Health

"Too often people’s illness stories are dismissed as being “unreliable” or “chaotic”, or that the person themselves are in some way “difficult” or want to complicate the issue of their condition. There are great injustices that are done to people’s stories if you can’t make sense of them, or you don’t value the knowledge a story contains. A story’s meaning is not only in what is said, but also in how it is said."

"Being heard shows us that we are of worth, of value. It restores our humanity. Being allowed to tell our story helps us connect our own dots and see different possibilities. For so long, my story was frightening and hopeless and despairing. I needed to tell a better story in order to heal. I needed to first be able to share my story before I could start to co-create new stories. Stories that make both biological and biographical sense. Stories that put order to the chaos and make meaning of my experiences."

"We talk a lot about good listening but closely listening is not so much about listening for diagnostic features or listening to respond or listening to tell someone to do something. It is the ability to hold the space for uncertainty, hold the space for ambiguity."

"...I was a reader and I went to meetings and conferences about literature and medicine, and...what I'm doing as a reader is what I want to do for my patients. I want to be a good reader for them in all the ways in which I was learning on my own how to read complex novels-- following the time, the temporal complexity, and metaphors, and when they stop telling one story and start another one."

"As the patient tells, I listen as hard as I can--- not taking notes during this segment of the interview, not interrupting unless critical, not indicating one way or another what I consider salient or meaningful or interesting. I try my best to register the diction, the form, the images, the pace of speech. I pay attention--- as I sit there on the edge of my seat, absorbing what is being given--- to metaphors, idioms, accompanying gestures, as well as plot and characters represented for me by the patient.... I listen not only for the content of his narrative but also for its form--- its temporal course, its images, its associated subplots, its silences, where he chooses to begin in telling of himself, how he sequences symptoms with other life events. After a few minutes, the patient stops talking and begins to weep. I ask him why he cries. He says, 'No one ever let me do this before.'"

"Radical listening is the effort to be present, to bear witness, and to listen without your biases and assumptions. It's about curiosity, not judgment."

"When I invited her to just tell me, I said, "I'm going to be your doctor. Tell me what you think I should know about your situation.""

"Considering how common illness is, how tremendous the spiritual change it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness… when we think of this, as we are so frequently forced to think of it, it becomes strange indeed that illness has not taken its place with love and battle and jealously among the prime themes of literature."

"...physicians are like literary critics, who...arrive at the text [of the patient] laden with theory, assumptions, hypotheses."

"In 1943, the United States began research into the use of biological agents for offensive purposes. This work was started, interestingly enough, in response to a perceived German biological biological warfare (BW) threat as opposed to a Japanese one. The United States conducted this research at Camp Detrick (now Fort Detrick), which was a small National Guard airfield prior to that time, and produced agents at other sites until 1969, when President Nixon stopped all offensive biological and toxin weapon research and production by executive order."

"Blome's admirers at Camp Detrick could not protect him from indictment. Instead they concentrated on securing his acquittal. Blome put up a spirited defense."

"Around the corner from Jahrling's office is a room known as the Secure Room, which is always kept locked. Inside it there is a stew phone, a secure fax machine, and several safes with combination locks. Inside the safes are sheets of paper in folders. The sheets contain formulas for biological weapons. Some of the weapons may be Soviet, some possibly may be Iraqi, and a number of the formulas are American and were developed at Fort Detrick in the nineteen sixties, before offensive bioweapons research in the United States was banned."

"Painstakingly, the germ-development program at Fort Detrick had tested prospective germ weapons on nearly a thousand American soldiers, in sealed chambers and the wilds of the Utah desert. Reaching beyond the military, it had exposed prisoners at the Ohio State Penitentiary, where volunteers were carefully monitored. Clandestinely, it also sprayed American cities with mild germs to investigate the likely impact of deadly pathogens."

