Hidden behind the screen: seeing the life and death boundary in an intensive care unit

2021 ◽  
Vol 4 (1) ◽  
pp. 104-125
Author(s):  
Alina Patrakova
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Video Surveillance ◽  
Point Of View ◽  
Life And Death ◽  
Naked Eye ◽  
Starting Point ◽  
The Moment ◽  
The One ◽  
Monitoring Technologies

The article traces how the life-death boundary in the intensive care unit is made visible on hospital monitors (in figures and diagnostic images), in medical dramas and docu-series as well as via video surveillance. The starting point is the question of how much the life-death boundary is accessible to be viewed directly – not only with the naked eye, but also with the help of special devices. In search for answers to this question, the author focuses on the semantic field of the “screen” concept. Screen, on the one hand, can be considered as a surface on which an image is projected; on the other hand, it can be a pro-tective barrier. In other words, screen can be a tool for both turning the invisible into the visible and vice versa. This antinomy between visibility and invisibility can be traced both in relation to hospital monitors as well as to TV and video surveillance. Screen has its frames and technical limitations that determine the selectivity of representation. In conclusion, the author assumes that the intention to objectively record the moment of death, to make this boundary clearly visible from a scientific point of view makes it, on the contrary, escape the eye. What is managed to be registered and made visible turns out to be an artifact. In this sense, the life-death boundary in critical medicine appears as a multiple construct – of theoretical, technological, and socio-cultural nature. Probably, the paradox is that this transition from life to death can be seen more clearly with the naked eye rather than with diagnostic and monitoring technologies.

L’absence chez Michel Butor. L’Emploi du temps et Degrés

2012 ◽  
pp. 66-80
Author(s):  
Michał Mrozowicki
Keyword(s):  
Human Memory ◽  
Point Of View ◽  
Narrative Discourse ◽  
The Novel ◽  
Michel Butor ◽  
Starting Point ◽  
One Year ◽  
The Moment ◽  
Narrative Mode ◽  
The City

Michel Butor, born in 1926, one of the leaders of the French New Novel movement, has written only four novels between 1954 and 1960. The most famous of them is La Modification (Second thoughts), published in 1957. The author of the paper analyzes two other Butor’s novels: L’Emploi du temps (Passing time) – 1956, and Degrés (Degrees) – 1960. The theme of absence is crucial in both of them. In the former, the novel, presented as the diary of Jacques Revel, a young Frenchman spending a year in Bleston (a fictitious English city vaguely similar to Manchester), describes the narrator’s struggle to survive in a double – spatial and temporal – labyrinth. The first of them, formed by Bleston’s streets, squares and parks, is symbolized by the City plan. During his one year sojourn in the city, using its plan, Revel learns patiently how to move in its different districts, and in its strange labyrinth – strange because devoid any centre – that at the end stops annoying him. The other, the temporal one, symbolized by the diary itself, the labyrinth of the human memory, discovered by the narrator rather lately, somewhere in the middle of the year passed in Bleston, becomes, by contrast, more and more dense and complex, which is reflected by an increasinly complex narration used to describe the past. However, at the moment Revel is leaving the city, he is still unable to recall and to describe the events of the 29th of February 1952. This gap, this absence, symbolizes his defeat as the narrator, and, in the same time, the human memory’s limits. In Degrees temporal and spatial structures are also very important. This time round, however, the problems of the narration itself, become predominant. Considered from this point of view, the novel announces Gerard Genette’s work Narrative Discourse and his theoretical discussion of two narratological categories: narrative voice and narrative mode. Having transgressed his narrative competences, Pierre Vernier, the narrator of the first and the second parts of the novel, who, taking as a starting point, a complete account of one hour at school, tries to describe the whole world and various aspects of the human civilization for the benefit of his nephew, Pierre Eller, must fail and disappear, as the narrator, from the third part, which is narrated by another narrator, less audacious and more credible.

scholarly journals Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mariona Badia ◽  
José Manuel Casanova ◽  
Lluís Serviá ◽  
Neus Montserrat ◽  
Jordi Codina ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cutaneous Lesion ◽  
Skin Lesions ◽  
Intensive Treatment ◽  
Main Diagnosis ◽  
Systemic Diseases ◽  
Cutaneous Manifestations ◽  
Critical Patients ◽  
The Moment

