Reflection on Emotional Distancing and its Effects in the Medical Field and the Literature

Throughout the semester, we have come to learn about a variety of injustices within our medical system. It is easy to appreciate the severity of these transgressions, but it is not as simple to understand what enabled these events to occur. Our course epigraph, “My job is to notice…and to notice that you can notice.”—Dionne Brand, was brought to my attention during a collaborative blog post in this class. In the post, the term “these people” was used. This was not written with bad intentions, but when the historical use of this term to alienate and mistreat others was brought to our attention, I could not help but begin to notice instances in which the characters in the novels we read also used this label of “the other” to alienate people and allow some sort of injustice to occur. This act of labeling and separating others extends beyond the text and is one of the many factors that has allowed the medical injustices we have explored in this class to occur. Through noticing and reflecting upon this factor of separation, I was able to begin to make connections to how this could be avoided in my own future practice in order to provide the best patient care possible.

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Evolution, Insecurity, & Bureaucracy

In the novel, Zone One, Colson Whitehead confronts readers with uncommonly employed language and references. Many of the words and allusions Whitehead confronts readers with are “esoteric” in nature— or “intended or likely to be understood by only a small number of people with a specialized knowledge of interest”. Of the many allusions presented in the text, I personally took interest in the ones referencing evolution. The book’s protagonist, Mark Spitz, is extremely introspective and through his experience working to secure “Zone One” during a zombie apocalypse, his internal narrative references both evolution and the daily struggles survivors face. These instances of past and present struggles for survival are juxtaposed with Mark’s notice of the prevailing intricacies of bureaucracy present amid the world’s destruction. This contrast serves to forge a connection between the current state of social organization in our own society, and the infinite struggles this system imposes on individuals. 

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Personal Experiences with Ethical International Health Practices

When I saw a publication by Irmgard Bauer titled “More Harm Than Good? The Questionable Ethics of Medical Volunteering and International Student Placements” posted on Canvas, I was both interested (and a bit apprehensive, as I will explain) about the information I was going to be reading. From as far back as I can remember, my desire to be a physician was synonymous with participating in some sort of international medicine program upon earning my MD; the information Bauer presented could not be more pertinent and timely to my endeavors, as I recently traveled to Perú and participated in a student health training program which strongly affirmed my desire to work as a physician and pursue international health. I read the publication with a strong obligation to be informed on current issues that might exist within international medicine. I also read it with some degree of apprehension, thinking that it was possible I would learn that I had unknowingly participated in well-meaning but detrimental practices. Bauer’s work identified a wide array of problems that need to be addressed in international health initiatives, and as I read I compared the examples listed in Bauer’s publication to my real-life experiences and observations during my program. I was also somewhat relieved to find that some programs, like the one I participated in, have already acknowledged and taken steps in order to avoid these issues. In my post I hope to both highlight what these problems are and demonstrate possible solutions that I saw during my own experience.

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Stockholm Syndrome in the Literature: A Technique of Questioning Our Own Morality

As you may know from life experience, people can bond over stressful situations: from being in a hard class to being on the same sports team, shared struggles often serve as a catalyst for the formation of stronger relationships. The two situations I have mentioned are examples of eustress, or stress with positive effects, however bonds can also be formed by more damaging forms of stress coined as distress. A well-known example of the latter is the infamous Stockholm syndrome, which I will begin to explore later in this post. In Octavia Butler’s novel, Clay’s Ark, the experiences of characters seem to parallel that of Stockholm syndrome. However, as Butler often does with her work, we come to notice that this may only taking place at the surface level; upon deeper examination of the what Stockholm syndrome is and comparing it to the experience of the novel’s characters, we begin to realize that perhaps their captors, and their ideals, are not as evil as we may originally think. This makes us as readers question both the morals of those in the book and in our own society, as well as how we can approach changing this.

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(Un)Informed Consent: Examples & Consequences

Written by: Katie Barry, Zach DeGraff, Matty Jackson, Courtney Lyon, Nina Mustico, Emily Vesperman

The topic of informed consent versus uninformed consent is repeatedly brought up throughout Clay’s Ark, whether it is mentioned subtly or outright. We are able to ground the differences between informed consent and uninformed consent in Harriet Washington’s Medical Apartheid. She defines informed consent clearly as “not a signed piece of paper, but rather, the fluid, continuous process by which a researcher informs the subject in detail of what he or she proposes to do … and what the possible consequences the experiment carries. The researcher must continue to inform the subjects of developments in the experiment that could affect him, and the subject may withdraw from the experiment at any time” (Washington: 55). In the case of informed consent, a subject must be aware of what is being done to them and why it is being done. If they are not provided with this information, it can be said that they do not have proper informed consent. Also, if the person involved in the research is not updated on what each step means, they are not providing informed consent, because they do not have the information needed to consent. In certain cases, such as in deception studies done by Dr. Ben Chapman, institutional review boards seek to provide an environment where test subjects are able to give informed consent according to the review board’s standards, but there can still be moral objections to deception studies as a whole. While this could be debated, the difference between informed consent and uninformed consent as a whole is clear. A person is able to provide consent without fully knowing what they are consenting to, but this by no means is adequate. The process of informing a person in order to get their consent is the principle that differentiates the two. 

