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On the Ragged Edge of Medicine: Doctoring Among the Dispossessed Paperback – March 15, 2017
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On the Ragged Edge of Medicine offers a unique and personal glimpse into a medical practice for the homeless and urban poor in Portland, Oregon. Told through fifteen patient vignettes and drawn from the author’s decades of experience on the front lines, this revealing memoir illuminates the impact of poverty on the delivery of health services and the ways in which people adapt and survive (or don’t survive) in conditions of abuse and deprivation. Kullberg’s stories show the direct and sometimes devastating effects of poverty on personal health, poignantly demonstrating that medicine is as much a social enterprise as a scientific one.
This collection of narratives is filled with questions about the realities people face in their everyday lives and the inadequacies of medicine to remedy them. A life-saving procedure is refused without explanation; an agoraphobic woman suffers silently and fails to cope; an accidental overdose takes another life. Delving into her daily interactions with patients, Kullberg muses on the impact of scarce resources, the ways she managed to succeed, the fall-out of her own mistakes, and the strategies she used to keep her sanity.
Written for anyone interested in the limits and possibilities of medicine within a context of social inequity, On the Ragged Edge of Medicine draws the reader into the big tragedies, small victories, and everyday mishaps of medicine when ministering to the destitute.
About the Author
Patricia Kullberg served for more than two decades as Medical Director at the Multnomah County Health Department and as a primary care doctor for persons living with physical, mental and addiction disorders. She has written award-winning articles about health and medicine, and in 2015 published her first novel, Girl in the River, about the intimate life of a working girl in mid-twentieth century Portland.
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practice as a physician serving a vulnerable and disadvantaged population. As she examined her own
attitudes, prejudices (who, me?), and perspectives about what people deserve and don't deserve, I
found it unavoidable to examine my own values. I was glued to the true stories, learned a lot about
my previously invisible neighbors, and will continue to examine startling realizations about my own
judgments of others. As we struggle, as a nation, with who we are collectively, this has been one of
the rare books which I read with enjoyment and intense interest - but has left me with new revelations
about myself which will not soon be dismissed.
Michael Helquist, "Marie Equi: Radical Politics and Outlaw Passions".
had some knowledge about when they needed medical intervention, and the two were
correlated. It was interesting reading stories about treating the medical needs of people
who lead desperate lives.