Irving Kenneth Zola

CULTURE AND SYMPTOMS-AN ANALYSIS OF PATIENTS' PRESENTING COMPLAINTS *

Physical disorder is often thought to be a fairly objective and relatively infrequent phenomenon. An examination of the literature reveals, however, that the empirical reality may be that illness, defined as the presence of clinically serious signs, is the statistical norm. Given that the prevalence of abnormalities is so high, the rate of acknowledgement so low, and the decision to seek aid unrelated to objective seriousness and discomfort, it is suggested that a socially conditioned selective process may be operating in what is brought in for medical treatment. Two such processes are delineated and the idea is postulated that it might be such selective processes and not etiological ones which account for many of the previously unexplained epidemiological differences between societies and even between subgroups within a society. A study is reported which illustrates the existence of such a selective process in the differing complaints of a group of Italian and Irish patients-a pattern of differences which is maintained even when the diagnosed disorder for which they sought aid is held constant.

Pathways to the doctor-from person to patient.

Abstract In this brief essay, I would like to accomplish several goals; the description of (1) a central problem in the understanding of the patient and his environment, (2) the difficulties inherent in studying this problem, (3) the insights from psychiatry and anthropology which made its investigation possible and (4) the first of a series of studies which ultimately was spawned out of a consideration of items 1, 2 and 3 [1].

Bringing our bodies and ourselves back in : reflections on a past, present, and future medical sociology

This paper is a revision of an address given upon receipt of the Leo G. Reeder Award for Distinguished Scholarship in Medical Sociology. It was presented on August 14, 1990 to The Medical Sociology Section of the American Sociological Association during its annual meetings, held in Washington, DC. Herein I reflect on the structured silence of personal bodily experience and on the unfinished paradigmatic challenge of feminism as a way of leading to a new praxis in medical sociology.

In the name of health and illness: On some socio-political consequences of medical influence

Abstract Medicine and health care are becoming major areas of socio control, nudging aside, if not incorporating, themore traditional institutions of religion and law. This is not occuring through the political power physicians hold or can influence, but is largely an insidious and often undramatic phenomenon accomplished by “medicalizing” much of daily living, by making medicine and the labels “health” and “ill” relevant to a ever increasing part of human existence. This paper tries to delineate the perils of this wholesale transfer of the medical model to workaday world.

AGING AND DISABILITY: TOWARD A UNIFYING AGENDA

The aged and the disabled have traditionally been split into two opposing camps by providers of services and themselves. With focus on five cross‐cutting phenomena—their prevalence the ever‐changing nature of their conditions their reactions to both the technicalization and medicalization of their care and the full implications of the home care revolution—for the importance of their finding a common ground is argued. The last section delineates the process by which such a unifying agenda might come to be.

Chronic Illness and Disability

Advances in medical diagnosis and treatment as well as shifting patterns of illness have brought about an increase in the number of patients afflicted with chronic illness and disability. The management of these patients entails unique stresses not only for those afflicted and their families but also for physicians and other health care providers. This chapter explores some of the barriers to effective care posed by these stresses and the resources a family physician may use to overcome them.

Work perceptions and their implications for professional identity: an exploratory analysis of public health nurses.

Abstract Our story has two themes. The first embodies a description of how a group of public health nurses tackled the problem of professional identification. This in turn involved two processes. The first was an intergroup one whereby they told who they were almost entirely by stressing who they were not; namely by contrasting their work with that of traditional hospital nursing. The second process of the search for identity was reflected by an intra-group phenomenon called by some “segmentation”. This was crystallized in the formation of two rather distinct groups, the ‘medically-oriented’ and the ‘socially-oriented’, who differed rather dramatically on what they thought were the most appropriate goals and tasks of public health nursing. The second theme is a frankly speculative projection of the implication of both these processes for the development of public health nursing as a professional specialty.

Shifting boundaries: Doing social science in the 1990s—A personal odyssey

Drawing on my own 40 years as a social scientist, I argue, as have others in recent years, that rather than “a contaminant,” ones own biography can be a useful tool in social analysis. I place my personal struggle with this issue in a larger cultural context and point to a shift in the boundaries between public and private, which has profound implications for the way we teach, write, and do research.

Illness Behaviour — A Political Analysis

This chapter examines the nature of medicine and the political context of the terms “health” and “illness”. More specifically, issues of power will be addressed. Power will be illustrated on the macro level by the phenomenon of medicalization and on the micro by the encounter between health-care provider and patient.