In lieu of an abstract, here is a brief excerpt of the content:Parenting Children With Autism Spectrum Disorders Through the Transition to AdulthoodAnonymous One, Anonymous Two, Lorri Centineo, Anonymous Three, Virginia Clapp, Catherine Cornell, Nancy Coughlin, David McDonald, Mark Osteen, Laura Shumaker, Julie Van der Poel, Anonymous FourMy Son's Life with Autistic Spectrum DisorderAnonymous OneThis is the story of how my son, David, has tried to become independent. David is now 25–years–old. His immediate family is his dad, (...) a brother (age 22) and myself (his mother). He was diagnosed with an autism spectrum disorder (ASD) when he was 13. We looked up all the information and decided not to make a big deal of it. Looking back, he displayed all the classic signs of a high functioning autistic disorder. Would he have been diagnosed with the new DSM 5 guidelines? He probably would have. His life would be much, much different if he had been diagnosed at an early age.I'll start with David at age 13 when he was able to harness his big interest in computer science into a career for himself. He was expelled from middle school for threatening some kid that had been picking on him all year. He had a meltdown and wasn't able to communicate his side of the story and that was it.During the summer of that year he took classes in computer engineering (Microsoft) and became an engineer when he was 13. At that time it was quite an accomplishment because he was the youngest person in the United States to do so at such a young age. (By the way, the administration of the school that expelled him sent him a congratulatory card when he was written up in the paper).His father and uncle are in business running a computer company so David had a ready–made job waiting for him when he graduated from high school and was able to keep it during difficult times. David finished high school (mainstreamed special education as emotionally disturbed) and he also received another engineering certification (Cisco).I have to mention here that I truly did not understand what it was like for my son until one day when he was in high school, as I was lecturing him again for some stupid reason, he said, "You don't know how hard it is for me to not sit in a corner and rock every day." Think about that. ASD individuals get up and keep going every day when they know they are going to be misunderstood and picked on. They all deserve a medal for bravery.David became really upset that he had never had a date and that girls were not even interested in talking to him. He started cutting himself and shaving his head. That got him some attention from the stoner group. He had someone to sit with at lunch anyhow. Parents, I think it's better to have no friends than the wrong friends. They introduced him to drugs.We did not mention any trouble David was having to any relatives. We had lived 800 miles from our families in a very unspoiled part of northern America. In hindsight this was not good either. [End Page 151]Another thing, and I think every parent will agree with this—teachers, school staff, health care industry staff, doctors and every one that comes into contact with an ASD individual—take the time to get to know them. It may be difficult and some may appear non–caring and rude. You must overlook this and look to the person underneath. They are great people. They have been through stuff and it means so much to them. Like I said—parents, you know this. Please remember it when times get tough.During David's senior year he started work release so he could start earning money to buy a car and move out as soon as he turned 18. Things were made easy for David since the company was owned by his father and his uncle and I worked there also. David enjoyed the work but had the occasional meltdown and had difficulties fitting in with other employees. He wasn't able to communicate... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative SymposiumPersonal Narratives Experiences of Psychiatric HospitalizationV. Barnard, J. Carson, Eugene Doe, Robin Driben, Anonymous One, Anonymous Two, Charles Kelley, Michael Kerins, D. Millman, Anonymous Three, Viesia Novosielski, Ben Zion, and Anonymous Four• Dreaming: A Recovery Story• The Intervention of the Demon• Bent but Not Broken• Tortured Souls Do Not Rest• Homesick• A Professional Patient No More• My Spiritual Journey• Personal Account of Psychiatric Hospitalization• (...) Psychiatric Hospitalization Story• As Ice Is to Water• The Power Of Human-To-Human Contact• Dignity• HospitalizationCopyright © 2011 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Difficult Road to Deciding on CircumcisionAnonymous TwoAnonymous TwoWhen I got my results back from my noninvasive prenatal testing, NIPT and found out I was going to have a little boy, one of my first thoughts was, "I don't want to circumcise him," which sounds silly because I just found out the gender of my baby and my first thought is about his genitalia. The idea of growing and (...) carrying this perfect little baby for nine months and then hurting him was unthinkable to me. I simply did not want to hurt him. The idea of it made me feel sick. Anytime the subject came up, I would protectively put my hand over my belly. And I do admit there were a lot of times I wished I was having a girl so I didn't have to deal with the circumcision debate.There was a lot of conversation between myself and my husband about it. My husband was adamant about getting it done. He referred to uncircumcised penises as "snake penises" and said our son will be made fun of for being different. He said it would be easier for him to clean and when he's old, he won't have to worry about infection. I would counter with, "well what if he falls in love with a girl from a culture that doesn't circumcise? She will think his penis is weird." The more we talked about it, the more ridiculous it felt thinking that far in advance and all these hypothetical situations he might get in over his penis. My parents wanted it done for religious reasons, but that wasn't a factor for me. My mom kept saying it's in the Bible and it needs to be done. My boss is Jewish and she joked that I could just convert to Judaism and the choice would be taken away from me so I didn't have to stress over it. Everything I read on my mommy groups and sites like Reddit called male circumcision child abuse and stated how barbaric it was. Terms like "genital mutilation" were thrown around a lot, and I didn't want to be part of a group that was seemingly looked down upon by so many.I spent my whole pregnancy saying how much I did not want to circumcise my baby. About a week after he was born and we were starting to get settled, my husband started to call around trying to get him an appointment for circumcision. It was unusual to do it this way, as typically it's done when babies are still in the hospital. But the hospital wasn't doing circumcisions because it was elective, and they weren't doing elective procedures because of COVID. At his first doctor's appointment, I talked to our pediatrician about it. She is Indian and told me she didn't circumcise her boys and said that it was very normal in many parts of the world to not do it. I would watch her pull back the skin to check it for fibers and think, "Is it really that bad to keep it? It's just skin." Our pediatrician didn't do it, as she doesn't perform procedures in the office, and she gave us some names of doctors that were supposed to be doing it. My husband called them all and none of them were doing circumcisions either. Finally, my husband found a doctor, but he was booked out for almost a month and a half. With no other option, we made the appointment. I was not thrilled about it, and made my husband do all the calls and arrange it because I did not agree with it.What made me change my mind about circumcising him was I didn't want him to be different. My husband assured me this was the best choice and he was very concerned our son would be bullied for being different. I have a good friend that is a nurse in a long term care facility currently. I called her and asked if it was really that bad for old men to care... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Road to RedemptionAnonymous TwoI “am Dr X.