I am old enough and fortunate enough to see and appreciate the changes that have occurred over the past half century in the health care system, especially regarding mental health. I still vividly remember visiting a state mental hospital where a great uncle spent much of his life. The building had all of the negative aspects of an institution including limited resources and communal showers. But then chlorpromazine (thorazine), a drug used for treating certain mood disorders, was invented and he was able to spend the rest of his days at home with his family. Fast-forward several decades, when I began my career as a psychiatrist, I was part of a team that completed a study with clozapine, the first antipsychotic that was demonstrably superior to others. Again, I saw the wonders of medical technology as people with severe mental illness once relegated to back wards in chronic institutions were able to engage in meaningful relationships and live productive lives. Relative to the rest of medicine, treatment of the mentally ill is relatively young and the wonders of new advances and treatment long seen in antibiotic therapy and cancer treatment are still emerging in psychiatry.
Of course, the next morning always comes and I find myself in my clinic again, the exam room speaking aloud in all of its blatant metaphors—the huge clock above where my patients sit implacably measuring lifetimes; the space itself narrow and compressed as a sonnet—and immediately I’m back to thinking about writing. Soon enough, my patients start to arrive, and the way they want me to understand what they are feeling only immerses me more deeply in language’s compelling alchemy: “The pain is like a cold, bitter wind blowing through my womb,” murmurs a young infertile woman from Guatemala with what I have diagnosed much less eloquently as chronic pelvic pain. “Please, doctor, can you heal me?”
Alan Friedman, Ph.D. and Craig Hurwitz, MD advocate for palliative care in HI’s Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley
How have medical advances over the long 20th century altered the ways western cultures represent illness, death, and dying? Before the turn of the 20th century, people living in North America and Britain commonly confronted death in their own homes. The bed was often the site not only of conception and birth but of death as well. The dead and dying were familiar, commonplace, and domestic, and, consequently, the practices and rituals associated with death and dying were typically supervised by women, who commanded the domestic sphere. Yet rapidly-changing advances in science and medicine over the course of the 20th century have dramatically altered our experiences and perception of death. Geoffrey Gorer argues in his essay, “The Pornography of Death,” that death has replaced sex as the ultimate taboo in the United States and the United Kingdom; it has become sanitized and discrete from our everyday lives. Medical doctors who were once mostly helpless at best or harmful at worst to the sick, have become, with medical advances, newly able to intervene in illness and promote healing. Continue reading The Sanitization of Death and Dying→
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