Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations.The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice.Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.

    In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. That these claims come from an experienced, practicing orthopedic surgeon who performs many of these operations himself, makes the unsettling argument particularly compelling. Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence.

    The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process.

    It focuses on the relationship between the inmate and the institution, how the setting affects the person and how the person can deal with life on the inside.

    Kopits takes me into an examining room and leans against the stainless steel bench and asks me what I'm writing about this time. When I tell him what I saw in Australia, he immediately starts to nod. "This is a great subject," he says. Then he stops, as if caught by the subject himself.I wait.After a moment, he continues. "What you are looking into is the abyss. This takes you to the very heart of a human being, to the deepest aspect of the soul.He gives me one of his solemn looks. "Because the thing is, you have to confront yourself."(from In the Little World) In 1997, almost by accident, John H. Richardson found himself sharing a hotel with more than a thousand dwarfs. Over the course of a single week, he witnessed love and anger, fear and bravery, arrogance and humility, even a bizarre romantic deception -- the entire spectrum of human emotion in one concentrated dose. But at the end of the week, he discovered that leaving the "Little World" wasn't as simple as checking out of a hotel. In fact, his journey would last a full two years.At a time when bigger often seems synonymous with better, and physical beauty serves as currency, the world of dwarfs usually passes beneath our notice. Now, in this groundbreaking work, awardwinning author John H. Richardson brings the Little World into focus.He introduces us to characters like a saintly but obsessed doctor and a mother who sacrifices her family to save her dwarf daughter. He follows two dwarf lovers from first meeting through the struggle to overcome their fear and shame and find the confidence to love each other. He becomes personally involved in a tangled and often confrontational friendship with a female dwarf. Through these stories and musings ranging from classic theories of beauty to the history of the disability movement to postmodern theories of difference, Richardson presents a world that is a skewed reflection of our own -- and offers us a glimpse into the essential human condition.

    Fifty-somethings just need an extra dose of inspiration to get us going! My book provides a landslide of inspiration to kickstart your very own fitness transformation, as well as my entire step-by-step journey - told with all the humor and down-to-earth honesty of an old gal on a mission! Packed with advice on how to get started, log your calorie intake and schedule your workouts, this book proves that you can accomplish any goal at any age once you have a plan.

    From Agate to Zoisite, each crystal entry includes a color photo, description of properties, listing of associated herbs, oils, and incenses, and astrological significance. You'll not only learn how to identify crystals, but how to harness their powers for decision-making, protection, health, and well-being. Relieve a child's earache with rose quartz or rid the workplace of tension with an amethyst geode tucked in your desk. Whether you carry a core set of crystals, fashion an amulet for portable empowerment, or whip up a pitcher of energy-boosting crystalline water, these practical suggestions can help you face fears and soothe daily stresses.

    Robert Lesslie, whose routine faced him with times of grief or pain, relief or delight, life or death. Such everyday happenings and encounters gave rise to these vignettes—in which readers will meet up with the characters, coincidences, and complications common to the emergency room:characters like Freddy, who literally shoots himself in the footcoincidences like finally having the chance to hear what patients say to each other when doctors and nurses aren’t in the roomcomplications such as dealing with parents who buy lottery tickets and alcohol instead of medicine for their little boyThese heart-tugging, heart-lifting slices of life will prompt readers to search for opportunities to give the comfort of a touch, the grace of a kind word, or a prayer that brings hope and healing.

    Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel--but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which- promote novel cancer therapies long before credible data are available to support such treatment; and- exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration.This is a book about how the actions of human beings--our policies, our standards of evidence, and our drug regulation--incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says,- more cancer clinical trials should measure outcomes that actually matter to people with cancer;- patients on those trials should look more like actual global citizens;- we need drug regulators to raise, not perpetually lower, the bar for approval; and- we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer--and how we can avoid repeating the policy and practice mistakes of the past.

    Through extensive research and interviews, as well as years of experience working in the field, the authors cover gender variance from birth through college. What do you do when your toddler daughter's first sentence is that she's a boy? What will happen when your preschool son insists on wearing a dress to school? Is this ever just a phase? How can you explain this to your neighbors and family? How can parents advocate for their children in elementary schools? What are the current laws on the rights of transgender children? What do doctors specializing in gender variant children recommend? What do the therapists say? What advice do other families who have trans kids have? What about hormone blockers and surgery? What issues should your college-bound trans child be thinking about when selecting a school? How can I best raise my gender variant or transgender child with love and compassion, even when I barely understand the issues ahead of us? And what is gender, anyway? These questions and more are answered in this book offering a deeper understanding of gender variant and transgender children and teens.

    That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait.Ill people are more than victims of disease or patients of medicine; they are wounded storytellers. People tell stories to make sense of their suffering; when they turn their diseases into stories, they find healing.Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known—Gilda Radner's battle with ovarian cancer—to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic.Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new.

    As a woman pregnant with more than one baby, you're feeling all these things . . . only more so! In When You're Expecting Twins, Triplets, or Quads, Dr. Barbara Luke, an acknowledged expert on the prenatal care of multiples, outlines a practical, nutrition-based program to keep you and your babies healthy, and she offers a comprehensive tour of what you can expect during your unique pregnancy and childbirth experience. Women who follow this program have significantly fewer complications during pregnancy—and their babies are born weighing 20 to 35 percent more than the average twin, triplet, or quad. Included is crucial information on:· Finding a qualified maternal/fetal medicine specialist · Dietary guidelines for maximizing birthweight · Safe limits on exercise, physical activity, and work · Taking a leave from your job and negotiating the best deal · Reducing your risk for pregnancy complications · Recognizing the signs of preterm labor and what to do about them · What to expect during and after delivery · Feeding and caring for your newborns . . . and yourself · Getting back into shape after delivery

    But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

    Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:> How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.> What ThedaCare leaders did to replace medicine’s “shame and blame” culture with a lean culture based on continuous improvement and respect for people.> How the lean principle of “building in quality at the source” broke down divisions among medical specialties allowing teams to develop patient care plans faster.> Why traditional modern management is the single biggest impediment to lean healthcare.> How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six.> How the lean concept of “one piece flow” saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%.> How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did — and what it would do differently.Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-designed around patients, waste and errors are eliminated, quality improves, costs come down, and healthcare professionals have more time to spend with patients, who get even better care.

    Susan Macqueen was 12 years old when she accompanied her mother to see her friend Ms. Fairweather, the matron at the local nursing home, and from that day on she knew she wanted to be a nurse. A few years later, despite being told that her grades weren't good enough, Susan was accepted on the three-year nurses training course at Addenbooke's hospital in Cambridge. It wasn't long before Susan knew she wanted to work with children and set her sights on a job at Great Ormond Street. Thirty-five years later, on her third attempt, Susan has finally retired from that iconic hospital and is enjoying a more leisurely pace of life. Hope, despair, laughter, and tears, Susan's stories move the reader through the incredible stories that she was faced with on an every day basis.