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Throughout history women have practiced the art of medicine and healing Yet they have always faced difficulties in the medical profession--not only have they struggled to gain acceptance from their male colleagues, they have also struggled to find a balance between being a doctor and being a wife and mother. Here, in This Side of Doctoring Eliza Lo Chin offers a penetrating analysis of what it's like to be a woman in the highly competitive field of medicine. Written over the last century and a half, this collection of personal stories, poems, essays, and quotations reveals the intimate lives of over a hundred female physicians. There are touching testimonies from early 19th-century medical pioneers like Elizabeth Blackwell, the first woman to graduate from medical school and Harriet Hunt, who had her own practice that catered to women and children yet was never formally trained, to modern-day medical students and doctors. Poignant and compelling, these narratives offer insights into the struggles and triumphs of women in medicine. Much like an American quilt, this book is a unique and richly textured patchwork of each woman's extraordinary life and career. This assemblage of so many different voices exemplifies the varied paths that women have created within the medical profession. Together they stand as an enduring tribute to the dedication of all women physicians to both their patients and their families. ""These accounts of doctoring and family concerns are universal enough to transcend gender in relationships with patients and colleagues, balancing work and family, and finding meaning in one's profession.... For those looking for a compendium of experiences that document the lives of a diverse cross-section of women in US medicine, This Side of Doctoring is a fine addition to the literature.""--The Journal of the American Medical Association.
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American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Dr. Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, Dr. Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science--objectivity, rationality--became the ideals of medicine, and disease--the target of most medical research--became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general--which is how they learn about the disease--rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease--such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure--is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.
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How cholera epidemics affected Victorian perceptions of the body and the nation..
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As visiting physician to Bethlem Hospital, the archetypal "Bedlam" and Britain's first and (for hundreds of years) only public institution for the insane, Dr. John Monro (1715Ð1791) was a celebrity in his own day. Jonathan Andrews and Andrew Scull call him a "connoisseur of insanity, this high priest of the trade in lunacy." Although the basics of his life and career are well known, this study is the first to explore in depth Monro's colorful and contentious milieu. Mad-doctoring grew into a recognized, if not entirely respectable, profession during the eighteenth century, and besides being affiliated with public hospitals, Monro and other mad-doctors became entrepreneurs and owners of private madhouses and were consulted by the rich and famous. Monro's close social connections with members of the aristocracy and gentry, as well as with medical professionals, politicians, and divines, guaranteed him a significant place in the social, political, cultural, and intellectual worlds of his time. Andrews and Scull draw on an astonishing array of visual materials and verbal sources that include the diaries, family papers, and correspondence of some of England's wealthiest and best-connected citizens. The book is also distinctive in the coverage it affords to individual case histories of Monro's patients, including such prominent contemporary figures as the Earls Ferrers and Orford, the religious "enthusiast" Alexander Cruden, and the "mad" King George III, as well as his crazy would-be assassin, Margaret Nicholson. What the authors make clear is that Monro, a serious physician neither reactionary nor enlightened in his methods, was the outright epitome of the mad- trade as it existed then, esteemed in some quarters and ridiculed in others. The fifty illustrations, expertly annotated and integrated with the text, will be a revelation to many readers..
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Offering a new perspective on medical progress in the nineteenth century, Steven M. Stowe provides an in-depth study of the midcentury culture of everyday medicine in the South. Reading deeply in the personal letters, daybooks, diaries, bedside notes, and published writings of doctors, Stowe illuminates an entire world of sickness and remedy, suffering and hope, and the deep ties between medicine and regional culture.

In a distinct American region where climate, race and slavery, and assumptions about "southernness" profoundly shaped illness and healing in the lives of ordinary people, Stowe argues that southern doctors inhabited a world of skills, medicines, and ideas about sickness that allowed them to play moral, as well as practical, roles in their communities. Looking closely at medical education, bedside encounters, and medicine's larger social aims, he describes a "country orthodoxy" of local, social medical practice that highly valued the "art" of medicine. While not modern in the sense of laboratory science a century later, this country orthodoxy was in its own way modern, Stowe argues, providing a style of caregiving deeply rooted in individual experience, moral values, and a consciousness of place and time..
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The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan-a pediatrician, writer, and historian-argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners-family physicians, internists, pediatricians, nurse practitioners, and physician assistants-asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine, Big Doctoring in America provides an engrossing and illuminating look at those in the trenches of the profession. Illustrations: 15 b/w photographs.
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