Pub Date : 2021-05-01DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4087
B. Jakubowski, R. Mehta
A 72-year-old man presented to our emergency room for evaluation of fevers, chills, and myalgias for twelve weeks. He also reported a history of chronic productive cough and chest tightness. Two weeks prior to presentation, he was working at the local international airport in March of 2020 when he noticed increasing dyspnea with exertion whilst performing routine tasks at his job. At the time of our interview, he denied sick contacts and no known history of tuberculosis exposure. He also reported a remote history of working as a stone cutter in concrete mines in Honduras. A chest x-ray was performed and demonstrated bilateral mass-like upper lobe opacities that were present on imaging two years prior. Computed tomography of the chest (figure 1) revealed volume loss and mass-like perihilar upper lobe predominant opacities with fibro-retractile architectural distortion, peribronchovascular and centrilobular nodules, and scattered areas of patchy ground-glass opacification with bibasilar predominance. His fibrotic changes were thought to be consistent with silicosis with progressive massive fibrosis secondary to prior inorganic dust inhalation. A superimposed process underpinning his acute presentation was suspected given the findings of patchy ground-glass opacities. A SARS-CoV-2 PCR test was obtained and was positive. Given several months of symptoms preceding this acute presentation, a third process was suspected, especially in light of his immigration history and centrilobular nodular pattern on imaging. An interferon gamma release assay for tuberculosis, mycobacterium tuberculosis PCR and mycobacterial cultures from expectorated sputum were obtained, all with positive results. He was discharged with a standard regimen of Rifampin, Isoniazid, Pyrazinamide, and Ethambutol with follow-up with the health department at which point he had recovered from his acute illness. He did remarkably well in regards to his COVID-19 diagnosis. He did not receive any COVID specific therapies given his active diagnosis of TB and was discharged home on room air. Silicosis is a well-known predisposing factor to development of tuberculosis, thought to arise from silica particulate macrophage dysfunction. A combination of immune dysfunction related to silicosis and occupational exposure likely led to development of viral pneumonia in this patient. His occupation at a large international airport in March 2020 prior to the institution of quarantine and travel restrictions uniquely put him at risk for both TB and COVID-19 pneumonia, which is nicely demonstrated with these classic CT findings.
{"title":"A Unique Case of COVID Pneumonia, Tuberculosis, and Silicosis","authors":"B. Jakubowski, R. Mehta","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4087","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4087","url":null,"abstract":"A 72-year-old man presented to our emergency room for evaluation of fevers, chills, and myalgias for twelve weeks. He also reported a history of chronic productive cough and chest tightness. Two weeks prior to presentation, he was working at the local international airport in March of 2020 when he noticed increasing dyspnea with exertion whilst performing routine tasks at his job. At the time of our interview, he denied sick contacts and no known history of tuberculosis exposure. He also reported a remote history of working as a stone cutter in concrete mines in Honduras. A chest x-ray was performed and demonstrated bilateral mass-like upper lobe opacities that were present on imaging two years prior. Computed tomography of the chest (figure 1) revealed volume loss and mass-like perihilar upper lobe predominant opacities with fibro-retractile architectural distortion, peribronchovascular and centrilobular nodules, and scattered areas of patchy ground-glass opacification with bibasilar predominance. His fibrotic changes were thought to be consistent with silicosis with progressive massive fibrosis secondary to prior inorganic dust inhalation. A superimposed process underpinning his acute presentation was suspected given the findings of patchy ground-glass opacities. A SARS-CoV-2 PCR test was obtained and was positive. Given several months of symptoms preceding