Berkowitz: I have another candidate for you too. Are you familiar with Oscar Ewing, the Social Security Administrator and a health insurance advocate. He had a similar chart, maybe in the Magnuson Report, or one of these reports, that was exactly the same. The university hospital in the center and the other hospitals around it in concentric circles, so that idea was around. Howard Rusk and similar types of people were very aware of this kind of idea.
Damien, in 2001, a psychiatrist for your defense team submitted an affidavit that essentially concluded -- I'm reading this -- "The nature and severity of your multiple psychiatric illnesses have left you unable to rationally understand the 1994 legal proceedings that convicted you or to rationally assist in your own defense."
How do you react to that, that you are not in a rational state?
ECHOLS: I think maybe -- I don't think they are saying I'm not in a rational state now.
And usually everyone in the barracks will be up and watching as they lead him out the doorway into the death chamber.
KING: Well, how is -- that must feel terrible for you when you -- especially when you have gotten to know them, right?
White: I visited Archie Cochrane. He was a wry Scot with a glorious sense of humor. I remember visiting him in Cardiff. He asked me about my activities and I replied that I was interested in applying epidemiological methods to the study of what we called medical care in those days but now refer to as " health services". He thought that was a bad idea and that epidemiology should have a rather narrow focus on infectious diseases but could be applied to the study of chronic diseases. The application of epidemiological concepts and methods to the study of health services was, in Cochrane's view at that time, inappropriate. The British epidemiologists emphasized the investigation of chronic diseases in spite of the fact that the infectious disease epidemiologists, largely American and eastern European, weren't about to accept such distortions of the "discipline" initially. I learned from Archie Cochrane the value of studying relatively large populations by means of carefully drawn samples and the importance of maintaining contact with them for repeated surveys over the years. He also stressed the importance of double-blind randomized clinical trials and of studying the distribution of so-called "normal" phenomena. For example, the textbook standards used in the laboratories of the day provided "normal" values for various blood elements to establish the presence of clinical anemias. Unfortunately these "normal standards" were based on samples drawn from volunteers found in medical centers, often sick patients. Sometimes the volunteers were from the staff or students or from otherwise "healthy" patients. The standards were not derived from a large general population base. Archie and one of his colleagues did population-based studies of the distribution of hemoglobin levels and of the different kinds of anemia, so the medical profession had more accurate and realistic knowledge of what to call "normal". This is the kind of thing that John Ryle of Oxford addressed in his essay on the question: "What is normal?" that I mentioned earlier. I learned a great deal from Archie Cochrane. I should continue with this story because later Cochrane started looking at health services and wrote a classic little volume, Effectiveness and Efficiency: Random Reflections on Health Services published in 1971 by the Nuffield Provincial Hospitals Trust. It attracted a lot of attention at the time but the fundamental message was not readily accepted by the medical profession. Cochrane set forth the urgent case for examining carefully the evidence supporting the decision that each medical intervention did more good than harm; he cited numerous examples to the contrary. For example, he showed that the consumption of Vitamin B-12 in Britain was something like 8 or 9 times the amount required to treat all the cases in that country of pernicious anemia, for which it is specific. The rest of its use was just acting as an expensive placebo. Cochrane quoted one observer of the passing scene who commented that the health services reminded him of a crematorium: so much went in and so little came out! I was most impressed with Cochrane's little volume; it was a pithy presentation of some extremely important concepts bearing on medical practice. In 1959 I had met Gordon McLachlan, the Secretary, as he was called although he was really the president of the Nuffield Provincial Hospitals Trust. McLachlan had commissioned and published Cochrane's little treatise. I arranged with Gordon to get about 200 (it may have been considerably more) copies of Effectiveness and Efficiency for free distribution at the 1974 meeting of the Institute of Medicine. And that's how we launched Archie Cochrane in this country, I think, and many aspects of the now burgeoning concern for the quality of medical care. In the early 1990s Iain Chalmers and his colleagues in Oxford established what is known as the Cochrane Collaboration. There are now units around the world that search the medical literature for articles describing clinical trials to see what forms of intervention are supported by evidence that in fact they are more efficacious than others. They are building up enormous data bases and starting to have a huge impact on the practice of medicine. I had suggested to Iain Chalmers initially that they should do like McDonald's and franchise the Cochrane Collaborating Centers all over the world, and that's essentially what they've done. So that's the global Cochrane Collaboration. Professor Kay Dickerson at the University of Maryland is the key anchor point in this country.
