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Plastic surgeon in the writer's eye.
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To end itself by death: suicide in Shakespeare's tragedies.
The tragedies of William Shakespeare make frequent use of suicide, some accomplished, some merely contemplated. Although his intent was their dramatic context, the Bard nonetheless clearly anticipated many features being discussed today, including assisted suicide, imitative ("copycat") suicide, and suicidal ideation by individuals with depression or disabilities. Recent debate over how often these factors influence the incidence of suicide rarely invokes their historical longevity. They are not new, so changes over the years in societal, religious, legal, and medical attitudes toward suicide must be considered when trying to understand their role. This review attempts to show that many such features of and attitudes toward suicide circa 1600 were perceived by Shakespeare and incorporated into his plays. In the 15 plays classified as tragedies, there are 13 definite and 8 possible suicides, ie, a total of 21 incidents for evaluation. Among the 13 overt suicides, at least 7 are depicted as being admirable under the circumstances at the time. Also, in various ways, 4 of these 13 were assisted, and at least 3 others contain an imitative element. Overall, the action of taking one's life is presented in a neutral or even favorable light, and the audience is left with a mingling of pity and admiration for the victim, not reproach.
Grief themes.
Four grief themes that were developed in clinical practice have been explored. These themes were also prevalent in Ibsen's play Little Eyolf. The conspiracy of silence, detachment, guilt, and resolutions are themes that are prevalent in Rita and Alfred's life and, therefore, in the grieving of little Eyolf's death. These themes are family motifs present in the family's history. They must be brought into the open, in the hope of achieving a resolution at times of death. If not, future physical and mental health might be affected. In counseling the dying and their families, the nurse must explore these developing themes. Previous themes must be understood before the present ones can be confronted and resolved. These themes can then be used to gain a broader perspective into the needs, problems, and emotions of the dying and his or her family.
The banning of Frederick Wiseman's movie, "Titicut Follies"--censoring the evidence.
Poor quality of care in the form of indifference and indignity can be seen as the filmmaker Frederick Wiseman shows in his classic documentary, "Titicut Follies," which was banned from public showing for 25 years.
Use of live theater to increase minority participation in Alzheimer disease research.
Recruitment and retention of African Americans into Alzheimer disease (AD) research studies poses challenges owing to long-standing socio-economic and cultural differences, pragmatic difficulties in reaching the African American population, and a legacy of distrust of medical research. In this study, we report on our efforts to use live theater to educate African Americans about AD research and to increase minority participation in it. We describe our experiences at the University Memory and Aging Center (Cleveland, OH) in commissioning, writing, and producing several theater productions focused on themes related to African Americans and their experiences dealing with family members with AD. Analysis of recruitment data, gathered before and after one of our productions, indicated that minority enrollment into our Center's Research Registry increased after the play. Survey data, gathered before and after production of a different play, indicated that viewing this piece increased knowledge about: (1) the symptoms of AD; (2) the fact that memory loss is not a part of normal aging; and (3) the greater prevalence of AD among African Americans. Also, after viewing this production, more audience members: (1) reported knowing how to become involved in research; (2) felt comfortable involving family members in research; and (3) would recommend research to others. We conclude that live theater that dramatizes the experiences of a family living with a person with AD can increase knowledge about AD, improve attitudes about taking part in research, and lead to greater participation in AD research studies. An explanatory model is offered to account for our findings.
The Noh mask effect: vertical viewpoint dependence of facial expression perception.
Full-face masks, worn by skilled actors in the Noh tradition, can induce a variety of perceived expressions with changes in head orientation. Out-of-plane rotation of the head changes the two-dimensional image characteristics of the face which viewers may misinterpret as non-rigid changes due to muscle action. Three experiments with Japanese and British viewers explored this effect. Experiment 1 confirmed a systematic relationship between vertical angle of view of a Noh mask and judged affect. A forward tilted mask was more often judged happy, and one backward tilted more often judged sad. This effect was moderated by culture. Japanese viewers ascribed happiness to the mask at greater degrees of backward tilt with a reversal towards sadness at extreme forward angles. Cropping the facial image of chin and upper head contour reduced the forward-tilt reversal. Finally, the relationship between head tilt and affect was replicated with a laser-scanned human face image, but with no cultural effect. Vertical orientation of the head changes the apparent disposition of facial features and viewers respond systematically to these changes. Culture moderates this effect, and we discuss how perceptual strategies for ascribing expression to familiar and unfamiliar images may account for the differences.
