| This innovative
collection offers a fresh look at health, healing, and illness--providing
a "bridge" between human experience and social policies and practices. The
book brings people with illness into the foreground; it goes beyond patient's
roles and into their lives--emphasizing the gap between the acute care model
and the needs of the chronically ill.
The readings link
personal accounts with structural problems, inviting students to identify
with these authors and to see the social issues within their stories. Selections
are accessible and edited for succinctness. Section and chapter introductions
bring the articles into focus and guide student reading. Discussion questions
stimulate critical thinking, and suggested readings direct students to pivotal
references.
This anthology addresses
significant topics that most other texts overlook: definitions of health
and illness, meanings of suffering, and the sociology of the body--as well
as discussions of the distribution of illness and care, health policy, and
health-care reform.
Throughout the book,
coverage demonstrates how gender, race, class, and age affect patients
and players within the health-care system. Stories help students reexamine
their assumptions about medical care "shoulds" and "oughts" and to think
critically about future priorities and trends. Other articles cover:
- Becoming a person
with HIV disease
- Marketing rehabilitation
goods and services
- The problematics
of defining health
- Socioeconomic differences
in health service
Table Of Contents
Defining Health
And Illness
1. Conceptions
of Health
David Mechanic
Mechanic suggests
the importance of a broad definition of health in understanding health and
illness behaviors.
2. Accounts of
Health and Illness: Dilemmas and Representations
Alan Radley and
Michael Billig
Radley and Billig
contend that views of health and illness are inherently social and ideological
rather than fixed and stable, and that these views change in relation to
intentions, audiences, and images of self.
3. The Origins
of the Health Movement
Michael Goldstein
Goldstein shows how
broad definitions of health and illness generate movements that define particular
attitudes and behaviors as requiring medical definition and attention.
4. The Subject
in Health Promotion Campaigns
Deborah Lupton
Lupton discusses
the implications of health promotion strategies for the United States,
Great Britain, and Australia when they instill fear and promote public surveillance
by juxtaposing "the grotesque" and "the civilized."
The Self In Social
Context
5. Seeing Through
Pain
Arthur Frank
Franks sheds light
on what pain means and how experiencing it can force the person to see
the world anew.
6. Mastectomy and
Reconstruction
Amy Gross and
Dee Ito
Gross and Ito's interview
excerpt portrays an unusually well-informed woman who took control of her
treatment for breast cancer.
7. The Desert
Nancy Mairs
Mairs relates her
relief upon receiving a serious diagnosis that legitimized her claims to
physical illness after long months of unvalidated disturbing sensations.
8. The Damaged
Self
Robert Murphy
Murphy reflects upon
how becoming progressively disabled felt like punishment, elicited negative
responses from others, and caused him to feel guilt and shame.
9. Discoveries
of Self in Illness
Kathy Charmaz
Charmaz's argument
is threefold: 1) until chronically ill adults learn concretely how physical
losses affect their daily lives, neither their expectations for recovery
nor their self-concepts change; 2) distressing discoveries of loss become
turning points for change in self-concept; and 3) struggling with loss may
result in gaining a more valued self.
10. Illness and
Identity
David Karp
Karp argues that
people with depression have careers as mental patients with profound implications
for their sense of identity.
11. The Body, Identity,
and the Self: Adapting to Impairment
Kathy Charmaz
Charmaz clarifies
relationships between body and self and analyzes how they change in chronically
ill adults as these people must adapt to an altered body again and again.
12. The Rigors
of Kidney Dialysis for Robert Banes
Laurie Abraham
Abraham's story of
Robert Banes' kidney dialysis brings to life social class and race differences
in the incidence of disease and death as well as in the quality and distribution
of care.
13. A Weekend in
the Life of a Medical Student
Perri Klass
Klass gives a personal
account of the rigors of learning and practicing medicine on the hospital
wards during her third year of medical school.
14. Never Enough
Time: How Medical Residents Manage a Scarce Resource
William Yoels
and Jeffrey Clair
Yoels and Clair detail
how medical residents learn to control medical work and the intensity of
their work schedules under pressing and limited time conditions.
Care-taking And
Caring-giving Relationships
15. Respect, Satisfaction,
and Health Care: Canada and the U.S.
David Himmelstein
and Steffie Woolhandler
Respect for medical
professionals and satisfaction with care are displayed comparatively for
the United States and Canada in two graphics.
16. The Caregiver's
Perspective
Emily Abel
Able corrects the
gerontological concept of "caregiver burden" as she finds adult daughters
who willingly care for their mothers, despite dilemmas in preserving their
mothers' dignity, autonomy, and safety.
