Rest Of You Research Articles

Lying in Wait

Lying in Wait Alexander Maksik (bio) You didn't arrive the way I'd imagined: inching your way, slow and steady. Instead, there was the top of your head and then the rest of you in a burst, unfolding like an acrobat. I asked if I could hold you. "She's your kid," our dry-witted doctor said, which I thought was very funny, until you were in my arms and the neat truth of it landed. She was already washing her hands. She was already heading for the door. Of course the doctor had used that line before. What could be more commonplace than a child born and her bewildered father? Soon the three of us were alone in the green glow of machines. When I was young, I was terrified by madness and its looming characters: the Hallelujah Lady rattling the fence of our elementary school playground; the Giant of Fourth Street under the August sun, swaddled in blankets and coats, gloves and hats, a brick in his huge fist. [End Page 299] In one of the early nights, when your mother and I were still hallucinating from exhaustion, you began to choke. We saw outrage in your face. Until then, you had cycled between peace and discomfort. Either you were happy, or you were not. But now your eyes bulged, as if to say: Fix this, goddammit. I was calm then. In times of immediate threat, I tend to go cold and rational. I don't remember what we did to make it so, but you survived and were at peace again. I had never loved your mother more. Later, we were driving somewhere, I don't remember where or when, maybe into town, maybe in those first months, when we were mostly alone, sequestered, when the menace and mystery of disease plagued the country. I caught your eyes in the rearview mirror and was sure I saw there an expression of absence, of dislocation. Something alien, controlled by a foreign power, and in it I thought I detected danger. I was frightened because I knew the look. I'd seen it on my own face when my own face was most unfamiliar. Frightened because, really, it wasn't alien at all. I tried the few shabby tricks I knew then—clownish tools of the novice. To no avail, so I let you be. Which seemed then, as it does now, the only way. I know this of myself. We can't be played into joy. There is no distraction good enough. I wish there were, but I've tried them all. Joy must reappear the way that sadness does. Of its own volition. All at once, or gradually. On that subject, I'm afraid the best wisdom I'll ever have to offer you is that they both inevitably return. Know this and you will be better prepared than I was. I was only fourteen years old when it came for me, this thing I saw, or imagined I saw, reflected in your face. Would it come for you, too? Was it lying in wait? [End Page 300] I was on my bike, alone by the river, and there it was: the first visit on a magnificent summer day. Treacherous territory, describing this thing. I tried once, in a novel. I made it tar and a circling bird. That seemed right then, and it seems good enough now. The spreading weight, the constant hunter. It's often misunderstood as simple sadness by those fortunate enough to misunderstand. But it is a far more complex creature, one that inhabits the body. An occupying force, it comes with weight and volume. Both of which are tremendous. Neither of which is inert. That day, it was baffling and brutal enough that I had to stop riding and sit on a bench. I don't remember going home, or when it left. As quickly and inexplicably as it had come, it was gone. The other night you were watching me cook dinner, and I saw that look again. When I asked what was wrong you said, "I'm just a little sad." I turned off the stove and picked you...

An Expert Roundtable Discussion on Experiences of Autistic Autism Researchers.

An Expert Roundtable Discussion on Experiences of Autistic Autism Researchers.