Some of them I knew quite well.
KING: How is death performed in Arkansas?
ECHOLS: Lethal injection.
KING: When they were killed, would every other inmate know the night that was going to happen?
And finally make a few remarks on accuracy of the transcripts and audio Open up a file, start the recording again and as you come to your .Writing interview transcript dissertation.
A transcript of an interview is usually in Q A (question and answer) How to write a transcript.I have transcribed 3 (plus 3 'pilot interviews' to practice technique, coding, etc).
CliCK GO transcribing interviews for dissertation SLG Transcribing has been providing transcription services to businesses, educational institutions and individuals.
White: No. At McGill we had a former health officer from Ontario who was the professor of preventive medicine and public health. He gave a series of dismal lectures on how dig a pit privy and how to can tomatoes so you wouldn't get botulism and other dreary subjects. I thought there must be more to this aspect of medicine than this guy was able to set forth. In fact I went to see him a couple of times and said, "What about this public health business?" and he said, "Well, it's so-and-so." He was a most uninspiring character. I took a pledge at that time that I wouldn't have much to do with public health as practiced by these kinds of guys. So the short answer is no, I didn't entertain the idea of an MPH. I did entertain the idea of spending the year with Ryle in his new Institute of Social Medicine at Oxford had it been feasible, but as I mentioned earlier he died unexpectedly.
Sorry for the late response, but I just noticed your handy transcription guide here. I wanted to say thanks for mentioning InqScribe! We always enjoy seeing how people put our software to use, especially in education. You mentioned an “education discount pricing,” and I’ll just clarify that, if you choose to buy InqScribe, we offer a 60% discount to students as well as a 30% discount to anyone working in academia.
White: I'm not sure of that history. I don't know how many state universities had medical schools. California must have had some, but I just don't know.
Overall, digital recording and transcribing interviews is mostly a matter of logistics. The more challenging intellectual work is to analyze interviews as an historian or qualitative social scientist. Ask your instructor for guidance, or read my essays that illustrate these concepts, such as:
White: It was Louis Block and his boss, Jack Haldeman, of the U.S. Public Health Service who initiated the idea. Block, I think, had been a hospital consultant and he spoke to Fogarty and/or Hill and got them to put the funds into the Hill-Burton appropriation. To the best of my knowledge that was the initial money for the field that eventually became known as Health Services Research. I had been doing cardiovascular research and was interested in the effect of emotions on cardiovascular disease, particularly on cardiac failure. We had done a number of laboratory studies, extensive interviews with patients, and population-based surveys. In fact our first grant submission got turned down by the NIH Cardiovascular Study Section. The National Heart Council under Tinsley Harrison, the author of one of the major text books on medicine, decided that my ideas were not all that crazy. He came down to Chapel Hill leading a site visit group himself. From his clinical experience he thought I was on to something. Our findings that emotional distress can play a major role in precipitating cardiac failure has later been confirmed by other studies. We got the grant to do laboratory work on the effects of emotions on venous and heart function. We gave a paper at an annual meeting of the American Heart Association that attracted considerable attention. The story was published in numerous newspapers across the country and in Time. A TV story received widespread airing but I never saw it. My interest in cardiac failure was not restricted to the laboratory or the bedside; it included the question: "Is this a big problem or a little problem in the population generally?" There was very little data available. I couldn't find any statistics on it because at that time it was not readily classified in the International Classification of Diseases (ICD). One of the students from the School of Public Health, Michel Ibrahim, who is now the Dean of the School of Public Health at Chapel Hill, did his doctoral dissertation with me. We did an epidemiological population-based study that was published in the Annals of Internal Medicine in which we showed the distribution of cardiac failure in the entire population for the first time. We found that one percent of the population suffers from it at any given time and that ten percent of those over 65 years of age are experiencing it. When I went to Vermont, we repeated the study and found the same kinds of distributions. Those studies, the first of their kind, were incorporated in Michael DeBakey's landmark report on Heart Disease, Stroke, and Cancer back in the 1960s. By studying this problem in the laboratory, the clinic or bedside, and the population I think we showed that all three approaches can be useful in understanding the genesis, natural history, and distribution of health problems.