Unraveling the diversity and cultural heritage of fruit crops through paleogenomics

Abundant and plentiful fruit crops are threatened by the loss of diverse legacy cultivars which are being replaced by a limited set of high-yielding ones. This article delves into the potential of paleogenomics that utilizes ancient DNA analysis to revive lost diversity. By focusing on grapevines, date palms, and tomatoes, recent studies showcase the effectiveness of paleogenomic techniques in identifying and understanding genetic traits crucial for crop resilience, disease resistance, and nutritional value. The approach not only tracks landrace dispersal and introgression but also sheds light on domestication events. In the face of major future environmental challenges, integrating paleogenomics with modern breeding strategies emerges as a promising avenue to significantly bolster fruit crop sustainability.

Mental health, subjective experiences and environmental change

This article responds to Coope's call for the medical humanities to address the climate crisis as a health issue. Coope proposes three areas for progress towards ecological thinking in healthcare, with a focus on ecological mental health. The article emphasises the need to understand the cultural dimensions of mental health and proposes an interdisciplinary approach that integrates insights from the arts and humanities. It examines the impact of climate change on mental health, drawing on The Rockefeller Foundation - Lancet Commission on Planetary Health and recent studies. The discussion focuses on the intersection of mental health, subjective experience and environmental change. Focusing on emotional experiences as constructed from biological and cultural elements, the article proposes a holistic approach to mental health. It proposes two converging lines of research, in constant interaction: first, a historical and cultural research of those concepts, practices and symbols related to the environment, emphasising a cultural history of nature; and second, a synchronous research, drawing on anthropology, sociology and participatory art-based research, to understand how these aforementioned elements influence our current relations with nature. The article concludes by emphasising the urgency of developing narratives and histories that redirect temporal trajectories towards a better future, while respecting and acknowledging diverse narratives of individual experience. It calls for collaborative efforts from the medical humanities to contribute to a more comprehensive understanding of the complex relationship between mental health, nature and ecological crisis.

Conceptual anatomy of the female genitalia using text mining and implications for patient care

This article analyses the conceptual histories of words associated with female genital parts to explore how they may affect the lived experience of people with these parts and the quality of gynaecological care they receive. Specifically, we examine the implications of using the word 'vagina' to replace the word 'vulva', or indeed to indicate the entire female genitalia. This article does so through an analysis of existing scholarly work and through text mining methods such as word frequencies, most distinctive word collocates and word-embeddings drawn from literary and women's magazine corpora. We find that words indicating specific female genital parts are very infrequently mentioned in our corpora, which shows that there is a troubling lack of exposure and education in our socio-cultural context when it comes to the female genital anatomy. When they are mentioned, their usage reflects historical and patriarchal associations that have been primarily attached to the word 'vagina'. When it comes to the 'vagina' and 'vulva', the penis is the most prevalent association by far; whereas the most commonly occurring female genital parts are parts to do with reproduction-reinforcing a long-standing and disproportionate emphasis on the female genitalia's reproductive function. Our research also reveals a concerning emphasis on non-evidence-based female hygiene products, thus perpetuating the damaging stereotype of the dirty vagina. These findings may explain many negative patient outcomes such as stigma attached to seeking out timely gynaecological care, lack of informed medical consent and non-evidence-based practices exacerbated by problematic cultural depictions of the female genitalia. They can also explain the neglect of female sexual agency, pleasure and well-being. Understanding historical and contemporary usages of words for the female genitalia has important implications for the quality of patient care today and is a critical component of gender and reproductive justice.

The 'Glasgow effect': the controversial cultural life of a public health term

The question of why more people in Glasgow were dying, and younger, compared with English cities with almost identical levels of deprivation, was a hot topic in Scottish public health debates in the early 21st century. Public health researchers, particularly the Glasgow Centre of Population Health (GCPH), used the terms 'Glasgow effect' and 'Scottish effect' as placeholders while identifying the unknown factors behind Scotland's excess mortality. Yet the terms took on a colourful life of their own in the press and larger culture and continue to circulate, despite GCPH's attempts to retire them. This paper is the first to analyse the cultural life of the 'Glasgow effect' and 'Scottish effect' terms. Looking primarily at the Scottish press 1998-2022, I analyse the politically charged and often controversial debates and lay recommendations around the concepts. I also trace the terms' parallel usage, and indeed origin, in contexts unrelated to health. I argue that the 'Glasgow effect' functions as a myth. This myth emphasises Scottish exceptionalism in public health and larger culture, at a time when devolution and the prospect of independence heightened optimism and anxiety about Scotland's future. It overlaps with a larger and longstanding myth of Scottish cultural pathology, or the pathological Scot. The flexibility of the 'Glasgow effect' and 'Scottish effect' terms is exploited by journalists, academics and artists to serve competing agendas, establish their own expertise and influence public opinion. While it may now be challenging to eradicate these terms, especially in lay contexts, researchers and policy makers should avoid using these unstable terms uncritically. The example of the 'Glasgow effect' shows how health concepts can become wrapped in larger national or political narratives and highlights the difficulties for public health communicators in introducing complex and emerging public health ideas into a dynamic landscape of lay beliefs.

They are not all wolves: menstruation, young adult fiction and nuancing the teenage boy

Before the 2020 publication of Elana K. Arnold's Red Hood and Sarah Cuthew's Blood Moon, Judy Blume's 1970 novel Are You There God? It's Me, Margaret, which ends with the heroine praising God for blessing her with menarche, was one of the only young adult novels to feature menstruation as a central theme. This paper opens with a brief overview of recent English and American menstrual activism and a discussion of scholarly considerations of the menstrual cycle in literature. Then, through a close comparative reading of works by Arnold and Cuthew, I argue that both novels fulfil their feminist agendas by representing the stigmatised experience of the physicality of menses, and by depicting young women negotiating instances of the kinds of misogyny that punctuate contemporary Western culture. At the same time, the novels share an overly simplistic, binarised attitude towards male adolescents. That aspect highlights the need for the development of affirmative feminist boys studies. Such progress would foster more nuanced literary depictions of young males-and address the challenges of building a more equitable world, thereby responding to some of the motivating concerns of Red Hood and Blood Moon.

Diagnosing Shosha: literature as a lens to view disease and history

In recent decades, physicians have diagnosed fictional and non-fictional characters through portraits, biographies and writing. We argue that such an exercise can be beneficial for a uniquely health humanities reason-better understanding of our current world and the social determinants of health. Drawing on the method of health and social justice studies, we explore the character of Shosha, who appears repeatedly in the writings of Nobel Prize winner Isaac Bashevis Singer. Singer's strong story-telling skill and commitment to writing about the Jewish communities of prewar Poland in vivid detail preserve a slice of history, ensure that future generations will better understand what was destroyed by Nazi extermination policies, and provide lessons for modern political, hunger and war threats to human health. Shosha suffers from a lifelong debilitating disease that neither Singer nor subsequent commentaries ever name. The authors focus first on diagnosing the disease by consulting medical literature and experts. They then examine the value and pitfalls of this exercise and suggest that the lessons of understanding the disease historically, for teaching physicians how to recognise diseases rooted in war and poverty, and for enlightening all of us to the risks faced in human health by a world increasingly taking up arms and sliding towards fascism make diagnosing Shosha necessary and meaningful.