Migranthood: Youth in a New Era of Deportation by Lauren Heidbrink

Reviewed by: Migranthood: Youth in a New Era of Deportation by Lauren Heidbrink Amelia Frank-Vitale Lauren Heidbrink. Migranthood: Youth in a New Era of Deportation. Stanford: Stanford University Press, 2020. 213 pp. Thinking about my own sense of identity, I realise that it has always depended on the fact of being a migrant, on the difference from the rest of you. So one of the fascinating things about this discussion is to find myself centered at last. Now that, in the postmodern age, you all feel so dispersed, I become centered. What I’ve thought of as dispersed and fragmented comes, paradoxically, to be the representative modern experience! This is “coming home” with a vengeance! Most of it I much enjoy—welcome to migranthood. — Stuart Hall (1987:44) It is fitting that most scholars cite Stuart Hall as the coiner of the term, “migranthood.” In this essay, he discusses his own experience, as a migrant himself, of dispersal and fragmentation. His term, his description, come from expertise based on his own experience. This is one of the arguments at the heart of Lauren Heidbrink’s Migranthood: Youth in a New Era of Deportation. We must take seriously, she tells us, the expertise of young people who migrate and are deported to understand the nature of this condition of being a migrant, of migranthood. Migrant children, she holds, are too often discussed as either passive victims made vulnerable by the poor decisions of adults around them or as an inherently criminal, dangerous, invasive force that cannot be trusted and must be expelled. Heidbrink strives to trouble a public discourse that rests on these two polar but connected tropes by grounding an analysis of Indigenous Guatemalan youth migration in the narratives and reflections of, precisely, Indigenous Guatemalan youth migrants. [End Page 345] One of the core arguments of this book is that migranthood, or “how migration is socially constructed, practiced, and experienced” (5), is not an individual experience. Rather, the decision to migrate as well as the attendant risks and potential rewards are all familial, communal, collective. She makes this argument through detailing how the migration and deportation of children has ripple effects on parents, siblings, grandparents, friends and, conversely, how the migration and deportation of parents has ripple effects on children, families, communities. She reinforces this argument through a similar analysis of how the Indigenous communities in Guatemala where she works have come to experience migration; it is grounded in the historical experience of forced labor, internal labor migration, discrimination, state violence, and neoliberal extractivism. As a work of public scholarship, Migranthood does a remarkable job of weaving together statistical data, survey results, ethnographic storytelling, and history to offer a clear and compelling assessment of how the so-called crisis of unaccompanied minor migrants in 2014 (and the series of migration-related crises since then) is, as Heidbrink calls it, a crisis of policymaking. Importantly, Migranthood, points us toward what I think will be a new and necessary approach to deportation. While many of the stories Heidbrink includes involve the deportations of individuals who have lived for years in the United States, she also brings in the voices of youth (and in some cases their parents) who have been deported without ever having had the chance to arrive. While narratives of displacement and dis-orientation for those deported after making a life elsewhere (see Zilberg 2011, Coutin 2016, among others) have done the crucial work of showing how deportation is not a matter of returning out-of-place people back to their “natural” place (Khosravi 2018), the experiences of those deported without ever having “made it” are also rife with trauma and multiple, layered consequences. Migranthood shows us families and communities grappling with the full range of post-deportation experience, and like the story of Sebastián—who at 20, after three deportations from Mexico, falls into depression and dies of alcohol poisoning (163–164)—suggests that those who never arrive may be the least able to survive deportation. As the United States and other countries in the global North further harden their borders, restrict access to asylum and other forms of protection, and externalize migration enforcement, we will...

Blue Lights, and: Faces

Blue Lights, and: Faces Cate Marvin (bio) Blue Lights The night classes pour into asphalt lotsthat soon empty of their engines,the students seeming to dissolve like raindrops,the students seeming now to have been a hallucination that buzzed angrily for hours beneath fluorescent litceilings at poems like hands that refused to be heldor glittered their eyes at the kisses placed bypoems on their palms, longing for the vantage of multiple choice answers over these overturesof beauty and malignance. And the questionnot just once but again, again, What is it?They are all gone, the poems and their students, have left me to wander into this mist settlingacross the soft lawns this nether time of night,to walk solitary toward my car's lone smudge beneaththe morose lumens cast from corners of campus that have at them stationed lighted poles thatglow a chlorine blue, designated lightning rods for fear,bedecked with alarm buttons to run to forpressing, to send sirens out to saviors. When did these lighted poles appear, their beaconsutterly unreachable? Even spied from behindthe windshield, one apprehends a great distancebetween their stars and the bus stop's canopy, beneath which hooded students smoke onlyto disappear into the damp exhaustion of the night.Which is always when the deer appear, ornamentthemselves upon the lawns, frozen in mist, [End Page 81] taking on the stance of the startled, now startlinglypale, the four before me equidistant, and onetipping the pitcher of her head as if to pour the grassa drink or, considered upside down, suckle the milk from soil or nurse the grass's dew. My bag of booksthrown over my back like a bag of bones, my bagof poems a bag of stones, crushes my shoulderas I wade in mist toward the car, and the deer, who watch me as I watch them, seem a dream'sdecision to find me far outside the room I sleep in.They are an astonishment I do not wish to analyze.And I am certain if I move too quickly they will, spooked, run from me, or I am scared that if I do not run from themthey will stampede the meagerness that is me.The buck tumbling before my headlights.The scrimp of lawn in the mouth of the doe. [End Page 82] Faces I'm just like the rest of you, a run-out pen. Or like you,with the paper bag hat, waiting outside the library to get in. It's about to open, we stand facing the glassdoors at three minutes to ten. I can barely stand it. Like a tree, I'm dying from the inside, shooting leavestoward the light and making out like I'll be around for a long time to come. Only now my heaviest branchdrops, splintering its huge, damp shard on the drive, causing everyone to sigh their gladness that no onewas standing on that very spot, as if anyone would ever happen to be standing beneath me, waiting forme to do something. It's my doing nothing you come to trust. But mine is an acrimonious relationship withtime. It feels like a wool sweater, or like the damp squeezed out of a sweater, or like a sweater, period.Clamped in the damp, ministering the body through doorways, shielding the points of elbows from knivesof furniture corners. This is a dangerous world. Even though I keep spooling out the gradual yo-yo of myshadow along the walk with the tenderness a snail invokes as it peers, gentle out of its shell, you know itcould freeze at any minute, all the ice that drips from my eyes to the concrete, tears striking countenanceslike shards hit glass doors, like hail, like exclamation points from the sky or eyes: I see you! Coming aroundthat corner, smile like a knife, ready to steal my life. [End Page 83] Cate Marvin Cate Marvin's fourth book of poems, Event Horizon, is forthcoming from Copper Canyon Press in 2022. She teaches English at the College of Staten...