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Bacteria and Books: An Analogy of Antibiotic Resistance in the Literature

Literature by Octavia Butler is quite digestible in terms of its format and the language it employs; however, as we have discussed in class, the underlying meanings of her work are anything but simple.  As an author, Butler continually puts readers in situations in which they are forced to recognize and challenge any preconceived notions they may have. In the novel, Clay’s Ark, Butler does just this: she writes what appears to be a typical zombie apocalypse novel. However, beneath the surface the infected individuals in her novel are being likened to bacteria. This analogy serves not only as a commentary on antibiotic resistance, but also as a warning regarding the current and future decay of our society—as well as an inkling of hope for reversing it.

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Mistakes & Medicine: How to Prevent and Address Medical Errors

Making mistakes is a part of being human, but what happens when one is never given the opportunity to try (and occasionally fail) at life’s challenges? Shielding people may temporarily spare them from discomfort, but when does this act result in more harm than good? In Toni Morrison’s novel, Home, we see the aftermath of what happens when the constant protection of Cee, by her brother Frank, abruptly ends. A similar dilemma is not unfamiliar to countless medical students each year as they transition from the academic environment of medical school to the realities of residency. In both cases, I will discuss what happens when “protectors” are removed, how to learn from mistakes that have been made, and how to prevent them. Although in this post I liken Cee’s transition to independence to that of medical students, it is important to note that even though both parties share commonalities in their intelligence, motivation, and transition to more independent people, Cee and modern medical students also have very stark differences between their circumstances. In the novel Home, Cee is oppressed because of both her socioeconomic status and her skin color; she is in a vulnerable position not because of her personal qualities, but because of the systematic oppression of her society. There is no doubt that some people who practice medicine also endure these challenges today, but it needs to be noted that those who attend medical school have already achieved a level of social status and education that Cee did not have access to. To simply compare the two parties without acknowledging this difference would be unjust.

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Ichor: A Physical and Figurative Marker of Infection in the Human Body and in the Literature

In the novel Zulus, we read from chapter A-Z instead of the customary 1-26; this is one of many conventions Percival Everett breaks in his writing. He uses this technique as an opportunity to provide various allusions that coincide with each chapter’s assigned letter. Take chapter I, for example: “I is for ichor. ‘… there is no soundness in it; but wounds, and bruises, and putrefying sores; they have not been closed …’” (Zulus, 111). I is for infection as well, and as I will explain, Ichor is the discharge that oozes from infected wounds. In Zulus, this infection is the rot and decay left behind by chemical and nuclear warfare. Two of the book’s protagonists try to eradicate this infection in very different ways: one by means of growth, and one by means of erasure. In our own medical system, we also have old wounds that need healing, and the choice is ours in terms of how to approach this challenge.   

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The Limitation of Reproductive Rights by Governmental Entities

In the fictional dystopia created by Percival Everett, fertility is a hot commodity, and nobody has it… except for Alice Achitophel. However, Alice’s capacity to bear children is not a superpower, but rather an ability that has not yet been taken away from her. The government-mandated sterilizations that set the stage of Zulus may seem like they would cease to exist outside of the surreal chapters of a fiction novel. Sadly, as I will begin to reveal, involuntary sterilization at the hands of the government is no new phenomena. In the 1970s the Indian Health Service is responsible for sterilizing staggering amounts of Native American women without their informed consent.

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Imposter Syndrome and Its Invisible Grasp on Medical Students

Imagine both helping to bring one of modern medicine’s most fundamental procedures to America and preventing an epidemic. Now, imagine doing all this and not receiving credit for it.  In our world ruled by copyrights and publications, this situation can be difficult to imagine. However, in 1721 this was far from reality.  An excerpt in chapter 2 of Medical Apartheid recounts the story of Onesimus: the man who helped make inoculation mainstream in the United States. When Onesimus shared his knowledge and experiences of the procedure in Africa with the man who kept him enslaved, Cotton Mathers, Mathers used this information to advocate for widespread smallpox inoculation in Boston. He also submitted a report to the Royal Society on the topic, and as a result reaped acclaim for preventing an epidemic and making inoculation a widespread Western practice. On the contrary, the mastermind behind the technique, “came to share the fate of nearly every slave who contributed to medical research: facelessness” (73). I interpreted this “facelessness” as a forced separation of Onesimus from his contributions. This alienation he experienced reminded me of more modernly acknowledged phenomena: imposter syndrome. People with this condition often feel uncomfortable acknowledging that they are wholly responsible for their successes. This condition is very common, especially for people in the medical field, but it is still not recognized by many: including its victims. In my writing I hope to both raise awareness of what imposter syndrome is and why it occurs, as well as how we can combat it so that more people can feel valid and responsible for all that they have accomplished.

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