Chloroform at Christmas. An early reference from the Theatre-Royal, Edinburgh.
James Young Simpson first administered chloroform to one of his obstetric patients on 5 November 1847. The speed with which the discovery caught the popular imagination is illustrated by a comic scene in a pantomime which formed part of an entertainment in Edinburgh presented on 27 December in the same year.
Social dramatics: social skills development for the chronically mentally ill.
The purpose of this study was to investigate the use of social dramatics as a clinical tool for teaching social skills to the chronically mentally ill on adult inpatient units of a state hospital. The research tested the hypothesis that patients exposed to social dramatics with videotape feedback would demonstrate greater ability to perform social skills as measured by the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Fifteen schizophrenic adults of both sexes meeting specific criteria were randomly assigned to experimental and control groups. Subjects were exposed over an 8-week period to randomly introduced social dramatic scenarios. The Wilcoxin test for two independent samples was used for testing differences between experimental and control groups. The research findings supported the hypothesis for one positive factor, social competence. The findings did not support any treatment effect on either social interest and personal neatness or irritability, manifest psychosis, and psychotic depression. There were no significant differences on the total score NOSIE-30. Recommendations for psychiatric nursing are made. Limitations of research methodologies and sample size were addressed.
The value of integrating interpretive research approaches in the exposition of health care context.
AIM: This paper discusses the use of a nested set of methodologies (dramaturgy, ethno-methodology and ethnography) to characterize and interpret the settings, practices and interactions inherent in the health care environment. The aim is to explain how a set of methodologies can help make sense of research data in the clinical setting. BACKGROUND: Despite the recognition of the importance of the context of care there has been limited debate about the use and value of research methods and methodologies and how they can be best applied to the health care context. DISCUSSION: Using dramaturgy the physical and social scene can clearly be established, to enable insight into 'how the scene is contrived'. The ethno-methodological approach assists in the examination of taken-for-granted assumptions inherent in the interactions between individuals in the 'scene', and the underlying 'shared' knowledge within interactions. 'Shared knowledge' identifies knowledge as a medium for communication. The use of ethnography ensures that social and cultural symbols, which are an integral component of how individuals collectively attribute meaning to places and events, become a significant part in the interpretation of interactions. CONCLUSION: The combination of these methods is advantageous in assisting qualitative researchers in the health care environment to 'make sense' of their complex field notes.
In their own words: presenting the patient's perspective using research-based theatre.
INTRODUCTION: In this paper we describe the development of a performance piece based on patients' stories of interacting with health care providers, its introduction into the curriculum to dramatise the patient's perspective on health care, and the evaluation of student responses. METHODS: The piece, entitled In Their Own Words, was created from transcripts of interviews with authors who wrote about their experiences of illness. Over the past 4 years, students have performed the piece as a dramatic reading as part of a required course for Year 1 medical students. RESULTS: Analysis of the students' written reflections identified 5 major themes describing what students learned from the performance piece. These themes were: illness evokes emotions and providers must address both the physical and emotional needs of their patients; patients want health care providers to listen well and to understand patients' perspectives; providers' words and gestures profoundly affect patients; patients do not want to be defined, identified or treated as only their symptoms or illnesses, and information and conditions that clinicians consider routine can be very distressing for patients. DISCUSSION: These themes identified in the students' comments represent critical concepts that health care providers must understand so that they can build therapeutic relationships with their patients. Thus, In Their Own Words is an effective tool for increasing students' awareness of patients' experiences of illness, which is a key aspect of learning to provide effective patient-centred care. Presenting patients' stories through dramatic readings represents an innovative approach to incorporating the patient's perspective into medical education.
How leprosy is depicted in Ben-Hur.
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Oh what a tangled web: the medicinal uses of spider silk.
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Understanding the illness experience.
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The Arthur Mills Oration--Shakespeare in daily life.
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