* and I am a trained and board certified neonatologist with some years of experience in a high volume NICU with complex pathologies. I have been dismissed from the care of your baby by the fetal surgeon who is not trained in what he’s attempting to do,” that was how I felt when I left the operating room (OR), after performing initial (...) resuscitation on a newborn with congenital diaphragmatic hernia (CDH) with very poor prenatal prognostic indices. CDH is a diaphragm abnormality that allows abdominal organs to move into the chest and restrict lung development. The better part of me knew not to make such a statement and chose not to do so, as this was about the family and a very sick baby, not the professional wrangling of two medical teams or the expression of frustration by a neonatologist who was morally conflicted.I work in a level four Neonatal Intensive Care Unit (NICU) and a very large one by any standard. Staff turnover had been an almost nonexistent issue in previous years because of the very conducive work environment of the NICU. Every team member (physician, nurse, respiratory therapist, pharmacist, etc.) felt like a stakeholder in providing optimal outcomes for the vulnerable neonates in the NICU.As change is the only constant thing in life, the hospital management decided to explore new frontiers and open a center for fetal medicine, with the hope of being a referral center in the region. They brought in a surgeon who came highly recommended for clinical acumen, but not for interpersonal relationship skills (unbeknownst to me). This surgeon, Dr Y., was hired to oversee the fetal center and build it into a center of excellence. Since this had to be a collaborative effort, other specialties (and subspecialties) had to be involved to make this a success. A representative from each of these specialties, including bioethics, was assigned to the fetal center team.The first inkling of a major problem occurred with the very first patient. The team met for the weekly meeting, reviewed the patient’s history and made a tentative plan, which included multidisciplinary counseling. This would require either a joint meeting with the patient or individual consults with the patient at her convenience. The following week at the weekly meeting, Dr Y. informed the group that he had met with the patient and counseled her and she had agreed to an extraordinary procedure for an oral lesion. In my opinion (and that of others), this lesion was not obstructive and could be immediately dealt with at delivery by an Otolaryngologist (ENT) surgeon, without putting the mother at risk for complications arising from the procedure being offered. There was a long discussion about why this was inappropriate [End Page E1] and why further imaging, discussion between the subspecialties and counseling should have been done prior to making this delivery plan. All felt this delivery plan could be remedied prior to delivery. However the surgeon had made plans with the obstetric team (who were at his mercy for financial/ political reasons) to continue with this plan. On the day of delivery, the NICU resuscitation team was called to another operating room instead of the labor and delivery room. I was even more appalled when I realized that the oral lesion was the size of a peanut! I felt like I failed in my obligation of veracity by avoiding the mother’s questions regarding the necessity of the procedure. Every member of my team felt the same and on several occasions I had to reassure concerned nurses that this was an aberrant occurrence that would not repeat itself... so I thought.I informed my departmental chairperson, Dr Z., who had a conversation with the fetal surgeon, Dr. Y., to inform him of my concerns and the effect of Dr. Y.’s actions on my group (physician, nurse practitioner, nurses). This led to being labeled unsupportive of Dr Y.’s goals and caused a less than cordial relationship towards me and the entire NICU group. The next week a picture of Dr Y. and the parents with the baby was on the front page... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Advocates, Not Problem ParentsAnonymous TwoNothing could have prepared us for the shock of hearing that our son had a brain tumor.Rob* was 13½, an active, healthy eighth grader, when he developed a headache so bad he couldn’t get out of bed in the morning. We saw the pediatrician three times over the next ten days. On the third visit, after ruling out problems at home, stress at school, strep (...) throat and mono, he sent us for an MRI. When the radiology tech handed me the films and told us to drive back to the pediatrician’s office, I knew we were in trouble. Sure enough, after all the other patients had left, our long–time doctor called us into his tiny office, shut the door and fumbled with the films as he pointed to a white spot that he said was a brain tumor.So began the experience that would change the course of our lives. We remember the diagnosis in detail and relive it in slow motion. We recall packing suitcases, driving to the hospital, waiting to be seen in the emergency room, and walking through doors marked “Pediatric Hematology/Oncology” for the first time.We date everything “BC” (Before Cancer) or “AD” (After Diagnosis). We are grateful every day that [End Page 13] our son is alive, but we know he is forever changed. We are changed: Our nuclear family, our extended family, everyone who knew us and supported us at the time was affected. A pediatric cancer diagnosis is a bomb that shatters your world without warning. If you’re lucky, you can pick up a lot of the pieces, maybe even most of them, but the world you re–enter is never the one you inhabited before.Our doctor delivered the diagnosis to Rob and me at the same time. I’ve thought about this many times and perhaps one day will ask him: Why did he choose to do it that way? Was it a conscious decision or just happenstance? Was it kinder, in the long run—like pulling off a band–aid quickly—or terribly risky? What if I had collapsed at the news? I asked to step into the hall to use the phone. In a state of numbness, I called my husband. He knew we had had an MRI a few hours earlier. “Come quickly,” I said. “There’s a mass.”We chose to go to a top-ranked major medical center and were admitted that evening. A couple of days later, the discovery of tumor markers in Rob’s cerebrospinal fluid and blood confirmed a central nervous system mixed germ cell tumor. We were told he would require six cycles of chemotherapy, followed by six weeks of radiation, and possibly second–look surgery and high-dose chemo with stem cell rescue on top of that. We were given a consent form listing a catalogue of short–and long–term side effects, among them the likelihood of infertility. We were urged to start treatment as soon as possible.By sheer coincidence I had just completed a project for a small, nonprofit organization that existed to inform young adult cancer patients about their fertility rights and options. I knew that infertility concerns were usually pushed aside at diagnosis to make way for other priorities, namely the urgency of starting treatment. And that’s exactly the kind of pressure we were facing.But my husband and I were not ready to sign away our son’s fertility in what felt like a no–confidence vote, a capitulation. We needed to believe that he would survive and put this horror behind him, that he would look forward to marriage and starting a family. We were willing to cede nothing to the disease at this early stage of the game. Was this rational, naive or selfish on our part? I don’t know.The medical team seemed surprised when we asked for a delay in treatment in order to collect sperm samples. They warned that our son’s condition could decline suddenly—and that postponing treatment by even several days might be dangerous. However, at our insistence, they agreed to the delay... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative SymposiumPersonal Narratives Experiences of Psychiatric HospitalizationV. Barnard, J. Carson, Eugene Doe, Robin Driben, Anonymous One, Anonymous Two, Charles Kelley, Michael Kerins, D. Millman, Anonymous Three, Viesia Novosielski, Ben Zion, and Anonymous Four• Dreaming: A Recovery Story• The Intervention of the Demon• Bent but Not Broken• Tortured Souls Do Not Rest• Homesick• A Professional Patient No More• My Spiritual Journey• Personal Account of Psychiatric Hospitalization• (...) Psychiatric Hospitalization Story• As Ice Is to Water• The Power Of Human-To-Human Contact• Dignity• HospitalizationCopyright © 2011 The Johns Hopkins University Press... (shrink)