The Year's Work in American Humor Studies, 2017

The Year's Work in American Humor Studies, 2017

IMPROVEMENT OF MARKETING ACTIVITY OF WHOLESALE TRADE ENTERPRISES

More recently, the crisis of the economy of Ukraine suttєvo vlylnuli on the efficiency of the robots of wholesale trade enterprises, which have become part of the commodity flow of the state. It is shown that the model of the functional model of economics in the meaning of the world plays the role of wholesale trade, the role of wholesale trade, and the result of this problem is on the quality of business and development, as a result of this, as a result of this, as a result of this, as a result of this, as a result of this, as a result of the development of this type of business. It is broken visnovka wholesale wholesale trading dolly singing hard to get out of action to get rid of the rest of the rest of the rest of the rest of the rest of the rest of the village, but also the rest of the rest of you . It is established that one of the reasons for this will be, about zagalnoe komponenimi factors, the lack of coordination of regulatory and methodological processes, as well as on wholesale markets of all types of goods significantly increased competitiveness from the side of the merchant that online store, one of one, and the market has become one of the most important competitors from the side of the trade market, which is one of the main trade markets, and the market has one of the most important factors. ppdpriєmstv in the idleness of self-objec Wisunuto's position, the way of adapting the wholesale trade companies to rinky minds, flickering around the companion marketing methods of the goods in the minds of the goods in the minds of the non-significant and diversified. It is shown that a very efficient wholesale trading robot enterprise in the meaning of the miri to lay out the methods of the best price conditions for the repository of commodity stocks. Oskіlki znachnі kіlkіst faktor_v, yakі vpvyvayut on this process, to be of a vipadkovy character, the method of repossession of commodity stocks is guilty of rummaging on ymovіrnyh methods p_dtrimki management rіshen. It is necessary, in the middle of the market minds, to be vrahuvati, that the applications from the wholesale distributors are satisfied with the product distributors discretely at the moment of delivery by deliveries of the goods to the market. This is the method of “implementing” for a wholesale wholesale trade enterprise, which is supposed to be active in your own marketing activity.

Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship.