this acute presentation, a third process was suspected, especially in light of his immigration history and centrilobular nodular pattern on imaging. An interferon gamma release assay for tuberculosis, mycobacterium tuberculosis PCR and mycobacterial cultures from expectorated sputum were obtained, all with positive results. He was discharged with a standard regimen of Rifampin, Isoniazid, Pyrazinamide, and Ethambutol with follow-up with the health department at which point he had recovered from his acute illness. He did remarkably well in regards to his COVID-19 diagnosis. He did not receive any COVID specific therapies given his active diagnosis of TB and was discharged home on room air. Silicosis is a well-known predisposing factor to development of tuberculosis, thought to arise from silica particulate macrophage dysfunction. A combination of immune dysfunction related to silicosis and occupational exposure likely led to development of viral pneumonia in this patient. His occupation at a large international airport in March 2020 prior to the institution of quarantine and travel restrictions uniquely put him at risk for both TB and COVID-19 pneumonia, which is nicely demonstrated with these classic CT findings.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85007083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4094
Z. Muzaffarr
Introduction The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has been linked with many sequelae not typical of other respiratory viruses. One of the unique features of this virus, known as COVID coagulopathy, has been associated with bleeding and/or clotting diathesis in the setting of a prothrombotic state. This has put patients at risk for hemorrhagic complications such as frank disseminated intravascular coagulation, and antiphospholipid syndrome activation. This is a case of hemothorax as a rare complication of COVID-19 infection. Case Presentation This is the case of a 48 year old male with a history of ESRD requiring dialysis, who presented to our facility with shortness of breath. He was recently admitted a month prior to an outside facility for a dialysis catheter infection and was found to be COVID-19 positive. He received IV antibiotics and supplemental oxygen. He was discharged home with plans for IV antibiotics. He presented to our facility with five days of shortness of breath. In the ED he was afebrile, tachypneic and tested negative for COVID-19. Computed Tomography of the chest was significant for a moderate to large right pleural effusion with loculated components. The next day he underwent a thoracentesis and 600 cc of bloody pleural fluid was aspirated. He then underwent a VATS, decortication, pleurodesis a few days later as the effusion failed to resolve. Cytology of the initial thoracentesis was negative for malignant cells and pathology from the VATS was positive for fibrosis, hemorrhage with fibrin deposition and acute and chronic inflammation. Discussion Hemothorax as a complication of COVID -19 has yet to be described in the literature. Altered markers such as D-dimer and fibrinogen were associated with increased coagulation and thrombotic complications respectively. Furthermore, studies have reported intra-alveolar hemorrhages and GI bleeding in post-mortem analysis of COVID patients. This case highlights the uniqueness of this novel virus and the vast array of complications that can result from infection.
{"title":"Hemothorax as Rare Complication from COVID-19 Infection","authors":"Z. Muzaffarr","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4094","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4094","url":null,"abstract":"Introduction The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has been linked with many sequelae not typical of other respiratory viruses. One of the unique features of this virus, known as COVID coagulopathy, has been associated with bleeding and/or clotting diathesis in the setting of a prothrombotic state. This has put patients at risk for hemorrhagic complications such as frank disseminated intravascular coagulation, and antiphospholipid syndrome activation. This is a case of hemothorax as a rare complication of COVID-19 infection. Case Presentation This is the case of a 48 year old male with a history of ESRD requiring dialysis, who presented to our facility with