Thomas R. Cole

What does it mean to grow old? : reflections from the humanities

In What Does It Mean to Grow Old? essayists come to grips as best they can with the phenomenon of an America that is about to become the Old Country. They have been drawn from every relevant discipline—gerontology, social medicine, politics, health, anthropology, ethics, law—and asked to speak their mind. Most of them write extremely well [and their] sharply individual voices are heard.

Aging, Meaning, and Well-Being: Musings of a Cultural Historian.

The social integration and well-being of old people depends in part on a culturally viable ideal of old age. Growing out of widely shared images and social values, an ideal old age legitimates norms and roles appropriate to the last stage of life. This article discusses the “late Calvinist” and “civilized” models of old age that flourished in Protestant, middle-class America between 1800 and 1920. It argues that the growing cultural dominance of science and the accelerating pace of capitalist productivity undercut the essential vision underlying these models: the view of life as a spiritual journey. The result has been a serious weakening of social meaning in aging and old age.

Faculty health in academic medicine : physicians, scientists, and the pressures of success

Foreword. James Willerson, MD, President, University of Texas-Houston Health Science Center Preface. Ken Shine, M.D., Executive Vice-Chancellor for Health Affairs and Interim Chancellor for the University of Texas System Introduction The Context of Concern for Faculty Health. Thelma Jean Goodrich, PhD, Thomas R. Cole, PhD and Ellen R. Gritz, PhD Examination of Faculty Health Epidemiology. Daria Boccher-Lattimore, DrPH Causes and Treatment of Impairment and Burnout in Physicians: The Epidemic Within. Eugene Boisaubin, MD Measuring and Maintaining Faculty Health: Lessons from the University of Ottawa. Mamta Gautam, Personal and Social Dimensions The Architecture of Alignment: Leadership and the Psychological Health of Faculty. Susan McDaniel, PhD, Stephen P. Bogdewic, PhD, Richard Holloway, PhD and Jeri Hepworth, PhD The Career Management Life Cycle: A Model for Supporting and Sustaining Faculty Vitality and Wellness. Thomas Viggiano, MD and Henry W. Strobel, PhD Faculty Resilience and Career Development: Strategies for Strengthening Academic Medicine. Janet Bickel, MA Diverse Academic Faculty: A Precious Resource for Innovative Institutions. Elise Cook, MD and Harry Gibbs, MD Perspectives from the Humanities and Interpretive Social Science Organizational Culture and its Consequences. Kevin Grigsby, DSW The Ethics of Self-Care. Craig Irvine, PhD Faculty Health and the Crisis of Meaning: Humanistic Diagnosis and Treatment. Thomas R. Cole, PhD and Nathan Carlin, MDiv Retaining and Reclaiming the Call of Medicine. Henry W. Strobel, PhD Supports and Interventions A Model for Designing and Developing a Faculty Health Program: The M. D. Anderson Experience. EllenR. Gritz, PhD, Janis Apted, MLS, Walter Baile, MD, Kathleen Sazama, MD, JD and Georgia Thomas, MD Fostering Faculty Well-Being through Personal, Community, and Cultural Formation at an Academic Medical Center: Indiana University School of Medicine as a Case Study. Debra K. Litzelman, MA, MD, Penelope R. Williamson, ScD, Anthony L. Suchman, MA, MD, Stephen P. Bogdewic, PhD, Ann H. Cottingham, MAR, Richard M. Frankel, PhD, David M. Mossbarger, MBA, and Thomas S. Inui, SCM, MD Conflict Resolution in an Academic Medical Center: The Ombuds Office. Anu Rao, PhD, Walter Baile, MD and Patricia Parker, PhD Preserving Principal: Programming for Faculty Health and Well-Being. Thelma Jean Goodrich, PhD Conclusion Faculty Health: A New Field of Inquiry and Programming. Thelma Jean Goodrich, PhD, Thomas R. Cole, PhD and Ellen R. Gritz, PhD Afterword. John Mendelsohn, M.D., President, University of Texas M. D. Anderson Cancer Center Appendix. Foundations of Faculty Health: A Consensus Statement of Editors and Authors.

Stimulating creativity in all elders: a continuum of interventions.

Contemporary society seldom associates creativity with people in later adult years. We challenge that perception. A continuum of creative programs defined here shows promise for eliciting late life creativeness offering elders in the community, in residential settings, in adult day care, and in home care new avenues for expression. Life story writing and sharing groups, Visible Lives storyboards, and TimeSlips© storytelling method for patients with dementia equip caregivers with new tools to nourish creativity in all elders. Evidence suggests that stimulating creativity in elders at all levels of functioning improves health outcomes. This article introduces programs designed to engage, encourage, and inspire elders regardless of functionality. All three related but discreet interventions share core components of listening with intention, utilizing positive affirmation, and facilitating sharing in community as participants develop surprising new capabilities. Health care providers, community volunteers, and family members can develop skills and techniques to implement any of the programs described. Fostering creative expression through cognitive exercise and imagination among those in later years may forestall dementias, improve quality of life for elders and their caregivers, and meet unmet personal and societal needs. These programs demonstrate the possibility of growth and creative potential at every stage in life, including the latest years, even for those with dementias.

The Political and Moral Economy of Aging: Not Such Strange Bedfellows

The authors develop E. P. Thompsons concept of moral economy as a useful complement to contemporary political economic analysis in problem areas involving moral conflict. Defined as the shared assumptions underlying norms of reciprocity in which an economic system is grounded, moral economy is seen as holding particular relevance for the study of aging. The evolution of pension systems, the “senior revolt” against catastrophic coverage in the United States, and debates over the allocation of health resources between generations are used to illustrate the utility of a combined political and moral economy for enriching our understanding in these areas. Marxs concept of a “morality of emancipation” is described as holding particular promise for the development of a new moral economy of old age that would move beyond alienation by giving broad attention to quality of life issues at each stage of the life course.