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

Septic Shock: Phenomenology

1971 ◽  
Vol 2 (4) ◽  
pp. 327-332
Author(s):  
Roy G. Fitzgerald
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Endotoxin Shock ◽  
Life Threatening ◽  
The Moment

This is an autobiographical account of an episode of life-threatening endotoxin shock experienced in the intensive care unit of a university-affiliated V.A. hospital. It was written within a day of the event by a psychiatrist interested in sharing with other physicians and nurses his harrowing time as a patient. He has added some afterthoughts as his perspective has broadened. The account presents the moment-to-moment events as he perceived them as well as his thoughts, feelings and fantasies. The ambiguities of being a psychiatrist-patient with its passivity-control, intellectual defenses, denial and fears of death are prominent in his thoughts.

Breaking Bad News and Discussing Goals of Care in the Intensive Care Unit

2015 ◽  
Vol 26 (2) ◽  
pp. 131-141 ◽  
Author(s):  
Sheryl L. Hollyday ◽  
Denise Buonocore
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bad News ◽  
High Stakes ◽  
Goals Of Care ◽  
Life And Death ◽  
Breaking Bad ◽  
Aggressive Care ◽  
Delivering Bad News ◽  
Practice Patient

The intensive care unit is a high-stakes environment in which nurses, including advanced practice registered nurses (APRNs), often assist patients and families to navigate life and death situations. These high-stakes situations often require discussions that include bad news and discussions about goals of care or limiting aggressive care, and APRNs must develop expertise and techniques to be skilled communicators for conducting these crucial conversations. This article explores the art of communication, the learned skill of delivering bad news in the health care setting, and the incorporation of this news into a discussion about goals of care for patients. As APRNs learn to incorporate effective communication skills into practice, patient care and communication will ultimately be enhanced.

scholarly journals Feelings and expectations of mothers of preterm babies at discharge

2007 ◽  
Vol 20 (3) ◽  
pp. 333-337 ◽  
Author(s):  
Maria Zuleide da Silva Rabelo ◽  
Edna Maria Camelo Chaves ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Maria do Socorro Mendonça Sherlock
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Descriptive Study ◽  
Preterm Babies ◽  
The Moment

OBJECTIVE: To investigate the feelings and expectations of mothers of preterm babies at discharge. METHODS: This descriptive study used Bardin's framework to collect data among 11 mothers of preterm babies from a Neonatal Intensive Care Unit. Data were collected through interviews from December 2004 to January 2005. RESULTS: Four categories emerged: the moment of the discharge; mothers' knowledge and questions; mothers' preparation and orientation for discharge; and, mothers' desired orientation. CONCLUSION: Although mothers' experienced excitement and happiness at discharge, many reported being anxious and insecure on how to take care of their preterm babies.

Combining Forms and Affixoids in Morphology

2020 ◽  
Author(s):  
Dany Amiot ◽  
Edwige Dugas
Keyword(s):  
Major Part ◽  
Word Formation ◽  
Point Of View ◽  
The Other ◽  
Formation Processes ◽  
Good Criterion ◽  
Part Of Speech ◽  
Starting Point ◽  
Wide Range ◽  
The One

Word-formation encompasses a wide range of processes, among which we find derivation and compounding, two processes yielding productive patterns which enable the speaker to understand and to coin new lexemes. This article draws a distinction between two types of constituents (suffixes, combining forms, splinters, affixoids, etc.) on the one hand and word-formation processes (derivation, compounding, blending, etc.) on the other hand but also shows that a given constituent can appear in different word-formation processes. First, it describes prototypical derivation and compounding in terms of word-formation processes and of their constituents: Prototypical derivation involves a base lexeme, that is, a free lexical elements belonging to a major part-of-speech category (noun, verb, or adjective) and, very often, an affix (e.g., Fr. laverV ‘to wash’ > lavableA ‘washable’), while prototypical compounding involves two lexemes (e.g., Eng. rainN + fallV > rainfallN). The description of these prototypical phenomena provides a starting point for the description of other types of constituents and word-formation processes. There are indeed at least two phenomena which do not meet this description, namely, combining forms (henceforth CFs) and affixoids, and which therefore pose an interesting challenge to linguistic description, be it synchronic or diachronic. The distinction between combining forms and affixoids is not easy to establish and the definitions are often confusing, but productivity is a good criterion to distinguish them from each other, even if it does not answer all the questions raised by bound forms. In the literature, the notions of CF and affixoid are not unanimously agreed upon, especially that of affixoid. Yet this article stresses that they enable us to highlight, and even conceptualize, the gradual nature of linguistic phenomena, whether from a synchronic or a diachronic point of view.