shortness of breath. He was recently admitted a month prior to an outside facility for a dialysis catheter infection and was found to be COVID-19 positive. He received IV antibiotics and supplemental oxygen. He was discharged home with plans for IV antibiotics. He presented to our facility with five days of shortness of breath. In the ED he was afebrile, tachypneic and tested negative for COVID-19. Computed Tomography of the chest was significant for a moderate to large right pleural effusion with loculated components. The next day he underwent a thoracentesis and 600 cc of bloody pleural fluid was aspirated. He then underwent a VATS, decortication, pleurodesis a few days later as the effusion failed to resolve. Cytology of the initial thoracentesis was negative for malignant cells and pathology from the VATS was positive for fibrosis, hemorrhage with fibrin deposition and acute and chronic inflammation. Discussion Hemothorax as a complication of COVID -19 has yet to be described in the literature. Altered markers such as D-dimer and fibrinogen were associated with increased coagulation and thrombotic complications respectively. Furthermore, studies have reported intra-alveolar hemorrhages and GI bleeding in post-mortem analysis of COVID patients. This case highlights the uniqueness of this novel virus and the vast array of complications that can result from infection.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91517592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4075
S. Haider, F. Shaikh, V. Rayasam, Dilpat Kumar, N. Helmstetter
A 71-year-old man with past medical history pertinent for chronic kidney disease stage III, hypertension, hyperlipidemia, atrial fibrillation (AF) on oral anticoagulation, and hypothyroidism presented with acute on chronic kidney disease (AoCKD), elevated transaminases and failure to thrive. COVID-19 polymerase chain reaction (PCR) was positive. Chest x-ray showed patchy bilateral airspace disease. Computed tomography (CT) of chest, abdomen, pelvis and magnetic resonance imaging (MRI) abdomen were unremarkable apart from Bilateral patchy infiltrates in the lungs. The patient did not require steroids and/or remdesivir as he was not hypoxic. He was discharged five days later on rivaroxaban. A week after discharge, he presented with worsening generalized weakness, worse in the lower extremities, culminating in a fall. On readmission, laboratory studies revealed rhabdomyolysis, AoCKD, and elevated transaminases. Additionally, a leukocytosis was present without symptoms concerning for infection. COVID-19 testing was repeated and was positive, with the remainder of the infectious workup including blood cultures being unremarkable. A repeat CT scan of chest, abdomen, pelvis with contrast demonstrated fat stranding around both adrenals concerning for infarction in the setting of COVID-19 infection (image 1). Subsequently, a morning cortisol was obtained, which was low concerning for adrenal insufficiency. This suspicion was confirmed with cosyntropin stimulation testing, which demonstrated adrenal insufficiency. He was started on hydrocortisone and fludrocortisone with improvement in symptoms over the next three days. Common causes of adrenal infarction and hemorrhage include thromboembolic disease, hypercoagulable states, HIT, physical trauma, the postoperative state, sepsis, and any cause of severe physiologic stress. We are still gaining insight into the multisystem disease manifestations of COVID-19 and its prothrombotic effects despite chronic oral anticoagulation therapy at prophylactic doses for other maladies like AF. Adrenal insufficiency due to infarction should be considered in patients who present with non-specific symptoms such as weakness, hypotension, electrolyte abnormalities, abdominal pain, nausea and/or vomiting in the setting of COVID-19 infection when other causes have been ruled out. Adrenal infarction has been reported in patients with COVID-19 infection, such as our patient. The adrenal glands are susceptible to infarction and hemorrhage due to their vascularity. It has been hypothesized that the hypercoagulable state wrought by SARS-CoV-2 viremia poses a particular risk to the adrenal microvasculature. In turn, reperfusion injury and hemorrhage can ensue due to anticoagulant therapy and secondary adrenal necrosis.
