Charlotte Perkins Gilman was a prominent and effective figure for social change in her prime, yet, despite her prodigious literary output, she had little direct influence on the generations immediately following her. Even before her death, all of her works were out of print. She has been the subject of increasingly widespread attention since her rediscovery, yet, although she was a stalwart advocate for women's rights, many of Gilman's views make hers a problematic revival. That Gilman has a place in (...) the history of feminism is undeniable, but how to situate her, and especially Herland, in relation to contemporary feminist thought remains a matter of debate. Feminist scholars have long been engaged in the question... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Social and Moral Aspects of the WarBertrand Russell and Introduced by Andrew G. BoneAmong nine loose-leaf folders of typed transcriptions of Russell's History of Western Philosophy lectures at the Barnes Foundation1 are two copies of a fourteen-page stenographic record of a political talk he gave there on 2 March 1941.2 The bulk of this significant new accrual to the Russell Archives, bearing as it does on Russell's most (...) successful philosophical work, could stimulate much further research and textual study. But his isolated Barnes lecture, about the politics of American neutrality, Nazi Germany's brutal and expansionist dictatorship, and the causes and possible consequences of the war against it, is also of considerable interest.The transcription reads more like detailed notes than a verbatim account, and there is no evidence that Russell approved this text.3 The stenographer initially recorded Russell in the third person, dispensed with this device before the second [End Page 52] paragraph, but then occasionally returned to it.4 There is also more enumeration of Russell's points than he would have supplied in a prepared script. Even the title may not be his: there is nothing in the text on any social changes wrought by the war. But this title has been retained in the absence of a more plausible alternative in a short report of the speech (quoting sixteen sentences) in the next day's Philadelphia Evening Bulletin.5 Russell's hour-long address on the "Social and Moral Aspects of the War" appears to have been the only occasion when he "laid philosophy aside"6 at the Barnes Foundation. It was delivered on a Sunday to an audience of 160 students (and possibly some invitees, although none are mentioned in the newspaper article), sandwiched between two of his weekly philosophical lectures (on Socrates and Sparta7) in the series scheduled for each Thursday.In opening his case for the United States joining the Allied war effort, Russell challenged the arguments for the "policy of conciliation" which, by his own recent admission in the New York Times,8 he had earlier endorsed. Published two weeks before Russell spoke on a similar topic at the Barnes Foundation, this 2,000-word letter to the editor served as a very detailed and public renunciation of the pacifist viewpoint—neutrality for national governments combined with non-resistance for individuals—which Russell had promoted in Which Way to Peace? (1936) and continued to condone after the Munich Agreement (September 1938) and even the dismemberment of Czechoslovakia (March 1939).Yet Russell the "relative political pacifist"9 also admitted in this most programmatic statement of his prewar position that "In other times and other circumstances, I should be prepared to consider gains and losses, and to concede that war might be worth while" (WWP, pp. 151–2).That moment had obviously arrived and may have done so already when on 15 October 1939 Russell confided to Constance Malleson that his passionate desire for a British victory made a "thorough-going pacifism difficult" (ra Rec. Acq. 596). But six months later he still did "not feel sufficiently sure of the opposite to say anything publicly by way of recantation"—before adding in this letter to Gilbert Murray that "it may come to that" (21 April 1940, ra Rec. Acq. 71g). It clearly did shortly afterwards—when the "phoney war" in Western Europe was dramatically ended by the invasion of France and the [End Page 53] Low Countries. On 13 May Russell asked the editor of the New Statesman and Nation to notify its readers that he had abandoned his once strongly held pacifist convictions.10In his lecture to the Barnes Foundation, Russell turned next to the defence of American non-intervention by Robert M. Hutchins (see n. 16 below)—which he had already critiqued in the New York Times. Although rather precariously situated as a resident alien in the United States, Russell was hardly circumspect about pushing a policy that so sharply divided American opinion.11 He also listed the faults of the League of Nations and the most grievous diplomatic mistakes made since the end of the last war and the fatally... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Social and Moral Aspects of the WarBertrand Russell and Introduced by Andrew G. BoneAmong nine loose-leaf folders of typed transcriptions of Russell's History of Western Philosophy lectures at the Barnes Foundation1 are two copies of a fourteen-page stenographic record of a political talk he gave there on 2 March 1941.2 The bulk of this significant new accrual to the Russell Archives, bearing as it does on Russell's most (...) successful philosophical work, could stimulate much further research and textual study. But his isolated Barnes lecture, about the politics of American neutrality, Nazi Germany's brutal and expansionist dictatorship, and the causes and possible consequences of the war against it, is also of considerable interest.The transcription reads more like detailed notes than a verbatim account, and there is no evidence that Russell approved this text.3 The stenographer initially recorded Russell in the third person, dispensed with this device before the second [End Page 52] paragraph, but then occasionally returned to it.4 There is also more enumeration of Russell's points than he would have supplied in a prepared script. Even the title may not be his: there is nothing in the text on any social changes wrought by the war. But this title has been retained in the absence of a more plausible alternative in a short report of the speech (quoting sixteen sentences) in the next day's Philadelphia Evening Bulletin.5 Russell's hour-long address on the "Social and Moral Aspects of the War" appears to have been the only occasion when he "laid philosophy aside"6 at the Barnes Foundation. It was delivered on a Sunday to an audience of 160 students (and possibly some invitees, although none are mentioned in the newspaper article), sandwiched between two of his weekly philosophical lectures (on Socrates and Sparta7) in the series scheduled for each Thursday.In opening his case for the United States joining the Allied war effort, Russell challenged the arguments for the "policy of conciliation" which, by his own recent admission in the New York Times,8 he had earlier endorsed. Published two weeks before Russell spoke on a similar topic at the Barnes Foundation, this 2,000-word letter to the editor served as a very detailed and public renunciation of the pacifist viewpoint—neutrality for national governments combined with non-resistance for individuals—which Russell had promoted in Which Way to Peace? (1936) and continued to condone after the Munich Agreement (September 1938) and even the dismemberment of Czechoslovakia (March 1939).Yet Russell the "relative political pacifist"9 also admitted in this most programmatic statement of his prewar position that "In other times and other circumstances, I should be prepared to consider gains and losses, and to concede that war might be worth while" (WWP, pp. 151–2).That moment had obviously arrived and may have done so already when on 15 October 1939 Russell confided to Constance Malleson that his passionate desire for a British victory made a "thorough-going pacifism difficult" (ra Rec. Acq. 596). But six months later he still did "not feel sufficiently sure of the opposite to say anything publicly by way of recantation"—before adding in this letter to Gilbert Murray that "it may come to that" (21 April 1940, ra Rec. Acq. 71g). It clearly did shortly afterwards—when the "phoney war" in Western Europe was dramatically ended by the invasion of France and the [End Page 53] Low Countries. On 13 May Russell asked the editor of the New Statesman and Nation to notify its readers that he had abandoned his once strongly held pacifist convictions.10In his lecture to the Barnes Foundation, Russell turned next to the defence of American non-intervention by Robert M. Hutchins (see n. 16 below)—which he had already critiqued in the New York Times. Although rather precariously situated as a resident alien in the United States, Russell was hardly circumspect about pushing a policy that so sharply divided American opinion.11 He also listed the faults of the League of Nations and the most grievous diplomatic mistakes made since the end of the last war and the fatally... (shrink)

