Health and Healing in America

After the Thanksgiving break, we will look at the history of nursing with a close examination of one era (the Civil War) and how it was critical in the development of nursing in America.

For Monday, 11/29 I’d like you to look at Stephen Oates’s book about Clara Barton, founder of the American Red Cross. His biography of her is titled A Woman of Valor: Clara Barton and the Civil War, and parts of it are available online at Google Books. Please read 15-20 pages (of your choice) from Part Two, “The Field” (pp. 55-134). It describes Barton’s experiences at several battles in northern Virginia as a field nurse. The chapter has missing pages because it’s only a free preview, so you won’t get a complete story in any selected 15-20 pages, but read for the gist of what it was like for soldiers, nurses, and doctors in the heat of battle, and be ready to talk about some of Barton’s nursing strategies, her responses, and what we can learn about mid-19th century nursing from Oates’s account.

From now ’til Thanksgiving, we’ll be trying to figure out the very complex system of health care in the US. Our goals are to understand the origins and development of this system, figure out where we each fit in it, and to become familiar with the main issues in the debate over health care reform.

I’ve assigned a number of readings (and “listenings”) which I think will help us do this, but I am hoping that you each get interested in this topic on your own and seek out other sources of information also. As you do so, if you come across reliable (preferably nonpartisan) sources, please bring them up in class or mention them to me by email so I can pass along other good resources.

For Monday 11/8, your Disease Project paper is due. I have assigned some readings also, but I am planning to look at and listen to these in class. The first is a short (8-page) policy paper from the Kaiser Foundation that provides an overview of the system and its development, “Focus on Health Reform” . Second, the article by Numbers (#17) in the Leavitt book. And third, an 11-minute segment from the NPR program “This American Life” which aired almost exactly a year ago, looking at health care costs. You may not get to all three, but make a stab at it, and we will begin our discussion in class. What is “health care”? What falls into that category? How did our system develop? What might be wrong with it? And how can we fix it? Our discussion continues on Wed 11/9, adding in the article by Rosemary Stevens that identifies some of the policy and historical differences in the US and UK health systems (and with the help of the YouToons).

Monday 11/15 – in preparation, listen to This American Life, “More is Less” (online audio – about 60 minutes worth of listening) and we’ll discuss why health care in America is so darn expensive & confusing, and what are some policy ideas to deal with rising costs.

Link of the Day: Dartmouth Health Atlas

See you there for our poster session!

This week we have been deeply immersed in David Oshinsky‘s absorbing account of the polio epidemic in mid-20th century America and the political and scientific race for a viable vaccine. We’ll conclude our discussion of this book on Monday, November 1.

Oshkinsky’s big questions include:

Why and how did one vaccine come to dominate, when there were multiple pathways to polio vaccine and little consensus on which kind of vaccine might be best?
What was the interplay between science and politics in the development of the polio vaccine?
Was polio a raging epidemic deserving of such panic and resources, or was that fear fueled/created by a powerful & well-mobilized, well-connected organization?
What conditions in the 1930s-1950s nurtured polio’s growth?
What conditions in the 1930s-1950s nurtured the growth of polio research efforts?
How did the development of a vaccine change American culture?
What contributions did the race for polio make to the system of medical and scientific research in the US?

Also, remember to consider Oshinsky’s scholarly technique:

What sources is he using?
What’s his narrative strategy – i.e. HOW is he telling this story?
Why should we care about this story?

Meantime, you are continuing to research a disease of your choice in the past. On Wed 10/27 I handed out some additional guidelines clarifying what I mean when I say that you should go beyond “web resources” to find quality research sources.

On Wednesday, Nov 3, we will have our Poster Conference Session, held in the Admin Bldg, Room 101-B (ground floor conference room near the front entrance). I would like this to be a professional-quality event showcasing your very best efforts. There will be opportunity for discussion and peer review of your colleague’s research findings.

Update 10/18 – Please note I added the Disease Project guidelines as a new page, see the tab above. Or you can download the guidelines as a PDF here.

