Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Sunday, December 1, 2013

Moses ben Maimon: Cool Dude

"I got a crush on you, Sweetie Pie.  All the day and night-time, hear me sigh..."

Mr. Maimon as I call him, whose name was Moses, son of Maimon (also a distinguished rabbi) additionally is referred to as RaMBam (Rabbi Moses Ben Maimon), or Maimonides.  He lived around the Mediterranean--Spain, Morocco, Palestine, Egypt--from 1135 or 1138, until his death, in 1204.  He was a fox.

He was beyond brilliant, and he was a Renaissance man before there was a Renaissance.  He belonged with the likes of Leonardo, Copernicus, Galileo, and as many greats of the future as one can recall.  St. Thomas Aquinas was inspired by Maimonides and used his work to better understand nature, science, and the realm of God in Christianity. Maimon was without question, the greatest thinker of the Middle Ages. Even today, it's difficult to find an equal who would match the genius and this remarkable and truly worldly philosopher.

Mr. Maimon, in addition to writing extensive commentary on the Mishnah--part of the Hebrew Talmud or books of law based on the Hebrew Scriptures or Torah--and organizing virtually all of said Jewish law until that time--was actually a physician, a scientist, an astronomer, a nutritionist, and a worldly philosopher.  He practiced medicine, was court physician to Al Qadi al Fadil, whose father was the incomparable Saladin--magnificent medieval ruler.

Word has it, dates aside, that King Richard the Lion Heart, in the midst of his travels during the Crusades, wanted Maimonides in his own court; but that for the times, Maimon felt his safety was in better hands with the Muslims.  Remember, this was the time of the Crusades, and expulsions/executions of Jews throughout the European civilized world. Strange bedfellows, eh?

As a physician, Maimonides was dedicated to medication, cures for multiple diseases and conditions, and pharmacological study as well as its organization.  The Maimonidean Oath for doctors, is practiced today. His methodology was a precursor for pharmaceutical practice.  He was a health nut, and was firm about diet and exercise.  The famous portrait of him that most see, is a contrivance no doubt, and has been duplicated multiple times.

However, Maimon could not have been heavy-set, or beefy in construct, as it wasn't who he was, nutritionally.  Rather than looking like Chef Boyardee, Moses Maimonides had to have been slender. He walked back and forth to his offices from his home, on a daily basis, saw patients, saw the Vizier in his palace, wrote voluminously, corresponded, spoke publicly and traveled to do so, and led a very active and full life with little time for food or rest.  It's difficult to imagine that Mr. Maimon would be anything but slim.

He was a student of Greece, Rome, and Islam, living in that geographical area.  He was not familiar with northern European thought or influence to any great extent.

His hero was Aristotle: pure and simple. There were others such as Averroes.  But the Greeks were his mentors.  He had virtually no contemporaries with whom he consulted; and virtually no Jews.   Reason was always his guide; nature was his companion.  Maimon wasn't just a Jewish philosopher who sat in a room and contemplated.  He was out and about with the people, working for a living.  He was involved with what he wrote, he practiced what he thought.  His ideas were based not only on his readings, but on his experiences in the real world.

In all of Judaism, I cannot think of a better role model for myself.  Mr. Maimon tried to re-construct Judaism in order to make the spiritual, rational.  He tried to justify God's role in a scientific world.  He did not have the backing of the kind of power or money to be able to do that; but what he left Judaism and the rest of those who were familiar with him--the western medieval world as a whole, and centuries beyond--was a dedication to a God of rational--again, rather than spiritual--existence and rationale that made such a universe possible.

He appeared to some to be arrogant and self-centered.  Instead, it's more likely that he was just himself, and so far above others' ability to comprehend him, that the appearance of superiority was really just honesty. As they say, "It isn't bragging if it's the truth..."

He was quick-tempered, had no patience for idiocy or foolishness; he was not interested in people who couldn't "connect the dots." He did his best to withhold unkindnesses toward others in personal meetings; however, he was candid in his writings or when he confided with certain contemporaries, re: what he felt to be blatant stupidity.  He was schooled in multiple languages, and was at home in Hebrew, Greek, and Arabic, just for openers.

He had to have had an eidetic/photographic memory.  He was funny, witty, had fine senses of humor, sarcasm, and wit; he was very kind, patient with those who were ingenuous and mattered; he was dedicated, responsible, and wise.  In short, he was simply "the best of the best."

