Question 1:
In Tesh, we are reading about the ways in which many in the 19th century society viewed the causes of disease. Which of these ways of thinking, if any, have we abandoned in the 21st century? Which of these are still with us? Why, in your opinion, have these ways of thinking persisted?
Question 2:
What connections can we make between the well-known debate about Agent Orange, and the newer, lesser-known controversy about the health impacts of burn pits? What political ideologies and vested interests are at play in determining how health problems related to burn pits are treated?
Question 3:
Recalling a patient he treated in Haiti, Ansell states, “If my patient in Haiti with broken heart syndrome died, the cause of death on the death certificate would be heart failure. But what was the true underlying cause of death: the earthquake, poverty, or homelessness? The rules require the physician to list illnesses, not social conditions, as causes, even if poverty, racism, tobacco, pollution, and stress might be considered proximal causal conditions” (p. 21).
Viewing the simple death certificate below, think about what kind of structural violence or social conditions might underlie a death such as this. What kinds of social conditions might precipitate chronic alcoholism (feel free to use a specific demographic as an example)? If clinical medicine treats only the pancreatitis, what kinds of community-level interventions could impact the conditions that led to the alcoholism in the first place?
