Health and Healing in America

Our workshop generated some terrific questions and I added a few of my own. Here are some topics to study; the exam’s questions will be based on this list, as well as the glossary wiki and people wiki terms. Continue reading →

During this unit, we’ll work at understanding our tremendously complex American health care system: its origins, current reform efforts, issues for debate, consequences, and possible future.

Wed 4/17 – View Michael Moore’s film Sicko. Response Paper #3 due.

Mon 4/22 – How Did We Get Here? Reading: Stevens, “History and Health Policy in the US” (PDF on Blackboard)

In-class link: “Why is American Health Care So Ridiculously Expensive?” (The Atlantic 3/27/13)

Wed 4/24 – Costs: Economic, Social and Ethical. Reading and Listening: Farmer, “Pathologies of Power” (PDF on Blackboard) and LISTEN to and take notes on this October 2009 hour-long episode of the NPR program This American Life

Links we watched in class:
MRI Costs (Washington Post WonkTalk, March 2013)
Health Care System Overview (Khan Academy)
Journalist Steven Brill talks about his Time cover story on Medical Bills (March 2013)

Mon 4/29 – Health Care Reform, Law & Policy. Start by browsing this site: Healthcare.gov

Then read these:
Health Care Reform – Top 10 Pros/Cons on Procon.org
“The Case for Universal Health Care in the United States,” AMSA (American Medical Student Association), 2008
Robert A. Levy, “The Case Against President Obama’s Health Care Reform: A Primer for Nonlawyers,” Cato Institute White Paper, 2011 (12-page downloadable PDF)
“Fighting to Control the Word ‘Obamacare'” NYT 25 March 2012
“The ABCs of the Health Care Law and its Future,” NYT 2 April 2012

Note: there quite a number of polemical websites, you might want to look at a few, keeping in mind none of these are official or scholarly sources –

Obamacarefacts.com
Obamacareprosandcons.org
therepealpledge.com
HeritageFoundation.org’s content on Obamacare
CommonHealth: Reform and Reality (WBUR.org)
NYT: Multimedia content on the Affordable Care Act and the Supreme Court

Wed 5/1 – The HC Debate in Microcosm. See the “Debate” tab at the top of the course website. Prepare for the debate by taking, and supporting with evidence, a position in the health care debate. Due in class: Your Position Paper

Mon 5/6 – Wrap Up Day and Exam Prep. We will complete the Glossary in or before class, and work on developing the format for the final together.

Mon 5/13 – Final Exam 12:30 pm. Due at the final: Your Course Reflection Paper (prompt TBA)

Throughout the third unit of this course we’ve been reading and discussing health care and medicine in the period 1890-1950. For Response Paper #3, due Wed 4/17, choose one of these prompts and craft a 3-4 page paper drawing on our class discussions and course readings in this unit: Willrich Pox, Rutkow Seeking the Cure Chapters 8-10, and Penney & Stastny The Lives They Left Behind.
Continue reading →

Over the next few weeks we’ll be exploring aspects of health care in the twentieth century: the post-Flexner, vaccine-and-antibiotic era in which a gigantic industry of health care began to flourish – and during which the medical profession’s opposition to centralized health care emerged with a vengeance.

For Wednesday, April 3rd – your Disease Report papers are due, but also: please bring Rutkow’s book and be ready to talk about chapters 8 and 9.

Relevant links:

A (hilariously campy) British government 1964 film looking back on the 1940s discovery of penicillin

See Jack Gibbon’s heart-lung machine in action (BBC Four)

Hear Ronald Reagan in his 10 minute LP recording from the AMA’s “Operation Coffee Cup” 1961 lobbying effort (never mind the images, just listen to the recording)

Listen to the 1948 “Truth or Consequences” episode introducing the original “Jimmy” of the Jimmy Fund

Next week we’ll read a short, but gripping, historical and medical detective book delving into the abandoned suitcases of inmates (is that the right word?) at a big New York mental hospital in the 1920s-1950s. I think you’ll really enjoy reading it and considering its thought-provoking depiction of care for the mentally ill. Read chapters 1-6 of The Lives They Left Behind for Monday, April 8th and Chapters 7-Epilogue for Wednesday, April 10th. I’ll then hand out a prompt for the third response paper, due on Wed 4/17.