When he died, Mr. Maimon's books were burned by many, despite the honor and homage that he received when he was alive.  The fierce discipline to maintain a rational point of view toward God, rather than a simpler unquestioning other-worldly spiritual one, was simply too difficult and too abstract for most to manage.  People wanted a personal god who attended them.  Maimon's in actuality, did not.

Maimon understood that God could not be all of the anthropomorphic components that the Hebrew Scriptures espoused; and he also understood that God, out of respect for humanity, could not intervene in lives; thus, he felt that prayer was really for he who prayed, and not for God, at all.  There was nothing God, as Maimon defined Him, could do.  In order for man to have free will, God could not intervene, deus ex machina, in a person's life. Rather God was present as form, rather than matter--the Greeks--the essences of all.  It was a tough road for the average Joe in the marketplace or herding the flocks.

Again, make no mistake: Moses ben Maimon was one of the greatest innovators that the world has ever known.  He did his best to organize Judaism--the origin of Western religion and thus one of the initial elements of Western civilization-- into something intelligent and tangible.  Rather than tons and tons of arguments, dissensions, and loose documents from the past, Jewish law for the first time, became a practical guide that could be followed. He did the same with medicine, science, diet, pharmacology, nature, preventative medicine, and with God.  He cared, he tried, he did his best.  He was an incredibly sensitive man who was highly in tune, whether or not he appeared that way on the surface.  He worked at all things until he died.  He was devoted to improving the world:  His way, certainly; but isn't that the way we all are... I will speak of him again.

I am fortunate enough to have many heroes.  Today, people don't believe in heroes.  Without heroes, there is no society to emulate, no goals, no role models, no understanding of what could be, no direction or a value system; a warning signal that is a presage regarding the end of a culture.  However, Moses ben Maimon, is as real and heroic to my mind, as any individual whoever lived.

Monday, November 4, 2013

A Rose By Any Other Name: The National Association of the Deaf (NAD) Broadcaster

This article was originally written  for the above paper in June of 1991.  What is interesting is that not much as changed in almost 23 years.  People are still trying to figure out what to call themselves, hoping their labels will forecast how they ought to be judged.  The reality, of course, is that it is the individual who matters; the nomenclature and stereotypes will come and go.  Also, society will judge as it wishes, and all the fancy labels in the world cannot change what the public wants to think, once the public makes up its mind...  

I read, with some interest, Ms. Kailes' February, 1991 article on the use of language.  I don't disagree with the author and her viewpoint, but lately, I find so may people concerned with what to call each other; I wonder if the focus isn't shifting away from how to treat each other.

The American Indian/Redskin is now the docile Native American; the Oriental has morphed to the Asian; the once Colored then Negro then Black has become the African American; the Mexican is now the Hispanic or Latino, depending on specific geography of origin, despite sameness of language.

For awhile, the Deaf were the Hearing Impaired until it was decided that the oral Deaf would remain Hearing Impaired, and the signing Deaf would return to their original name and be just Deaf.  The handicapped want to be the disabled, or the challenged.

I wonder how the cultural anthropologists and sociologists manage to keep up!

The problem with "disabled" is the implication of time and brokenness/non-usable-ness; i.e., once one used to be able, but now because of circumstance, he is dis-abled.  The original meaning of the prefix "dis" (not) implies apart-ness, a whole no longer complete or now in two or more pieces.

A cup with the handle broken off is disabled.  A sink whose faucet has been disconnected is disabled.  A man whose leg has been amputated is disabled. There is a sense of time having passed.  There is an implication that that which was once useful and whole is no longer so; function is non-operable.

My daughter as born with multiple medical involvements.  No time passed; nothing happened to her that transformed her from a whole into parts.  I don't think of her as "dis," or "not."  Most of her parts work all right; some of her parts operate on a partial basis.  I don't recall abilities once hers, that are no more.  I do think of her as handicapped, as there are clearly tasks with which she needs special help; she always has and will require significant assistance.

Ms. Kailes refers to the term "handicapped" as being a derogatory one; it calls to her mind the individual on the street corner with cap in hand, begging.

(In truth, the hand in the cap--not the other way around--was an aspect of horse racing, many years ago in Great Britain; the jockeys, vying for the most advantageous place on the track, would draw numbers out of a cap; hence, the derivation of the word.  He who drew the best number, had the inside path; he who drew the worst number was stuck with the outside path and a greater likelihood of losing the race.  The good or ill fortune of the horse's position around the track was a result of the jockey's "hand-i-the-cap.")