This book is a collection of riddles in Arabic divided into two main sections, one part on spiritual themes, the other on morals. The book was intended to develop the mind and character of young people.

In lieu of an abstract, here is a brief excerpt of the content:An Encounter with the Art and Science of MedicineAnonymous Five“Let Nothing Upset YouLet Nothing Frighten YouEverything is ChangingOnly God is Changeless”—St. Theresa of AvilaSt. Teresa’s prayer is on the front cover of each of four binders dedicated to storing insurance authorizations, studies, references, and reports about our daughter’s brain tumor treatment. They represent our experience, what we learned, the information we were given, and the information we sought out. (...) I kept them in case our daughter ever wanted to understand how my husband and I arrived at a decision for her treatment that was in direct opposition to the strong recommendation of her primary treatment team of physicians.On December 10, 2003, I received an urgent call from our daughter’s neurologist requesting that we meet with the doctor late that afternoon. For six months prior to that appointment, our daughter had been telling us about odd sensations with breathing, nausea, and balance. Sometimes she would seem extremely distressed for a short period of time or report that her friends told her about doing or saying things that didn’t make sense and that she didn’t remember. We consulted a series of physicians as her symptoms became steadily more intense and more prevalent. Our family practice physician referred us to an allergy specialist and a pulmonologist. There were a number of tests for allergies and lung problems. As the tests and treatments did not help, our daughter became increasingly unwilling to go to doctor’s appointments. My husband and I were confused and deeply concerned about the lack of progress. The next series of referrals included a gastroenterologist and a neurologist. The gastroenterologist suggested our daughter had partial–complex epilepsy, concurred with our plan to see a neurologist, and mentioned she should have an MRI.I remember the neurologist putting the MRI scans up, pointing to the large dark spot which he called a “large mass” (5 cm), that could be either a cluster of blood vessels or a neoplasm. He said his office had arranged for us to meet a neurosurgeon the following day. We all remember the same thing about that visit—the image of the large dark mass on the scan—and the neurologists flat, brisk tone. We met with the neuro-surgeon the next day. Her team was kind and sympathetic—she was positive, up beat and direct. She did not think this mass was blood vessels. She thought it was a large tumor that needed to be removed right away. Our daughters surgery was scheduled for the following Friday—December 19, 2003. She had turned 15 on November 5.Four and a half hours after our daughter was wheeled into the operating room, her surgeon told us they had removed 98% of the tumor. She said there was no cure, but there was a good prognosis based on the surgical outcome. Several days later, she called us and said she had more data, and it looked like the resection was closer to 90%. The first pathology report, a “first impression” directly after surgery, described our daughter’s tumor as an astrocytoma, probably high grade. Three weeks after surgery, we met with a panel of doctors—two oncologists and radiologist—who explained that based on the final pathology report, our daughter’s tumor was classified as an ependymoma, grade 2. We were dismayed. First, there had been the change in the estimated success of the resection and now a complete shift in both grade and tumor type.The team recommended radiation to follow her surgery, which they said was standard treatment. We began to try to inform ourselves about her tumor. Her father, an agronomist, did an extensive search in PubMed to evaluate and sort through the literature on low–grade gliomas and radiation. What he could find was inconclusive and grim. Most reports in the literature suggested at best delayed mortality at five years after radiation. [End Page E7] Meanwhile, our daughter went through a spinal MRI and the preparatory “fitting” of the mask to immobilize her head during radiation.E7I consulted with a friend who had worked as an EKG tech. She urged... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Down the Medical Rabbit HoleAnonymous ThreeEditors’ Note: This woman’s child was treated for an astrocytoma at 8–years–old. The surgery included tumor resection and placement of a ventricular peritoneal shunt, which manages the flow, drainage and pressure of cerebral spinal fluid (CSF ) throughout the brain and spinal column.Am I aliveWhat’s this pain I feelAching insideMaking me kneelDown to the groundSubmissiveLike I’ve been sentTo Hell–AnonymousI am making a time capsule (...) of words. If I don’t write these words now, how will I remember? It is for her. She will need these words to know who she is.They took her at the lowest point, when she was barfing and admitting she needed to be in the emergency room (ER). And they stripped her of the ability to use her words to defend herself.“There’s really no reason for you to be here. The x–ray of your shunt tubing looks fine. The CT of your head looks fine. You should think about going home.” I start to speak, but she is speaking so I wait to hear what she will say.“I was worried since my side hurts so bad that maybe it was my appendix and I didn’t want it to burst and then have the infection go up my shunt, I know someone that that happened to, and then my head was exploding and I threw–up.”“That’s when we have to come in to the ER “ I say. “We’ve done this before. We wait until the last possible moment before coming. You’ve seen us here for almost 12 hours now, but we waited more than 24 hours before coming and she was just like this the whole time.”“One of the only things we can see that might be wrong is that we think she might be constipated.”“I try to stay on top of it, ”My 20-year-old says. “I’ve been taking more pain killers lately because my head is always killing me and I push myself to make it to class. But I take stuff to make it easier for me so I don’t get constipated. Last Wednesday during class my head was exploding and I had to vomit. I don’t think my shunt is broken. But...”I interrupt, which is my job, because they are not hearing her, still she gives me hated looks, “She spends two days in bed laying basically flat so she can spend one day or even a few hours vertical the next day. This has been progressing for a while. Last May she had surgery for a CSF leak in her spine. But the headaches are different this time.”