“Because It Kind of Falls in Between, Doesn’t It? Like an Acute Thing and a Chronic”: the Psychological Experience of Anaphylaxis in Adulthood

Anaphylaxis is a serious, rare condition increasing in prevalence. This study explored the psychological experience of adult-onset anaphylaxis from patient, family and staff perspectives. Semi-structured interviews were conducted with twelve participants. Two global themes emerged from thematic analysis: ‘controllability’ (‘an unknown and distressing experience’, ‘the importance of control over triggers’ and ‘responsibility but no control: the impact on others’) and ‘conflict’ (‘rejecting illness identity’, ‘minimisation of risk’, ‘accessing specialist care: running in slow motion’ and ‘patient-centred versus service-centred care’). Findings highlight the importance of perceived control and emphasise the presence of conflict in the experience of this complex, episodic condition.

Social Justice Cannot, in the Form Commonly Articulated, Meaningfully Guide Action

Nurses – along with many others – are often told that they should or must accept and work towards the promotion of social justice. Further, it is claimed that social justice represents or is a shared nursing value. This presentation challenges these assertions. Claims regarding shared values easily fall prey to forms of attribution error. Alternatively, while social justice is sometimes presented as a remedy or alternative to market disutility, the quality of arguments in which this linkage appears leave much to be desired and, in such instances, the robustness of these claims collapse. Or, assertions regarding social justice frequently appear without supporting explanation or justification. It is simply assumed that social justice (inadequately defined) is a ‘good thing’. This is not necessarily a problem. The normative strength of a claim does not rest only upon the arguments put forward in support of it. However, when social justice is advanced as mere assertion, often in a manner devoid of specificity, claims that the concept should be embraced and claims that the concept should or can promote action in the world, lack persuasive force. Moreover, in some articulations, the concept appears to generate illiberal and intolerant consequences. This presentation does not argue for inequality or social injustice. Rather, it suggests that underdeveloped and frail arguments require improvement or dismissal.

Encountering the Spectre of Painting

When thinking what paintings are, I am continually brought back to my memory of a short sequence in Alfred Hitchcock’s Vertigo. In the scene, Kim Novak’s Madeleine is seated on a bench in an art gallery. She is apparently transfixed by a painting, Portrait of Carlotta. Alongside James Stewart, we watch her looking intently. Madeleine is pretending to be a ghost. At this stage she does not expect us to believe she is a ghost, but simply to immerse ourselves in the conceit, to delight in the shudder. Madeleine’s back is turned away from us, and as the camera draws near to show that the knot pattern in her hair mirrors the image in the portrait, I imagine Madeleine suppressing a smile. She resolutely shows us her back, though, so her feint is not betrayed. Madeleine’s stillness in this scene makes her appear as an object, a thing in the world, a rock or a pile of logs perhaps. We are not looking at that thing, however, but rather a residual image of something creaturely, a spectre. This after-image is held to the ground both by the gravity suggested by its manifestation and by the fine lie - the camouflage - of pretending to be a ghost. Encountering a painting is like meeting Madeleine. It sits in front of its own picture, gazing at it. Despite being motionless and having its back to us, there is a lurching sensation the painting brings about by pretending to be the ghost of its picture, and, at the same time, never really anticipating your credulity.