"In 1940, with Europe into its second great war, the federal government leased the field for use in its Cadet Pilot Training Program. The Army erected the barracks and the large hangar, and poured concrete for an aircraft tie-down ramp, a taxiway, and sidewalks. That was the physical state of the place when on March 9, 1943, the Army Chemical Warfare Service took formal possession of Detrick Field, annexed some of the surrounding farmland for field trials, and renamed it Camp Detrick. Personnel started arriving in April. They were not pilots or even, for the most part, military men. They were civilian biologists whose task was to mass-produce germ weapons. Their first order of business was to fill the British production order for "three kilo dried X.""

"There were some episodes of infection, but they weren't all that bad. In any case, anything that did happen on the post was restricted to the post. Nobody got infected at Camp Detrick and started an epidemic outside in Frederick, Maryland. It was contained on the post. I mention this because all of the horrifying scenarios that have been written by molecular biologists and science fiction writers don't have to happen. Many of these proved methods and techniques of handling organisms and storing them, having access to them, were developed in Camp Detrick. These are still the criteria by which most people in pathogenic microbiology operate."

"Mr. Rockefeller was not a man to be hurried into precipitate action. Careful study and long deliberation were for him invariably prerequisite to any move in an unknown field. It was two years before the idea was sufficiently matured in his mind to enable him to go forward, and during this period there were many conferences between him and Mr. Gates. On June 29, 1909, he signed a deed of trust, turning over to three trustees—his son; Harold McCormick; and Mr. Gates—72,569 shares of the Standard Oil Company of New Jersey, valued at $50,000,000, the trust to be known as the "Rockefeller Foundation.""

"The offices of the Rockefeller Foundation were in the RCA builing on West 50th Street, fifty-fourth floor, and from there they had their public health and research empire all over the world, where they had considerable weight in various countries. It was interesting. It served a very useful purpose, I think. The foundation never got full credit, in my estimate, for all the things it did for mankind. It didn't want it. It always kept a low visibility. But they did some wonderful things, especially in malaria and hookworm in the south—that's how they started, working on hookworm—and then they went into malaria, which was and still is a great problem."

"[The medical student to the master, in 11th century Persia:] But if you were able to look within the center of the earth, would you? [The master:] Of course! [The student:] Yet you are able to peer inside the human body, but you do not [due to restrictions against human dissection]."

"[The master to the student:] I've a gift of my own, as strong as yours... I can detect a man in whom there may be a physician, and in you I feel a need to heal, so strong that it burns."

"To watch a master of physical diagnosis in the execution of a complete physical examination is something of an aesthetic experience, rather like observing a great ballet dancer or a concert cellist."

"It is...in institutions that the [medieval] university tradition is most direct.... the notion of a curriculum of study...tested by examination and leading to a degree, as well as many of the degrees themselves-- bachelor, as a stage toward the mastership, master, doctor, in arts, law, medicine, and theology."

""Mr. Rapp [a medical student], what is the difference between an element and a compound body?" Mr. Rapp is again obliged to confess his ignorance. "A compound body is composed of two or more elements," says the grinder, "in various proportions. Give me an example, Mr. Jones." [A "grinder" is an outdated term for a person who coaches students for an upcoming examination.] "Half-and-half is a compound body, composed of the two elements, ale and porter, the proportion of the porter increasing in an inverse ratio to the respectability of the public-house you get it from," replies Mr. Jones."

"To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all."

"Except it be a lover, no one is more interesting as an object of study than a student."

"Everywhere now the medical student is welcomed as an honored member of the guild. There was a time, I confess, and it is within the memory of some of us, when, like Falstaff, he was given to "taverns and sack [sherry] and wine and methelgins [mead], and to drinkings and swearings and starings, pribbles and prattles"; but all that has changed with the curriculum."

"Universities, like cathedrals and parliaments, are a product of the Middle Ages."

"[Regarding the registration of Vesalius into medical school in the year 1533] Vesalius matriculated in the medical school...He was now termed a philiater, one devoted to medicine."