“We really think you should consider going home, the tests we’ve done look good.”This is the part that always happens, the part where I say you go into the twilight zone or down Alice’s rabbit hole. In May I had to demand that she have the right to sit up, pain free in the hospital for two hours before leaving. And that is how they admitted her, Mother wants her to sit upright.Here we are again 15 days before Christmas back in the ER—they, meaning the white coats, disbelieving us.She broke then, like a piece of a falling statue, an arm or a leg or part of a shoulder busting off. “I can’t go on like this, my head is exploding and I push myself so hard just to walk across campus [End Page 18] and when I’m sitting in class I know I shouldn’t be there, it’s just so hard. I had a surgery in April last year to replace my shunt and I never really bounced back, and then they found the cyst in my back and the leak and after that surgery I just couldn’t get any energy and my head still hurt.”They don’t know that she never tells anyone any of this.“I know you don’t see anything on her scans,” I say. They always look fine... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Surprised DivideAnonymous OneAnonymous OneNot long after our daughter was born, my wife and I were expecting a son. We were busy new parents, so her pregnancy with our second child went by quickly and without a lot of the fuss that a first pregnancy brings. To our surprise, our son was born a few weeks early but aside from a little jaundice he was a happy, healthy baby.My parents (...) were caring for our daughter while we were at the hospital. After my son's birth, we were excited for them to bring our daughter up to the hospital to visit her new baby brother. The hospital photographer came by and took photos of our two kids together and photos of our son swaddled and sleeping soundly in a basket. Other family members stopped by to meet the new baby as well. It was a happy time.Little did we know that a couple of hours later we would be faced with a communication breakdown. My wife and I usually pride ourselves on how well we are able to communicate and plan our future.I grew up heavily Catholic, attending parochial schools through high school graduation. Meanwhile, my wife's family are Unitarian Universalists. You could not have two more polar opposite religions! We are used to having different points of view. We have always talked through many of life's choices and have both had to make compromises in order to have a successful relationship. It was on that happy day of my son's birth that we discovered we forgot to discuss one important topic.As our family was gathered in my wife's hospital room, joyfully celebrating the newest addition, the doctor entered the room to check on my wife and said it was time to do the circumcision if we wanted.Without hesitation, I responded in the affirmative, then the doctor and I looked over at my wife, who was staring at us with saddened, conflicted eyes. I was confused. Didn't she want the same thing for our son that I did? Surprisingly we never discussed this decision, at least not that I remember. I don't recall her ever telling me she was against it.My wife stated that she wasn't prepared to make a decision because she didn't know what our son would want and she was worried about him experiencing pain. She worked hard for 9 months to grow this baby boy, and he was so little. I understood her anguish in the thought of letting someone alter his tiny body.I am circumcised myself. My background provided me guidance and an expectation that this would be happening, so it was a nonissue for me. I never considered a scenario in which my son would not be circumcised. In truth, it felt ridiculous to even contemplate not circumcising him. My words of reassurance that it would be fine and my explanation to my wife that this was just one of the many decisions we would need to make for him and our other child did little to settle her.It was clear that no one (including me) had discussed this with my wife prior to this point, which was unfortunate. The doctor described the process and tried to reassure my wife that it was a safe and minor procedure. This still left my wife in a conflicted state. The other men in my family there visiting at the time chimed in to reassure my wife that this is what our son would want. She reluctantly agreed to the circumcision, giving in to peer pressure I suppose. I'm confident that an alliance of circumcised men telling her that our son would also want to be circumcised is what swayed her. Frankly, I'm glad they happened to be there when the doctor stopped by to help back up my position.But while our son was out of the room undergoing his procedure, my wife remained conflicted and saddened. We were both surprised at each other's response. My opinion on this was coming from the position of expectation and tradition, while she was worried about not knowing... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:My Story:Evolving ObesitiesAnonymous OneI am a 66–year–old Caucasian woman. I have always had, either in perception or fact, a “weight problem.” In my childhood and early teens when my weight was within the normal range, I felt fat and was always trying to lose weight. After gaining weight in college, I had a weight problem in body as well as mind. Weight concerns have consumed much of my energy (...) over the years. I have spent most of my life evolving toward a healthy way to manage my weight.Act 1: Obesity as MetaphorI can’t remember ever not feeling fat. Growing up I felt humiliated and shamed by my body, even though I was not overweight, just bigger than my peers, with a pear shape and heavy legs, thighs, and ankles. In high school my BMI, although not used at the time as a measuring tool, was 22.8. Yet despite these facts, I was made to feel fat.In my family being overweight was tantamount to sin. My father and sister were tall and skinny; my mother was petite and shapely. I took after another genetic code—the dumpy ones with knocked knees—the grotesque branch of the family tree. Hand–me–downs from my sister were supposed to fit me, but we were too different, and the difference was not celebrated.Other things were at play, a perfect storm of conditions that contributed to my feelings of