Compared with younger populations, adults 65 years and older are more likely to suffer infection-related morbidity and mortality, experience antibiotic-related adverse events, and acquire multidrug-resistant organisms. We developed a series of case-based discussions that stressed antibiotic stewardship while addressing management of common infections in older adults. Five 1-hour case-based discussions address recognition, diagnosis, and management of infections common in older adults, including those living in long-term care settings: urinary tract infections, upper respiratory tract infections, lower respiratory tract infections, skin and soft tissue infections, and Clostridium difficile infection. The education was implemented at the skilled nursing centers at 15 Veterans Affairs medical centers. Participants from an array of disciplines completed an educational evaluation for each session as well as a pre- and postcourse knowledge assessment. The number of respondents to the educational evaluation administered following each session ranged from 68 to 108. Learners agreed that each session met its learning objectives (4.80-4.89 on a 5-point Likert scale, 5 = strongly agree) and that they were likely to make changes (2.50-2.89 on a 3-point scale, 3 = highly likely to make changes). The average score on the five-question knowledge assessment increased from 3.6 (72%) to 3.9 (78%, p = .06). By stressing recognition of atypical signs and symptoms of infection in older adults, diagnostic tests, and antibiotic stewardship, this series of five case-based discussions enhanced clinical training of learners from several disciplines.

Chromosome microarray analysis: A soothing guide.

Chromosome microarray analysis: A soothing guide.

Learning from Blindness

Only when my friend kevin said, in an aside to his wife i was not meant to hear, that i was still grieving for my loss of sight did i realize that I was and had been for the past seven years. When a friend or family member dies, it is an obvious time to grieve; when someone you love dies, you have to get on as best you can without them. But when you are confronted with a disability, it is as if a part of you has died, and the rest of you has to get on as best it can. Learning how to come to terms with the change in your day-to-day life disguises the need for grief. So, seven years on, let me give you an inkling of what happens when one of your senses dies. The metaphor of death (or perhaps it's not a metaphor) is convenient since it leads to a framework for my explanation. Elisabeth Kübler-Ross, in On Death and Dying, explored the ways we come to terms with death through five emotional stages: denial, anger, bargaining, depression, and acceptance.

Access, Affordability, Accountability 2013-2014 President-elect Address to the 2014 AACP House of Delegates

Access, Affordability, Accountability 2013-2014 President-elect Address to the 2014 AACP House of Delegates

Who Owns a Dissertation, and Why Does It Matter?

Who Owns a Dissertation, and Why Does It Matter?

‘Keep the best of you, “do” the rest of you’: passing, ambivalence and keeping queer time in gender performative negotiations of popular music

AbstractThis article considers the integral role music plays in drag in general and ‘femme’ gender performance (or queer performances of femininity) in particular. Drawing from ethnographic interviews with performers and observations of their performances, I delineate some of the purposes music can serve in these contexts: a tool for character development, a musical lingua franca with which to establish a dialogue with the audience; a part of a nuanced intertext that troubles the cohesiveness of a musical plot or ideological discourse; a fan strategy for staking ownership over a beloved song or genre. I argue that femme gender performers critically stage their own consumption of the popular music they enjoy, interrupting its narratives and rhythms with their choreography and reterritorialising it with their dancing bodies.

