurity: my daughter, Cady. I hope I’ll live long enough that she has some memory of me. Words have a longevity I do not.

-From a short, beautiful Stanford Medicine essay by neurosurgeon Paul Kalanithi, who suffered from terminal lung cancer. Update: Kalanithi died on March 9, 2015. He was 37. “We are all devastated by the tragedy of his sudden illness and untimely demise,” said Gary Steinberg, professor and chair of neurosurgery at the university.

His book, When Breath Becomes Air, was released on January 12, 2016. Here is an excerpt from The New Yorker.

Read the story

What Would a More Efficient Clinical Trial System Look Like?

Photo: Pixabay

What might a more-efficient trial system look like? One collaboration in Chicago offers a possible way forward.

Working together, several of the city’s academic medical centers have established a joint network for conducting clinical trials. Participating institutions now routinely interview all of their hospitalized patients, regardless of diagnosis, to keep detailed records on their health status. With permission, those records are made available to researchers.

Over 15 years, the process has enrolled 100,000 patients, many of whom are then recruited for clinical trials, said David O. Meltzer, a professor of medicine and director of the Center for Health and the Social Sciences at the University of Chicago. Much of the data is collected by undergraduates, and the team has grown large enough that newcomers can be trained without the need to constantly rebuild for each new trial, Dr. Meltzer said. “It’s wildly cost-effective,” he said, “and it’s incredibly good for the students.”

Even more savings could be realized by reconsidering when trial participants are even needed. A dozen years ago, Benjamin A. Olken, a professor of economics at the Massachusetts Institute of Technology, wanted to study corruption in Indonesia, to learn which of two strategies—threatening audits of government officials or giving community members a more direct role in monitoring—would do a better job of keeping road builders from “cheating.”

Paul Basken writing in The Chronicle of Higher Education about what he learned over the course of seven years as a participant in a medical clinical trial.

Read the story

‘In the Name of Our Own Fear’: Eula Biss on Vaccination, Privilege and Fear

In light of the recent measles outbreak in California, I want to share this excerpt from an interview with Eula Biss, author of On Immunity. After the birth of her first child, Biss’s research turned to vaccination, and she ruminated on a culture in which no man, woman or child is an island. Michael Schulson interviewed Biss at Salon:

Salon: You point out that people who oppose vaccination tend to be wealthier, whiter and more educated than the population at large. Why does this kind of social (but not medical) immunity hold a particular attraction for this demographic group?

Eula Biss: I should say that there are a few different demographics that tend not to vaccinate.

I think there’s a lot going on there, actually. Maybe the largest component is the kind of thinking that attends privilege. What I mean is a pattern of thought that’s been developed over a long period of time.

One of the favorite narratives [of privilege] is that we’ve just worked harder, so we deserve more. But there’s another narrative. It has to do with vulnerability, and that’s a narrative that I first started thinking about and noticing when I was writing about race. It justifies certain ways of wielding privilege, on the argument that the person who is privileged is actually not powerful but very, very vulnerable and needing protection, and that the people who are dangerous are the people who are less privileged. There’s a story line that runs something like this: vaccination may be OK for some people, but my child is uniquely vulnerable. My child is actually too vulnerable to receive this preventative medicine, and therefore I’m going to opt out of this public health initiative to spare my child this risk.

Salon: The healthcare system is large and confusing. To what extent does anti-vaccination sentiment involve individuals trying to reckon with these enormous systems that are just so hard for us to comprehend?

Biss: I think there are many, many facets to this question, and I think that is one facet. In some cases, lack of information and lack of understanding is compounded by the fact that vaccination works quite differently from other medical interventions. Just because you understand something else, like how stitches or aspirin work, it doesn’t mean you’ll understand vaccination in great detail without having it explained to you.

One of the shortcomings of our medical system is that doctors have very little time with their patients. There isn’t really the time for a doctor to sit down and carefully explain to you how the vaccines are working, what each of the different diseases are that your child is being vaccinated against, why those diseases are of concern, who they’re of concern to, and basically the whole public health strategy or justification behind mass vaccination.

Read the interview

Queen Victoria’s Cramps and the History of Medicinal Marijuana in Europe

Documents espousing marijuana’s medical benefits first appeared in 2900 B.C. in China, but medicinal cannabis in Europe is indebted to one over-achieving Irishman. Born in 1809, Dr. William Brooke O’Shaughnessy invented the modern treatment for cholera, laid the first telegraph system in Asia, contributed inventions in underwater engineering, and effectively pioneered the use of medical cannabis in Europe. Inspired by the use of cannabis in Ayurvedic and Persian medicine, O’Shaughnessy conducted the first clinical trials of marijuana, treating rheumatism, hydrophobia, cholera, tetanus, and convulsions.