A Special Relationship-Aspects of Human-Animal Interaction in Birds of Prey, Brown Bears, Beavers, and Elk in Prehistoric Europe

Humans have developed a special relationship with some animal species throughout history, even though these animals were never domesticated. Based on raptors, bears, beavers, and elks, the question of whether there are similarities between the perception of these animals that triggered a special kind of fascination in humans and how the relationship between humans and these animals changed between Mesolithic age and medieval times is addressed. As we demonstrate, the categorical antagonism between 'animal' and 'human' is a concept that saw different kinds of influence, from the advent of sedentarism and husbandry to Christianity and from philosophical thinking in Classical Antiquity and the Period of Enlightenment. In prehistory and early history, we find different, opposing world views across time, cultures, and periods. Differences between animals and humans have been considered as fluid, and humans have had to engage with animals and their needs. The well-known and famous 'bear ceremonies' attested to different peoples and times were not unique, but were a part of belief systems that also included other animal species. Among the considered animals, certain raptor species attracted the attention of humans who tried to establish contact with them, as companions, whereas bears were almost 'disguised humans' due to all their similarities with humans, but they were also tabooed beings whose real names had to be avoided.

Authority and medical expertise: Arthur Conan Doyle in The Idler

Arthur Conan Doyle's medical and writing careers intertwined and his work has a history of being read in the light of his medical expertise. He wrote at a time when the professionalisation and specialisation of medicine had resulted in an increasing distance between the profession and the public, yet general practitioners relied financially on maintaining good relationships with their patients and popular medical journalism proliferated. A variety of contrasting voices often disseminated narratives of medical science. These conflicting developments raised questions of authority and expertise in relation to the construction of medicine in the popular imagination: how is knowledge constructed? Who should disseminate it? How and by whom is authority conferred? How can the general population judge experts in medical science? These are questions explored more widely in Conan Doyle's writing as he examines the relationship between expertise and authority. In the early 1890s, Conan Doyle wrote for the popular, mass-market periodical The Idler: An Illustrated Magazine His contributions to it address these questions of authority and expertise for a lay audience. First establishing the medical context of doctor/patient relationships in which these questions arose, this article undertakes a close reading of these mostly rarely studied single-issue stories and articles as a means of ascertaining how Conan Doyle and his illustrators identified the relationship between competing narratives, expertise and authority. It argues that rather than maintaining a distance between public and professional, Conan Doyle's illustrated work demonstrates to his readers that there are ways to successfully navigate the appearance of authority and recognise expertise as they confront entangled representations of advances in medical science.

Medical specimens and the erasure of racial violence: the case of Harriet Cole

This article analyses the complex narrative of Harriet Cole, a 36-year-old African-American woman whose body was delivered to the anatomy department of Hahnemann Medical School in 1888. The anatomist Rufus B Weaver used her preserved remains to create a singular anatomical specimen, an intact extraction of the 'cerebro-spinal nervous system'. Initially anonymised, deracialised and unsexed, the central nervous system specimen endured for decades before her identity as a working-class woman of colour was reunited with her remains. In the 1930s, media accounts began to circulate that Harriet Cole had bequeathed her remains to the anatomist, a claim that continues to circulate uncritically in the biomedical literature today. Although we conclude that this is likely a confabulation that erased the history of violence to her autonomy and her dead body, the rhetorical possibility that Harriet Cole might have chosen to donate her body to the medical school reflects the racial, political and legal dimensions that influenced how and why the story of Harriet Cole's 'gift' served multiple purposes in the century and a half since her death.

'Freudism' and modernity: transcultural impact of psychoanalysis in the modern Turkish novel

The theory of psychoanalysis came to Turkey in the early 1900s, but it was dismissed as being unmedical in a psychiatric context shaped by the Kraepelinian model. Still, it rapidly entered the intellectual discourses of the period, and in literature, it became a contact zone to discuss broader issues concerning the modernisation of the country. Novelists in particular undertook a critique of its epistemology to explore what they deemed the conflictual relationship between the native values and the westernising attitudes as broadly conceived at the time. Two early examples of such novelistic engagements with psychoanalysis are Peyami Safa's Matmazel Noraliya'nın Koltuğu and Ahmet Hamdi Tanpınar's Saatleri Ayarlama Enstitüsü This article focuses on the novelists' engagement with psychoanalysis in their critique of the modernisation project adopted in Turkey through the theme of the 'self-in-crisis'. Both texts contribute to the broader discussions of their milieu in a way that presents psychoanalysis as being representative of that which is modern and portray it critically to underline the dissonances between the old, traditional values and the new, imported ones.

Sex, relationships and 'everyday psychology' on British magazine problem pages, c. 1960-1990

The later decades of the 20th century saw dramatic changes in sexual attitudes and behaviour in Britain: rates of divorce and remarriage increased; premarital sex and illegitimacy became more common, even as the pill and legal abortion opened up new reproductive choices; and following on from the decriminalisation of homosex, liberation movements began to celebrate gay lives. These shifts generated new possibilities, but often entailed much inner turmoil. The same period witnessed an unprecedented flourishing of professional and popular psychological expertise. Influential social and cultural theorists have argued that the intertwined rise of "permissiveness" and therapeutic culture caused an important shift in the ethical dimensions of modern life, in which citizens and subjects came to idolise self-realisation over the public good.This article uses women's magazine problem pages, exploring the role of advice columnists on and off the page, to examine the intersections of "permissiveness" and the psychologisation of everyday life. Millions looked to agony aunts in mass-market women's magazines to help them negotiate new emotional and sexual worlds. As purveyors of counsel, but not (usually) formally trained counsellors, magazine advisors worked with the new languages and concepts of psychological expertise and disseminated them to avid readers.Across this period, problem pages demonstrated greater openness towards sex and displacement of morality from external standards to the individual. However, advisors also continued to emphasise self-control and responsibility, and to provide practical guidance that took at best a superficially psychological veneer. These trends were underpinned by a model of sex as an essential part of loving, stable relationships, and the (largely unexpressed) notion that such relationships were essential to social functioning. In the woman's world of the magazine, before and beyond the 1980s, the problem page does not show the rise of individualism or the pursuit of pleasure above all else.