worthlessness. I really shouldn’t have been born. The earth should have opened up and swallowed me. Of course I was not conscious of reasons for these feelings at the time. That awareness came later. But these feelings of loss, grief, terror, and terrible wrongness were the context of my struggles over the years.I developed a pattern of binge eating, which satisfied two contradictory impulses: my need to nurture myself combined with my desire to punish myself. The intensity of a binge–eating episode was also an avenue for rage. I was young so the extra calories didn’t result in weight gain, but the behavior had begun to take root.Stepping on the scale was like the final judgment. The scale did not measure weight; it measured value. I would see the number, as would the person weighing me, and my failure, as a person, would be evident. My secret shame would become public. I would be declared guilty for the worthless grub that was me.Nothing else mattered: that I was an A student; that I was kind and compassionate; that I had friends. These facts had no bearing. All that counted was the number on the scale. That number sent a shudder of condemnation down to my very soul. That number threatened to hurl me into a bottomless abyss from which I could not escape.I avoided being weighed. I was a very obedient youth, with an exaggerated respect for authority drilled into me by my father. The one time I ever cut class was in high school. I skipped health class where I had heard we would be weighed.The situations when I could not avoid being weighed confirmed my worst fears. Before one gym class we were publicly weighed in [End Page 96] assembly–line fashion. As I stepped off the scale my gym teacher yelled out “Diet” for all to hear. Doctors who knew nothing about me, to whom I had been sent for various required physicals, told me to lose weight.In the mysterious and internally logical way that the mind works, my weight became a metaphor for all that was reprehensible in me. With no comprehension of why I was so unhappy, it was easy for me to fixate on my weight. It was too horrible to contemplate that I was the problem. The problem with me was my size, my body.As I look back now, I am angry that because of its shape, this perfectly wonderful body was judged as wrong, and that there was no compassionate voice loud enough to contradict this message. But at the time I felt no anger. To feel anger over being made to feel bad requires self–respect... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Second GuessingAnonymous OneThis is difficult for me to write because I have tremendous respect for every doctor that has been involved in my son’s care. I firmly believe that they chose and administered the highest level of care that they assessed as appropriate; that they cared for him both personally and professionally as if he were their own child; and that he was in the care of acknowledged giants (...) in their fields. I write this knowing that I will share this narrative with these doctors, in order that they can better understand the decisions I was faced with and the guilt I must live with feeling that I may not have made the best possible informed choice for my son, because of this trust and relationship.Let me describe my oncologist. I say “my” instead of my son’s whose doctor he really is, because he is mine too in every sense of the word. He cares passionately about his work and about my son specifically; he engenders my trust because he is compassionate, brilliant, and available to me for concerns both great and small. His accomplishments have saved lives and will continue to impact his field. He became the narrow bridge I walk, that is the only thing between me and dangerous water and rocks waiting below; the balancing bar on the tightrope that is the only thing that stands to keep me from falling into the abyss and breaking my neck. And this made it difficult for me to disagree with him and seek a second opinion. Because his unspoken words were, “Don’t you trust me that I will do the best for your child?” and I could not answer then what I would answer now, “Nobody is infallible and sometimes we may miss something that someone else can see despite how much we know or care.”It is ironic, I think, that sometimes a layperson, because of her limited knowledge, can see more clearly where a professional may not.My son was diagnosed at age six with Grade II ependymoma in 2006. He was treated with surgery, a complete resection, and then 33 rounds of conformal radiation. He recurred in 2012, and was diagnosed with anaplastic ependymoma Grade III. He had another surgery, with the same surgeons, who pronounced it another successful total resection. This is where my story begins.The MRI taken the next day showed a sliver of something there. My oncologist, much sought after for his diagnostic abilities in reading MRI’s showed slight concern that it may be residual tumor, but both the surgeons and the MRI report came back negative, identifying the sliver as inflammation. Six [End Page 9] weeks later, 3 days before we were scheduled to leave out of town to receive proton beam radiation, I insisted on another MRI. The sliver was enlarged from the post–op MRI. My oncologist said it was tumor; one surgeon said it was inflammation and the other surgeon abstained from speculation. The MRI report stated it appeared to be recurrent tumor.Now here was my dilemma as a parent. The prognosis today of radiation on residual tumor for ependymomas is very bad, especially with a residual tumor of his size. On the other hand, my oncologist felt that going in for surgery with no guarantee of a total resection anyway, was incurring a risk of damage to my child that may impact severely on his quality of life.My oncologist felt that for many medical reasons, inherent risks of surgery, uncertainty about status of the scan reading, quality versus quantity of life, and—I think—an understandably pessimistic view of the possibility of cure for recurrent anaplastic grade III ependymoma, he was against another surgery, and opted to continue with radiation with the tumor as is.I am part of two support groups on line, one for parents of children with any type of brain tumor and the other specific for ependymoma parents. The clinical and anecdotal knowledge of these groups as a whole is phenomenal because, unfortunately, we have parents who have experienced and researched almost everything about this illness, in all its stages. When I was faced... (shrink)