17. Care and Control:
Managing Stress by Medicalizing Deviance
Karen Lyman
Lyman shows how staff
members' views of Alzheimer's disease, interpretations of client behavior,
and adherence to a medical model result in their taking control over clients.
18. Narratives
of Aging and Social Problems in Medical Encounters with Older Persons
Howard Waitzkin,
Theron Britt, and Constance Williams
This analysis reveals
how physicians might miss important diagnostic information by not attending
to the context that frames elderly patient's explanations of illness.
19. The Prevalence
of Patient's Expectations for Care
Richard Kravitz,
Edward Callahan, Debora Paterniti, Deirdre Antonius, Marcia Dunham, and
Charles Lewis
Kravitz and his coauthors
examine the origins of patient's unmet expectations for care and what these
expectations mean to medical treatment.
20. If It's Not
Charted, It Didn't Happen
Timothy Diamond
Diamond uncovers
the invisible work performed by nurse aides as they care for institutionalized
patients.
21. Mr. Kilwauski
Frederic Hafferty
Hafferty discloses
some startling aspects of new medical student's perceptions of death and
their patients as they are forced to deal with the unexpected death of
an elderly man.
Institutional and
Organizational Constraints
22. My Residency
Michele Harrison
Harrison reveals
the dilemmas and experiences of being a woman in medicine and of discovering
a new specialtyCfamily medicine.
23. The Radicalization
of Birthing: Going Through Changes
Barbara Katz-Rothman
Katz-Rothman describes
different, often conflicting, perspectives on and approaches to childbirth
between hospital nurses and nurse midwives formulating a "new model" of
birthing.
24. Boundary Encroachment
and Task Delegation: Clinical Pharmacists on the Medical Team
Mark Mesler
Mesler details the
problems of defining and maintaining medical work boundaries that plague
clinical pharmacists.
25. What It Means
to Be a Nurse
Daniel Chambliss
Chambliss shows the
contradictory mission of nursing: to be simultaneously "in charge" and "under
control."
26. Wellness in
the Workplace: Potentials and Pitfalls of Worksite Health Promotion
Peter Conrad
Conrad investigates
fitness and health promotion in the workplace, charging that the phenomenon
is not only culturally specific but more generally exemplifies a specific
approach to health policy.
27. Stress and
Burnout in the Social World of Hospice
Judith Levy and
Audrey Gordon
Levy and Gordon suggest
that burnout comes not merely from emotional requirements of hospice
work but also from
ideological demands imposed by the "good death" philosophy.
Social and Cultural
Structures Of Care
28. Medical Metaphors
of Women's Bodies: Menstruation and Menopause
Emily Martin
Martin delineates
how physicians invoke medical metaphors about women's bodies that reflect
social, historical, and cultural conditions rather than biological facts.
29. The Rise of
the Surgical Fix
Kathy Davis
Davis chronicles
the rise of cosmetic surgery as a popular phenomenon, comparing its popularity
in the United States under the market model of medicine with welfare models
of medicine found in European countries.
30. The Marketing
of Goods and Services
Gary Albrecht
Albrecht argues that
rehabilitation employs marketing strategies for developing, evaluating,
and distributing goods and services to maximize profit and organizational
survival in the competitive business environment of health care.
31. Robust Resistance
Alexandra Dundas
Todd
Todd recounts the
best effects of Eastern and Western medicine in a tale of her son's struggles
and triumphs with cancer.
32. Race and Infant
Mortality
David Himmelstein
and Steffie Woolhandler
These graphics report
national and racial differences in mortality rates for blacks and whites
in the United States and between the United States and six developed countries.
33. U.S. Socioeconomic
Differences in Health: Patterns and Explanations
David Williams
and Chiquita Collins
Williams and Collins
examine why the health status of African Americans in the United States
seems to be worsening in comparison to whites and other racial groups.
34. Pathways of
Health and Death
Lois Verbrugge
Verbrugge, a social
epidemiologist, compares rates for the most common causes of morbidity and
mortality for United States men and women.
35. Latina and
African American Women: Continuing Disparities in Health
Marsha Lillie-Blanton,
Rose Marie Martinez, Andrea Kidd Taylor, and Betty Garman Robinson
These authors argue
that long-standing social inequalities account for health differentials
between Latina and African American women and nonminority women in the United
States.
36. Impact of Marital
Status on Outcomes in Hospitalized Patients
Howard Gordon
and Gary Rosenthal
Gordon and Rosenthal
show how being unmarried can jeopardize the results of hospitalization,
suggesting the importance of social support for hospitalization and illness
outcomes.