Choosing the best apple: counselling leaflets and technologies of communication in the history of reproduction

Historians have shown how the establishment of human genetic counselling in West Germany was characterised by several sociohistorical factors, in particular the impact of the legacies of Nazi biopolitics. These accounts have reconstructed continuities on an intellectual level which delayed a turn towards non-directive approaches, emphasising individual (emotional) well-being and voluntariness, and instead have prolonged a discourse that defined disability as an economic and social burden. However, while the distinct legacies of eugenics and racial hygienics are well researched, other factors that constituted counselling encounters, such as the ways of communicating reproduction and material objects' roles in transformations of concepts, actors and their relations, have not been examined in detail. Drawing on the archives of a Marburg-based charity, this paper aimed to reconstruct these factors at the example of the production and circulation of a major family planning leaflet, Our Child Shall Be Healthy, developed ca 1977. In doing so, I want to suggest that connections between science, politics and economy were a key element in technologies of communicating reproduction. This essay approaches counselling as a communicative practice that was in continual productive engagement with different concepts of reproductive health. First, it argues that the communicative and paper technologies used in counselling interactions in West Germany changed in the aftermath of the worldwide thalidomide tragedy. Second, it argues that a novel approach to reproductive health emerged that focused on individual decision making as the basis of prosperity and emotional well-being. Taking a family planning leaflet as a site for reconstructing how people of different organisations, with different stakes and expertise converged in the design of a counselling encounter, this paper targets the crossroads of economic, political and scientific activities in the history of communicating reproductive health and reproductive risks.

The freighted social histories of HIV and hepatitis C: exploring service providers' perspectives on stigma in the current epidemics

A virus has a social history. In the case of the hepatitis C virus (HCV) and HIV, this history is one involving stigma and discrimination, advocacy and activism, and recent dramatic improvements in treatment. These social histories influence the experience of people who live with the viruses, and those who work with them. One aspect of this is the impact of social changes on the biographical disruption and integration brought about by illness. Healthcare practitioners who see significant improvements in the effectiveness of treatment for a condition over the course of their professional life will incorporate those changes into their own history and their relationship to that condition.This article is based on a study of the experiences of serodiscordance, or mixed infection status, in families living with HIV and two types of viral hepatitis, hepatitis B and hepatitis C. The article explores the perspectives of healthcare workers who work with people affected by these viruses, who were asked about their experiences in working with serodiscordance in families. Interviews revealed that changing social meanings given to bloodborne viruses, and changes to treatment over time, held a significant place in the accounts that service providers gave of their work. In asking them to describe their work with HIV and HCV, we were also asking about work that has been shaped by changing patterns and sources of stigma, and recently reshaped by changes in treatment and outcomes. While typically the experiences of patients and their families are used to investigate the social histories of diagnosis and stigma, the professional perspectives and life stories of the service providers who work with them are also revealing. We heard accounts in which histories as well as current regimes were prominent, illuminated further by insights from the sociology of health on narrative and biographical disruption.

The Jew's penis: circumcision and sexual pathology in eighteenth-century England

This essay explores the contradictory, prejudicial attitudes towards circumcision and Jewish male sexuality circulating in eighteenth-century English print culture. I argue that while Jewish men had long been accused of lustfulness, effeminacy and sexual deviance, eighteenth-century culture added to these concerns a unique interest in sexual pathology, borne in part from the growing medical anxiety around venereal disease. Consequently, while Jewish men were still widely condemned for their lechery, they were also increasingly ridiculed for a range of penile and sexual disorders that were believed to make sex unsatisfying, difficult or even impossible-most notably impotence, a condition often associated with venereal disease. I link these paradoxical eighteenth-century characterisations of Jewish male sexuality with a similarly paradoxical understanding of circumcision as a procedure that could prevent, but also cause, various penile or sexual disorders. I conclude that these prejudices not only constitute an example of what Sander Gilman has identified as the 'bipolar' nature of anti-Semitism; they also indicate a darker trend towards the pathologising of the Jewish body.

White supremacy culture and the assimilation trauma of medical training: ungaslighting the physician burnout discourse

The physician burnout discourse emphasises organisational challenges and personal well-being as primary points of intervention. However, these foci have minimally impacted this worsening public health crisis by failing to address the primary sources of harm: oppression. Organised medicine's whiteness, developed and sustained since the nineteenth century, has moulded training and clinical practice, favouring those who embody its oppressive ideals while punishing those who do not. Here, we reframe physician burnout as the trauma resulting from the forced assimilation into whiteness and the white supremacy culture embedded in medical training's hidden curriculum. We argue that 'ungaslighting' the physician burnout discourse requires exposing the history giving rise to medicine's whiteness and related white supremacy culture, rejecting discourses obscuring their harm, and using bold and radical frameworks to reimagine and transform medical training and practice into a reflective, healing process.

An Uncommon Cause of Choreoathetosis

Choreoathetosis is an uncommon presentation in the emergency department setting. The differential diagnosis is broad and includes life-threatening as well as benign causes. Lethal etiologies include metabolic derangements such as hyponatremia as in the case presented here. Hypotonic hyponatremia is the most common electrolyte imbalance and can result from 1 of 2 broad categories of dysregulation: excess free-water intake and solute depletion. Here we describe a case of hypotonic hyponatremia due to a less common route of excess free-water intake. Choreoathetosis as a presenting symptom of hyponatremia is described in case reports. We present a case of a 77-year-old Thai woman who presented to the ED with complaints of weakness, mild headache, confusion, vomiting, and choreoathetoid movements for 1 day. She endorsed chronic, worsening constipation and decreased appetite. She was found to be severely hyponatremic with a serum level of 114 mEq/L requiring admission to the intensive care unit (ICU) for emergent electrolyte correction. She denied any diuretic use or excess oral water or alcohol intake. The etiology was unclear until a careful history was taken, whereupon it was revealed that she had been self-administering tap-water enemas excessively for relief of constipation. Choreoathetosis resolved with careful electrolyte correction. A home-administered tap-water enema leading to hyponatremia and choreoathetosis is a subtle presentation that underscores the importance of careful social history-taking, especially when dealing with vague or non-specific symptoms. We review some more common causes of hyponatremia and discuss its initial management.

