Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this (...) essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)

In this theoretical paper, I analyze business groups’ corporate social responsibility. Building on economic thinking, I propose that the level and diversity of CSR investments of business groups evolve with the development of the country, as a result of the interaction of two drivers: the level of infrastructure deficiencies and the cost of negative externalities. I argue that in underdeveloped countries, business groups have high levels and low diversity of CSR investments, focusing on the social arena to compensate for infrastructure (...) deficiencies. As countries implement pro-market reforms and become emerging economies, the level of CSR investments diminishes as business groups can rely on external providers and the government for supporting infrastructure, but CSR diversity increases to address the growing costs of negative externalities in the environmental and economic arenas. As countries further develop to become advanced economies, business groups’ level and diversity of CSR investments increase to prevent the high costs of negative externalities in the social, environmental, and economic arenas proactively. (shrink)

Historians of science have attributed the emergence of ecology as a discipline in the late nineteenth century to the synthesis of Humboldtian botanical geography and Darwinian evolution. In this essay, I begin to explore another, largely neglected but very important dimension of this history. Using Sergei Vinogradskii’s career and scientific research trajectory as a point of entry, I illustrate the manner in which microbiologists, chemists, botanists, and plant physiologists inscribed the concept of a “cycle of life” into their investigations. Their (...) research transformed a longstanding notion into the fundamental approaches and concepts that underlay the new ecological disciplines that emerged in the 1920s. Pasteur thus joins Humboldt as a foundational figure in ecological thinking, and the broader picture that emerges of the history of ecology explains some otherwise puzzling features of that discipline – such as its fusion of experimental and natural historical methodologies. Vinogradskii’s personal “cycle of life” is also interesting as an example of the interplay between Russian and Western European scientific networks and intellectual traditions. Trained in Russia to investigate nature as a super-organism comprised of circulating energy, matter, and life; over the course of five decades – in contact with scientists and scientific discourses in France, Germany, and Switzerland – he developed a series of research methods that translated the concept of a “cycle of life” into an ecologically conceived soil science and microbiology in the 1920s and 1930s. These methods, bolstered by his authority as a founding father of microbiology, captured the attention of an international network of scientists. Vinogradskii’s conceptualization of the “cycle of life” as chemosynthesis, autotrophy, and global nutrient cycles attracted the attention of ecosystem ecologists; and his methods appealed to practitioners at agricultural experiment stations and microbiological institutes in the United States, Western Europe, and the Soviet Union. (shrink)