I argue that by constructing an identity of Bohemian whim and spontaneity one can make what was previously an akratic action into a fully rational action, since in performing the action, one asserts one identity.

These two volumes consist of a critical edition and English translation of the two earliest known Armenian sets of scholia on the Heavenly Hierarchy of Dionysius the Areopagite. Composed in the monastic schools of Erznka in the late thirteenth century, these scholia provide significant insight into how the Heavenly Hierarchy in particular, and Armenian translations of Greek texts in general, were understood by Armenian scholars in the Middle Ages. This editio princeps of the scholia represents a rare critical edition of (...) a native Armenian composition from the medieval period. In addition to the text and translation, these volumes include a textual commentary as well as a critical collation and English translation of a number of scholia from the Armenian version of the Greek scholia on the Heavenly Hierarchy. (shrink)

These two volumes consist of a critical edition and English translation of the two earliest known Armenian sets of scholia on the Heavenly Hierarchy of Dionysius the Areopagite. Composed in the monastic schools of Erznka in the late thirteenth century, these scholia provide significant insight into how the Heavenly Hierarchy in particular, and Armenian translations of Greek texts in general, were understood by Armenian scholars in the Middle Ages. This editio princeps of the scholia represents a rare critical edition of (...) a native Armenian composition from the medieval period. In addition to the text and translation, these volumes include a textual commentary as well as a critical collation and English translation of a number of scholia from the Armenian version of the Greek scholia on the Heavenly Hierarchy. (shrink)

Several commentators have argued that with his concept of anonymity Merleau-Ponty breaks away from classical Husserlian phenomenology that is methodologically tied to the first person perspective. Many contemporary commentators see Merleau-Ponty’s discourse on anonymity as a break away from Husserl’s framework that is seen as hopelessly subjectivistic and solipsistic. Some judge and reproach it as a disastrous misunderstanding that leads to a confusion of philosophical and empirical concerns. Both parties agree that Merleau-Ponty’s concepts of anonymity mark a divergence from classical (...) Husserlian phenomenology. I will question this view and demonstrate that Merleau-Ponty’s discourse on anonymity remains Husserlian in two important senses: it analyses senses in terms of constituting selves and communities of such selves, and it accounts for the formation of experience by the temporal sedimentation of intentional activity. The argument proceeds in four steps. The first section argues against the widely spread notion according to which Merleau-Ponty’s anonymous subject is collective. In the second section, I offer an alternative reading by demonstrating that Merleau-Ponty uses the term “anonymous” primarily to characterize the lived body of a personal subject. In section three, I introduce Merleau-Ponty’s idea of trace and show that for him both the perceived thing and the perceiving body are traces and as such refer to earlier constitutive acts of alien subjects. I then argue that Husserl’s concepts of sedimentation are crucial for the understanding of this idea. Finally, in section four, I show how Husserl’s theory of depresentation informs Merleau-Ponty’s discourse on anonymity. (shrink)

This paper examines the moral arguments for and against employees' blowing the whistle on illegal or immoral actions of their employers. It asks whether such professional dissidents are justified in disclosing wrongdoing by others while concealing their own identity. Part I examines the concept of anonymity, distinguishing it from two similar concepts — secrecy and privacy. Part II analyzes the concept of whistleblowing using recent definitions by Bok, Bowie and De George. Various arguments against anonymous whistleblowing are identified and (...) evaluated. The author concludes with a defense of the practice in terms of social benefits — primarily the redressing of wrongdoing. (shrink)

This paper provides an account of anonymous speech treated as anonymized speech. It is argued that anonymous speech acts are best defined by reference to intentional acts of blocking a speaker's identification as opposed to the various epistemic effects that imperfectly correlate with these actions. The account is used to examine two important subclasses of anonymized speech: speech using pseudonyms, and speech anonymized in a specifically communicative manner. Several pragmatic and ethical issues with anonymized speech are considered.