Law as Lyric, Lyric as Star Trek: A Reading of Kol Nidre

Law as Lyric, Lyric as Star Trek: A Reading of Kol Nidre Eric Murphy Selinger Some years ago, I decided to stop coming to Yom Kippur services—at least, to the services for adults. This wasn’t just a matter of scheduling or comfort, although I’ll admit that the 90‐minute children’s service I took up instead has a good deal to offer on both counts, including a live performance of the Book of Jonah, complete with a four‐foot cardboard fish and a pint‐sized female God in a cotton‐ball beard. I decided to stop coming because, frankly, I didn’t see the point. When the second intifada broke out, right in the middle of the Days of Awe, the responses I heard to it before Yom Kippur were just the same as those I heard after the holiday. Those who blamed the Palestinians before, blamed them afterward. Those who blamed Israel, blamed Israel. Those who didn’t know what to do, or say, or think, remained confused. For my friends, for “my people” as I saw them on the news, and, most of all, for myself, 25 hours of fasting and prayer hadn’t done a thing. At which point, bring on the cotton balls. My years among the kinderlach haven’t taught me much about politics. They have, however, let me step back from the text of the Yom Kippur services a while—let me see it freshly, and not through that scrim of disappointment. In this essay I want to look at one part of that service rather closely, the way I might look at a poem, with an eye to what it says and does and can teach us about how to make the holiday do its work. I want to look at “Kol Nidre.” The first thing to notice about Kol Nidre is, I think, how very strange it is—and strange in a variety of ways. Let’s start with the invocation, those first few lines we rise at, setting the stage: By authority of the court on high and by the authority of this court below, with divine consent and with the consent of this congregation we hereby declare that it is permitted to pray with those who have transgressed. Notice how, right from the start, we’re in the world of make‐believe, of performance, just as much as we would be at any children’s service. We rise and speak, and two courts appear: one visible, played by us, and one invisible, echoing our actions. These two courts, of heaven and earth, are in concord—neither sits (or stands) in judgment on the other. This is, then, not simply an invocation, but an incantation: a set of words that make things happen. “With the consent of XYZ” is, in fact, a common formula in Jewish folk religion, a start to exorcisms and other forms of counter‐magic. Joshua Trachtenberg, in Jewish Magic and Superstition, quotes several spells like this: By the authority of the Heavenly Court and by the authority of the Earthly Court, with the consent of the Holy One, blessed by He, and with the consent of Elijah…we release and annul and cancel all the oaths that have been sworn…by every angel and demon and all the angels of destruction and demonic winds against Israel, . . . With the consent of the heavenly and earthly courts, of our sacred Torah, of the great and small Sanhedrins, and of this holy congregation, we release N son of N from all the curses, maledictions, oaths, vows…uttered in his home or directed against him, be they his own curses or the curses of others against his person, etc. So: we start with magic. Not the binding of demons or dissolution of curses, or even the undoing of an oath; that will come later. Rather, we make a gesture of permission. “It is permitted to pray/with those who have transgressed.” What magic does this declaration perform? The first thing it does, at least to my suspicious mind, is raise a few doubts about the rest of you. What do I know, after all, about what you’ve...

The Machine: A Hot Team, a Legendary Season, and a Heart-stopping World Series: The Story of the 1975 Cincinnati Reds (review)

Joe Posnanski. Machine: A Hot Team, a Legendary Season, and a Heart-stopping World Series: Story of the 1975 Cincinnati Reds. New York: William Morrow, 2009.302 pp. Cloth, $25.99. 1970s Cincinnati Reds, remembered to history as the Big Red Machine, a well-mined literary story. Besides the several books written in the aftermath of their 1975 and 1976 championships, and the many memoirs written by players and the manager, there is Greg Rhodes and John Erardi's wonderful Big Red Dynasty (Road West, 1997), and Daryl Smith's thorough Making the Big Red Machine (McFarland, 2009). latter two in particular deal extensively with how the Reds evolved into one of history's greatest teams. One might wonder: what else is there to say? Joe Posnanski tells us that he wrote Machine so that he could write about baseball from my childhood, about his favorite players and personalities from an era that feels faded and distant (276). An award-winning columnist for the Kansas City Star and Sports Illustrated, as well as the author of the Casey Award--winning Soul of Baseball: A Road Trip Through Buck O'Neil's America (William Morrow, 2007), Posnanski stands out among many of his newspaper peers for his embrace of sabermetrics and modern analysis, which has made him a favorite among many of the newer internet writers. In Machine, Posnanski stays away from the heavy analysis and the story of the Reds' evolution, instead giving us a more traditional inside look at what it might have been like to be in the Reds' locker room and dugout in the summer of 1975. Posnanski's main sources were contemporary Cincinnati newspapers and his own interviews with the writers and players who were there. What makes this an outstanding book is only Posnanski's writing, which is typically first-rate, but the subject matter. Reds were only one of history's great teams, they were also a team filled with fascinating personalities, people who were household names then and still well-known, foremost among them Johnny Bench, Pete Rose, Joe Morgan, Tony Perez, and manager Sparky Anderson. Posnanski tells the story of the season through the eyes of these men and their lesser teammates. Posnanski writes of a speech Anderson made to his team that spring in Tampa. Sparky informed his charges that the club had two different types of players. On the one hand, there were the four superstars: Bench, Morgan, Rose, and Perez. If they needed to show up late or go play golf or go to the track, well, Sparky would wish them luck. The rest of you, said Sparky, are turds (25). This approach would seem likely to backfire on most clubs, but with the Reds it worked--mainly because the four stars generally showed up every day and worked hard. rest of the Reds went along, though they had little choice. At one point Dave Concepcion, the team's fine shortstop, let Joe Morgan know that he felt he was now a star in his own right. No, you're not, Morgan told him. We're stars, you're not (101). Ken Griffey still bears the resentment of his second-class status with the Reds. In particular, he felt that both Bench and Morgan were asshole[s] (210). Years later, the caste system had become more complex--at various celebrations commemorating the great club, the eight starting position players were honored, while the pitching staff was ignored. Posnanski does take us through the season game-by-game. Instead he describes the season's more interesting turning points and the postseason. There was no pennant race--the Reds ran away with the division and league championship before defeating the Red Sox in one of baseball's most fabled World Series. Posnanski keeps the reader interested with the way Anderson creatively solved problems with his lineup and pitching rotation, and how Anderson's own insecurities motivated him to keep his foot on the throttle to the very end. It is easy to forget now that the Reds had been seen as underachievers, having been tripped up by seemingly inferior teams the previous few years. …