{"title":"Bilateral Adrenal Gland Infarction in the Setting of COVID-19 Infection","authors":"S. Haider, F. Shaikh, V. Rayasam, Dilpat Kumar, N. Helmstetter","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4075","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4075","url":null,"abstract":"A 71-year-old man with past medical history pertinent for chronic kidney disease stage III, hypertension, hyperlipidemia, atrial fibrillation (AF) on oral anticoagulation, and hypothyroidism presented with acute on chronic kidney disease (AoCKD), elevated transaminases and failure to thrive. COVID-19 polymerase chain reaction (PCR) was positive. Chest x-ray showed patchy bilateral airspace disease. Computed tomography (CT) of chest, abdomen, pelvis and magnetic resonance imaging (MRI) abdomen were unremarkable apart from Bilateral patchy infiltrates in the lungs. The patient did not require steroids and/or remdesivir as he was not hypoxic. He was discharged five days later on rivaroxaban. A week after discharge, he presented with worsening generalized weakness, worse in the lower extremities, culminating in a fall. On readmission, laboratory studies revealed rhabdomyolysis, AoCKD, and elevated transaminases. Additionally, a leukocytosis was present without symptoms concerning for infection. COVID-19 testing was repeated and was positive, with the remainder of the infectious workup including blood cultures being unremarkable. A repeat CT scan of chest, abdomen, pelvis with contrast demonstrated fat stranding around both adrenals concerning for infarction in the setting of COVID-19 infection (image 1). Subsequently, a morning cortisol was obtained, which was low concerning for adrenal insufficiency. This suspicion was confirmed with cosyntropin stimulation testing, which demonstrated adrenal insufficiency. He was started on hydrocortisone and fludrocortisone with improvement in symptoms over the next three days. Common causes of adrenal infarction and hemorrhage include thromboembolic disease, hypercoagulable states, HIT, physical trauma, the postoperative state, sepsis, and any cause of severe physiologic stress. We are still gaining insight into the multisystem disease manifestations of COVID-19 and its prothrombotic effects despite chronic oral anticoagulation therapy at prophylactic doses for other maladies like AF. Adrenal insufficiency due to infarction should be considered in patients who present with non-specific symptoms such as weakness, hypotension, electrolyte abnormalities, abdominal pain, nausea and/or vomiting in the setting of COVID-19 infection when other causes have been ruled out. Adrenal infarction has been reported in patients with COVID-19 infection, such as our patient. The adrenal glands are susceptible to infarction and hemorrhage due to their vascularity. It has been hypothesized that the hypercoagulable state wrought by SARS-CoV-2 viremia poses a particular risk to the adrenal microvasculature. In turn, reperfusion injury and hemorrhage can ensue due to anticoagulant therapy and secondary adrenal necrosis.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91304982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4085
A. Arjuna, M. Olson, C. Rogers, B. Buddhdev
Introduction: Coccidioides immitis and posadasii are dimorphic fungi endemic to the southwestern United States. Most immunocompetent hosts who contract coccidioidomycosis will clear the infection without symptoms. We detail the case of an immunocompetent, 56-year-old female who presented with symptoms of lower respiratory tract infection and concern for COVID-19 infection given significant exposure history. Case Description: The patient was referred to our advanced lung disease center (located in the southwestern United States) for subacute, productive cough associated with clear-yellow phlegm, dyspnea on exertion, infrequent night sweats, and abnormal chest x-ray (Figure A). The patient denied any history of fever, chills, hemoptysis, unintentional weight loss, or chest pain. Six-weeks prior to admission, the patient had significant exposure to multiple symptomatic persons with COVID-19. Two RT-PCR tests for COVID-19 to date were ruled negative, and a third test performed on admission was also negative. Computed tomography of the chest revealed right upper lobe cavitary consolidation with surrounding nodules bilaterally (Figure B). Sputum smear was negative for acid-fast bacillus or other bacterial organisms, prompting a bronchoscopy with bronchoalveolar lavage. Results demonstrated fungal cultures of Coccidioides immitis/posadasii. The patient also had significant IgG antibodies against Coccidioides species. She was started on therapeutic doses of fluconazole with a gradual improvement in symptoms. Discussion: History of significant exposure to COVID-19 warrants prompt and thorough investigation for disease status. Nonetheless, clinicians should still maintain a high suspicion and vigilance for excluding other, potentially treatable infectious etiologies, even regional endemic fungal infections that tend to manifest without symptoms.
