Bartleby in the NICU

The limits of pity in Bartleby and Moby Dick.

Failures in the emotional connection between doctors and their patients tend to be reported in terms of compassion fatigue, burn-out, secondary trauma and depression in overlapping and somewhat interchangeable ways. In Moby Dick and Bartleby, Melville interrogates the culturally accepted descriptions of pity and explores the reasons for the limits in human pity he observed and depicted. In an a...

Antimicrobial stewardship in the NICU.

There are unique challenges to antimicrobial stewardship in neonatal intensive care units (NICUs). Diagnosis of infection is difficult as neonates can have nonspecific signs and symptoms. Between and within NICUs, significant variation exists in the treatment duration of suspected sepsis and pneumonia. Development of multidisciplinary teams and meaningful metrics are essential for sustainable a...

The Scandal of Insensibility; or, The Bartleby Problem

I N THE FIRST PART OF LEVIATHAN, “OF MAN,” BEFORE HOBBES DEFINES a commonwealth and prophesies the philosophical “Kingdome of Darknesse” into which it can descend (956), he proclaims that “to have no Desire, is to be Dead” (110). As a motto for the passions, the phrase resonates as a defense of desire, a call to understand strong feelings as on the side of life. To have no desire is to be dead ...

Noise pollution in the NICU

Neurodevelopmental care in the NICU.

Neurodevelopmental care, which is any NICU intervention undertaken to improve neurodevelopmental outcome, includes NICU design, nursing routines, nursing care plans, management of pain, feeding methods and, most importantly, encouraging parental involvement with their NICU infant. Recognition that sensory stimulation can overwhelm preterm infants and increase physiologic signs of stress led to ...