Summing up your #1 takeaway from Michael Willrich, Pox: An American History:

Continue reading →

This week, we begin reading Michael Willrich’s thorough and well-written account of smallpox epidemics and eradication campaigns at the turn of the 20th century. Think about how to connect the story Willrich tells in such detail with the overall framework we’ve gotten from Rutkow: the rise of bacteriology, scientific thinking, public health, teaching hospitals, and other institutions of modern medicine. And notice, too, how race and class intersect with this story in perhaps unexpected ways.

For Mon 3/11 – Read Pox Prologue and Chapter 1

For Wed 3/13 – Read Pox Chapters 2-3

Over spring break, read Pox Chapters 4-5 for Mon 3/25

Reminder: the Disease Project poster and presentation day is Wed 3/27 of the week we come back from break.

I mentioned “radium girls” in class – here are a couple of links for more information.

Alan Bellows, “Undark and the Radium Girls,” Damn Interesting #241
Deborah Blum, “The Radium Girls,” Speakeasy Science 24 March 2011

There’s also a play based on their experiences, “These Shining Lives” (the photo is from a recent Minnesota production of the show).

See also this eyepopping post for more on the early 20th century fascination with radium and radiation in advertising and product names.

Our first unit explored foundational concepts of disease and health, different theories about the origins of disease, and the prevailing beliefs and practices in early America.

In our next unit, we consider the long 19th century and the rise of medical professionalization – a process Rutkow also argues was one of democratization. The middle chapters of Rutkow’s book are our main texts in this unit, although we begin with the ideas of the French philosopher and literary scholar, Michel Foucault, on the birth of the clinic and his observations on perception, power and “the gaze” in medical diagnosis and healing. If you’ve ever read feminist film theory, you might recognize this concept is similar to Jacques Lacan’s scholarship on the normative camera’s eye as heterosexual male gaze and on the complex interplay between subject/object and the processes of subjectification and objectification.* Foucault is interested, broadly, in power and discourse – how meaning is encoded. His provocative book, which we are reading in excerpt, explores the development of the medical “clinic” (which stands for any professional medical setting) as a discursive system in modern society. You will find it densely packed with ideas, please take your time with reading it!

The first part of the unit will look like this –

Mon 2/18 – Reminder, no class – Presidents’ Day

Wed 2/20 – The Medical Gaze. Reading: Foucault, Birth of the Clinic (excerpts – as PDF on Blackboard). Bring the essay or take good notes on it and bring those. Remember to BRING a list of terms to class so we can begin our glossary together. The terms/concepts can come from Porter, Rutkow’s Intro/Ch1, Ulrich’s article, and Steele’s essay – or from anything we’ve brought up in class so far.

Mon 2/25 – Democratization of Healing. Reading: Rutkow, Ch 2. Your Diagnosis: History paper is due.

Further reading:
The “Ether Dome” original article from the Boston Medical and Surgical Journal, 1846

Wed 2/27 – Modern Medicine and Quackery. Reading: Rutkow, Ch 3-4. See also: The Quack Doctor blog.

Other links for Wed:
HarpWeek Cartoon, 1865 “The Hygiene of New York City”
Full text of Cathell’s book The Physician Himself (1886 edition) on Google Books
More on Garfield’s death: “The Doctors Who Killed a President” (New York Times Review of Books, 2011)

Mon 3/4 – Rise of Medical Professionalism. Reading: Rutkow, Ch 5-6. See also: The Flexner Report 100 Years Later (Yale J of Bio and Med, Sept 2011).

Response Paper #2 Prompt –
In his first 7 chapters, Rutkow has briskly marched his readers through a tour of medical progress (both forward and backward) and professionalization. In a 2-3 page response paper, choose and describe one debate, ideological conflict, or inflection point of change in American health care history. Reflect/respond on the impact and importance of this episode. Be sure to cite any direct quotations from the text. We will use your response papers as the basis of discussion on Wednesday, so preferably bring it as a printed hard copy paper.

Wed 3/6 – Progressive Era Challenges. Reading: Rutkow, Ch 7. Due in class: Response Paper #2.

* I rarely recommend Wikipedia entries, but the one on the gaze is actually pretty decent – maybe partly because it’s flagged as “too technical for most readers to understand.”