Assembling (non) treatable cases: The communicative constitution of medical object in doctor–doctor interaction

2017 ◽  
Vol 19 (1) ◽  
pp. 30-48 ◽  
Author(s):  
Letizia Caronia ◽  
Arturo Chieregato ◽  
Marzia Saglietti
Keyword(s):  
Infectious Disease ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Case ◽  
Disease Diagnosis ◽  
Ethnographic Study ◽  
Discursive Construction ◽  
Medical Object ◽  
Communicative Constitution ◽  
The One

Research on medical interactions shows how the discursive construction of the clinical case impacts diagnostic reasoning and treatment recommendations. Drawing on an ethnographic study in an intensive care unit, we illustrate how this process is at play in a ward that adopts an extreme, guideline-divergent policy as to the use of antibiotics. The article focuses on how physicians assemble the case as ‘treatable’ or ‘not yet treatable’, and how in doing so they ‘talk into being’ two contrastive policies on antibiotics and position themselves toward the one adopted in the ward. The analysis identifies the discursive resources displayed by physicians to both project an infectious disease diagnosis and resist this treatment-implicative trajectory. We argue that the physicians’ contentious discursive construction of the case has crucial consequences in the way the ward’s extreme policy is jointly accomplished as a highly reflexive process sensitive to the contingencies of any particular case.

Video surveillance audit of hand-washing practices in a neonatal intensive care unit

2015 ◽  
Vol 52 (5) ◽  
pp. 409-411 ◽  
Author(s):  
Rutvi Shah ◽  
Dipen V. Patel ◽  
Kushal Shah ◽  
Ajay Phatak ◽  
Somashekhar Nimbalkar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Video Surveillance ◽  
Neonatal Intensive Care ◽  
Hand Washing

scholarly journals Glycemic Control in Neurological Intensive Care Unit Patients

2021 ◽  
Vol 1 (4) ◽  
pp. 190-196
Author(s):  
Kirill Y. Krylov ◽  
Ivan A. Savin ◽  
Sergey V. Sviridov ◽  
Irina V. Vedenina ◽  
Marina V. Petrova ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glycemic Control ◽  
Critically Ill ◽  
Metabolic Response ◽  
Glucose Production ◽  
Tight Glycemic Control ◽  
Point Of View ◽  
Neurological Intensive Care Unit ◽  
Neurological Intensive Care

Critically ill patients often develop hyperglycemia because of the metabolic response to trauma and stress. In response to any form of damage to the organism, it reacts by increasing its own glucose production which subsequently causes hyperglycemia. This adaptive reaction of the organism is directed to aid in the rapid restoration after the damage. Therefore, glucose is an indispensable substrate in the critically ill which aids the reparation process. Severe and persistent hyperglycemia is associated with unfavorable outcomes and is considered to be an independent predictor of in-hospital mortality. The discussion remains on whether hyperglycemia is just a marker of increased stress which makes it a surrogate indicator of disease severity or if it is the reason for the unfavorable outcome. A few years ago, several published articles suggested that a tight glycemic control within the normal range improves treatment outcome. Over time, researchers have changed their point of view and currently there is a discussion on this matter in the scientific literatures. At the same time, the question of what glycemic level should be maintained for patients in the Neurological Intensive Care Unit is a matter of discussion. In this review, the authors analyzed the latest guidelines on treatment of critical patients with neurosurgical and neurological pathologies, specifically the glycemic control in this category of patients.

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