Iconic Arable Weeds: The Significance of Corn Poppy (Papaver rhoeas), Cornflower (Centaurea cyanus), and Field Larkspur (Delphinium consolida) in Hungarian Ethnobotanical and Cultural Heritage

There are an increasing number of initiatives that recognize arable weed species as an important component of agricultural biodiversity. Such initiatives often focus on declining species that were once abundant and are still well known, but the ethnographic relevance of such species receives little recognition. We carried out an extensive literature review on the medicinal, ornamental, and cultural applications of three selected species, Papaver rhoeas, Centaurea cyanus, and Delphinium consolida, in the relevant Hungarian literature published between 1578 and 2021. We found a great diversity of medicinal usages. While P. rhoeas stands out with its sedative influence, D. consolida was mainly employed to stop bleeding, and C. cyanus was most frequently used to cure eye inflammation. The buds of P. rhoeas were sporadically eaten and its petals were used as a food dye. All species fulfilled ornamental purposes, either as garden plants or gathered in the wild for bouquets. They were essential elements of harvest festivals and religious festivities, particularly in Corpus Christi processions. P. rhoeas was also a part of several children's games. These wildflowers were regularly depicted in traditional Hungarian folk art. In poetry, P. rhoeas was used as a symbol of burning love or impermanence; C. cyanus was frequently associated with tenderness and faithfulness; while D. consolida regularly emerged as a nostalgic remembrance of the disappearing rural lifestyle. These plants were also used as patriotic symbols in illustrations for faithfulness, loyalty, or homesickness. Our results highlight the deep and prevalent embeddedness of the three iconic weed species studied in the folk culture of the Carpathian Basin. The ethnobotanical and cultural embeddedness of arable weed species should also be considered when efforts and instruments for the conservation of arable weed communities are designed.

'Written of by novelists': scripting and managing emotions in 19th-century medical manuscripts

Literary and medical historical scholars have long explored the work of physician-writers and the cross-pollination of literature and medicine. However, few scholars have considered how these interactions have shaped medical manuscripts and the echoes they contain of the emotional contours of the medical encounter. This essay uses the papers of Southern physician Andrew Bowles Holder (1860-1896) to explore how the emotions of the physician were managed at the bedside and in the aftermath of medical encounters through recourse to literary thinking. Holder, like many 19th-century physicians, was an avid reader with an interest in literary endeavours, and his manuscripts reveal the influences of literature on his work as a physician. This article frames the bedside as a theatre of emotions, in which Holder's performance and management of his emotions was key to his professional identity. His literary interests thus provided him with two tools: first, literature provided him with models for how to respond to and record different kinds of medical encounters, particularly deaths, near-death experiences and childbirth; second, his mode of keeping these records, which included the production of poetry as well as medical prose, served as a technology of coping, further allowing him to manage his emotions by exorcising them on the page.

Temporal technologies of epidemics

The COVID-19 pandemic has largely been made sense of as a crisis However, using crisis as a temporal-analytical category arguably obscures the complexity of the different temporalities at work in the pandemic. In this article, we examine how the pandemic outbreak led to numerous acts of synchronisation and de-synchronisation-between humans and viruses, between social groups and even between historical ages. In order to make sense of the temporal consequences of an epidemic, we introduce the concept of 'temporal technologies', understood as a set of procedures that control, regulate, produce and assemble time in relational networks of both human and non-human actors. This article thus attempts to create a framework for understanding the epidemic experience in temporal terms by using 'temporal technologies' as an analytical tool.

Women's voices, emotion and empathy: engaging different publics with 'everyday' health histories

This article explores our experiences on a Wellcome Trust-funded project on women's experiences of 'everyday health' in Britain between the 1960s and the 1990s. We explore issues around researching 'everyday health', including the generation and interpretation of source materials, and the role of empathy and emotion in interactions with different audiences as we share these materials in public engagement activities. We discuss three case studies of engagement activities to draw out potential uses of source materials and the responses of different audiences to these materials, and reflect on what we have learnt since embarking on these public engagement activities. We took into our interactions with different audiences the belief that fully historicised understandings of 'health' enrich individual lives and create new capacities for meaningful action now. The public engagement activities we carried out reinforced this belief, but also caused us to question some of our assumptions. In particular, an activity with trainee healthcare professionals designed to demonstrate how active and empathetic listening can prevent the unintentional infliction of harm in healthcare settings achieved this end-but did so in a way that was itself unintentionally insensitive to the pressures healthcare professionals face. Medical humanities can help to contextualise, nuance and improve healthcare practice-but only through active listening and dialogue across medicine and the humanities. We conclude by considering how these activities, which currently rely on the interpersonal relations of the team with audiences, might be adapted and preserved in digital form beyond the span of the project.

Fatherlessness, sperm donors and 'so what?' parentage: arguing against the immorality of donor conception through 'world literature'

Is biology and knowing biological ancestral information essential to the construction of identity? Bioethicist James David Velleman believes this is the case and argues that donor gamete conception is immoral because a portion of genetic heritage will be unknown. Velleman is critical of sperm donation and the absence of a biological father in donor-assisted families. His bioethical work, specifically the 2005 article 'Family History', is oft-cited in articles debating the ethics surrounding gamete donations and diverse family formations. However, I wonder to what extent Velleman's ethical stance is exhibited in contemporary culture? Velleman suggests that innate knowledge of bio-superiority helps readers and audiences appreciate the importance of biological family structures in literature and film; he says, 'When people deny the importance of biological ties, I wonder how they can read world literature with any comprehension' (2005, 369). Velleman understands the stories of Oedipus, Moses, Telemachus and Luke Skywalker as demonstrating a universal cultural comprehension that genetics are essential to identity construction. I adopt Velleman's list of stories and ask if they really can support an antidonation sentiment and suggest that most of the stories actually support diverse family structures. By exploring the significance of story-telling in cultural understandings of family and identity, it is possible to identify the ways in which story-telling can impact how society negotiates complex issues such as assisted reproduction, donor conception and donor industry regulation.

'A Procedure Without a Problem', or the face transplant that didn't happen. The Royal Free, the Royal College of Surgeons and the challenge of surgical firsts

Face transplants are an innovative and unusual form of modern surgery. There have been 47 face transplants around the world to date, but none as yet in the UK. Yet in 2003, the UK was poised to undertake the first face transplant in the world. The reasons why it didn't take place are not straightforward, but largely unexplored by historians. The Royal College of Surgeons, concerned about the media attention given to face transplants and the ethical and surgical issues involved, held a working party and concluded that it could not give approval for face transplants, effectively bringing to a halt the UK's momentum in the field. This extraordinary episode in medical history has been anecdotally influential in shaping the course of British surgical history. This article explores and explains the lack of a face transplant in the UK and draws attention to the complex emotional, institutional and international issues involved. Its findings have implications beyond the theme of face transplants, into the cultural contexts and practices in which surgical innovation takes place.

'Living in a Material World': Frankenstein and new materialism

This paper uses concepts from Karen Barad's theories from quantum physics and other theoretical approaches from new materialism to show how Frankenstein can be used to introduce this new framework and to challenge an older one based on dualism, representationalism and individualism. A new ethical understanding of the message of the text emerges from this reading-one that rethinks the prohibitions against 'playing God' or creating the unnatural and relies instead on an ethics of care.