In sports today, golfers and bowlers have handicaps; horse racing still awards handicaps; there is a handicap in betting. There is no shame in the word, or in the use.  Rather, the condemnation is in peoples' opinions.

Recently, I met a physician who denied both terms.  He liked the idea of the "exceptional body"  instead of either "disabled" or "handicapped." My, I thought, my little girl is only eight, and already, she's up there with Madonna and Marilyn Monroe.

I keep wondering when Jews are going to change their names.  Anti-Semitism increased by 18% this year; it certainly would be a good time to enhance self-image, and the concept of the altered "handle" is very much in vogue.  I was considering the possibility of "American Moses-ite..."
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If changing the name or label of an individual or a group assists with positive group or self-identity, I'm all for it.  If that same change also heightens the awareness and sensitivity levels of the broader society, I'm in favor of that, too.

I just hope people understand the old adage, "Actions speak louder than words."  Terms don't start out with positive or negative connotations, only objective denotations.  The former is imposed by the response from society. Once "queer" meant to be odd, and "gay" meant to be happy.  Now, both connote homosexuality--one negatively, one positively.

If "disabled" is more palatable than "handicapped," then let it be so.  If the larger community is more comfortable in accepting the disabled rather than the handicapped, I guess I think that's fine.  If individuals would rather be identified as "disabled," instead of "handicapped," I support that, too.  Often, it's not what the word means that counts; rather it's what the word implies.

The choice of this term or that is not what is most important, but rather that we are taking the time to care about our places and our acceptance in this world.  We are demanding to be recognized with a sense of pride and integrity.  As long as accomplishments measure up to the demands for verbal dignity, there should be no problem.

Friday, October 18, 2013

Bully for You...Written for the Colorado Cross-Disabilties Coalition

People go into professions that suit their personal psychological needs as well as their physical and mental abilities.  A pediatrician, for example, usually has his own more childlike view of the world and enjoys children; a physician who treats only adults, will be more comfortable with patients and people who are over the age of 18.

Those who relate well with others, do just that in their workplaces--they enjoy the camaraderie of their colleagues, and their customers.  Folks who are more task oriented, preferring to involve themselves with skills rather than customers, orient to occupations that are duty-focused.  Individuals who would rather control or direct, are most often selected for leadership positions, not wanting to be confined to the day-to-day tasks, nor having to "relate" to folks as their primary goal.  These are your three types of workers: "Taskers;" leaders; "relaters."

It generally works this way.  Sadly, workers who are in the wrong jobs for their psychological needs, either don't remain there very long, or aren't very effective in terms of performance--let alone occupationally fulfilled.  Career preferences chosen according to an individual's psychological needs are as important as any training, schooling, or experience that one encounters.
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The world of disabilities is enormous.  Today, people are living longer, managing to survive terrible ordeals, illnesses, and deficits. When an infant or child is too immature to advocate for himself, when a person's physical, mental, or emotional abilities are compromised, when aging takes those properties from people who were at one time, able to function independently but no longer can, there is a dis-ability to participate adequately within the mainstream world.

Providers are called in: Caregivers in all varieties; social workers; healthcare professionals; medical support personnel; educators; job coaches;therapists; advocates; nurses along a wide spectrum of expertise re: special needs; agencies for this function or that.

One of the tragedies, yet all-too-frequent realities for the more "helpless victim" and the "rescuing caregiver" or provider, can be a blur between professional and personal needs on the parts of the caregivers and/or the people who are in charge.

The primary role of the caregiver, in any capacity, is not meant to be a personal one, but a professional one. There are boundaries or limits between client and caregiver; there are duties or executive orders that lie between them. While a caregiver must be compassionate and understanding in his job, the role of a provider primarily is not about being a people person, so much as it is about being a task person.  Get the job done, provide comfort and proper care, above all. Duty first.  Or the patient can be injured or die. Nurturing, protection, enabling, have their places; however, the caregiver's focus must be objective, and separate from the client or patient, before all personal involvements.