At the height of the Sino-Indian border dispute in 1962, Bertrand Russell, as “a lifetime friend of India” (Unarmed Victory, p. 88), appealed to Prime Minister Nehru for peace. Yet for the first 75 years of Russell’s life, India had not been an independent, developing state whose non-aligned diplomacy he could (usually) admire, but rather an economically and stra­tegically vital part of the British Empire. Thus Russell’s fraternal bond with India was formed during its protracted struggle against British rule. The (...) central purpose of this article is to reconstruct Russell’s occasionally contorted connection with that historic contest, and it will do so by drawing on a wealth of neglected textual material. More than simply fleshing out a significant but overlooked chapter in Russell’s political life, this assessment of his decades-long association, as participant and observer, with the campaign for Indian independence also strives to capture the complex essence of his thinking on questions of empire generally. (shrink)

At the height of the Sino-Indian border dispute in 1962, Bertrand Russell, as “a lifetime friend of India” (_Unarmed Victory_, p. 88), appealed to Prime Minister Nehru for peace. Yet for the first 75 years of Russell’s life, India had not been an independent, developing state whose non-aligned diplomacy he could (usually) admire, but rather an economically and stra­tegically vital part of the British Empire. Thus Russell’s fraternal bond with India was formed during its protracted struggle against British rule. The (...) central purpose of this article is to reconstruct Russell’s occasionally contorted connection with that historic contest, and it will do so by drawing on a wealth of neglected textual material. More than simply fleshing out a significant but overlooked chapter in Russell’s political life, this assessment of his decades-long association, as participant and observer, with the campaign for Indian independence also strives to capture the complex essence of his thinking on questions of empire generally. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Social and Moral Aspects of the WarBertrand Russell and Introduced by Andrew G. BoneAmong nine loose-leaf folders of typed transcriptions of Russell's History of Western Philosophy lectures at the Barnes Foundation1 are two copies of a fourteen-page stenographic record of a political talk he gave there on 2 March 1941.2 The bulk of this significant new accrual to the Russell Archives, bearing as it does on Russell's most (...) successful philosophical work, could stimulate much further research and textual study. But his isolated Barnes lecture, about the politics of American neutrality, Nazi Germany's brutal and expansionist dictatorship, and the causes and possible consequences of the war against it, is also of considerable interest.The transcription reads more like detailed notes than a verbatim account, and there is no evidence that Russell approved this text.3 The stenographer initially recorded Russell in the third person, dispensed with this device before the second [End Page 52] paragraph, but then occasionally returned to it.4 There is also more enumeration of Russell's points than he would have supplied in a prepared script. Even the title may not be his: there is nothing in the text on any social changes wrought by the war. But this title has been retained in the absence of a more plausible alternative in a short report of the speech (quoting sixteen sentences) in the next day's Philadelphia Evening Bulletin.5 Russell's hour-long address on the "Social and Moral Aspects of the War" appears to have been the only occasion when he "laid philosophy aside"6 at the Barnes Foundation. It was delivered on a Sunday to an audience of 160 students (and possibly some invitees, although none are mentioned in the newspaper article), sandwiched between two of his weekly philosophical lectures (on Socrates and Sparta7) in the series scheduled for each Thursday.In opening his case for the United States joining the Allied war effort, Russell challenged the arguments for the "policy of conciliation" which, by his own recent admission in the New York Times,8 he had earlier endorsed. Published two weeks before Russell spoke on a similar topic at the Barnes Foundation, this 2,000-word letter to the editor served as a very detailed and public renunciation of the pacifist viewpoint—neutrality for national governments combined with non-resistance for individuals—which Russell had promoted in Which Way to Peace? (1936) and continued to condone after the Munich Agreement (September 1938) and even the dismemberment of Czechoslovakia (March 1939).Yet Russell the "relative political pacifist"9 also admitted in this most programmatic statement of his prewar position that "In other times and other circumstances, I should be prepared to consider gains and losses, and to concede that war might be worth while" (WWP, pp. 151–2).That moment had obviously arrived and may have done so already when on 15 October 1939 Russell confided to Constance Malleson that his passionate desire for a British victory made a "thorough-going pacifism difficult" (ra Rec. Acq. 596). But six months later he still did "not feel sufficiently sure of the opposite to say anything publicly by way of recantation"—before adding in this letter to Gilbert Murray that "it may come to that" (21 April 1940, ra Rec. Acq. 71g). It clearly did shortly afterwards—when the "phoney war" in Western Europe was dramatically ended by the invasion of France and the [End Page 53] Low Countries. On 13 May Russell asked the editor of the New Statesman and Nation to notify its readers that he had abandoned his once strongly held pacifist convictions.10In his lecture to the Barnes Foundation, Russell turned next to the defence of American non-intervention by Robert M. Hutchins (see n. 16 below)—which he had already critiqued in the New York Times. Although rather precariously situated as a resident alien in the United States, Russell was hardly circumspect about pushing a policy that so sharply divided American opinion.11 He also listed the faults of the League of Nations and the most grievous diplomatic mistakes made since the end of the last war and the fatally... (shrink)