Parasites and priorities: the early evolution of 'neglected disease' initiatives and the history of a global health agenda

This article explores the development and evolution of 'neglected tropical diseases' (NTDs) as an operative and imaginative category in global public health, focusing on the early intellectual and institutional development of the category in the 1970s. It examines early work around 'neglected' diseases in the Rockefeller Foundation's Health Sciences Division, specifically the Foundation's 'Great Neglected Diseases of Mankind' initiative that ran between 1978 and 1988, as well as intersections with the WHO's parallel Special Programme for Research and Training in Tropical Diseases and efforts by the US-based Edna McConnell Clark and MacArthur Foundations. A key concern of advocates who influenced initial programmes focused around 'neglect' was a lack of sophistication in medical parasitological research globally. Central to the NTDs' capacity to animate diverse energies were claims about parasitic diseases and their place in new biotechnological approaches to medicine. This article explores how the emphasis on 'neglected', 'tropical' or even 'endemic' diseases encoded specific concerns and desires of parasitologists in the early 1970s. Despite the desire to prioritise the needs of 'endemic' countries and the recognition of a widening cohort of experts from both high-income and low-income nations, NTD advocates often recapitulated historic power dynamics privileging research institutions in the USA and Europe. Historicising and contextualising 'neglect' illuminates the contingent and changing politics of global health in a formative period in the late twentieth century.

Nations must be defended: public health, enmity and immunity in Katherine Mayo's Mother India

This essay explores repressed hostility and punitive fantasies in the discourse of international health, using Katherine Mayo's Mother India (1927). Multiple tendencies in interwar thinking converge in Mayo's book, making it a veritable archive of major, minor and emergent forces, including those shaping the phenomenon of 'international health' post-Versailles. Mother India provides a unique opportunity to explore how progressive principles of international public health tend to obscure a 'minor' and forgettable yet disturbing truth: the discourse on life and health can 'safely' harbour an alternative politics and poetics of enmity. Spotlighting the way international health interventions, centrally shaped by USA, operated across multiple levels of governance, the essay locates the significant detail of Mayo's representation of India as 'world-menace'. Propelled by the logic of enmity, her shaming portrait of a dysgenic Hindu India justifying emergency international intervention resonates with a strand of interwar conservatism given theoretical expression in the writings of Mayo's contemporary, Carl Schmitt. Schmitt's animosity towards political liberalism helps identify Mother India's vision of imperial sovereignty as a curious antiliberal, American iteration of the logic of enmity in extra-European space and in the 'humane' domain of health. Biologising the discourse of juridical-political maturity at a time when Indian nationalism's organised challenge to Empire could not be gainsaid, Mother India urges a re-imagination of the political field as a battlefield where 'the enemy', construed as a problem of health, will kill. Building a case for continued imperial domination in the name of global health and immunity, the book's humiliating representation of colonial bodily habits, habitations and contagions aimed to undermine liberal imperialism, internationalism and Indian nationalism, all increasingly vocal after World War I.

Contact building: emotional exchanges between counsellees and counsellors in the late socialist period in Poland

In Poland after World War II, the related fields of sexology, sex education and sex counselling developed a distinctive model of communication between counsellees and counsellors. This article focuses on Wiesław Sokoluk, one of the key Polish youth counsellors and sex educators active during the late socialist period (the 1970s and 1980s), looking at his path to becoming a sex educator and youth counsellor as well as his practice in both fields. It treats his story as a case study that illustrates the distinctive development of the related disciplines of sex counselling and education. It specifically focuses on the communication between Sokoluk and his counsellees, school pupils, correspondents and readership. It shows how the distinctive methods underpinning emotion-driven communication between counsellor and counsellee developed, while presenting them as products of particular economic, political and religious conditions of late socialism, including state-funded education and healthcare as well as the relative sexual openness resulting from the struggle between the state and the Catholic Church.

Pine fresh: the cultural and medical context of pine scent in relation to health-from the forest to the home

Pine is a familiar scent in domestic cleaning products, but how often do we relate it to its origins as an odour emanating from a tree? This article takes a sensory history approach to trace the late 19th century and early 20th century use of the pine forest as a therapeutic space, via the tuberculosis sanatoria to the use of pine scent in domestic disinfectant. By focusing on pine as experienced in this period as a microhistorical subject, this methodology will in turn allow for a detailed consideration of how historical context, and in particular medical conceptions and health concerns, can influence the creation of cultural memory. By following the trajectory of pine from its place in the forest to a commercial product used in the home, this will allow for an investigation at the intersection of environmental and medical histories and provide a framework for the consideration of the relationship of place to senses associated with concepts of health and well-being. As interest grows in the development of more effective sensory settings, in particular within healthcare, it also highlights the importance of considering the roles both cultural and personal memory play in response to various sensory stimuli.

How care holds humanity: the myth of Cura and theories of care

Modern medicine has often struggled to grasp the cultural aspects of interpersonal care. The medical humanities, on the other hand, have struggled to grasp the embodied, intimate character of care. In a recent appeal to the medical humanities, Julia Kristeva et al argue that care can be a point of crossing between these two 'ontological domains'. They evoke the myth of Cura, referring to previous utilisations by such diverse thinkers as Heidegger and Kleinman, as well as Kristeva's previous work. This study adds to these bodies of work by using the original text from Hyginus in much greater detail. Textual analysis, theoretical discussions and autotheoretical work unpack care as (1) a fundamental aspect of the human condition, (2) a holding-together of different domains of knowledge, (3) a withholding from these domains and (4) the site of intimate knowledge that both 'ontological domains' struggle to grasp.

From blocked flows to suppressed emotions: the life of a trope

Internal blockages and build-ups cause disease: traditionally, this principle seemed intuitive both to professionals and the laity, explained conditions as diverse as melancholy and scurvy (among many others), and justified the use of evacuative treatments to get rid of noxious matter. With the collapse of humoral medicine and the establishment of the concept of specific causation, one might have expected time-honoured tropes of obstruction to die off. They did not die off, but moved with the times and adapted to new conditions. Emphasis swung from the noxious character of retained substances to the harms of suppressed urges and emotions-harms including disabling maladjustments as a result of sexual inhibition, and cancer as a result of emotional inhibition. In both cases the causal mechanisms resemble traditional blockages. Theories of noxious inhibitions or psychological blocks, which have a familiar and perhaps even intuitive sound because they have so much history behind them, can easily lead patients into fanciful methods of prevention and treatment.