Influenced by O’Shaughnessy, Sir J. Russell Reynolds prescribed cannabis to relieve Queen Victoria’s menstrual cramps. “When pure and administered carefully, [cannabis] is one of the most valuable medicines we possess,” he wrote in 1890. But the widespread use of the syringe a few years later, which allowed drugs to dissolve quickly into a patient’s blood stream, ended medical marijuana’s popularity in Europe.

Following an international drugs conference in Geneva in 1928, marijuana was banned in the UK after allegations from the Egyptian delegation that the plant was as dangerous as opium and a threat to society. Hashish was already illegal in Egypt, where it was negatively associated with Sufis and the fellahin, urban and rural poor, who used it both recreationally and medicinally. “Hashish addicts,” delegate Mohammed El Guindy declared, “are useless derelicts.”

Between 1912 and 1953, multilateral drug control treaties were negotiated around the world. The United Nations Single Convention on Narcotic Drugs consolidated these in 1961. The convention classified marijuana at the same level as opiates and cocaine, Schedule I, as drugs “having strong addictive properties” and “a risk to public health.” While the UN permitted medical use, in 1969 the World Health Organization determined that “medical need for cannabis as such no longer exists.”

Sarah Souli, writing for Roads & Kingdoms about underground social clubs that dispense medicinal marijuana in Italy.

Read the story

Can ‘Mad Maps’ Offer Patients a Way to Take Charge of Their Psychiatric Care?

Like advanced directives for the dying, DuBrul explained, mad maps allow psychiatric patients to outline what they’d like their care to look like in future mental health crises. The logic is: If a person can define health, while healthy, and differentiate health from crisis, that person can shape his or her own care. The maps are not intended to be rejections of psychiatry, though they could be that. The maps are designed to force patients and family members to plan ahead—to treat a relapse as possible or even likely—in order to avoid, or at least minimize, future mistakes.

When Jonas was 16 months old, Giulia and I put a bottle of anti-psychotics in our medicine cabinet, just in case. This might seem reasonable, but it was silly. We hadn’t yet heard of mad maps, so we’d never discussed what a situation would have to look like for Giulia to take the pills, and that made the medication useless. Was she going to take them if she wasn’t sleeping enough? Or was she going to wait until she was already psychotic? If she waited until she was psychotic, she would also likely be paranoid, meaning that she wouldn’t take the pills willingly. Me convincing her to do so at that point would be almost impossible.

…This is where mad maps offer a shard of hope. Giulia and I, finally, are trying to make one, and now that we’re doing so I have to concede that in some ways, Laing was right: The treatment of psychosis is about power. Who gets to decide what behavior is tolerated? Who chooses how and when to enforce the rules? We started trying to create Giulia’s map by discussing the pills in the medicine cabinet. Under what circumstances would Giulia take them, and how much would she take? I took a hardline approach: No sleep for one night, pills at maximum dosage. Giulia wanted more time before jumping to medication, and favored starting the dose out light. We argued bitterly as we outlined our positions and punched holes in each other’s logic. Ultimately we had to sit down with Giulia’s psychiatrist to figure it out. Now we have a plan—for one bottle of pills. It’s a small victory, but a genuine step in the right direction in a world where such steps are rare.

—From “My Lovely Wife in the Psych Ward,” a recent essay by Mark Lukach for Pacific Standard. In the piece Lukach discusses his relationship with his wife Giulia, and how it shifted from husband to caregiver and back again after she suffered a psychotic break.

A Meditation on Pain

Illustration by: Kjell Reigstad

Ira Sukrungruang | River Teeth | Fall 2014 | 15 minutes (3,767 words)

River TeethFor this week’s Longreads Member Pick, we are thrilled to share an essay from Ashland, Ohio’s narrative nonfiction journal River Teeth. Longreads readers can receive a 20 percent discount off of a River Teeth subscription by going here.
Subscribe to River Teeth

Download .mobi (Kindle) Download .epub (iBooks)

 

“And once it comes, now that I am wise in its ways, I no longer fight it. I lie down and let it happen. At first every small apprehension is magnified, every anxiety a pounding terror. Then the pain comes, and I concentrate only on that.” –Joan Didion, “In Bed”

It’s happening, says the woman I love to someone in the other room. The someone is most likely her sister, and I hear the shuffle of clogs on the ruined carpet, the swish and swirl of her turquoise dress. I feel the shadow of her body in the doorway. I hear her breathing, tiny bursts of air through the nose and mouth. I feel and hear everything, but I am not a body. And because I am no longer a body, I do not register sound or voice. I do not register anything. Even my presence on the scratchy carpet. I do not know that I have been lying in the lap of the woman I love as she soothes my sweat-drenched hair, as she whispers that this will pass. I do not hear her because I do not have ears. I do not have eyes. I do not see the hazy outline of her humid-frizzed hair or the worry etched in her face or how she looks down at me and then out the window, out past the dilapidated houses of this rundown block in Lafayette, Colorado, past the Rockies rising in jagged edges to snowy peaks, past logical explanation. Because right now, I do not register logic. Because this pain is not logical. This pain makes me whimper, makes me produce a noise that is octaves higher and sharper than I can otherwise make. I become a supplicant to its needs. I have a mouth. Of this I am sure. I have a mouth but it acts without my guidance. Saliva seeps from corners. Lips chapped as cracked earth. The woman I love feeds me water. I sip from a straw, but all of it dribbles out from the corners of my mouth. All of it wetting my cheeks and chin, like a child sloppy with food. I am a child. I am helpless. I am without strength. I am without will. I believe I might die. That this might be the end of me, this moment. I believe that death would be a relief from it all.

Hang on, she says. It’s almost over, she says. The end is in sight, she says. Read more…

Where Do You Go When Being Around Cell Phones Makes You Sick?

Photo: Ben

In the Washingtonian, a story about people afflicted with “electromagnetic hypersensitivity” who are moving to the small town of Green Bank, West Virginia, where much of modern technology has been banned due to their possible interference with a government telescope:

It turned out there was a whole community of people out there who called themselves “electrosensitives” and said they were suffering due to the electromagnetic frequencies that radiate wirelessly from cell phones, wi-fi networks, radio waves, and virtually every other modern technology that the rest of society now thinks of as indispensable.

The affliction has been dubbed “electromagnetic hypersensitivity,” or EHS, and it involves a textbook’s worth of ailments: headaches, nausea, insomnia, chest pains, disorientation, digestive difficulties, and so on. Mainstream medicine doesn’t recognize the syndrome, but the symptoms described everything Grimes was experiencing.

She went back to her doctors with her newfound evidence of EHS, relieved to have sorted out the mystery. But she got no sympathy. As she puts it, “They look at you like you have three heads.”

Grimes moved to a new building, then another, and six more times, but at each turn a smart-meter rollout wasn’t far behind. “I sat down there in Florida,” she says, “and just prayed to God: ‘Where is my way out?’ ”

Read the story

A Modern-Day Faery Tale

I recently discovered Kelly Link, an incredible short story author with a penchant for twisty magical realism. Her new collection, Get In Trouble, comes out in February. Luckily, “The Faery Handbag” is available online:

The faery handbag: It’s huge and black and kind of hairy. Even when your eyes are closed, it feels black. As black as black ever gets, like if you touch it, your hand might get stuck in it, like tar or black quicksand or when you stretch out your hand at night, to turn on a light, but all you feel is darkness.

Fairies live inside it. I know what that sounds like, but it’s true.

Grandmother Zofia said it was a family heirloom. She said that it was over two hundred years old. She said that when she died, I had to look after it. Be its guardian. She said that it would be my responsibility.

I said that it didn’t look that old, and that they didn’t have handbag two hundred years ago, but that just made her cross. She said, “So then tell me, Genevieve, darling, where do you think old ladies used to put their reading glasses and their heart medicine and their knitting needles?”

I know that no one is going to believe any of this. That’s okay. If I thought you would, then I couldn’t tell you. Promise me that you won’t believe a word. That’s what Zofia used to say to me when she told me stories. At the funeral, my mother said, half-laughing and half-crying, that her mother was the world’s best liar. I think she thought maybe Zofia wasn’t really dead. But I went up to Zofia’s coffin, and I looked her right in the eyes. They were closed. The funeral parlor had made her up with blue eyeshadow, and blue eyeliner. She looked like she was going to be a news anchor on Fox television, instead of dead. It was creepy and it made me even sadder than I already was. But I didn’t let that distract me.

“Okay, Zofia,” I whispered. “I know you’re dead, but this is important. You know exactly how important this is. Where’s the handbag? What did you do with it? How do I find it? What am I supposed to do now?”

Read the story