{"title":"Coccidioidomycosis in an Immunocompetent Host During the COVID-19 Era","authors":"A. Arjuna, M. Olson, C. Rogers, B. Buddhdev","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4085","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4085","url":null,"abstract":"Introduction: Coccidioides immitis and posadasii are dimorphic fungi endemic to the southwestern United States. Most immunocompetent hosts who contract coccidioidomycosis will clear the infection without symptoms. We detail the case of an immunocompetent, 56-year-old female who presented with symptoms of lower respiratory tract infection and concern for COVID-19 infection given significant exposure history. Case Description: The patient was referred to our advanced lung disease center (located in the southwestern United States) for subacute, productive cough associated with clear-yellow phlegm, dyspnea on exertion, infrequent night sweats, and abnormal chest x-ray (Figure A). The patient denied any history of fever, chills, hemoptysis, unintentional weight loss, or chest pain. Six-weeks prior to admission, the patient had significant exposure to multiple symptomatic persons with COVID-19. Two RT-PCR tests for COVID-19 to date were ruled negative, and a third test performed on admission was also negative. Computed tomography of the chest revealed right upper lobe cavitary consolidation with surrounding nodules bilaterally (Figure B). Sputum smear was negative for acid-fast bacillus or other bacterial organisms, prompting a bronchoscopy with bronchoalveolar lavage. Results demonstrated fungal cultures of Coccidioides immitis/posadasii. The patient also had significant IgG antibodies against Coccidioides species. She was started on therapeutic doses of fluconazole with a gradual improvement in symptoms. Discussion: History of significant exposure to COVID-19 warrants prompt and thorough investigation for disease status. Nonetheless, clinicians should still maintain a high suspicion and vigilance for excluding other, potentially treatable infectious etiologies, even regional endemic fungal infections that tend to manifest without symptoms.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81966593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0001
Alison Piepmeier, George Estreich, R. Adams
When Alison Piepmeier finds out that her intentional pregnancy might result in a child with Down syndrome, she shares her anxiety with readers of her blog. With many of them assuring her that she’ll probably not have a baby with a disability, Alison looks elsewhere for reassurance. Three activists, who are also parents of children with Down syndrome, embody the evolution in popular thought about Down syndrome and other conditions. Emily Perl Kingsley, Cindi May, and Stephanie Meredith experienced society’s evolving view of disability with their children. Each woman has worked toward presenting disability as part of the diversity of human beings. With time, Alison learns that her daughter, Maybelle, need not attain cultural definitions of normal and that Maybelle’s valued personhood demands broader societal recognition.
{"title":"“I Wouldn’t Change You If I Could”","authors":"Alison Piepmeier, George Estreich, R. Adams","doi":"10.18574/nyu/9781479816637.003.0001","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0001","url":null,"abstract":"When Alison Piepmeier finds out that her intentional pregnancy might result in a child with Down syndrome, she shares her anxiety with readers of her blog. With many of them assuring her that she’ll probably not have a baby with a disability, Alison looks elsewhere for reassurance. Three activists, who are also parents of children with Down syndrome, embody the evolution in popular thought about Down syndrome and other conditions. Emily Perl Kingsley, Cindi May, and Stephanie Meredith experienced society’s evolving view of disability with their children. Each woman has worked toward presenting disability as part of the diversity of human beings. With time, Alison learns that her daughter, Maybelle, need not attain cultural definitions of normal and that Maybelle’s valued personhood demands broader societal recognition.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83207916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0006
R. Adams
Rachel Adams uses a question-and-answer format to extend the conversations she has had with her friend and colleague Alison Piepmeier and to imagine which issues Alison might have tackled, had her friend lived beyond 2016. Rachel believes that Alison would have been wary of such developments in genomics as the commercialization of prenatal genetic tests, direct-to-consumer genetic services, and the gene-editing technology CRISPR-Cas9. She discusses Alison’s likely concerns about how genetic technology can influence society’s perception of disability, identity, and social justice. Rachel considers Alison’s response to conservatives’ continued use of disability to curtail women’s reproductive freedom today. The chapter also describes Alison’s likely concern that the #MeToo movement has overlooked people with disabilities. Rachel assumes that as Maybelle, Alison’s daughter, grows older, Alison’s own experience with a teenager and then an adult would have propelled her toward further examining such issues as sexuality, employment, and independence for people with intellectual disabilities. Finally, Rachel asks whether Alison would have had more to say about the differences between disability and illness and how much Down syndrome can represent other disabilities and how much it is simply one unique characteristic of some people.