This Special Issue commemorates the 60th anniversary of Business & Society with nine rigorous literature reviews that address important societal problems and provide opportunities for theory development in the business and society field; in this introduction we present an overview of the Special Issue. With the theme “Building on Its Past,” the nine articles address a host of contemporary issues, including climate change, wicked problems, business and human rights, human health, certifications standards, the governance of artificial intelligence, stakeholder engagement, stakeholder (...) theory, and corporate political activity. Together, these reviews offer a wealth of suggested themes, theories and approaches that can drive our research forward for the next decades in business and society research and practice. Using the lens of a miner-prospector continuum to categorize the diversity of articles within this special issue, a common theme emerges across the portfolio of reviews: they all call for a more systemic and integrative perspective toward studying the complex interactions that link business and society actors and issues. Building on these findings, we encourage future scholars to fill long-standing researched gaps through a more open systems approach, which supports both contextually sensitive and multi-level and multi-disciplinary approaches to address grand societal challenges. We conclude with specific suggestions as to how business and society scholars might use an open systems approach, including embracing methodologies to address complex causal pathways, theorizing with a view towards spanning external and internal elements of an organization, and reflecting on the temporal and spatial dynamics of complex systems. (shrink)

In this report, we describe the case of a patient who has remained in a comatose state for more than one year after a traumatic and hypoxic brain injury. This state, which we refer to as long-lasting coma (LLC), may be a disorder of consciousness with significantly different features from those of conventional coma, the vegetative state, or brain death. On the basis of clinical, neurophysiological and neuroimaging data, we hypothesize that a multilevel involvement of the ascending reticular activating (...) system is required in LLC. This description may be useful for the identification of other patients suffering from this severe disorder of consciousness, which raises important ethical issues. (shrink)

Newton's philosophical views are unique and uniquely difficult to categorise. In the course of a long career from the early 1670s until his death in 1727, he articulated profound responses to Cartesian natural philosophy and to the prevailing mechanical philosophy of his day. Newton as Philosopher presents Newton as an original and sophisticated contributor to natural philosophy, one who engaged with the principal ideas of his most important predecessor, René Descartes, and of his most influential critic, G. W. Leibniz. (...) Unlike Descartes and Leibniz, Newton was systematic and philosophical without presenting a philosophical system, but over the course of his life, he developed a novel picture of nature, our place within it, and its relation to the creator. This rich treatment of his philosophical ideas will be of wide interest to historians of philosophy, science, and ideas. (shrink)

Deep brain stimulation of the subthalamic nucleus is a clinically effective tool for treating medically refractory Parkinson’s disease, but its neural mechanisms remain debated. Previous work has demonstrated that STN DBS results in evoked potentials in the primary motor cortex, suggesting that modulation of cortical physiology may be involved in its therapeutic effects. Due to technical challenges presented by high-amplitude DBS artifacts, these EPs are often measured in response to low-frequency stimulation, which is generally ineffective at PD symptom management. This (...) study aims to characterize STN-to-cortex EPs seen during clinically relevant high-frequency STN DBS for PD. Intraoperatively, we applied STN DBS to 6 PD patients while recording electrocorticography from an electrode strip over the ipsilateral central sulcus. Using recently published techniques, we removed large stimulation artifacts to enable quantification of STN-to-cortex EPs. Two cortical EPs were observed – one synchronized with DBS onset and persisting during ongoing stimulation, and one immediately following DBS offset, here termed the “start” and the “end” EPs respectively. The start EP is, to our knowledge, the first long-latency cortical EP reported during ongoing high-frequency DBS. The start and end EPs differ in magnitude and latency, and the end, but not the start, EP magnitude has a significant relationship to ongoing high gamma power during the EP. These contrasts may suggest mechanistic or circuit differences in EP production during the two time periods. This represents a potential framework for relating DBS clinical efficacy to the effects of a variety of stimulation parameters on EPs. (shrink)

The social sciences often explain behavioral differences by appealing to membership in distinct cultural groups. This work uses the concepts of “cultures” and “cultural groups” like any other demographic category (e.g. “gender”, “socioeconomic status”). I call these joint conceptualizations of “cultures” and “cultural groups” _demographic cultures_. Such demographic cultures have long been subject to scrutiny. Here I isolate and respond to a set of arguments I call _demographic skepticism_. This skeptical position denies that the demographic cultures concept can support (...) metaphysically plausible and empirically principled research. I argue against the skeptic, showing that their position relies on a questionable alignment between the demographic cultures concept and what I call the _folk anthropological model_. While the commitments of that model are problematic—they are not necessary for comparative work in the social sciences. In addition to clarifying skeptical arguments, then, I provide four recommendations for the comparative social scientist that allow them to avoid demographic skepticism. (shrink)