Before compassion: sympathy, tact and the history of the ideal nurse

The word 'compassion' is ubiquitous in modern healthcare. Yet few writers agree on what the term means, and what makes it an essential trait in nursing. In this article, I take a historical approach to the problem of understanding compassion. Although many modern writers have assumed that compassion is a universal and unchanging trait, my research reveals that the term is extremely new to healthcare, only becoming widely used in 2009. Of course, even if compassion is a new term in nursing, the concept could have previously existed under another name. I thus consider the emotional qualities associated with the ideal nurse during the interwar period in the UK. While compassion was not mentioned in nursing guidance in this era another term, 'sympathy', made frequent appearance. The interwar concept of sympathy, however, differs significantly from the modern one of compassion. Sympathy was not an isolated concept. In the interwar era, it was most often linked to the nurse's tact or diplomacy. A closer investigation of this link highlights the emphasis laid on patient management in nursing in this period, and the way class differentials in emotion between nurse and patient were considered essential to the efficient running of hospitals. This model of sympathy is very different from the way the modern 'compassion' is associated with patient satisfaction or choice. Although contemporary healthcare policy assumes 'compassion' to be a timeless, personal characteristic rooted in the individual behaviours and choices of the nurse, this article concludes that compassionate nursing is a recent construct. Moreover, the performance of compassion relies on conditions and resources that often lie outside of the nurse's personal control. Compassion in nursing-in theory and in practice-is inseparable from its specific contemporary contexts, just as sympathy was in the interwar period.

Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design

History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.

Infectious thinking: the pathophysiology of 19th-century pedagogy

Systems for improving public health and organisations for providing national education were two of the great reforming achievements of 19th-century Britain. Despite the overlapping personnel and historical contemporaneity, scholars have rarely considered the two projects in tandem. This essay shows that developments in public health were at the heart of two foundational moments in the rise of 19th-century mass schooling. The originators of the monitorial system, a method of peer-educating working-class children cheaply that dominated British mass schooling at the turn of the 19th century, were deeply invested in the origin and spread of vaccination. Similarly, the first state teacher training system was conceived by a medical doctor in the 1830s, who first rose to prominence investigating cholera in Manchester earlier in the decade. Using archives of school providers, training institutions and the educational state apparatus, I show that medical prophylactic interventions of vaccination and sanitary reform helped galvanise the government into educational reform, by imagining the working class as pathological and providing templates for their palliation. By showing that the roots of the modern school system were deeply imbricated in attempts to combat smallpox and cholera, both in form and in epistemology, this paper argue that critical medical humanists should consider the role of epidemiological thinking in institutions and disciplines which seem, on first sight, removed from the clinic and the lab.

'On the different Species of Phobia' and 'On the different Species of Mania' (1786): from popular furies to mental disorders in America

Benjamin Rush's twin 1786 letters on the different species of phobia and mania sit at an extended historical juncture at which an early modern quasi-medical troping of mental disorder in American social commentary sobered up to mental medicine. The letters' satirical drive hinged on a perennial problem still occupying George Beard almost a century onward: which idiosyncratic trepidation or ill-grounded idea warranted the nomination of national and epochal ill? Rush's mania letter exemplified an established genre identifying popular and especially political crazes; at the same time, it foreshadowed the early 19th-century rise and mid-century fall of monomania as forensic-nosological stopgap. The phobia text established the term's dictionary (OED) sense of specific morbid fears, but did so in the form of a mobilisation of nosological jargon for social diagnostics purposes: an ambivalent prelude to Rush's later formal engagement with unreasonable fears and follies. Both letters draw attention to a pervasive duality in early modern and Enlightenment conceptions of hydrophobia, aerophobia, syphilophobia and lyssophobia, between public-health and mental-hygienic follies.

On the need for an ecologically dimensioned medical humanities

Increasing calls from medical professionals and scholars suggest an urgent need for better and more widespread understandings of the ecological dimensions of health. Such calls have included: two recent Lancet special commissions on impacts of climate change on health; and recognition by senior figures from the WHO and United Nations of relationships between human impacts on the natural world and disease pandemics, with some suggesting prevention of future pandemics may require a radical reassessment of modernity's relationship with the natural world.Among the medical humanities as a whole, however, calls for better and more widespread understandings of the ecological dimensions of health have not always been as prominent, or urgently expressed, as they might be.This paper, which presumes there is an urgent need for better and more widespread understandings of the ecological dimensions of human health, draws on ecological public health and other models to propose an ecological re-visioning of our conceptions of health and medical humanities; and in ways that challenge some contemporary assumptions about health, well-being and the 'good society'. Indeed, once we begin to heed what ecocritic Tim Morton terms 'the ecological thought', we may discover few areas of healthcare and the humanities remain untouched by its implications.With growing recognition that the fate of global human health and the fate of the biosphere are inextricably entwined, the project of a more ecologically dimensioned medical humanities appears both timely and urgent. Such a project may represent a significant opportunity for the medical humanities, and a significant responsibility.

Animal research nexus: a new approach to the connections between science, health and animal welfare

Animals used in biological research and testing have become integrated into the trajectories of modern biomedicine, generating increased expectations for and connections between human and animal health. Animal research also remains controversial and its acceptability is contingent on a complex network of relations and assurances across science and society, which are both formally constituted through law and informal or assumed. In this paper, we propose these entanglements can be studied through an approach that understands animal research as a nexus spanning the domains of science, health and animal welfare. We introduce this argument through, first, outlining some key challenges in UK debates around animal research, and second, reviewing the way nexus concepts have been used to connect issues in environmental research. Third, we explore how existing social sciences and humanities scholarship on animal research tends to focus on different aspects of the connections between scientific research, human health and animal welfare, which we suggest can be combined in a nexus approach. In the fourth section, we introduce our collaborative research on the animal research nexus, indicating how this approach can be used to study the history, governance and changing sensibilities around UK laboratory animal research. We suggest the attention to complex connections in nexus approaches can be enriched through conversations with the social sciences and medical humanities in ways that deepen appreciation of the importance of path-dependency and contingency, inclusion and exclusion in governance and the affective dimension to research. In conclusion, we reflect on the value of nexus thinking for developing research that is interdisciplinary, interactive and reflexive in understanding how accounts of the histories and current relations of animal research have significant implications for how scientific practices, policy debates and broad social contracts around animal research are being remade today.