{"title":"Six Questions on the Special, the Inclusive, and the Universal","authors":"R. Adams","doi":"10.18574/nyu/9781479816637.003.0006","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0006","url":null,"abstract":"Rachel Adams uses a question-and-answer format to extend the conversations she has had with her friend and colleague Alison Piepmeier and to imagine which issues Alison might have tackled, had her friend lived beyond 2016. Rachel believes that Alison would have been wary of such developments in genomics as the commercialization of prenatal genetic tests, direct-to-consumer genetic services, and the gene-editing technology CRISPR-Cas9. She discusses Alison’s likely concerns about how genetic technology can influence society’s perception of disability, identity, and social justice. Rachel considers Alison’s response to conservatives’ continued use of disability to curtail women’s reproductive freedom today. The chapter also describes Alison’s likely concern that the #MeToo movement has overlooked people with disabilities. Rachel assumes that as Maybelle, Alison’s daughter, grows older, Alison’s own experience with a teenager and then an adult would have propelled her toward further examining such issues as sexuality, employment, and independence for people with intellectual disabilities. Finally, Rachel asks whether Alison would have had more to say about the differences between disability and illness and how much Down syndrome can represent other disabilities and how much it is simply one unique characteristic of some people.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74396578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0005
George Estreich
Though Alison Piepmeier was best known as a feminist literary critic with a strong focus on disability, academic writing was insufficient to her range, creativity, and questing mind. Her informal writing—op-eds, articles, blogs—displayed something else, an essayist’s skill with metaphor and narrative, a taste for stylistic experiment, and a drive to connect with readers outside the academy. This writing reached its peak in Alison’s blog Every Little Thing, which ran from 2013 to 2016 and in which she dealt with the core topics of this book: disability, illness, and motherhood. In this chapter, George Estreich looks at the blog and follows its transformation as Alison herself is transformed by her evolving serious health issues.
虽然Alison Piepmeier是一位女权主义文学评论家，她非常关注残疾人，但学术写作对她的视野、创造力和探索精神来说是不够的。她的非正式写作——专栏、文章、博客——展示了另一种东西，一个散文家运用隐喻和叙事的技巧，对风格实验的品味，以及与学院以外的读者建立联系的动力。从2013年到2016年，艾莉森的博客《每一件小事》(Every Little Thing)达到了她写作的顶峰，她在博客中讨论了本书的核心主题:残疾、疾病和母亲。在这一章中，乔治·埃斯特赖希(George Estreich)审视了这个博客，并跟随它的转变，就像艾莉森自己被不断发展的严重健康问题所改变一样。
{"title":"Accessible Words","authors":"George Estreich","doi":"10.18574/nyu/9781479816637.003.0005","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0005","url":null,"abstract":"Though Alison Piepmeier was best known as a feminist literary critic with a strong focus on disability, academic writing was insufficient to her range, creativity, and questing mind. Her informal writing—op-eds, articles, blogs—displayed something else, an essayist’s skill with metaphor and narrative, a taste for stylistic experiment, and a drive to connect with readers outside the academy. This writing reached its peak in Alison’s blog Every Little Thing, which ran from 2013 to 2016 and in which she dealt with the core topics of this book: disability, illness, and motherhood. In this chapter, George Estreich looks at the blog and follows its transformation as Alison herself is transformed by her evolving serious health issues.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85380352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0003
Alison Piepmeier, George Estreich, R. Adams
In this chapter, Alison Piepmeier describes how eating at a table can figuratively and literally show the barriers people with disability face in trying to connect with a larger community. She interviews adults with Down syndrome and parents of children with Down syndrome to learn how some people are included in, or excluded from, social gatherings like family meals, children’s parties, school activities, and organizational meetings. Alison recalls disability rights activist Harriet McBryde Johnson’s fight for accommodation and Johnson’s interaction with a professor whose views on euthanasia are criticized as being ableist. Being invited to sit at a table—be it a dinner party among friends or an organization’s luncheon—means accepting a person’s value as fully human. Alison points out that even some well-intentioned groups forget the importance of inclusion. She quotes disability advocacy leader Nancy Brown’s observation “We segregate those we don’t value.”