The admiration of the Soviet Union amongst Britain's interwar scientific left is well known. This article reveals a parallel story. Focusing on the biologists Julian Huxley and Lancelot Hogben and the scientific journalist J.G. Crowther, I show that a number of scientific thinkers began to look west, to the US. In the mid- to late 1930s and into the 1940s, Huxley, Crowther and Hogben all visited the US and commented favourably on Roosevelt's New Deal, in particular its experimental approach to (...) politics. Huxley was first to appreciate the significance of the experiment; he looked to the Tennessee Valley Authority as a model of democratic planning by persuasion that could also be applied in Britain. Crowther, meanwhile, examined the US through the lens of history of science. In Famous American Men of Science and in lectures at Harvard University, he aimed to shed light on the flaws in the Constitution which were frustrating the New Deal. Finally, Hogben's interest in the US was related to his long-standing opposition to dialectical materialism, and when he finally saw the US at first hand, he regarded it as a model for how to bring about a planned socialist society through peaceful persuasion. (shrink)

Recently, several libertarian philosophers have argued that we appear free on the basis of widespread experience, and that this appearance justifies believing that we enjoy libertarian free will (e.g. Pink 2004 and Swinburne 2013). Such arguments have a long history in philosophy but have been easily dismissed on one of two grounds: either the appearance of freedom does not exist, or else it is an illusion. In this paper, I argue that although presentations of the argument have been historically (...) inadequate, non-libertarians have also seriously underappreciated the force of libertarian appeals to phenomenology. I show that, when properly construed, the appearance of freedom constitutes a wide range of diverse phenomena in need of explanation, of which extant non-libertarian alternatives provide only partial explanations, or else fail to explain altogether. In identifying this lacuna, I take the first step towards providing a better non-libertarian alternative. (shrink)

Asset egalitarianism is a new agenda but an old idea. At its root is the notion that every citizen should be able to have an individual property stake, and it has recently been revived in Britain and in the U.S. in a number of proposals aimed at countering the huge and growing inequality in the distribution of assets. Such asset egalitarianism is fed from many streams; it has a long history in civic republican thought, beginning with Thomas Paine and (...) Thomas Jefferson, but has also featured in the distributist theories of G.K. Chesterton and Hilaire Belloc; the guild socialism of G.D.H. Cole and the ethical socialism of R.H. Tawney; the market liberalism of the Ordo Liberals and some of the Austrian School, particularly F.A. Hayek; and more recently the market socialism of James Meade, A.B. Atkinson and Julian Le Grand, and the market egalitarianism of Michael Sherraden, Samuel Bowles, Herbert Gintis, Richard Freeman and Bruce Ackerman. There are also important links to the proponents of a citizens' income as a different approach to the welfare state (White 2002) as well as to the ideas of stakeholding (Dowding et al. 2003). (shrink)

Students in two classes in the fall of 2004 making extensive use of online courseware were logged as they visited over 500 different “learning pages” which varied in length and in difficulty. We computed the time spent on each page by each student during each session they were logged in. We then modeled the time spent for a particular visit as a function of the page itself, the session, and the student. Surprisingly, the average time a student spent on learning (...) pages was of almost no value in predicting how long they would spend on a given page, even controlling for the session and page difficulty. The page itself was highly predictive, but so was the average time spent on learning pages in a given session. This indicates that local considerations, e.g., mood, deadline proximity, etc., play a much greater role in determining student pace and attention than do intrinsic student traits. We also consider the average time spent on learning pages as a function of the time of semester. Students spent less time on pages later in the semester, even for more demanding material. (shrink)

Malebranche's Theodicy ANDREW G. BLACK LEIBNIZ'S SOLUTION tO the problem of evil, his theodicy, might be regarded as a paradigm of philosophical theology. Its pattern, as with so much of Leibniz's philosophy, is reconciliation of deep metaphysical truth with recalcitrant ap- pearance. Thus, a theodicy is not just any solution to the problem; strictly speaking it is a vindication of divine providence in the face of the challenge posed by apparent imperfections of all kinds in creation.' The preeminence of (...) Leibniz's theodicy as a modern solution to the problem of evil has helped to obscure distinguished contributions from among his contemporaries. Not least among these is that made by Nicolas Malebranche, a philosopher having much in common with Leibniz . ~ Malebranche shows a deep concern for the problem of evil throughout his philosophical writings, though nowhere more so than in his Treatise on Nature and Grace, a a book written in response to the Jansenist4 challenge to orthodox In addition to an entire and substantial book, the Theodicy , a number of Leibniz's essays contain versions of his theodicy. See, for example, articles 1- 7 of the Discourse on Metaphysics; also "A Vindication of God's Justice Reconciled with his.. (shrink)

Name der Zeitschrift: Klio Jahrgang: 97 Heft: 1 Seiten: 157-175.

