Obscure Diagnosis, STAT!

by Dish Staff

Julie Beck explains how TV medical dramas have warped our perception of health care and illness:

Treatments for patients with seizures are sometimes downright dangerous, with doctors trying to hold patients down, or put things in their mouths (they could choke). Patients tend to survive cardiac arrest more often on television than they do in real life, making CPR seem more effective than it often is. “That can lead to a misunderstanding as to the likelihood of a patient or loved one surviving a cardiac arrest,” says Dr. David Brown, chair of the department of emergency medicine at Massachusetts General Hospital. “But it isn’t really good TV if everybody dies, right?”

What does make for good TV: Rare diseases. Injuries. Natural disasters. Which means the amount of screen time given to different conditions isn’t proportional to how common those diseases are in real life, according to a new study published in Human Communication Research. People flock to these shows, after all, first and foremost to be entertained. So less sensational, more quotidian conditions like diabetes are underrepresented.

The Freedom Of Fiction

by Dish Staff

Etgar Keret speculates about why he turned to writing:

What I feel about fiction is that it’s removed from life, that nothing in it is real, the characters can die or have wings. For me it’s a great release. I’m the kind of person who thinks about the consequences of his actions. Especially as the youngest son of two Holocaust survivors. One of the first things I knew about my mother was that her mother and her brother were murdered in front of her eyes and that a year after that her father was murdered too. She was in the Warsaw ghetto. So from very early on I realized that if my mother were to ask me if I wanted to eat another cucumber, regardless of what I might or might not want, if I said yes, then this woman, whom I loved more than life itself and who had suffered so much, would be happy. And if I said no, then she would not be happy. So the idea was that whatever I felt or did resonated in life, caused people pain or happiness. This gave me a feeling of huge responsibility even as a child – to the extent that sometimes I had to block my own feelings or wishes. When I started writing fiction, suddenly I was allowed to do what I wanted.

The Affliction Of Self

by Dish Staff

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Katy Waldman examines the nature of narcissism:

[T]o qualify as pathological, narcissistic tendencies must impair functioning in real and painful ways. The self-absorption must not be explicable by age (toddlers are notorious tyrants) or socio-cultural environment (football stars are encouraged to act like Roman emperors). A true narcissist is all ego, unfettered and clumsy—he sees only himself, and yet the vision is opaque to him. He thrashes around in desires he can’t understand. Perhaps he loves No. 1 uncomplicatedly, or perhaps there is loathing mixed in. In her Harper’s piece “Me, Myself, and Id,” Laura Kipnis writes that the narcissist “lives as though surrounded by mirrors, but he doesn’t like what he sees.”

As Waldman explains, narcissism’s classification remains contested:

For psychiatrists, the question isn’t really “do narcissists exist” or “are narcissists any different from the rest of us.” It’s “are narcissists mentally ill?”

Behind this question lurks another one: What do we gain, and lose, from picking out a psychic phenomenon and declaring it “sick”? Are we needlessly stigmatizing ordinary behavior? Absolving jerks of responsibility for their trespasses? Conversely, given our more advanced understanding of mental illness as biological—a complicated interweaving of genetic, developmental, and environmental factors—are we being more humane? Making it easier for people who are suffering to find treatment? …

[I]t seems strange to insist that, because small-N narcissism lives in everyone, narcissistic personality disorder can’t inhabit its own pathological real estate on the far end of the continuum. Anxiety disorders exist, though we all get anxious. And just as mental illness itself has undergone a transformation from perceived moral failing to medical ailment, perhaps we can begin to see certain persistent dispositions as disabilities rather than spiritual flaws.

(Photo by Andrew Fysh)

The Working Class Have Little Room For Error

by Dish Staff

David Sheff was struck by that fact during a recent visit to the impound lot:

I took a cab and entered a single-story brick building where a few dozen people were crowded together in a scene that evoked Kafka; weariness, frustration and anger were palpable. Some stood in line, some paced and some sat hunched on the floor. A family huddled in a corner, an infant asleep on the father’s shoulder. A woman on a pay phone wept as she begged whomever was on the line to find money so she could get her car back–she said she needed $875. “I’m gonna lose my job if I’m not there at 5.”

Clerks sat on stools behind Plexiglas. At a window, a man pleaded with an agent, “I have to pick up my kids in less than an hour. What am I supposed to do?” At the next window, another man railed loudly and furiously, yelling, “How the hell am I supposed to get my goddam money if I can’t get to goddam work?” The clerk said, “If you can’t get cash, you can pay by credit card or cashier’s check.” The man shouted, “And if I had a goddam limousine, we wouldn’t be having this conversation.”

A Sterile Environment?

by Dish Staff

hospital decor

Virginia Postrel suggests some improvements for hospital-room decor:

When the University Medical Center of Princeton tested a mock-up room with nice views, a sofa for guests and no roommates, it found that patients asked for 30 percent less pain medication, reports the New York Times architecture critic Michael Kimmelman. This result shouldn’t be surprising.

The seminal study on the subject was published in 1984 — that’s right, 30 years ago — in Science. Roger S. Ulrich, now an architecture professor at the Center for Healthcare Building Research at Chalmers University of Technology in Sweden after many years at Texas A&M University, compared two groups of patients recovering from gallbladder surgery in the same hospital, matching patients for characteristics such as age and obesity that might affect their recovery. One group looked out on some trees while the other faced a brick wall; their rooms were otherwise almost the same. Patients with a view of the trees required significantly less high-powered pain medication and left the hospital earlier, after 7.96 days versus 8.70.

Thirty years of follow-up research later, and it’s still news when someone designs a hospital room with a view.

(Photo by Flickr user whatsthatpicture)

Women In Wartime

by Dish Staff

Karen Abbot discusses women’s experiences in the Civil War South:

In the sudden absence of husbands, fathers, brothers and beaus, white Southern women discovered a newfound freedom — one that simultaneously granted them more power in relationships and increased their likelihood of heartbreak. Gone were the traditions of antebellum courtships, where family connections and wealth were paramount and a closed circle of friends and neighbors scrutinized potential mates, a process that could last for years. The war’s disruptions forced elite Southern parents to loosen rules regarding chaperoning and coquetry, which one prominent lecturer called “an artful mixture of hypocrisy, fraud, treachery and falsehood” that risked tarnishing a girl’s reputation. The girls themselves relinquished the anticipation, instilled since birth, that they would one day assume their positions as wives, mothers and slave mistresses, that their lives would be steeped in every privilege and comfort. The war ultimately challenged not only long-held traditions of courtship and marriage, but the expectation that one might wed at all.

Turning ahead several decades, Niamh Gallagher reviews Elisabeth Shipton’s Female Tommies, which chronicles women’s role in World War I:

Significantly, Shipton’s work suggests that the war may have marked a watershed for women after all, at least for those engaged in the military. She argues that “the place to look for the lasting effects of the militarisation of women in the First World War is not 1919 but twenty years further on, in 1939”. For example, the famous Bletchley Park Wrens (members of the Women’s Royal Naval Service) who participated in decoding the secret communications of the Axis during the Second World War had their origins in the Hushwaacs, a section of the Women’s Army Auxiliary Corps formed in 1917 in the wake of persistent efforts by British “female Tommies” to force the War Office to form an official women’s military corps.

A century after the Great War began, and at a time when the changing roles of women in the armed forces are a focus of media attention and public debate, Female Tommies is a valuable resource for those keen to learn about individuals who helped to lay the foundations for women’s frontline participation in wars of the 20th and 21st centuries.

As War Reporters Die, So Dies War Reporting

by Dish Staff

George Packer unpacks what the world lost in the murder of James Foley, and continues to lose as journalism in the Syria-Iraq war zone becomes ever more dangerous:

Among the many reasons to mourn Foley’s death is the loss of his reporting, and of reporting in general, from Syria. News of the civil war from Western media organizations has been dwindling as security has deteriorated, and it is now likely to dry up. Local Syrian reporters face an even greater threat. The Committee to Protect Journalists says that at least eighty journalists have been kidnapped since the start of the war and at least seventy have been killed, almost all of them Syrians, and almost all in 2012 and 2013. So far this year, the confirmed number of journalists killed is down to six, Foley being the most recent. (Solid information is increasingly difficult to get.) This cannot be because working conditions in Syria have improved. One likely explanation is that few reporters, and even fewer who reach Western audiences, are still covering the war. This would be disastrous under any circumstances, but it is especially calamitous now.

He also laments how thoroughly the chattering class has politicized the crisis:

The debate about ISIS almost automatically becomes a debate about who’s to blame for it: who started the Iraq War, who withdrew from it, who supported Nouri al-Maliki, who didn’t support the Syrian rebels, who helped to create ISIS, who failed to see ISIS coming, whose policies turned Muslims into jihadists, who has a right to say anything at all. These arguments are a sweet substitute for the thankless task of formulating honest answers to the questions raised by ISIS, which would inevitably mean advocating morally dubious actions with no certainty of a good outcome, as well as having to repudiate many of one’s earlier views.

Reflecting on his own experience as a war reporter, Tom Peter concludes that collecting facts that will only be doubted, disbelieved, and repackaged into partisan discourse is no longer worth risking one’s life for:

Covering wars for a polarized nation has destroyed the civic mission I once found in journalism. Why risk it all to get the facts for people who increasingly seem only to seek out the information they want and brand the stories and facts that don’t conform to their opinions as biased or inaccurate? And without a higher purpose, what is a career as a reporter? It may count among the so-called “glamor jobs” sought after by recent graduates, but one careers website has listed newspaper reporting as the second worst job in America, based on factors such as stress, pay, and employment uncertainty; toiling as a janitor, dishwasher, or garbage collector all scored better. Even if you love the work, it’s hard not to get worn down by a job that sometimes requires you to risk life and limb for readers who wonder if maybe you suffer all the downsides and hazards just to support some hidden agenda.

Faces Of The Day

by Dish Staff

scotland-fotd

Yes and Better Together supporters exchange views with one another as Jim Murphy, Shadow Secretary of State for International Development (not seen), speaks on his soapbox during his “100 Towns in 100 Days” tour on August 27, 2014 in Dundee, Scotland. Mr. Murphy, Labour MP, is touring Scotland on behalf of the Better Together, spreading his message about the benefits of Scotland remaining part of the United Kingdom and informing the public of the risks that independence poses for the country. Photo by Jeff J Mitchell/Getty Images.