The Politics of Medical Encounters


Book Description

The complaints that patients bring to their doctors often have roots in social issues that involve work, family life, gender roles and sexuality, aging, substance use; or other problems of nonmedical origin. In this book, physician/sociologist Howard Waitzkin examines interactions between patients and doctors to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal problems that cause or aggravate these maladies. A progressive doctor-patient relationship, Waitzkin argues, fosters social change. Waitzkin provides a pathbreaking analysis of medical encounters, applying perspectives from structuralism, post-structuralism, and critical literary theory to transcripts of recorded conversations between doctors and patients. He demonstrates how doctors unintentionally maintain dominance in their dealings with patients, encourage conforming social behavior and attitudes, and marginalize patients' concerns with social problems. Waitzkin urges physicians to attend to the social as well as the medical problems that emerge from patients' narratives and suggests ways to restructure the manner in which patients and doctors communicate with each other. Physicians and patients, for example, should work together to demystify medical discourse, should refrain from medicalizing social problems through medications or reassurances that dull socially caused pain, and should be prepared to call on advocacy organizations seeking to change the social conditions that create personal distress. This book will influence and challenge physicians scholars, and students in the social sciences and humanities, as well as anyone concerned about the present problems and future direction of medicine.




Uneasy Encounters


Book Description

Early twentieth century China went through a tumultuous period, marked by the end of an ancient monarchy, political instability and profound cultural upheaval. The medical discourse both reflected and contributed to these transformations. Western medicine arrived in China as part of missionary, foreign imperialist and internal modernization efforts. In various ways it interacted with Chinese practices and belief systems. The contributions in this volume explore important episodes of this multi-faceted process, describing key institutions, personalities and their respective motives and interests. Collectively, the chapters reveal a complex web of interlocking dimensions, which evade simple categorizations of Western or Chinese, exploitive or supportive, traditional or modern.




Medical Encounters


Book Description

"Kelly Wisecup examines how European settlers, Native Americans, and New World Africans communicated medical knowledge in early America, and how the colonists represented what they learned in their literatures."--Book cover.




Psychoanalysis, Class and Politics


Book Description

Do political concerns belong in psychodynamic treatment? How do class and politics shape the unconscious? The effects of an increasingly polarized, insecure and threatening world mean that the ideologically enforced split between the political order and personal life is becoming difficult to sustain. This book explores the impact of the social and political domains at the individual level. The contributions included in this volume describe how issues of class and politics, and the intense emotions they engender, emerge in the clinical setting and how psychotherapists can respectfully address them rather than deny their significance. They demonstrate how clinicians need to take into account the complex convergences between psychic and social reality in the clinical setting in order to help their patients understand the anxiety, fear, insecurity and anger caused by the complex relations of class and power. This examination of the psychodynamics of terror and aggression and the unconscious defences employed to deny reality offers powerful insights into the microscopic unconscious ways that ideology is enacted and lived. Psychoanalysis, Class and Politics will be of interest to all mental health professionals interested in improving their understanding of the ideological factors that impede or facilitate critical and engaged citizenship. It has a valuable contribution to make to the psychoanalytic enterprise, as well as to related scholarly and professional disciplines.







Healing Knowledge in Atlantic Africa


Book Description

Kananoja demonstrates how medical interaction in early modern Atlantic Africa was characterised by continuous knowledge exchange between Africans and Europeans.




Social Medicine and the Coming Transformation


Book Description

Social medicine, starting two centuries ago, has shown that social conditions affect health and illness more than biology does, and social change affects the outcomes of health and illness more than health services do. Understanding and exposing sickness-generating structures in society helps us change them. This first book providing a critical introduction to social medicine sheds light on an increasingly important field. The authors draw on examples worldwide to show how principles based on solidarity and mutual aid have enabled people to participate collaboratively to construct health-promoting social conditions. The book offers vital information and analysis to enhance our understanding regarding the promotion of health through social and individual means; the micro-politics of medical encounters; the social determination of illness; the influences of racism, class, gender, and ethnicity on health; health and empire; and health praxis, reform, and sociomedical activism. Illustrations are included throughout the book to convey these key themes and important issues, as well as on Routledge’s webpage for the book, under the Support Materials tab. The authors offer compelling ways to understand and to change the social dimensions of health and health care. Students, teachers, practitioners, activists, policy makers, and people concerned about health and health care will value this book, which goes beyond the usual approaches of texts in public health, medical sociology, health economics, and health policy.