What can happen, when an individual who is primarily a people person (who wants to be friends, pals, a parent or sibling) is placed in the caregiver's dutiful role, and that professional is truly not suited for properly performing regimented tasks and executing details, lines get crossed.  The caregiver who is more personally people oriented instead of distanced, disciplined, and objective enough to perform and organize in an exemplary manner, ends up re-focusing his or her own "duties" so that they become more about controlling the patient, rather than seeing to those elements that surround the patient, and support his wellbeing.  A kind of guardian effect may occur, where the healthcare professional decides that a personal relationship with the client is more important than the tasks this professional was originally hired to perform: Father knows best? Mother knows best?  Nope.  Support person knows best. And, that's not okay.

Caregivers, providers, support people, or agencies of any type, can easily slip away from the tasks at hand, and become instead, very people oriented or personally involved with the patient.  Thus, the priority of the caregiver is no longer about objective care, but subjectively about the patient needing care that seemingly only the caregiver can provide; that only the caregiver knows how to provide.  It creates a dependency, and it validates the caregiver's psychological need to be personally connected, in order to be of value.  The tasks the caregiver was originally hired to perform for the patient, become secondary to the caregiver's own psychological needs.

What is potentially worse is the same scenario but where the caregiver becomes a leader, or puts himself in charge of the patient; a role of importance and control, not through a personal relationship, but rather through a kind of executive decision made by the caregiver, himself.  This healthcare provider or caregiver, legislates the needs of the particular client or patient to the exclusion of others--including the patient, himself.   Control gradually becomes absolute.  It is no longer about the patient's receiving objectively evaluated care from a competent task person; all else is subordinated to the caregiver's need to control, commanding others to do what was once the caregiver's actual task-oriented job of scheduling, organizing, and executing specific duties.

The inappropriate shift in roles, in order to fill personal psychological needs, warps a caregiver in whatever capacity; the thrust of that individual toward his client, student, or patient, is no longer a clear, distanced evaluative focus, but rather one of superiority.  It's all too easy when tending folks who are challenged in one way or another, to forget about respect, empathy, distancing, boundaries; and to slip into the role of ruler, surrogate parent, or boss.   Providers and caregivers, remember, come in all sorts of ancillary job descriptions, when networking the world of healthcare.

People who are caregivers or providers in agency work or on their own; who have more psychological needs than their particular job placement may provide; on a day-in-day-out, year-by-year kind of schedule (particularly with the same clients for extended periods of time); are most susceptible when it comes to slipping out of their assigned duty-oriented careers; rather, they ease into an orientation of control.

Certainly, there are practical reasons that exist for caregivers to have a certain amount of supervisory influence, when people are disabled or challenged; these professionals are presumably trained accordingly, they have experience, and they are familiar with the patient's history in one way or another.  It is true that patients often need direction from others, in order to guide and assist themselves.

However, direction is one thing; bullying is quite another.

Simply because a person or agency has done a job for years and years and years; has expertise in his field; has taken responsibility in various areas of his vocation; it does not give him a green light when it comes to taking charge of another person's life, to the exclusion of that individual's personal rights or the rights of others. When it comes to contribution, input, or care that is of significant benefit to a patient or client, there must be shared responsibility between all parties; the professionals must stick to the job descriptions they were meant to carry out.

When any caregiver or support person takes over the rights of a particular individual; when that individual becomes manipulated or less independent as a result of increasing control on the part of that caregiver, what is referred to as "for your own good," is more aptly  labeled "ego trip."  It speaks to the psychological needs of a healthcare professional or agency gone awry and who has turned away from the tasks that are his responsibility;  instead, twisting his job to suit himself, either by creating a too dependent relationship with the client, or by legislating what the client needs or ought to do:  Not only so that it ostensibly suits the client, but primarily so that it suits the caregiver's needs to control, as well.

Either way, it's about personal psychological needs trumping job-description. It's about bullying rather than advocating for the patient's right to be treated as normally as possible, and with as much dignity and respect as possible, given his special situation.

Wednesday, October 9, 1996

Bringing A Soul To Life: Interview with Debra Hindlemann Webster

Hillary Webster, now 14, is an active child with large grey eyes, and inch-long brown hair.  She was born with multiple congenital anomalies:  Tube-fed (gastrostomy) since birth; a breathing tube (tracheostomy); impaired fine and gross motor control; autistic tendencies.  Hillary has massive cranial nerve damage  (nerves which control the operation of neck, face, sensory, vocal and eating abilities).  She is Deaf, she is learning disabled, she has Tourette Syndrome.