Abstract:This paper examines the historiographic controversies and disagreements surrounding the figure of Septimius Severus and highlighted by Herodian in his Roman History as a means of investigating the development of history writing during and in the aftermath of that emperor's reign. Herodian cites Severus' transition to power and reign as a locus for historical and historiographical controversy and debate, and a comparison of Herodian with other Severan writers allows for an examination of Herodian's competitive relationship with his older historiographic peers (...) and of the innovative aspects of his work that set it apart from others. (shrink)

A number of aphorisms in Plutarch’s Laconian Apophthegms contain a similar verbal formulation indicating death in battle. This formulation can be traced back to Thucydides, and was likely descriptive of expected Spartan behavior from the time of Thermopylae. Its employment in the Apophthegms, masking personal and civic shortcomings, reveals both an insistence on maintaining this behavioral directive and the social anxiety surrounding its maintenance.

Despite the worldwide prestige of America's doctoral programs in the humanities, all is not well in this area of higher education and hasn't been for some time. The content of graduate programs has undergone major changes, while high rates of student attrition, long times to degree, and financial burdens prevail. In response, the Andrew W. Mellon Foundation in 1991 launched the Graduate Education Initiative, the largest effort ever undertaken to improve doctoral programs in the humanities and related social (...) sciences. The only book to focus exclusively on the current state of doctoral education in the humanities, Educating Scholars reports on the GEI's success in reducing attrition and times to degree, the positive changes implemented by specific graduate programs, and the many challenges still to be addressed.Over a ten-year period, the Foundation devoted almost eighty-five million dollars through the GEI to provide support for doctoral programs and student aid in fifty-four departments at ten leading universities. The authors examine data that tracked the students in these departments and in control departments, as well as information gathered from a retrospective survey of students. They reveal that completion and attrition rates depend upon financial support, the quality of advising, clarity of program requirements, and each department's expectations regarding the dissertation. The authors consider who earns doctoral degrees, what affects students' chances of finishing their programs, and how successful they are at finding academic jobs.Answering some of the most important questions being raised about American doctoral programs today, Educating Scholars will interest all those concerned about our nation's intellectual future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Operating Through HatredAndrew G. Shuman“You’re not cutting my ***ing neck. The cancer is in my ***ing mouth.”While many patient encounters are memorable, Mr. K’s introduction to the head and [End Page 20] neck surgical oncology clinic is indelibly imprinted into the minds of all of the clinicians present on that certain autumn morning. This was, quite simply, a man who resonated hate. He was rude and disruptive. He insisted (...) on an expedited workup “without any waiting.” He questioned the ethnicity and nationality of his care providers. He told me, in no uncertain terms, that he did not appreciate my Jewish heritage—the swastika tattooed on his bicep underscored the point. He bragged about his recent incarceration for armed robbery. While my colleagues and I were tempted to simply refuse to assume his care, Mr. K had a bad problem—his recurrent tongue cancer required a major operation in order to offer him any hope for cure.Mr. K initially received an abbreviated course of radiation at an outside institution, which was limited by his non–compliance. While one might debate the wisdom of this decision in retrospect—in general, surgery is preferred for his type of tumor—the die was already cast. A heroic attempt at surgical salvage was now his only curative option. He previously sought care elsewhere... only to be fired by this original surgeon when Mr. K physically threatened him in the outpatient office during preoperative consultation. [It was the doctor’s fault for insulting him in the first place, Mr. K maintained... and no charges were filed.] We were, indeed, his last resort. Other than his recurrent cancer, Mr. K was robust; he was in his sixth decade, physically fit, and on the whole, fairly healthy. In the classic surgical lexicon, he was a reasonable surgical candidate. But was it reasonable to operate on such a person?I remember thinking, at the time, about our obligation to care for such an individual. Of course, being a medical professional carries with it many obligations, including a judicious assumption of personal risk. And, working in a tertiary care center begets the responsibility to assist referring clinicians in the management of difficult cases. Although professional obligations certainly have their limits, defining their bounds is decidedly more difficult. Paramount is creating an atmosphere of mutual trust and acceptance. Naturally, this was easier said than done in regard to Mr. K.Perhaps against our better judgment, we agreed to operate under the condition that he abide by strict behavioral ground rules, on our terms. We agreed upon the extent of the necessary operation (which indeed involved cutting his ***ing neck, much to his chagrin and reluctant acceptance). Mr. K promised to follow instructions for postoperative care. He assured us that he would not swear or yell (again). And, in the presence of hospital security, who reinforced our institutional policies regarding patient behavior, he guaranteed that he would not be verbally or physically violent or inappropriate, and would not make disparaging comments to other patients or staff. It seemed, at least, that we had an understanding.Needless to say, these rules were broken shortly after he awoke from surgery. I vividly remember being summoned from the OR when he threatened to murder his impressionable and terrified nurse a few days later, who would not acquiesce to his unreasonable demands. From that point onward, hospital security was deployed to his room regularly, and anything resembling a potential weapon was safeguarded. Any semblance of a mutual doctor–patient bond was shattered. At this point, everyone’s goal was simply to get Mr. K home.My visceral reactions to his behavior, while intense, were not unexpected, and fell in line with those of the entire team of clinicians caring for him. His antics brought his healthcare team together in collective unity (and condemnation). However, my surgical colleagues and I also felt somewhat guilty and responsible. While surgeons can choose to assume some degree of inherent personal danger in caring for a violent and angry patient, we also put the safety and soundness of the entire perioperative team in jeopardy, without necessarily seeking their input. But once we had decided to... (shrink)

