Home > Topic > intensive

intensive  QUOTES

26 " In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.”

People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives. "

Atul Gawande

28 " In some instances, even when crisis intervention has been intensive and appropriate, the mother and daughter are already so deeply estranged at the time of disclosure that the bond between them seems irreparable. In this situation, no useful purpose is served by trying to separate the mother and father and keep the daughter at home. The daughter has already been emotionally expelled from her family; removing her to protective custody is simply the concrete expression of the family reality.
These are the cases which many agencies call their “tragedies.” This report of a child protective worker illustrates a case where removing the child from the home was the only reasonable course of action:

Division of Family and Children’s Services received an anonymous telephone call on Sept. 14 from a man who stated that he
overheard Tracy W., age 8, of [address] tell his daughter of a forced oral-genital assault, allegedly perpetrated against this child by her mother’s boyfriend, one Raymond S.

Two workers visited the W. home on Sept. 17. According to their report, Mrs. W. was heavily under the influence of alcohol at the time of the visit. Mrs. W. stated immediately that she was aware why the two workers wanted to see her, because Mr. S. had “hurt her little girl.” In the course of the interview, Mrs. W. acknowledged and described how Mr. S. had forced Tracy to have relations with him. Workers then interviewed Tracy and she verified what mother had stated. According to Mrs. W., Mr. S. admitted the sexual assault, claiming that he was drunk and not accountable for his actions. Mother then stated to workers that she banished Mr. S. from her home.

I had my first contact with mother and child at their home on Sept. 20 and I subsequently saw this family once a week. Mother was usually intoxicated and drinking beer when I saw her. I met Mr. S. on my second visit. Mr. S. denied having had any sexual relations with Tracy. Mother explained that she had obtained a license and planned to marry Mr. S.

On my third visit, Mrs. W. was again intoxicated and drinking despite my previous request that she not drink during my visit. Mother explained that Mr. S. had taken off to another state and she never wanted to see him again. On this visit mother demanded that Tracy tell me the details of her sexual involvement with Mr. S.
On my fourth visit, Mr. S. and Mrs. S. were present. Mother explained that they had been married the previous Saturday.
On my fifth visit, Mr. S. was not present. During our discussion, mother commented that “Bay was not the first one who had
Tracy.” After exploring this statement with mother and Tracy, it became clear that Tracy had been sexually exploited in the same manner at age six by another of Mrs. S.'s previous boyfriends.
On my sixth visit, Mrs. S. stated that she could accept Tracy’s being placed with another family as long as it did not appear to Tracy that it was her mother’s decision to give her up. Mother also commented, “I wish the fuck I never had her.”

It appears that Mrs. S. has had a number of other children all of whom have lived with other relatives or were in foster care for part of their lives. Tracy herself lived with a paternal aunt from birth to age five. "

Judith Lewis Herman , Father-Daughter Incest: With a New Afterword

31 " As far as food is concerned, the great extravagance is not caviar or truffles, but beef, pork and poultry. Some 38 percent of the world's grain crop is now fed to animals, as well as large quantities of soybeans. There are three times as many domestic animals on this planet as there are human beings. The combined weight of the world's 1.28 billion cattle alone exceeds that of the human population. While we look darkly at the number of babies being born in poorer parts of the world, we ignore the over-population of farm animals, to which we ourselves contribute...[t]hat, however, is only part of the damage done by the animals we deliberately breed. The energy intensive factory farming methods of the industrialised nations are responsible for the consumption of huge amounts of fossil fuels. Chemical fertilizers, used to grow the feed crops for cattle in feedlots and pigs and chickens kept indoors in sheds, produce nitrous oxide, another greenhouse gas. Then there is the loss of forests. Everywhere, forest-dwellers, both human and non-human, can be pushed out. Since 1960, 25 percent of the forests of Central America have been cleared for cattle. Once cleared, the poor soils will support grazing for a few years; then the graziers must move on. Shrub takes over the abandoned pasture, but the forest does not return. When the forests are cleared so the cattle can graze, billions of tons of carbon dioxide are released into the atmosphere. Finally, the world's cattle are thought to produce about 20 percent of the methane released into the atmosphere, and methane traps twenty-five times as much heat from the sun as carbon dioxide. Factory farm manure also produces methane because, unlike manured dropped naturally in the fields, it dies not decompose in the presence of oxygen. All of this amounts to a compelling reason...for a plant based diet. "

Peter Singer , Practical Ethics