37. Why the U.S.
Health-Care System Does Not Respond to People's Needs
Vicente Navarro
Navarro critically
reveals the complexities of the American health-care system--the connections
between health care and the American class system and corporate America--noting
its deficiencies compared to other countries' systems of care.
38. The Canadian
System
David Himmelstein
and Steffie Woolhandler
These graphics compare
rates of technology and innovation in the United States and Canada.
39. Japan's Medical
System
John Igelhardt
Igelhardt studies
several controversial aspects of the Japanese medical-care system, including
physician services, health insurance, drug prescription, and dispensing.
40. Twenty Years
of Health Care in Japan
Toshiomi Asahi
A personal journey
through the Japanese health system is recounted by both patient and caregiver.
The Social Construction
of Illness: The Case of Aids
41. Brad
Maggie Callanan
and Patricia Kelley
Callanan and Kelley
tell the story of a young man dying of AIDS whose parents gave loving care
despite their shock about his homosexuality.
42. Trends in AIDS
Incidence, Deaths, and Prevalence in the United States
Centers for Disease
Control
Data from the Centers
for Disease Control show the history of AIDS incidence and prevalence as
well as 15 years of HIV's opportunistic infections and suggest directions
for treatment and social policy.
43. Women and HIV
Gena Corea
Corea discusses some
problems with the Centers for Disease Control's classification of people
infected by HIV and the insensitivity of CDC guidelines for establishing
risk for women with HIV.
44. Becoming a
Person With HIV Disease
Rose Weitz
Weitz explores how
people with HIV disease learn about what their conditions portend, why
they believe they contracted them, and how they cope with an uncertain
future.
45. Ethical Problems
Involving Sexuality
Miriam Cameron
Cameron takes medical
ethics into patient's lives as she examines continuities and contradictions
between beliefs and sexual practices of people with AIDS and HIV disease.
46. Confronting
Deadly Disease: The Drama of Identity Construction Among Gay Men With AIDS
Kent Sandstrom
Sandstrom outlines
how gay men reconstructed an empowered self after facing the uncertainty
and stigma of having AIDS.
47. AIDS and the
Impact on Medical Work: The Culture and Politics of the Shop Floor
Charles Bosk and
Joel Frader
Bosk and Frader reveal
the complexities of everyday interaction at the dawn of HIV and AIDS in
medicine, emphasizing how the "new disease" changed the context of medical
work and understandings of medical practice.
48. AIDS Prevention
Outreach Among Injection Drug Users: Agency Problems and New Approaches
Robert Broadhead
and Douglas Heckathorn
This selection discusses
the achievements and pitfalls associated with enlisting community members
in HIV health education
and outreach programs for intravenous drug users.
The Future of Health,
Illness, And Healing
49. Playing God
David Hilfiker
Hilfiker wrestles
with dilemmas presented to him by life and death medical decisions and the
"best interest" of patients.
50. Baby Doe Before
Regulations
Charles Bosk
Through two detailed
accounts of genetically deformed infants, Bosk discovers a process of decision
making in which no individual wants to take responsibility for decisions
about genetic defects.
51. The "Do Not
Resuscitate" Order as Ritual
Robert Zussman
Zussman illustrates
the moral quality inherent in DNR orders and describes the problematics
of establishing and carrying out these orders as a result of their moral quality.
52. On the Ragged
Edge: Needs, Endless Needs
Daniel Callahan
Callahan defines
the tensions framing health policy and organizational decision making in
providing health care in America: meeting individual demands for care at
an efficient cost.
53. The Rising
Costs of Health Care
David Himmelstein
and Steffie Woolhandler
These graphics display
the cost of health care to individuals and to the United States government.
54. The Disability
Wars
Timothy Kenny
Kenny's personal
tragedy of chronic illness, disability, and the limits of worker's compensation
exemplify some of the inefficiencies of health insurance for chronically ill
individuals.
55. The Politics
of Women's Health
Sally Shumaker
and Teresa Smith
Shumaker and Smith
trace the history of women's health as a policy issue and raise questions
regarding public interest in women's health for health benefits and medical
research.
56. Rationing Medical
Care: A Sociological Reflection
Peter Conrad and
Phil Brown
In this selection,
Conrad and Brown outline three perspectives on rationing health care and
discuss the efficacy of these perspectives for combatting rapidly increasing
costs of health care in the U.S.
57. Why Major Reform
Is Needed
Anselm Strauss
and Juliet Corbin
Strauss and Corbin
stress that major reform of the American health-care system would result
from adopting a model built upon the views and circumstances of people
who have chronic conditions.
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