The haunted heart and the Holy Ghost: on retrieval, donation and death

This enquiry examines problems which haunt the 'heart' and its donation. It begins by examining the heart's enduring significance for culturally mediated self-understanding, its vulnerability to misunderstanding and abuse and its relevance to challenging the determination of death by neurological criteria. Despite turns to brain-centred self-conceptions, the heart remains haunted by the hybrid experiences of identity accompanying organ transplant, the relational significance attached to dead hearts witnessed in the Alder Hey scandal and claims that heart transplants commonly constitute the legitimate killing of a person. To explore these phenomena, traditions are retrieved in which the heart-as-organ was construed in terms of a person's core identity. Influential Abrahamic beliefs about 'the heart' are considered in order to explore explanations for why the heart remains culturally pre-eminent, to make intelligible our haunted hearts and to examine possible violations of solidarity in organ donation practice. Jewish and Christian Scriptures are exegeted to illumine the sources of our haunting and address the desire for holistic bodily life. In these sources, the heart is the seat of affections, intelligence and agency but requires healing, conceived via the surgical metaphors of heart transplant and circumcision, if people are to join the insightful, solidary path of pilgrimage. Absent healing, the heart experiences a judgement of the whole person-organ-and-core-at the moment of death. Through such exegesis, the doctrine of the Holy Ghost emerges as a way to make intelligible, though not dispel, the heart's haunting. The doctrine's practical significance concerns the possibility of social unity among hearts, 'intercordiality', which construes people within a covenantal life of pilgrimage which encourages heart donation in certain circumstances, makes intelligible the Alder Hey parents' experience of social misunderstanding and rejects ascribing any legitimacy in medical culture to the consensual killing of patients for the sake of retrieving their organs.

Public hygiene and funeral rituals during the Risorgimento: mummies and ashes

Starting in 1865, regulations pursuant to public hygiene issued by the Unitary Government provided for administrative and political control of the funerary practice. Specifically, they regulated the management of cemeteries and the burials, increasingly drawing the funeral rituals from the control of the Church and of Catholicism, therefore secularising death for the construction of a new political religion. Hygiene became fundamental in order to promulgate cremation as a system of preserving the integrity of the bodies, preserving the ashes as a tangible and indestructible product of body matter and as a measure to protect public health by eliminating the risk of miasmatic pollution of the air caused by the cadaveric fumes. In the early 1870s, the practice of cremation began to spread, especially in the territories of Lombardy-Veneto and Savoy, as an expression of the progressive policies of the new Italian state, antagonistic to the old Catholic religious traditions. This paper intends to highlight the key aspects of the political significance that the cremation took on during the Risorgimento period, while also illustrating the methods adopted by important authors from that time period regarding incineration techniques and cremation methods.

Sacred hearts and pumps: cardiology and the conflicted body politic (1500-1900)

This article examines how conflicting notions of the body politic between the natural and the spiritual have contextualised the evolution of cardiology. After a brief look at the place of the heart in biblical, patristic and medieval notions of the church, the article turns to the Reformation period. While Martin Luther moved theological gravity to the individual's heart and conscience, his contemporary Michael Servetus described the pulmonary cycle in the context of an antitrinitarian theology condemned as theological and political heresy. In the early modern period, nature conceived as creation grounded sovereign political authority, which science could then align with. Whereas William Harvey still adhered to an Aristotelian teleology, René Descartes and subsequent mechanistic contributions to cardiology were flanked by an intense 'cardiolatry'. Both, it is argued, are two sides of the same, almost non-corporeal coin. The emerging Enlightened epistemology allowed for a position distinct from both sovereign and ecclesial powers. The French Revolution was a paradigm shift: the ancien régime falls, and its Sacred Heart devotion is mocked; the new 'Erastian' state-university emerges as the context of cardiology. These developments are reflected in the life of René Laënnec and in cultural interpretations of the heart later in the 19th century. It is shown that the heart as a doubly inscribed, both biological and spiritual organ, played a central role in theological, and therefore political and scientific notions of the body politic. These continue to haunt the present, allowing us to interpret normative appeals to the heart particularly in political contexts.

Distressed doctors: a narrative and historical study of work-related mental discomfort among practising physicians

This article explores the complexity of mental distress among physicians, as portrayed in two literary narratives: John Berger and Jean Mohr's A Fortunate Man: The Story of a Country Doctor (1967) and Pia Dellson's Väggen: En utbränd psykiaters noteringar (2015, 'The Wall: Notes by a Burnt-Out Psychiatrist'). Departing from a historical understanding of medical practice, the article seeks to discuss whether some of the noted similarities and differences in the two narratives could be related to changes appearing over time in the role model of the medical encounter. As the two narratives provide illustrative descriptions of the difficulties experienced by doctors suffering from mental discomfort, they also call for a greater awareness among medical practitioners of the sociological terms of doctoring. Practising a person-centred, rather than patient-centred, care might be part of such awareness and is discussed as a possible protective strategy for physicians at risk of work-related mental distress.

Awaking insomnia: sleeplessness in the 19th century through medical literature

Sleep disorders have received growing public and scientific attention in the last decades. Scientific research and publications on sleeplessness are ongoing and considerable progress has been made on the medical understanding of sleep. And yet, insomnia affects an ever-growing number of people around the globe and remains both a difficult and common complaint general practitioners have to deal with on a daily basis. Sleeplessness is not new, although its transformation from a state of accepted wake to that of exasperating insomnia is a relatively recent transition in which, this article argues, Western medicine took an active part. In the 19th century, the theorisation of different nervous disorders and later of neurasthenia shaped the transformation of insomnia from a constituent of everyday life into a pathology. Based on research in French medical journals published in the second half of the 19th century, this article retraces a succession of medical paradigms for sleeplessness, including 'symptomatic insomnia', 'nervous insomnia' and interestingly, 'insomnia' as a key element in neurasthenia theories. The analysis of medical discourse in all successive theories reveals the decisive influence of physicians in the medicalisation of insomnia, their sociocultural representations echoing patient's complaints as well as professional imperatives.

Enhancing relational care through expressions of gratitude: insights from a historical case study of almoner-patient correspondence

This paper considers insights for contemporary medical practice from an archival study of gratitude in letters exchanged between almoners at London's Brompton Hospital and patients treated at the Hospital's tuberculosis sanatorium in Frimley. In the era before the National Health Service, almoners were responsible for assessing the entitlement of patients to charitable treatment, but they also took on responsibility for aftercare and advising patients on all aspects of welfare. In addition, a major part of the work of almoners at the Brompton was to record the health and employment status of former sanatorium patients for medical research. Of over 6000 patients treated between 1905 and 1963 that were tracked for the purposes of Medical Research Council cohort studies, fewer than 6% were recorded as 'lost to follow-up'-a remarkable testimony to the success of the almoners' strategies for maintaining long-term patient engagement. A longitudinal narrative case study is presented with illustrative examples of types of gratitude extracted from a corpus of over 1500 correspondents' letters. Patients sent money, gifts and stamps in gratitude for treatment received and for the almoners' ongoing interest in their welfare. Textual analysis of letters from the almoner shows the semantic strategies that position gratitude as central to the personalisation of an institutional relationship. The Brompton letters are conceptualised as a Maussian gift-exchange ritual, in which communal ties are created, consolidated and extended through the performance of gratitude. This study implicates gratitude as central to the willingness of former patients to continue to engage with the Hospital, sometimes for decades after treatment. Suggestions are offered for how contemporary relational healthcare might be informed by this unique collection of patients' and almoners' voices.