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The importance of being Frank

Frank Oberklaid has finally stepped down from the Journal of Paediatrics and Child Health after 20 years as a deputy editor, followed by 10 years as an editor, then 8 years as editor-in-chief. He is sometimes referred to outside Melbourne as Frankly Overpaid, a friendly but totally undeserved slight. The irony is that Frank has never taken or been offered a cent for his work for the Journal, and in typical Frank fashion has committed his energy and intelligence totally to running the Journal. Frankly Underpaid would be more appropriate. At the same time, he has been running a superb Centre for Community Child Health in Melbourne and his only sin is that Frank's fossil fuel footprint is black as black, because he is in such demand internationally. Frank has continued the struggle to change our Journal from a relatively small, local paediatric journal into an international one, with considerable success. Are there any aspects of being editor-in-chief that Frank might regret? He would have liked to raise the impact factor, a measure of how often published papers are quoted in other journals, which has remained steady. Raising one's impact factor is difficult. Impact factors have a vicious circularity to them: the best journals (New England Journal of Medicine, the Lancet, etc.) attract the best papers, which attract more readers. Smaller journals struggle to break the cycle. How can we improve the popularity of our Journal and thus improve its impact factor? Does it matter? Those of us who care deeply about the Journal have thought deeply about the problem. We need to make it really enjoyable for you to read the Journal, whether you are reading this in the bath or on your computer (or on your computer in the bath, in which case disconnect the electricity, please). The British Medical Journal has decided it cannot compete with the top scientific journals, and has reinvented itself to appeal like a magazine. Not by dumbing down, but by finding a large variety of different ways to interest readers: medical news, summarising recent journal articles, debates, ethics, book reviews, using evidence, even obituaries (I suppose their readers take a vicarious delight that they are not reading their own obituary). The major difference between our Journal and the mainstream journals is that they employ a large number of full-time staff, whereas we depend on the energy and goodwill of volunteers and those volunteers are already heavily overcommitted. If you value this Journal, we need some favours. First, we want you to contact us and tell us which current features you like, which you do not, and what future, new features you would particularly like to see. Second, we want volunteers prepared to be editors. We want you to write reviews or personal practice articles about general paediatrics and subspecialties. We want you or your juniors to volunteer to be reviewers. We would like to start a regular feature about recent important publications in other journals, similar to Alison Tonks' excellent ‘Short Cuts’ in the British Medical Journal, to keep readers up to date. We invite expressions of interest to be the editor of this section. We need the rest of you to contribute by sending us references to the most important new research or even better short commentaries on papers in your specialty area or general medicine. If you write a commentary, we will publish it under your name. We want to liven up the journal with humour, anecdotes, drawings and photographs. We want you to get involved, please. Your Journal needs you.

What Is a Plume? and Why Do I Care?

What Is a Plume? and Why Do I Care?