Faculty Health and the Crisis of Meaning: Humanistic Diagnosis and Treatment

Recent concern for faculty health is a symptom of the damaged situation of contemporary health science centers; our human infrastructure is being compromised. This chapter argues that problems in faculty health often grow out of a crisis of meaning and identity that confronts health professionals increasingly unable to live up to their highest values and ideals. Recent trends in bioethics have emphasized concern for the patient as a whole person, but the patient is not the only whole person in the consulting room. Very little attention has been paid to the legitimate needs and concerns of the physician. Likewise, the research scientist is more than a machine for turning out grants and publications; yet the personhood of the researcher is almost nowhere acknowledged. This chapter offers perspectives from the humanities on faculty health. First, it sketches a historical context by locating faculty health within the recent crisis of academic health centers. Second, it uses the philosophical concept of “ethical violence” to cast new light on how academic physicians and scientists come to suffer and develop disease in striving to live up to their professional ideals. In conclusion, it discusses specific methods and programs in which the humanities and expressive arts provide avenues of reflection, release, and personal growth to replenish those whose work life requires, but virtually excludes these essential ingredients of meaning. Ideally, these programs will be part of a conscious commitment to compassion and care in institutional culture.

Scientific and Medical Concepts of Nature in the Modern Period in Europe and North America

This chapter addresses scientific and medical concepts of nature in the modern period in Europe and North America, from the seventeenth century to the present. During this period, under the influence of Francis Bacon (1561–1626) and his followers, biology and medicine self-consciously became increasingly scientific, resulting in the biotechnologies that are the focus of this volume. The reach of contemporary biotechnology is global, but its origins are to be found in the science and medicine of early modern Europe and North America, the main focus of this chapter. Appeals to nature, the natural, and the unnatural in contemporary assessments of biotechnology and policy proposals for its regulation owe an unacknowledged debt to historical concepts of nature. Our choice of the plural, concepts, is deliberate. The central theme of this chapter is that since the seventeenth century, there has been no single, canonical concept of nature. Instead, there has been a competition among concepts of nature which continues to this day. Our goal in this chapter is to map three major conceptions of nature in the context of three case studies: food, animal, and plants as pure and impure; medical interventions to correct the deficiencies of nature; and the dynamic and ever-changing conceptions of aging. We therefore do not attempt a comprehensive historical explanation of the social, cultural, and other forces that shaped concepts of nature during these centuries. We do attempt to understand how concepts of and appeals to nature were conceptualized in each of the three case studies, allowing the distinctive voices of the past to be heard, as best we can, on their own terms. On this basis we identify lessons learned from these three case studies for appeals to nature as normative. These lessons emphasize the complexities and challenges of appeals to nature as normative in assessing scientific and technological advances. Responsible management of these complexities can be accomplished by adhering to requirements,

The ideology of old age and death in American history.

that have engaged anthropologists, psychologists, and sociologists for almost 30 years. Swept along by a new spirit of inquiry into subjects commonly passed over in silence, the logic of social history at last suggests that-like childhood, adolescence, women, and the family-old age and death also deserve historical attention. Yet this logic artificially approaches its subjects as if they existed in discrete, isolated categories and places them in social or cultural contexts equally isolated from shifting relations of power and struggles over the economic surplus. The current fashion of studying the history of society without politics (broadly considered) is as inadequate as the older style of studying the history of politics without society: both obscure the dialectical tension of historical experience. Old age and death-the latest targets for social and cultural historians-provide a fresh opportunity to transcend these limitations.

No Country for Old Men: Four Challenges for Men Facing the Fourth Age

abstract:This essay reads the protagonist of Cormac McCarthys No Country for Old Men (2005), Sheriff Ed Tom Bell, as an exemplar of problems that contemporary aging men face when they look to ahead to the so-called Fourth Age. As the plot unfolds, Bell is an aging, increasingly ineffectual cowboy lawman who retires, renounces the violence that sustained his male dominance, and loses the moral certainty that ensured his identity. Like Bell, most old men struggle with four interrelated challenges as they move along the ever-lengthening journey of life: relevance, masculinity, love, and meaning.

The Context of Concern for Faculty Health

So began a three-day working conference on faculty health and well-being in academic medical centers, the first to focus entirely on that subject. Henry Strobel spoke these words at the opening dinner. They both set the theme and recalled the reason for the gathering: faculty burnout and demoralization. The causes are multiple. Sometimes faculty work under onerous conditions—too much to do in too short a time, not enough resources, not enough support staff, and so on. Other times—out of what they regard as dedication and passion—faculty work past needing rest, past needing family, and past needing renewal. Either way, the result is finally a separation from the very inspiration that “sparked the notion of joining an honored tradition of service.” The conference was organized by the editors of this volume and was sponsored by the McGovern Center at the University of Texas Health Science Center in Houston in collaboration with the M. D. Anderson Cancer Center, also in Houston. It had its origins in concern for loss of meaning and its deleterious consequences. But what pulled us forward was envisioning a new field of inquiry that would explore all facets of faculty well-being—the major factors affecting it and resources for protecting, recovering, and enhancing it. Our aim was to convene those with expertise in relevant areas and produce a foundational book for this new field. Chapter 1 The Context of Concern for Faculty Health