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Chapter 2 turns to the presence of the stethoscope in medical consultations from the perspective of the newly objectified patient, now acutely aware of, yet unable to hear or to interpret, the sounds of their own body. Horror, dread, and insight into the unknown are staples of the Victorian sensation and gothic genres, which, I argue, provided an anxious site for the medical and the imaginative to inform and disrupt one another in fictional explorations of the powers of the stethoscope. Drawing on works by Wilkie Collins, Bram Stoker, Mary Elizabeth Braddon, and Sheridan Le Fanu, as well as short stories and poetry from popular periodicals, this chapter demonstrates that, as medical institutions accepted new technologies and became increasingly specialised throughout the century, the stethoscope became for many patients an object of anxious contemplation, serving as a palpable interface between doctor and patient, between hope and fear, and between the visible and invisible.
Chapter 3 offers a sustained reading of the nature of auditory perception in George Eliot’s Middlemarchin order to demonstrate the significance of listening and attentiveness not only to the pathological sounds of the body but to those metaphoric heart beats and vibrations that signify psychological struggles within the novel as a whole. In Eliot’s realist project, I argue, both medical and imaginative explorations of the vibrations and pulses beyond the thresholds of usual human ‘stupidity’ and sensory perception are stimulants to the imagination, but they are not a cause for horror or dread like those gothic treatments of the stethoscope discussed in the previous chapter. Rather, they offer an opportunity for cultivating medical knowledge, sympathy, and humility. Here, attentive, stethoscopic listening ultimately provides a means of discrimination, of knowing and orienting oneself, and of relating to others in the modern world.
The invention of the stethoscope by the French physician René Laennec in 1816 was a pivotal moment in the burgeoning field of modern clinical diagnosis. It brought the inner soundscape of the human body – an invisible realm which largely existed beyond the range of the human ear – into not only medical but also more general cultural awareness. This chapter considers the stethoscope as the subject not of ongoing scientific debate and experimentation, but of poetry and fiction, as tales of its use and abuse, as well as its supposed powers, spread among those who first encountered it and sowed a more general sense of confusion, mistrust, and corporeal anxiety in relation to the medical consultation. Drawing on interactions with the stethoscope in works by Wilkie Collins, Bram Stoker, Mary Elizabeth Braddon, and Sheridan Le Fanu, as well as short stories and poetry from popular periodicals, I demonstrate that, as medical institutions accepted new technologies and became increasingly specialized throughout the century, the stethoscope became for many patients an object of anxious contemplation, serving as a palpable interface between doctor and patient, between hope and fear, and between the visible and the invisible.
Holmes went to Paris to further his medical studies in 1833, because the French were leading the way in basing medicine on hard scientific facts and new tools, such as the stethoscope. He took full advantage of all that Paris had to offer in the classroom, clinics, and dissecting sites. Pierre Charles Alexandre Louis, who railed against worthless therapies (e.g., bloodletting) and unsubstantiated theorizing, was his favorite teacher. Holmes agreed with Louis about medical quackery and learning more about phrenology while in Paris, where some of his teachers embraced it, while others damned it. Many French physicians were then publishing books on phrenology, and Paris was now home to a very active phrenological society, the Société Phrénologique. Some of the Americans he was with also visited phrenology shops. For example, John Collins Warren’s son bought books and specimens for his father while there. Yet Holmes was still not ready to present his own opinions about the new science in print. He did not even bring it up in private letters to his parents, though he did mention finding charlatanism running rampant in Britain, which he visited. He did not elaborate.
The objective of this study was to determine the prevalence of Staphylococcus-contaminated stethoscopes belonging to emergency department (ED) staff and to identify the proportion of these that were Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA).
Methods:
We conducted a prospective observational cohort study of bacterial cultures from 100 ED staff members' stethoscopes at three EDs. Study participants were asked to complete a questionnaire.
Results:
Fifty-four specimens grew coagulase-negative staphylococci and one grew methicillin-susceptible S. aureus. No MRSA was cultured. Only 8% of participants, all of whom were nurses, reported cleaning their stethoscope before or after each patient assessment. Alcohol-based wipes were most commonly used to clean stethoscopes. A lack of time, being too busy, and forgetfulness were the most frequently reported reasons for not cleaning the stethoscope in the ED.
Conclusions:
This study indicates that although stethoscope contamination rates in these EDs are high, the prevalence of S. aureus or MRSA on stethoscopes is low.
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