"The white coats...were symbol and proof that medicine was a guild, with a strict hierarchy, with steps up the stairway that you took not when you felt you were ready, but when you were permitted....You had to learn what was necessary, as decided by those who went before you, those who knew. You had to go up the steps, learn in order, no skipping, slow."

"[The student]...sighed ruefully, "I may end up no physician, for I am not a scholar".... [The master:] "Then you must build harder and faster than the others.""

"...doing that one full and complete...[practice physical] exam was amazing. It was like making pottery or woodworking-- detailed, precise, careful. It was my first inkling that medicine was not only a science but also a craft. Everything mattered, everything was important and told a story. The patient's hands-- their warmth and dryness or cold and wetness; their nails, palms, pulse; the texture of their skin and hair; the presence or absence of lymph nodes-- and that was just up to the elbow."

"The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a college course, not a medical course, but a life course, for which the work of a few years under teachers is but a preparation."

"[An account of an American doctor who "went back to medical school" in Paris in the year 1836:] I get up in the morning at six o'clock and am at La Charité [hospital] by seven, follow Velpeau until eight, see him operate and lecture until half after nine, breakfast at ten at a café. At eleven I am at a school of practical anatomy, where I dissect until two. Then I attend a class of practical surgery until three; then hear Broussais and Andral until five; then dine. At seven I attend Helmagrande's class of midwifery, which lasts until nine; then I come to my room and read or write until eleven, when I retire."

"We had the courage to watch the dreadful sight for four hours ... Damiens was a fanatic, who, with the idea of doing a good work and obtaining a heavenly reward, had tried to assassinate Louis XV; and though the attempt was a failure, and he only gave the king a slight wound, he was torn to pieces as if his crime had been consummated. ... I was several times obliged to turn away my face and to stop my ears as I heard his piercing shrieks, half of his body having been torn from him, but the Lambertini and Mme XXX did not budge an inch. Was it because their hearts were hardened? They told me, and I pretended to believe them, that their horror at the wretch's wickedness prevented them feeling that compassion which his unheard-of torments should have excited."

"And (as for) the man and the woman addicted to theft, cut off their hands as a punishment for what they have earned, an exemplary punishment from Allah. And Allah is Mighty, Wise. But whoever repents after his wrongdoing and reforms, Allah will turn to him (mercifully). Surely Allah is Forgiving, Merciful."

"The video of 'paranoid' has been censored by MTV. They took all nipples out of the cartoon, but they had no problem with the scene in which a man cuts off his own arms and legs."

"any government that mutilates its citizens for the express purpose precipitating social stigma is, frankly, unfit to govern."

"Here's what doctors don't tell you"

"Most doctors say that it takes six weeks to heal from an episiotomy, but for many people it takes longer."

"Once a C-section, always a C-section"

"Nowadays, episiotomies are not part of routine birth; however, circumstances may require an episiotomy to lower the health risk of the mother or her baby."

"Episiotomies are used in emergency situations."

"Warrants are in the process of being secured. The driver is expected to be arrested upon release from the hospital."

"[Baby Sevyn presented] Sunnyside up [and was stuck in the birth canal so Williams performed an episiotomy; it didn’t work]"

"Pregnant women can talk to their care providers before labor begins to enable them to have an open mind towards episiotomies if needed."

"There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

"A concrete example showing the importance of preserving difference is that of healing systems throughout the world. Each brings something useful to the table because of its distinct models and approaches. Western medicine, Indian Ayurveda and yoga, and Chinese medicine and acupuncture all provide unique solutions for certain types of diseases and wellness management. Yet none can be properly mapped onto another's framework without compromise. What is needed is not a cut-and-paste insertion of these practices into a Western model of medicine but an understanding of the integrity and utility of each system's own model and the philosophy behind it, so as to give it a place alongside Western systems."

"What I may see or hear...in regard to the life of men...I will keep to myself, holding such things shameful to be spoken about."

"I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."

"Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves."

"If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men..."