Communication
Ritual / BeliefMedicine and culture: varieties of treatment [Lynn Payer]
This book was published first 1988, again 1995, and is still in print. This book compares and contrasts the attitude of physicians and patients in England, France, the USA and in Germany. This is not a book concerning different health systems, but rather a book concerning the fact how differently physicians and patients in these countries use diagnoses and therapies, and how, frequently unexpressed ideologies, thereby participates. Lynn Payer gets straight, that these assumptions drastically differentiate between countries, and that, what is by agreement recognized as diagnosis or therapy in one country, it is regarded in another country quite often as "malpractice".
"French doctors will diagnose vague symptoms as spasmophilia or something to do with the liver; German doctors will explain it as due to the heart, low blood pressure, or vasovegetative dystonia; the British will see it as a mood disorder such as depression; and Americans are likely to search for a viral or allergic cause."
"A belief in the terrain also undoubtedly plays a role in the fact that fewer invasive procedures are used in intensive care units in France than in the United States - with patients doing equally well in both countries."
"West Germans use about six times the amount of heart drugs, per capita, as do the French and English."
"'Herzinsuffizienz' really has no translation into English because it would not be considered a disease in England, France, or America. German doctors often translate it as 'cardiac insufficiency'."
"By far the strongest philosophical movement in Britain has been that of the empiricists. 'But because it ought to work doesn't mean it does ... The data are more important than the hypothesis' This respect for factual details explains why the British have been the chief proponents of the randomized, controlled trial in medical research."
"Not all French doctors are Cartesian, not all German doctors authoritarian romantics, not all English doctors kindly but paternalistic, not all American doctors aggressive. As with most caricatures, these pictures may be distorted, but they are based on truths found in the overall practices of each country."
Reintegration after organ transplantation
"Actually there are substantial cultural differences concerning the choice of pharmaceuticals or cures or the choice of certain operation methods, despite the international exchange of knowledge and experiences. One finds more to this topic in the book of Lynn Payer 'Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France'" [ Volker Koellner, University Hospital Carl Gustav Carus, Dresden, 1999]
Selling Sickness. How Drug Companies Are Turning Us All into Patients (Allen & Unwin, 2005)
Over three decades ago the maverick thinker Ivan Illich warned that an expanding medical establishment was medicalising life itself, undermining the human capacity to cope with the reality of suffering and death, and making too many well people into patients. He criticised a medical system “that claims authority over people who are not yet ill, people who cannot reasonably expect to get well, and those for whom doctors have no more effective treatment than that which could be offered by their uncles or aunts” (2).
A decade ago medical writer Lynn Payer described the process she called disease-mongering, in which doctors and drug companies unnecessarily widened the boundaries of illness to recruit more patients and sell more drugs (3). Her writings have become ever more relevant as the industry’s marketing roar becomes louder and its grip on the healthcare system much stronger. [Source » US: selling to the worried well … Ray Moynihan / Alan Cassels ]
Disease-Mongers: How Doctors, Drug Companies, and Insurers are Making You Feel Sick (Lynn Payer & 1992)
Lynn Payer, formerly chief medical correspondent for the International Herald Tribune and health editor for the New York Times, is arguing in this book that far too many doctors, as well as drug companies and insurers, are bilking the public, frightening people with ineffective tests, and concentrating too much on benign conditions.
The book's thesis is compelling: doctors, drug companies, and device manufacturers are engaged in "broadening the definitions of diseases" in order to increase demand for their products and services. Since the book was first published in 1992, the evidence has mounted that Payer's view of the medical establishment is all too accurate.
The epidemiological data (or lack of data), is reviewed in order to find a basis for some common health recommendations, practices and beliefs. The breast cancer screening advice for women under age 50 is to receive a physical examination and a mammogram every 2 years. However, research studies show that women who underwent regular screenings did not fare much better against breast cancer than those who were not screened. Nonetheless, physicians support the recommendation and manufacturers promote their mammogram machines as profit-making ventures. Even worse for the individual, mammograms detect noncancerous abnormalities that must be checked out, they cause anguish and unnecessary surgical expenses – and thus mammograms provide a source of income one way or the other.