On Monday 10/18, we will talk about medicine in the late 19th and early 20th centuries – summing up what happened to health care over that previous century & bringing together our learning from the several recently-assigned articles in Leavitt’s reader. What institutions, new scientific findings, and new cultural practices characterized medicine and health care by 1900? Steele’s essay helps us synthesize that knowledge; his book (from which this chapter is excerpted) concerns medicine on the American frontier, far from those growing urban hospitals that provided the statistical basis for Duffy and Leavitt’s research.

Link of the day: Typhoid Mary’s story

Your Article Abstract is also due Monday (along with the article, if it’s not from the Leavitt reader).

For Wednesday 10/20, we’ll begin to hone in how that system was tested–and changed–in the early decades of the 20th century by looking closely at two epidemics in the 1910s: polio, which had a significant outbreak in 1916 (the Rogers article = Leavitt #35); and the devastating 1918 flu pandemic (via an online article from Popular Mechanics in 2007 – written in light of recent flu scares but prior to the H1N1/Mexican swine flu outbreak).

Note: although it seems like the Popular Mechanics article has 3 pages, all the text is on the first one! The other 2, for some reason, repeat part of the article but have additional images.

Links for Wed: Alaska – Survivors – Rose Worth

On Monday 10/4, we discussed two scholarly articles on changing medical therapeutics and how the American medical system matured – which served as a workshop on becoming a more critical and discerning reader of scholarly articles. We also talked about how to find articles about the history of medicine and health care in the university’s e-Journal resources and using the (free) JSTOR database from the Boston Public Library’s electronic resources.

Our reading for Wednesday 10/6 is essays #19 and #20 in the Leavitt reader, and the pictorial essay found on pp. 295-305. We are talking along two parallel tracks –

• The content, i.e. what visual and source record we have for the institutions where people received medical care in the Victorian era, and how those institutions changed over time
• The scholarly work, i.e. HOW historians use visual and documentary evidence to convince us that their interpretation of the past is correct

Remember to keep in mind the suggestions and guideposts for being a “predatory reader” of scholarly material. Prepare thoughtful discussion questions for class – perhaps at least one for each “track” of our discussion = a question or two about the content of the article(s) AND a question or two about how these scholars approached the problem under consideration, their methods or sources, or how successful/persuasive the essays are.

Also, I posted the PDF of the Article Abstract assignment under the “Assignments and Due Dates” tab – click here to download a copy if you need it.

Leavitt mentions that nutrition and diet have been a major factor in the long-term trends about sickness and health in America. Here are a couple of places online to explore that idea.

Great site on food history in the US
http://www.foodtimeline.org

See also http://www.foodhistorynews.com

Historic Cookbooks at the Feeding America Digital Project
http://digital.lib.msu.edu/projects/cookbooks/

Breakfast in Sturbridge Village
http://www.youtube.com/watch?v=eEZirBqUuUc (5 minute mark)

Portion sizes, then and now

Over the next four class periods, we will explore ideas and historical practices around sickness, health and healing in early America, using 2 case studies: the Martha Ballard diary from Maine (1780s-1810s) and the Journals of the Lewis and Clark Expedition (1803-1806).

For each case study, the first class period will discuss the writings of a  historian and give a general overview to the text, the time period, and the conclusions that scholars are able to draw from these sources. Then you’ll go to the original text and explore for yourself, and bring your findings, questions and conclusions to our second class discussion.

Wed 9/15 – read 2 articles about Ballard as a “social healer” by Laurel Thatcher Ulrich: “Martha Moore Ballard and the Medical Challenge to Midwifery” in the Leavitt reader (Chapter 4 in the big blue volume), AND an excerpt from her 1990 Pulitzer Prize-winning book, A Midwife’s Tale, titled “1787: Exceeding Dangerously Ill” (as a PDF).

Mon 9/20 – explore the diary itself at DoHistory.org

Wed 9/22 – read a chapter from Volney Steele’s 2005 book, Bleed, Blister and Purge: A History of Medicine on the American Frontier, titled “Lewis and Clark: Keelboat Physicians” (PDF)

Mon 9/27 – explore the journals themselves at the Online Lewis and Clark Journals Project (University of Nebraska Lincoln)