Orthorexia: eating right in the context of healthism

Orthorexia is a putative new eating disorder vying for a place in the DSM, roughly meaning "eating right". While a continuum can be drawn between anorexia and orthorexia, there are enough differences to make this disorder a distinct one. In this paper, I trace the origins of the term and its clinical career to date, employing Ian Hacking's concept of "ecological niche" to establish the place of orthorexia as a contemporary cyberpathy, a digitally transmitted disorder inwardly and narrowly focused on health through the consumption of "pure" foods. I critique both the notions of "health" and "purity" in this context, showing that orthorexia can only be understood in the context of healthism, an individual preoccupation with health in the context of neoliberalism. Using Jordan Younger's Breaking Vegan memoir (2015) and "Balanced Blonde" blog as a case study, I argue that orthorexia replicates via a digital proliferation of entrepreneurship of the self. Ultimately, this excessive preoccupation with health as a neoliberal cultural pathology bares life of meaning.

Commentary: Serving the nation, serving the people: echoes of war in the early NHS

It is something of a cliché to speak of Britain as having been transformed by the traumas of World War II and by its aftermath. From the advent of the 'cradle to grave' Welfare State to the end of (formal) empire, the effects of total war were enduring. Typically, they have been explored in relation to demographic, socioeconomic, technological and geopolitical trends and events. Yet as the articles in this volume observe across a variety of examples, World War II affected individuals, groups and communities in ways both intimate and immediate. For them, its effects were directly embodied That is, they were experienced physically and emotionally-in physical and mental wounds, in ruptured domesticities and new opportunities and in the wholesale disruption and re-formation of communities displaced by bombing and reconstruction. So it is, perhaps, unsurprising that Britain's post-war National Health Service, as the state institution charged with managing the bodies and behaviour of the British people, was itself permeated by a 'wartime spirit' long after the cessation of international hostilities.

'A higher form of listening': a commentary on 'the human bodies of World War II: beyond the battlefield'

This issue's interdisciplinary range parallels the generative multidisciplinary scope in the developing field of medical humanities. A closely detailed and empathic interdisciplinary analysis of physical and mental injury can offer additional historical and cultural resources to medical practitioners, thus broadening potential patient treatment options beyond institutional and disciplinary boundaries.

Towards a translational medical humanities: introducing the cultural crossings of care

In this introductory essay, we will present a translational medical humanities approach where the humanities are not only an auxiliary to medical science and practice, but also an interdisciplinary space where both medicine and the humanities mutually challenge and inform each other. First, we explore how medicine's attempt to tackle the nature-culture divide is emblematically expressed in the concept and practice of knowledge translation (hereinafter KT). Second, we compare and contrast KT as an epistemic ideology and a socio-medical practice, with concepts and practices of translation developed in the human sciences. In particular, we emphasise Derrida's understanding of translation as inherent in all meaning making, as a fundamentally textual process and as a process necessarily creating difference rather than semantic equivalence. Finally, we analyse a case from clinical medicine showing how a more refined notion of translation can enlighten the interaction between biomedical and cultural factors. Such a translational medical humanities approach also requires a rethinking of the concept of evidence in medicine.

Corporate medical cultures: MD Anderson as a case study in American corporate medical values

This paper contributes to the evolving body of literature diagnosing the 'business-like' transformation of American medicine by historicising and recuperating the concepts of medical leadership and the corporation. In an analysis of the evolving uses of 'leadership' in medical literature, we argue that the term's appeal derives from its ability to productively articulate the inevitable conflicts that arise between competing values in corporations, and so should be understood as a response to the neoliberal corporation's false resolutions of conflict according to the single value of profit (or consumer welfare for the business-like non-profit). Drawing on mid-century theories of the corporation to reframe dominant social histories of medical corporatisation, we go on to argue that large medical institutions are productive sites for deliberation over the medical profession's social contract. Our primary case study for this longer historical and broader theoretical argument is the MD Anderson Cancer Center, the world's foremost treatment hospital for patients with cancer. We hold that the historical trajectory that led to MD Anderson's exceptional but exemplary place in the evolution of American corporate medicine is reflective of historical trends in the practice.

Health at the writing desk of John Ruskin: a study of handwriting and illness

Though John Ruskin (1819-1900) is remembered principally for his work as a theorist, art critic and historian of visual culture, he wrote exhaustively about his health in his correspondence and diaries. Ruskin was prone to recurring depressive and hypochondriacal feelings in his youth and adulthood. In 1871, at the age of 52 years, he developed an illness with relapsing psychiatric and neurological features. He had a series of attacks of brain disturbance, and a deterioration of his mental faculties affected his writing for years before curtailing his career a decade before he died. Previous writers have suggested he had a psychiatric malady, perhaps schizophrenia or schizoaffective disorder. But the more obvious conclusion from a close medical reading of Ruskin's descriptions of his illness is he had some sort of 'organic' brain illness. This paper aims to give insight into the relationship between Ruskin's state of well-being and the features of his writing through a palaeographical study of his letters and diary entries. We examine the handwriting for physical traces of Ruskin's major brain illness, guided by the historical narrative of the illness. We also examine Ruskin's recording of his experiences for what they reveal about the failure of his health and its impact on his work. Ruskin's handwriting does not have clear-cut pathological features before around 1885, though suggestions of subtle writing deficits were present as early as 1876. After 1887, Ruskin's handwriting shows fixed pathological signs-tremor, disturbed letter formation and features that reflect a slow and laborious process of writing. These observations are more than could be explained by normal ageing, and suggest the presence of a neurological deficit affecting writing control. Our findings are consistent with conclusions that we drew from the historical record-that John Ruskin had an organic neurological disorder with cognitive, behavioural, psychiatric and motor effects.

Ferments and the AIDS virus: interspecies counter-conduct in the history of AIDS

In the first three decades after AIDS started infecting people in the USA and Canada, before, during and after the emergence of anti-retroviral therapies, numerous "alternative and holistic treatments" for AIDS were debated, tested, circulated, written about and taught. This paper, taking a narrow focus, examines documents that reveal how some people with AIDS developed a logic of care predicated on intimate interactions with microscopic lifeforms-the AIDS virus and the bacteria involved in fermentation, in particular. Focusing on the writings of Jon Greenberg and Sandor Katz, two former members of ACT UP/NY, I show that the men did not just dissent from management by biomedical authority but found new authority about how to care for themselves as people with AIDS from their interactions with non-human microscopic life. The practices and writings of both men demonstrate that Foucault's theory of counter-conduct exists in the history of AIDS as an interspecies process in which microscopic existents lead humans. From Katz and Greenberg, I argue there is an interspecies dimension to counter-conduct that exists as a frame for understanding people who find in non-human life a guide towards unconventional forms of care, revised forms of human behaviour and philosophies for persisting with illness.