Organizational Culture and Police Misconduct

Most police departments defend controversial uses of force by individual officers in one of two ways: as well-intentioned but unfortunate responses to dangerous and ambiguous situations or as the aberrant behavior of rogue cops. These explanations are powerful and important because they frame the way police departments respond to police brutality. article argues that because the stories police departments tell themselves (and us) about the causes of police violence are flawed and incomplete in essential ways, it is not surprising that judicial, administrative, and departmental responses to police violence are notoriously unsuccessful.The primary defect in these explanations (and the solutions that go with them) is that they view police misconduct as resulting from a series of isolated factual and moral judgments made by officers functioning as individuals rather than as part of a distinctive and influential organizational culture. The regrettable-accident explanation asks whether the officer's judgment about how much force to apply was reasonable under the circumstances as known by the officer at the time of the incident. explanation fails to consider, however, how the officer came to be in that situation in the first place and how her training and role in the police bureaucracy affected the way she viewed the broader parameters of her decision. The officer-gone-bad explanation is similarly flawed because it assumes that the misbehaving officer is off on a frolic and detour for which she alone is accountable. It allows the department to distance itself from an incident by labeling the perpetrators as deviants who are wholly unlike their fellow officers. Conversely, it allows managers to declare to the rest of the rank and file, This terrible incident does not reflect on the rest of you. allows the organization within which the official is embedded to absolve itself of responsibility for facilitating the officer's wrong-doing.By contrast, theoretical and empirical scholarship on policing strongly suggests that organizational factors are a major determinant of police misconduct and thus an important - and often neglected - part of the solution. Unfortunately, like the individualistic explanations police departments offer for the misbehavior of their members, many of the remedies currently invoked to control police brutality are inadequate precisely because they ignore or undervalue institutional and organizational factors.This Article demonstrates the individualistic focus of extant legal remedies and argues that we will never control police brutality unless we take account of the role of organizational culture in creating the milieu that perpetuates police violence. While the rogue cop explanation has turned the focus of attention toward trying to identify problem officers, the real story is that organizational factors interact with individual propensities to produce police brutality. Cops do not arrive at the police department door as fully-formed brutalizers; they are created, in some part, by features of the organizational culture that makes it possible or probable that they will act on their violent propensities. Thus, judicial remedies that focus on individual conduct (and departmental strategies that seek to identify psychological factors that might predispose to violence) must be supplemented by measures whose aim is to change the culture that encourages these propensities to be expressed in a pattern of conduct.

Editorial

There was, no doubt, a time when the end of winter brought a sense of jubilation at the frontline of hospital medicine. Now, not only do the emergency pressures seem to continue year-round, but spring also brings the challenge of a revised set of Government targets. This April we are greeted with a 20 minute door to needle time for thrombolysis, and a four hour wait target measured from the time of arrival in A&E. Those of you who take a light-hearted view of such things may be may be amused to hear of a local hospital’s appropriately mis-spelt response in the form of a ‘Darft Action Plan’. For the rest of you, good luck – remember, your Trust’s ‘Star Rating’ is dependent on you! In this edition, John O’Reilly reminds us that chronic obstructive airways disease accounts for up to 25% of the workload of a UK medical ‘Take’, although for the last few months it has probably felt like even more. In contrast, accelerated hypertension is rarely encountered, but nonetheless must be recognised and treated by physicians working at the front door. Two of the reviews approach contrasting presentations of the septic patient. On page 13, Cardy and Poulton have produced a comprehensive overview of the critical care perspective, while Clare Spice reminds us of the non-specific way in which infection can present in the elderly in her paper on delirium. The ‘Regular Features’ section brings the second in a series of ‘How to do it’ papers from ophthalmologists Beth Edmonds and Peter Francis. Having covered fundoscopy last year, they now turn their attention to the demystifying of pupillary responses. This month’s ‘case to remember’ provides a salutary lesson in the need for lateral thinking in the management of patients taking immunosuppressant medication. Although a recognised complication of methotrexate therapy, the diagnosis of pneumocystis carinii pneumonia can so easily be forgotten, with potentially serious consequences. As I have mentioned in previous editorials, I am keen to encourage submissions of case reports, audits and original research relevant to the acute medical setting for future publication. Reviews are normally commissioned in line with the cycle on page 35. However, if you have a particular interest in a condition not included in the cycle, with a relevance to other clinicians involved in the acute medical take, please feel free to write and submit to us at the address opposite, or contact me directly by e-mail. The multiple choice questions are, once again, for self-assessment only. Answers are on the following page, so no ‘external’ CPD points can be accrued for now. However, reading the journal can still count towards your ‘personal’ CPD credit. Hopefully you will find something to interest you in the following pages, along with a little light relief from the pressures (and targets) of the ‘day-job’!

Presidential address: Our heritage and our future

J Thorac Cardiovasc Surg 2002;124:649-54