A revealing look into a troubling world, and a valuable contribution to our understanding of the forces at work behind the...
How doctors, nurses, patients, and their families experience hospital deaths—and how hospital systems move such matters along through set pathways.
In 1997 and again in 1999, Kaufman (Medical Anthropology/Univ. of Calif., San Francisco) put her professional research tools to good use at three California community hospitals. She followed the course of over a hundred critically ill patients, speaking frequently with their families as they waited for a relative to die, observing and interviewing the various health professionals involved, and attending rounds, staff meetings, and family-staff conferences. From tapes and verbatim notes, she has reconstructed the death scenarios of 27 patients whose stories represent a range of problematic experiences. Kaufman finds that the deathwatch of former times has been transformed into a time of waiting for procedures to be performed and for decisions to be made about what to do next. The very old and very ill are commonly placed on one of two pathways: the heroic intervention pathway or the revolving door one. In the latter, patients are repeatedly shuttled from home or nursing home to hospital and back again in the weeks or months before they die. Kaufman examines the complex practices surrounding life support, how various interpretations of the patient’s suffering, dignity, and quality of life are invoked to control and arrange death by either promoting or stopping aggressive treatment. When the hospital system directs that it’s time to switch pathways, patients and families, she says, are expected to conform to the change—to move from prolonging life to preparing for death. These stories of individual patients illustrate the strains and tensions inherent for everyone involved and demonstrate why the goal of “death with dignity” is so illusive. (Kaufman also looks at those patients hovering in a “zone of indistinction,” such as a coma or a persistent vegetative state.)
A revealing look into a troubling world, and a valuable contribution to our understanding of the forces at work behind the culture of hospital death.Pub Date: April 1, 2005
ISBN: 0-7432-6476-2
Page Count: 416
Publisher: Scribner
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Jan. 1, 2005
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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