“WE CAME TO TALK WITH THE PEOPLE BEHIND THE DISEASE:” COMMUNICATION AND CONTROL IN MEDICAL EDUCATION

To explore the ways in which biomedical culture responds to the new curricular addition of communication skills training, we observed activities related to the communication skills training of a class of 70 first-year medical students in an Israeli medical school during 2002–3. In addition, focus groups were conducted with medical students (n = 210) during 1998–2001. A gap was found between the rhetoric of “patient-centered communication” and “empathy” and the traditional concerns of medical authority, efficiency, and scientism. Communication skills and empathy training were appropriated into medical socialization by being reconstructed as clinical competence. Findings are further discussed in the context of medical professionalism, Israeli culture, service acting and service roles, and organizational learning.     

“Ayahuasca,” the South American hallucinogenic drink: An ethnobotanical and chemical investigation

The Sharanahua and Culina, small Indian tribes located in the southwestern Amazon basin, use a hallucinogenic drink for medicinal and social purposes. This decoction, called “Ayahuasca” in Peru, is prepared from Banisteriopsis Caapi stems and Psychotria sp. leaves. These plants have been botanically identified on the basis of voucher herbarium specimens and investigated for alkaloid content by means of a gas chromatography-mass spectrometry technique. A list of other occasional plant admixtures is given. Harmine, Harmaline, Tetrahydroharmine, Harmol and 6-Methoxytryptamine have been found in Banisteriopsis Caapi. Dimethyltryptamine, Monomethyltryptamine and 2-methyl-1,2,3,4-tetrahydro-β-carboline have been found in Psychotria viridis and Psychotria carthaginensis. Harmine, Harmaline, Tetrahydroharmine and Dimethyltryptamine have been found in the drink. Quantitative calculations show the amount of each alkaloid administered in the Ayahuasca drink.