» The pharmaceutical industry has a dream: at least one disease (and more than one prescription drug) for every American - Stan Cox
Neurogenesis in the adult human hippocampus
The genesis of new cells, including neurons, in the adult human brain has not yet been demonstrated. This study was undertaken to investigate whether neurogenesis occurs in the adult human brain, in regions previously identified as neurogenic in adult rodents and monkeys. Human brain tissue was obtained postmortem from patients who had been treated with the thymidine analog, bromodeoxyuridine (BrdU), that labels DNA during the S phase. Using immunofluorescent labeling for BrdU and for one of the neuronal markers, NeuN, calbindin or neuron specific enolase (NSE), we demonstrate that new neurons, as defined by these markers, are generated from dividing progenitor cells in the dentate gyrus of adult humans. Our results further indicate that the human hippocampus retains its ability to generate neurons throughout life. [Eriksson PS, Perfilieva E, Bjork-Eriksson T, Alborn AM, Nordborg C, Peterson DA, Gage FH.; Nature Medicine 1998 Nov;4(11)]
No hiding place
"While Dr Cohen's group wrestles with how people make choices, Klaus Mathiak, of the University of Tübingen, in Germany, and his colleagues, are using fMRI to study the effects which certain sorts of choice have on brain activity. Specifically, the team is looking at what goes on in the heads of dedicated video-games players during violent 'social interactions' within a game."
"Dr Mathiak enlisted 13 gamers who played video games for, on average, 20 hours a week. While the gamers stalked and shot the enemy from the relative discomfort of a scanner's interior, the researchers recorded events in their brains."
"As a player approached a violent encounter, part of his brain called the anterior cingulate cortex became active. This area is associated with aggression in less fictional scenarios, and also with the subsequent suppression of more positive emotions, such as empathy. Dr Mathiak noted that the responses in his gamers were thus strikingly similar to the neural correlates of real aggression. As he puts it, 'Contrary to what the industry says, it appears to be more than just a game.'" [The Economist, Oct 28th, 2004]
Mind Games
"In the halls of Congress, on newspaper opinion pages, in the fevered nightmares of worried parents, the debate continues: Are video games good or bad? On college campuses, though, the talk has moved on. There, the games are increasingly seen as an important social and cultural force worthy of serious study.
"When a new medium arrives, young people are the early adapters," said Henry Jenkins, director of the Comparative Media Studies program at MIT and one of the nation's leading video-game thinkers. "Parents are spooked by it because it was not part of their world when they grew up. It gets blamed for all sorts of things."
"Whether we like it or not, this is the medium of our moment," said Sheldon Brown, a UCSD visual arts professor and director of the school's Center for Research in Computing and the Arts.
"It is a medium that is telling our cultural story, and the fact that it is a primary tool of youth and adolescents means it will have a tremendous impact on how the next generation or two plays itself out. It's not something we can ignore."
"When you put this into the realm of art, you are asking people to look at it seriously," Brown said. "One of the problems with video games in our culture is that they are not taken seriously, or they are done so in a patronizing way."
The data is still being analyzed, Vorderer said, with the results scheduled to be discussed at a neuroscience convention in San Diego in October. But one interesting offshoot, dramatic proof of the all-encompassing lure of the games for some people, has emerged, he and Rene Weber, the principal investigator, said.
Most people can tolerate being in the MRI machine for maybe 20 minutes. It is claustrophobic and loud. But the gamers stayed in for an hour at a time, looking into a mirror positioned above their heads so they could see the video screen set up just outside the scanning tube. "
According to industry estimates, that average age is now 29. ... Before long, Vorderer and others believe, the White House will be occupied by a president who is a gamer." [John Wilkens, The San Diego Union-Tribune, August 15, 2004]