The anonymous Declaratio on the Elementatio theologica of Proclus transmitted in MS Vat. lat. 4567 is the last of the three professed commentaries on the text extant in Latin to receive a critical edition. The commentary is not only a paraphrase of Proclus’ own remarks on 210 of the original 211 propositions, but frequently provides additional arguments and clarifications. Its author is clearly influenced by the Liber de causis and aims to compare the metaphysics of Aristotle and Proclus. The (...) introduction to the following edition compares the methods of the Declaratio to the other two Latin commentaries on the Elementatio theologica and considers a few clues that may shed light on the identity and aims of its author. (shrink)

Anonymized reflection was employed as an innovative way of teaching ethics in order to enhance students' ability in ethical decision making during a `Care of the Dying Patient and Family' module. Both qualitative and quantitative data were collected from the first two student cohorts who experienced anonymized reflection ( n = 24). The themes identified were the richness and relevance of scenarios, small-group work and a team approach to teaching. Students indicated that they preferred this style of teaching. This finding (...) was verified by a postal questionnaire conducted four months later. The conclusions drawn from this study suggest that using anonymized reflection is an effective method for teaching ethics to nurses and indicates that learning about ethical issues in this way reduces uncertainties. (shrink)

Political writings of eighteenth-century France have been so far mostly overlooked as a source of republican thought. Philosophers such as Condorcet actively promoted the ideal of republicanism in ways that can shed light on current debates. In this paper, I look at one particular source: Le Republicain, published in the summer 1791, focusing on previously unattributed articles by Condorcet’s wife and collaborator, Sophie de Grouchy. Grouchy, a philosopher in her own right, is beginning to be known for her Letters on (...) Sympathy, a response to Adam Smith’s Theory of Moral Sentiment, which she published at the same time as her translation of that text into French. I argue, further, that in the texts, which I attribute to Grouchy, we can find the early development of a commercial republican theory, a belief, which is reflected in her discussion of the ‘cost’ of tyranny. (shrink)

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood (...) left over from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

I shall translate Kierkegaard's account of the dangers and opportunities of what he called the Press into a critique of the Internet so as to raise the question: what contribution -- for good or ill -- can the World Wide Web, with its ability to deliver vast amounts of information to users all over the world, make to educators trying to pass on knowledge and to develop skills and wisdom in their students? I will then use Kierkegaard's three-stage answer to (...) the problem of lack of involvement posed by the Press -- his claim that to have a meaningful life the learner must pass through the aesthetic, the ethical and the religious spheres of existence -- to suggest that only the first two stages -- the aesthetic and the ethical -- can be implemented with Information Technology, while the final stage, which alone makes meaningful learning possible, is undermined rather than supported by the tendencies of the desituated and anonymous Net. (shrink)

Memes, of the kind found often on the internet, are an increasingly significant medium of expressive activity. I develop a theory of their ontological nature and, in parallel, an analysis of the concept meme. On my view, memes are abstract artifacts made out of norms for production of instances. The norms say things like ‘use a certain image; add text of a certain kind; the text should be delivered in two chunks, one at the top of the image, one at (...) the bottom, etc.’ Instances of these memes are created when users follow these norms and publish the results. The concept meme is analyzed in terms of the notion of memographic practice, a historically situated form of activity within which memes are created and their instances produced and made public. (shrink)

Reductionism as an approach to the epistemology of testimony places certain demands on the recipient of testimony that its competitor, antireductionism, does not. After laying out the two approaches and their respective demands on the recipient of testimony, I argue that reductionism also places certain anonymity-shedding demands on the testifier that antireductionism does not. The difficulty of deciding between the approaches leads to a worry about the extent to which the current state of affairs in epistemology can offer secure advice (...) on the sorts of anonymity constraints that a networked society should place on its testifiers. This worry can be mitigated, I further argue, upon recognition of the fact that the two approaches stand on common ground when it comes to cases of known testimonial conflict. (shrink)

The interest in data anonymization is exponentially growing, motivated by the will of the governments to open their data. The main challenge of data anonymization is to find a balance between data utility and the amount of disclosure risk. One of the most known frameworks of data anonymization is k-anonymity, this method assumes that a dataset is anonymous if and only if for each element of the dataset, there exist at least k − 1 elements identical to it. In (...) this paper, we propose two techniques to achieve k-anonymity through microaggregation: k-CMVM and Constrained-CMVM. Both, use topological collaborative clustering to obtain k-anonymous data. The first one determines the k levels automatically and the second defines it by exploration. We also improved the results of these two approaches by using pLVQ2 as a weighted vector quantization method. The four methods proposed were proven to be efficient using two data utility measures, the separability utility and the structural utility. The experimental results have shown a very promising performance. (shrink)

Democratic societies are rife with talk of trust in institutions such as governments, banks, news agencies, medical practitioners, nuclear power plants, weather forecasters and social network sites. These institutions are anonymous in the sense that citizens tend to know very little about them. Philosophers have argued that trust in the absence of sufficient evidence may fit a child who trusts its parents but is inappropriate for the vigilant citizens of a democratic society. In this article, I defend the appropriateness (...) of trusting anonymous institutions against its critics. To this end, I develop two principles of appropriateness that apply to a wide range of trusting attitudes. First, the principle of epistemic duties according to which the truster should not be culpably ignorant about the trustee, where, what constitutes culpable ignorance will depend on the relationship of trust. Second, the principle of appropriate normative expectations according to which a truster should have normative expectations that fit the relationship with the trustee and the valued outcome at stake in the trust relation. I then show that it is often appropriate to trust anonymous institutions. In fact, the evidential requirements on trust are sometimes so low as to allow citizens to trust institutions which they know literally nothing about. (shrink)

