Search

The policy was the multi-tiered approach designed by New York City officials in the event of an Ebola case. This included designation of eight hospitals as being care centers for Ebola cases, teaching non-designated hospitals or care centers how to identify Ebola candidates, communication with transportation services (both EMS and non-EMS), and running unscheduled drills to practice handling scenes with an Ebola candidate (the example given was someone falling ill in a subway car). The poly aimed to standardize the approaches and protocols used when dealing with a possible Ebola case. It focused on minimizing the excessive risk to citizens, EMS personnel, and healthcare workers in the event of a patient with Ebola. The policy also sought to train and drill these protocols, including unscheduled calls (mentioned above) and continued inspections to ensure preparedness. The obvious end goal was to minimize the possibility of wide-spread infection, either through improper handling or failed detection of an Ebola case.

The bibliography is not included in the PDF uploaded, most likely because this a chapter excerpt from a larger work. However, there are several citations within the article, most of which are elaborated on. These descriptions indicate the works follow similar lines of thought and provide similar information to supplement Dr. Good's assertions. This includes his description of Dr. Evelyn A. Early's works (discussed earlier--ha), and several other prominent medical anthropologists. 

The policy does not make any specific mentions of how to deal with vulnerable populations. However, if one were to consider the nature of New York, it can be argued that the city's entire population is vulnerable to outbreak. As a hub of trade, finance, travel, and business, New York is at a considerably higher risk than a city without this high metropolitan activity. The policy does include measures on how to treat individuals who show signs and symptoms in public locations, but does not mandate testing or health checks for individuals involved in transport, travel, or who have limited access to health care (the homeless).

1)      From the perspective of readers or hearers of stories that are in process, plot is less a finished form or structure than an engagement with what has been told or read so far in relation to imagined outcomes that the story may bring - outcomes that are feared, longed for, or seem ironically or tragically inevitable.

2)      Second. several prototypical plot types can be identified among the illness narratives, as well as among the specific stories of which they are constituted. These have a distinctive cultural form, rooted in Turkish popular medical culture. They are present as the plot structures of the narratives we heard. They are also available as cultural resources for those in the midst of illness attempting to make sense of their experience; that is, they are possible stories one might reasonably tell about such an illness, potential plots giving order to the events one is experiencing.

3)       Meanwhile, he continues to work in a job at the municipality, where he is treated well by co-workers. His major concern is that he and his wife have had no children, and he wonders if either the illness or the medications are to blame. This, rather than treatment of the primary disease, organizes his interest in shaping the outcome of his illness story.

This chapter from the work "Medicine, Rationality, and Experience: an anthropological perspective" seems to most frequently appear on websites for various Universities and Colleges. Moreover, the work as a whole seems to have been cited several times by subsequent reports further defining patient narration and medical relations.

The Ebola outbreak is, by its very definition, a matter of public health. The outbreak presented a danger to the global health community and resulting policies dealing with this epidemic were public health policies. That being said, the policy in place mostly served as a protocol mostly for agencies of New York in the event the epidemic spread. It focused on standardizing the practices of health, transport, and government agencies in the event of an outbreak; it did not focus on individuals already effected with the disease, but more so on preventing the spread of the epidemic. 

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

Emergency response is not specifically addressed in the article. However, medical professional-patient relations are a key component of emergency response; as such, Dr. Good's assertions surrounding patient narrative should be taken into consideration in emergency situations. He notes that the methodology and cultural nuances of narration can provide a cornucopia of information that would otherwise be ignored.  

As described by Governor Cuomo, Dallas was the first major US city to see an Ebola case. This, in turn, allowed New York leadership to have some semblance of what methods did or did not work when trying to contain the disease. Moreover, the policy was implemented in response to the major Ebola outbreaks occurring at this time. This included those within Africa, Europe, and cases seen in Dallas. Moreover, the policy follows the city's "Safe-than-sorry" methodology discussed by Governor Cuomo; he, along with other state and city leaders, believed assuming an Ebola outbreak would occur within the state would give them the best chance of mitigating its effects and minimizing disease spread.

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology.