John Menary

Mercy Ships

The 60 minute
piece with Doctor Farmer and his alternative delivery methods of medical care
in Haiti and countries in sub Saharan Africa motivated me to write about mercy
ships. Mercy Ships is an organization founded in 1978, describes its self as “the
world’s leading non-governmental ship-based medical organization”.  Operating its current hospital ship the m/v (motor
vessel) Africa Mercy, the organization’s vessel with its 400 volunteers (both
medical and technical)  operate primarily
in western Africa.

In these “cruises”, the ship provides clinical services, public health, community
health, epidemiology, and health education.
This ship is a full service (and obviously) very mobile hospital. These comprehensive
hospitals have full diagnostic facilities including eye clinics and dental
facilities and a pharmacy.

One great
thing that this organization does is its shore side work. This includes dental hygienist
visiting primary schools to education African children on the importance of
oral hygiene as well as providing basic preventative care for themselves. Expanding
shore side missions and in the pattern of Dr. Farmer is what Mercy Ships calls “capacity
building” working with indigenous medical professionals.

Another reason
I picked this topic is because of my future career. I am going to be a marine
engineer. I was attending the Great Lakes Maritime Academy, in their marine
engineering program. I ran into some economic problems at the school, so I had
to take a year leave of absence to get my money situation in order; so I can
back to Michigan State University to knock out my last few credits (to get my mandatory
bachelor’s degree). When I complete the program at the Great Lakes Maritime
Academy and am a licensed marine engineer, I could see myself volunteering some
of my off time (which is one of the great things about the marine
transportation industry there is lots of time off) to help people in the third
world.

Since I will
not be a medical professional, I could explain to them to look at the children
that they are providing preventive care education and address them in a culturally
sensitive meathod method. http://www.youtube.com/watch?v=f4YvViOLKA8&list=UUeyq3MDtsasdCX4MYrnNzfA&index=10&feature=plcp

 

smoking

Nicotine
Cessation

Although the use of Cigarettes
(and smokeless tobacco products) have been declining for years the dependency
on nicotine  is still a “problem” for
about twenty percent of the United States
adult population.  It is claimed
by some that alcoholism is a disease. Alcoholism is not a disease, alcoholism
is a dependency and dependency is a choice. So like alcoholism nicotine is not
a dieses but a choice, so this does not fit this assignment in absolute sense
the production of smoking cessation drugs that have resulted does.

The first drugs for nicotine
dependency; the transdermal patch first hit the prescription market in the
early 1990s overtime nicotine gums hit the market and in the fullness of time
the requirement for a prescription was withdrawn by the FDA.  The patch and gum were simply replacing the
nicotine found in tobacco with an tobacco free delivery device. Non tobacco drugs
have been introduced by pharmaceutical companies, including the drug Zyban.

The marketing strategy used by
advertising agencies is that stopping smoking is hard in fact stopping smoking
by yourself is basically imposable.  The social
roles and cultural ideology in this “condition” and its intertwined with the
drugs that have been reduced to rectify the “problem”.  Smoking has become much less culturally
significant in the United States to the point that is seen as some sort of
social boogey man by the “chattering class”.  This has led to many people to wanting to stop
smoking (that and obvious health detriments). This has been combined with a
culture of a pill for everything (that may have started to rear its head in
full by the 1960s [see the idea of a happy pill]).

There is not much in the way of
doctor patient interaction because most of the products are offered over the
counter. However of one of the non-nicotine drugs such as zyban all you have do
is ask for a prescription and you will get one.

As a former heavy smoker I know
you do not need anything but a small amount of willpower for a few days.

One of the leading names in
nicotine replacement products has its own YouTube page with a variety of ads to
watch. http://www.youtube.com/user/nicorette

life and death

Life and Death

It is one of the few things, if
not the only thing that all people have in common; death.  We all must die, it is the cost of life and
there are no exceptions.  Given this and
the finality of this death is an important subject to study (even if some
people don’t want to because if makes them keenly aware of their own
mortality).

Medical dichotomy: There is probably
no larger separation of anything in the world than the difference between an organism,
(any organism whether it is plant or animal) that is alive and the same organism
that is dead.  Given this light I tended
to disagree heavily with this week’s presentation more than those in the past. Death
is not qualitative death is quantitate. The cessation of life functions is absolute,
there is no gray area. As a society moves from primitive ignorance to that of
advanced science the ability to pinpoint the most absolute moment of life
cessation increases.  This has moved from
an ear on the chest to mirror under the nose to the modern use of brain
activity. But this is not changing the time of death or what death is; death is
the cessation of life. The ability for biomedicine to more accurately pinpoint
the absolute time of death or the ability to pull a victim back from  the “brink of death” did not change what
death is.