Hillary has been kept alive with the support of 5 life-support machines, and she requires 24 hour per day medical care.  She can experience touch and sight, but she cannot smell, taste, nor hear.  Although she knows some sign language, she has a major language disorder.  Yet, despite the challenges, Hillary’s mom points out that “she is bright, strong-willed, and has been raised as a well child:  She lives at home, she goes to public school, and she has friends.”

Always looking for ways to encourage her daughter to respond to her environment, Debra Webster had read that therapeutic riding often proved beneficial.  She felt that what it offered—a sense of locomotion, control, and bonding—were worthwhile pursuits.  When Hillary turned 5, she was enrolled in a weekly therapeutic program.

Debra cautions:  “It’s difficult to specifically gauge the effect that the horses had upon Hillary because she cannot express her thoughts as others do, and speak for herself.  However, there is every reason to believe that her riding experience helped enormously.”

It was her mother’s goal to provide Hillary with the opportunities which could be gained from riding.  The animals were available to demonstrate the sensation of locomotion, and Debra reports, “The horses’ movements beneath Hillary were as though they were her own.”   Hillary began to walk. 

Hillary had been involved in physical therapy since her birth, as well as the more recent therapeutic riding; it is impossible to say which form of therapy contributed which ingredient, or which was the more influential.  Yet, after 2 years of riding, Hillary was able to walk independently—she had finally understood the process.

Riding definitely helped Hillary to gain a sense of control and self-esteem.  Sometimes Hillary would start to cry when she was first put on the horse, but when her mom or dad asked if she wished to stop riding, she refused.  She insisted on continuing her lessons.  Riding gave her the feeling that she was someone special; she could finally do something which none of her friends knew how.

Hillary took lessons for 6 years, and her mother states that Hillary looked forward to the relationship she shared with the animals.  She treasured the grooming, the saddling and unsaddling, the feeding time.  It was soothing to both Hillary, and her mount.  She enjoyed watching the animals for hours—especially their lips and whiskers (how they moved when they ate).  Perhaps it was because Hillary’s facial muscles were paralyzed; perhaps it was because Hillary could not eat by mouth.  Whatever the reason, she was fascinated.

Possibly the most important aspect gained by Hillary from therapeutic riding was that she made friends with the horses.  She allowed them into her withdrawn and silent world, and they helped her to understand how to reach out and relate to others. 

Hillary made significant strides in her 6 years with the therapy.  She experienced the Special Olympics and multiple horse-shows.  She was able to win ribbons—something that field-days in public school could not accommodate for children with multiple disabilities. 

As the years have gone by and Hillary has matured, her experiences have broadened and her interests have narrowed more to those things where she can do her best.  Riding has become less of a priority, replaced with art, computers, and picture books.  

“Even though her interests have changed, there is every reason to believe that therapeutic horseback riding was a significant influence in her life,” said Hillary Webster’s mother.  “The animals encouraged my daughter to accept the challenges of movement, of increased self-confidence and self-esteem, and of increased empathy with other living beings.”


Wednesday, September 1, 1993

Deaf Capitalizing on Cultural Pride: Editorial for National Association of the Deaf (NAD) Broadcaster

catwalker/shutterstock.com
America's Deaf community adopted a capital "D" to promote self-respect.  Tired of the old image that deaf people are disabled, the silent culture has come up with its own powerful identity, insisting that "Deaf" begin with a capital "D."

"A basic rule of English grammar is that all proper nouns are capitalized.  That's any specific person, place, thing, or idea--including Deaf life," said Mary Elstad, former teacher at the Colorado School for Deaf & Blind.

Tom Willard, editor for "Silent News," a national Deaf newspaper wrote, "When 'deaf' is not capitalized, it generally refers to...a physical disability. When it is capitalized, it denotes deafness as a cultural trait...as Hispanic or Russian is capitalized."

A person can be one, the other, or both.  The first is circumstance; the second is commitment.

It has become evident that Deaf people have pride in their own way of life. Popularity of the National Theater of the Deaf; Gallaudet University students choosing their own Deaf president; increased demand for use of American Sign Language; closed captioning of films and television programs; these are strong indicators of a thriving culture.

Mourene Tesler, executive director of Denver's Center on Deafness and activist for the Deaf said, "We think of Jews and Japanese--not jews and japanese--as peoples with their own languages, TV programs, theaters, newspapers, and schools.  They have their own styles, senses of humor, behaviors.  They are separate cultures existing within the mainstream.  The Deaf world is no different, and expects the same recognition."