Under the Medical Gaze


Book Description

This compelling account of the author's experience with a chronic pain disorder and subsequent interaction with the American health care system goes to the heart of the workings of power and culture in the biomedical domain. It is a medical whodunit full of mysterious misdiagnosis, subtle power plays, and shrewd detective work. Setting a new standard for the practice of autoethnography, Susan Greenhalgh presents a case study of her intense encounter with an enthusiastic young specialist who, through creative interpretation of the diagnostic criteria for a newly emerging chronic disease, became convinced she had a painful, essentially untreatable, lifelong muscle condition called fibromyalgia. Greenhalgh traces the ruinous effects of this diagnosis on her inner world, bodily health, and overall well-being. Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. Greenhalgh ultimately learns that she had been misdiagnosed and begins the long process of undoing the physical and emotional damage brought about by her nearly catastrophic treatment. In considering how things could go so awry, she embarks on a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical discourse and practice in the United States. She develops fresh arguments about the power of medicine to medicalize our selves and lives, the seductions of medical science, and the deep, psychologically rooted difficulties women patients face in interactions with male physicians. In the end, Under the Medical Gaze goes beyond the critique of biomedicine to probe the social roots of chronic pain and therapeutic alternatives that rely on neither the body-cure of conventional medicine nor the mind-cure of some alternative medicines, but rather a broader set of strategies that address the sociopolitical sources of pain.




Emotion in the Clinical Encounter


Book Description

The foundational knowledge and practical actions you need to effectively address your patients’ emotions—and manage your own Emotions are ever-present in the context of illness and medical care and can have an enormous impact on the well-being of patients and healthcare providers alike. Despite this impact, emotions are often devalued in a medical culture that praises stoicism and analytical reasoning. Featuring the latest theories and research on emotion in healthcare, this much-needed resource will help you build the necessary skillset to navigate the extraordinary emotional demands of practicing medicine. Emotion in the Clinical Encounter will help you: Learn the science of emotion, as it relates to clinical care Understand the role of emotion in illness Recognize the connection between clinical response to patient emotions and care outcomes Develop effective strategies for emotion recognition Build strong emotional dialogue skills for medical encounters Identify biases that may shape clinical interactions and subsequent outcomes Understand emotion regulation in patients, providers, and in the clinical relationship Address challenges and opportunities for clinical emotional wellness Identify a new path forward for delivering emotion-based medical school curricula “How did we manage for this long in healthcare without this textbook? This is an essential guide to help both trainees and established clinicians sharpen their skills. Our patients will only benefit when we bring our full set of skills to the bedside." —Danielle Ofri MD, PhD, Clinical Professor of Medicine, New York University, Editor-in-Chief of Bellevue Literary Review, and author of What Doctors Feel: How Emotions Affect the Practice of Medicine “This is a unique contribution that deeply explores the role of emotions in clinical medicine, drawing on a wide range of disciplines and presenting both scholarly paradigms and practical applications. It should be essential reading for medical educators, clinicians and patient advocates who all aim to better navigate today’s frustrating healthcare system.” —Jerome Groopman MD, Recanati Professor Harvard Medical School, and author of How Doctors Think “Emotion in the Clinical Encounter is a must-read book for clinicians. It would be especially helpful if medical students start their careers by reading this invaluable volume to gain a deeper understanding of human emotion. The book is evidence-based and detailed enough to be perhaps the definitive guide to emotions for the clinician.” —William Branch, MD, MACP, FACH, The Carter Smith, Sr Professor of Medicine, Emory University




The Second Sickness


Book Description

Since the appearance of Waitzkin's The Second Sickness, a landmark book of the 1980s, American medicine has been dramatically transformed. Waitzkin's earlier edition used qualitative research to take readers inside the "black box" of medical decision making. This new, fully updated and expanded edition retains the earlier edition's vivid approach and adds timely analysis of how managed care and other economic and social forces influence medical practice today.