schussman.com logo

Week in review, I

Medical Sociology is wrapping up, and although the length of the semester is somewhat fatiguing as compared to compressed summer and winter sessions (which have their own brand of fatigue in their two- or three-hour daily classes, of course), I think it’s also more productive and conducive to real learning. Spending many weeks on the material, with time between sessions, gives students a chance to pick up on themes and really reflect. And they’re not the only ones; my own understandings of the material get deeper as I make my way through the longer course. At the same time, I’m able to get some other work done.

One of the most interesting class discussions we’ve had this semester have been on an excerpt from Stefan Timmermans’ Sudden Death and the Myth of CPR. Timmermans explores the development of CPR in the United States and the ways in which lifesaving technology change our perceptions of “normal” deaths. Reading Timmermans, students are surprised by the evidence that CPR for heart attack patients, when not initiated promptly by trained professionals, has an extraordinarily high failure rate: Timmermans observes fewer than 3% of such patients leave the hospital. At the same time, CPR has tremendous cultural power, such that nearly every student in my class of 60 had been certified in CPR, at some point, by the AHA or Red Cross. It isn’t necessarily easy for students to make sense of the notion that the cultural authority of CPR is based on a social campaign that mixed a comprehensive program of education, power, and limited real-world efficacy. This process, by the way, is strongly akin to Paul Starr’s story of the rise of medicine as a social force in the U.S. It turns out that issues of politics and control pervade areas of life, such as medicine, that we would prefer be based on performance, data, science. Timmermans explores more than just the social construction of practice, extending his observations to the powerful norms that now define the role of health care practitioners, patients, and family once they enter the emergency system: He questions the nearly universal expectation of heroic lifesaving measures in the face of what was once a natural—and very social—process of dying.

  1. Alan, Is the excerpt available on reserve? "Timmermans observes fewer than 3% of such patients leave the hospital." Certainly, though, even 3% success rate is enough to convince most people that CPR is necessary. Who are "trained professionals"? EMTs? First Responders? Does the success rate increase with defribulator use?
    marcum    Nov 17, 01:17 AM    #
  2. Chris - You can reach the reserve through my class POLIS site. Timmermans places the 3% success rate (and this rate is observational, although it's in line with some broader surveys) into the overall context of changing meanings of sudden death; his argument is that the cultural power of CPR takes away, in some cases, from a dignified death or good quality of life, and that our use of resuscitative technologies/procedures should be more reflexive than it currently is. "Trained professionals" in this care are folks like EMTs/Paramedics who are more likely than lay responders to be adequately trained. AEDs (automatic external defibrilators) change the dynamic some: a recent study indicates that the use of AEDs by trained responders can double the survival rate. While this doesn't cut to the core of some of Timmermans' observations (some questions of appropriateness of intervention may be argued, I think, to be irrespective of numbers), it does give us more to think about.
    Alan    Nov 17, 05:26 AM    #
Name
E-mail (will be spam-armored)
http://
Message
  Textile Help