Many bodies around the world make their decisions through voting systems in which voters have several options and the collective result also has several options. Many of these voting systems are anonymous, i.e., all voters have an identical role in voting. Anonymous simple voting games, a binary vote for voters and a binary collective decision, can be represented by an easy weighted game, i.e., by means of a quota and an identical weight for the voters. Widely used voting (...) systems of this type are the majority and the unanimity decision rules. In this article, we analyze the case in which voters have two or more voting options and the collective result of the vote has also two or more options. We prove that anonymity implies being representable through a weighted game if and only if the voting options for voters are binary. As a consequence of this result, several significant enumerations are obtained. (shrink)

The aim of this paper is to identify, given certain democratic normative standards regarding deliberation, some pros as well as cons of possible online deliberation designs due to variations in two key design dimensions: namely, asynchronicity and anonymity. In particular, we consider one crucial aspect of deliberative argumentation: namely, its reciprocity, which puts interaction centre stage to capture the back-and-forth of reasons. More precisely, we focus on two essential features of the deliberative interaction: namely, its listening widely and listening carefully. (...) We conclude that one sort of online deliberation that combines the two design features of anonymity and asynchronicity is likely to better promote the reciprocity required for democratic deliberation than both natural and designed offline deliberations and online simulations of them. (shrink)

Although not ignored, Rahner’s theology has not played a significant influence on the interdisciplinary scholarship between Catholic theology and literature, perhaps because Rahner’s thought is often considered to lack a theological aesthetics. This article encourages a reevaluation of this impression by bringing Rahner’s theology of symbol and his argument for the anonymous Christian into dialogue with the last novel of the acclaimed Japanese Catholic Shusaku Endo, Deep River. Endo’s novel challenges theologians to consider Rahner’s insights in concrete, multi-cultural, and (...) non-Christian contexts, and demonstrates the importance of thinking about Rahner’s theology of symbol in terms of narrative. At the same time, Endo’s novel prompts a reconsideration of Rahner’s controversial argument for the anonymous Christian, for Rahner’s thought and Endo’s novel present two different approaches to the issue of religious pluralism. In this dialogue between novelist and theologian, the Incarnational foundation of Rahner’s argument for the anonymous Christian emerges more clearly, a foundation that can be easily missed amidst his abstract rhetoric. (shrink)

This paper looks at the situation first described by Dreyfus :369–378, 2002) in his seminal paper, in order to find out whether and, if so, to what extent the use of Internet in education is still characterized by anonymity and commitment in today’s social media and ‘post-truth’ era. Current form of web technology provides an occasion for us to rethink what the Press and the Public, two main Kierkegaardian themes, actually consist in. The very ease and rapidity of how information (...) is shared and the blurring of the line between journalists and consumers have made it very difficult to find where the Public actually is so that one can conform one’s own thoughts and beliefs to it. In addition, an effect of social media is that the Public does not seem to be monolithic, but has splintered into many smaller groups, each one overlapping with one another in a highly complex way. In Kierkegaard’s time the Press consisted of nothing more than a rather small number of newspapers, but now we have countless number of sources of information, so much so that it is almost impossible to see where the Press actually is. This situation has a way of diluting Kierkegaard’s contention that it is the Press that anonymized the people, rending them faceless and eliminating their individuality. Furthermore, the effect of Facebook is such that, not only does one still retain much of one’s commitment, but the commitment can be very passionate. As Petrik et al. have pointed out, it is possible for someone to be passionately committed to something while remaining very active on the Internet. This shows that the direction can go both ways. On the one hand, fragmenting the Public can go along with lack of commitment and other ills that Kierkegaard mentioned. On the other hand, fragmenting the Public, thereby creating many smaller groups existing in the online world can also bring about specific and well-directed commitments than would be possible if the Public remained a single monolithic entity. Furthermore, Kierkegaard’s insistence on lack of commitment by the Public seems to foretell the current malaise of what is known as ‘post-truth’. For Dreyfus the Internet is ultimately responsible for this. Indeed, however, both lack of commitment and too much commitment seem to be both responsible. A way out of this is proposed where a commitment to rational and critical thought is needed. (shrink)

I argue for the principle of Anonymity, according to which two populations are equally good whenever they have the same anonymous distribution of wellbeing. I first show that, given transitivity of the at-least-as-good-as relation, Anonymity is entailed by the ``Non-Identity Principle'', according to which the consequence of bringing better rather than worse lives into existence is, all else equal, better. I then argue for the Non-Identity Principle on the basis that if it were false, it would follow that we (...) fail to improve the world when we make existing people better off, while at the same time replacing worse-off future people with different better-off future people. Since this is implausible, we should accept the Non-Identity Principle, and therefore Anonymity as well. (shrink)

This article focuses on an anonymous ascetic text which is unpublished until now, and offers the critical edition of this short work containing a series of recommendations to Athonite monks, alphabetically organized and ending with the letter gamma ; the text is preserved in two manuscripts: Athous, Dionysiou 269, of the XVth c., and Athous, Lavra K 116, of the XVIth c.

Against the backdrop of a longstanding feminist critique that Michel Foucault’s call to anonymity is insensitive to the erasure of marginalized persons, I aim to contribute to a critical account of anonymity as a feminist Foucauldian ideal. I do this in two ways. First, I analyze the tactical role of anonymity in the Prisons Information Group, an organization in which Foucault was involved. Second, I analyze the unique paradoxes of anonymity faced by gender non-conforming prisoners then and now. I conclude (...) that anonymity is ideally a situational and multi-layered tactic. By developing a modality of anonymity accountable to the differential politics involved in the chosen or forced renunciation of a name, I contribute to a critical evaluation of anonymity as a practice of resistance from within and beyond the prison system. (shrink)