I think as western society accepts that there is
a difference between life and death is because the west is the most advance civilization
in human history and it got that why through logic. Death is the natural end of
life death is unavoidable, and although many people try to “heroically” stave
off death for a few days at the very end death is natural. Death is also absolute

MTV show

I have diabetes

Subjecting myself to the insipid tripe that is MTV for the
first time in over a decade (Beavis and Butt head on Itunes does not count) I
watched a show I never heard of before True Life.  I picked the episode I Have Diabetes. This episode documents three young diabetics, and
how they cope with the disease.  There is Kristen a formally independent twenty
something that is forced to move home to cope with her medical bills. Mathew a
diabetic college student who binge drinks even though being a diabetic heavy
alcohol use is dangerous, and Jennifer a very young women who is diagnosed with
diabetes when she is pregnant.

In this documentary they three subjects struggle with the
sick role the male subject knows that drinking with his diabetes is very dangerous
but he continues to do it because I wants a “college experience”. One of the
female subject struggles with the strict dietary restrictions.  Another female subject struggles with bills
and move back home with mom and dad to help cover her bills.

I think the narrative type is the chaos narrative I think
this because the three young people seemed to have major difficulties in obeying
well known dietary restrictions (including limiting the amount of alcohol
consumed). The financial difficulties, of one of the subjects adds to this. It appears
that their lives are spiraling out of control.

The interaction of the three characters with the medical system
is primarily with biomedical professionals (probably endocrinologists). This is
a medical system that is modern, and that we all are failure with.  Diabetes is a common common medical condition;
all of us know at least on problem with this condition. With the obesity
epidemic in this country it is also a growing problem.  There is not a stigma with diabetes even
though type two diabetes has a behavior component to it.

ppd

Post
-partum depression

The baby blues are a known and
historically recorded phenomenon that expresses itself for a few days to a week
after childbirth (passnc.org). Symptoms include trouble sleeping, loss of appetite,
trouble sleeping, and anxiety (passnc.org). A more severe and lingering condition
is post- partum depression. Were as the baby blues are short lasting a benign,
post- partum depression can last for up to a year and includes more menacing symptoms
such as a want to engage in self harm, harm the infant, or neglect the infant (passnc.org).

For many decades  post- partum depression, was believed to be a culturally
bound syndrome restricted to western nations, (rcpsych.org) but more recent studies
“have shown that  post- partum depression seems to be a universal
condition with similar rates in different countries” (rcpsych.org).

However, I do think that it is
far more common in the United States for several reasons. The primary reason
can be simply narrowed down to one source; popular media delivered into the
living rooms of women through the media of television.

There were two tragic incidents
in the last ten years; the first was that of Andrea Yates when in 2001 a thirty
something mother in Houston, Texas drowned her five children in a bathtub. The second
and somewhat less sensationalized case(but still heavily covered by the media),
was when another thirty something mother used a kitchen knife to traumatically
amputate the arms of her infant daughter who died of blood loss.  Both women were found not guilty by reasons of
insanity, and committed to a state hospital.

The non-stop media coverage after
these tragedies ranging from the evening news to the afternoon talk shows like
Dr. Phil and Oprah, lead to widespread knowledge about post- partum depression.  This media bombardment may have a negative placebo
effect,
known as a nocebo (the weeks class material).

http://www.passnc.org/faq/babybluesvsppdpppsychosis

http://bjp.rcpsych.org/content/184/46/s10.full

Shaman

Shaman

Health care
is a vital and necessary part of life. From prenatal care to end of like care,
everyone sees or at least needs to seek medical care. In this week’s assignment
the class is to read and digest care given by various “alternative” methods. The
methods included herbal tradition (I am guessing like Chinese “medicine” and spiritual).

In this article
hospitals are inviting in Hmong shamans to preform what is essentially witch
doctor “magic” to treat disease and sickness. Using hand cymbals and incense
(which necessitated turning OFF the smoke detectors), to drive out spirits and
what not.

The new “healers”
in this case are Hmong shaman. Hmong are a south East Asian hill people that immigrated
to the United States as refugees, escaping retribution from communist governments
and paramilitaries for their armed resistance to communism and aiding the
United States (and prior to that France).  The article states that they use spiritual
healing to drive out spirits. In the United States they work alongside
physicians and paramedical staff in select hospitals.

The shaman
did not appear to have a strong understanding of medicine as a science. As the article
states “the Hmong believe that souls, like errant children, are capable of
wandering off or being captured by malevolent spirits, causing illness”. The hospitals
participating in this project, made the shaman attend a seven week sort of boot
camp., in which they learned germ theory and looked through microscopes.

The hope of
these programs were to ease Hmong into using modern medicine, to treat some
ailments that respond well with treatment, although as the article further
states  even some basic and routine care
is viewed with fear and as a taboo. As the older initial wave of refugees age
and younger and increasingly assimilated, the need for such “care” is diminished.

Source http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=2