A thirty-year-old single mother with recurrent, metastatic, treatment-refractory cancer presents to the emergency room with severe difficulty breathing due to an obstructive tumor in her neck, compounded by progressive disease in her lungs and a new pulmonary embolism. She cannot be safely intubated and would require an emergent awake tracheotomy. Even if the airway can be successfully secured surgically, the likelihood that she will be able to be weaned from mechanical ventilation is very low. The surgeon, a young mother too, (...) appreciates the patient's desire for more time with her toddler. But the surgeon knows the significant risk of surgery, the massive responsibility she would accept in trying to get the patient through it, and the emotional toll of an intraoperative death on surgical staff. And she can imagine the second-guessing that will come during the inevitable morbidity and mortality conference if the patient should die in the perioperative window. Yet the surgeon does not want to take the “easy” way out; after all, critically ill patients undergo aggressive resuscitation all the time. What should she do? (shrink)

Suzie loves to talk. A successful mid-thirties businesswoman, she is a self-described social butterfly—which made her diagnosis of tongue cancer even more devastating. She came to the clinic complaining of a lump in her throat, which in most young healthy people turns out to be benign and easily treated. But not for Suzie, who had a very rare salivary tumor arising in the back of her tongue. Its slow growth was both a blessing and a curse; such tumors do not (...) kill people quickly, but they typically require surgery. It would slowly and relentlessly grow until and unless we removed most of her tongue. In head and neck surgery, issues of appearance, identity, function, and communication are the foremost considerations when we decide when, and whether, to operate. As the adage goes, knowing when not to operate is the sine qua non of the wise surgeon. But the inverse is also true. (shrink)

This article documents the main developments in the textual history of a short polemical treatise ascribed to Aḥmad Ibn Ḥanbal, al-Radd ʿalā al-zanādiqa wa-l-jahmiyya. In particular, I show that three different, if related, recensions of the text exist in manuscript. Then, drawing on evidence from the text and biobibliographical sources, I show that al-Radd only emerged over several centuries. The idea for the text finds its roots in the earlist elaborations of Hanbali theology, perhaps even in the notebooks of Ibn (...) Ḥanbal himself. The first recension of the text, however, only emerged after the mid-fourth/tenth century in Baghdad. Another recension appears at the beginning of the sixth/twelfth century, perhaps also in Baghdad. These recensions were combined to form a third recension no later than the eighth/fourteenth century, and it is the third recension that became the basis for most print editions of the work. (shrink)