{"title":"The Welcome Table","authors":"Alison Piepmeier, George Estreich, R. Adams","doi":"10.18574/nyu/9781479816637.003.0003","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0003","url":null,"abstract":"In this chapter, Alison Piepmeier describes how eating at a table can figuratively and literally show the barriers people with disability face in trying to connect with a larger community. She interviews adults with Down syndrome and parents of children with Down syndrome to learn how some people are included in, or excluded from, social gatherings like family meals, children’s parties, school activities, and organizational meetings. Alison recalls disability rights activist Harriet McBryde Johnson’s fight for accommodation and Johnson’s interaction with a professor whose views on euthanasia are criticized as being ableist. Being invited to sit at a table—be it a dinner party among friends or an organization’s luncheon—means accepting a person’s value as fully human. Alison points out that even some well-intentioned groups forget the importance of inclusion. She quotes disability advocacy leader Nancy Brown’s observation “We segregate those we don’t value.”","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72858366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0004
Alison Piepmeier, George Estreich, R. Adams
This chapter examines a complicated genre: the memoir written by a parent of a child with a disability. Despite the formulaic presentation of these narratives as a triumph over adversity, Alison Piepmeier describes many of them as sites of dehumanization. Parental memoirs often overly focus on grief or a medicalized picture of disability. They can reinforce familiar, deeply troubling attitudes about people with disabilities as tragic, burdensome, and unworthy. At the same time, Alison shows that parental memoirs can serve an activist function, acting as sites of resistance, challenging misinformation, and reworking prevailing perceptions of disability.
{"title":"Saints, Sages, and Victims","authors":"Alison Piepmeier, George Estreich, R. Adams","doi":"10.18574/nyu/9781479816637.003.0004","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0004","url":null,"abstract":"This chapter examines a complicated genre: the memoir written by a parent of a child with a disability. Despite the formulaic presentation of these narratives as a triumph over adversity, Alison Piepmeier describes many of them as sites of dehumanization. Parental memoirs often overly focus on grief or a medicalized picture of disability. They can reinforce familiar, deeply troubling attitudes about people with disabilities as tragic, burdensome, and unworthy. At the same time, Alison shows that parental memoirs can serve an activist function, acting as sites of resistance, challenging misinformation, and reworking prevailing perceptions of disability.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73548886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-23DOI: 10.18574/nyu/9781479816637.003.0002
Alison Piepmeier, George Estreich, R. Adams
This chapter examines the limitations of feminist discussions about disability and reproduction. Feminism and disability rights often hold different places in reproductive justice discussions. Feminism often oversimplifies the idea of reproductive choice, focusing on individual women and endorsing cultural stereotypes of disability. As a counterpoint to the scholarly literature of these issues, Alison Piepmeier interviewed twenty-nine parents of children with Down syndrome, asking them about their pregnancy, prenatal testing, and their families. The responses of these parents illustrate how families need more support than just individual rights to raise a child with a disability. Although reproductive decisions may rest on an individual woman, she must also consider community support and health services in her decision to raise a child, particularly one with a disability.
{"title":"The Inadequacy of “Choice”","authors":"Alison Piepmeier, George Estreich, R. Adams","doi":"10.18574/nyu/9781479816637.003.0002","DOIUrl":"https://doi.org/10.18574/nyu/9781479816637.003.0002","url":null,"abstract":"This chapter examines the limitations of feminist discussions about disability and reproduction. Feminism and disability rights often hold different places in reproductive justice discussions. Feminism often oversimplifies the idea of reproductive choice, focusing on individual women and endorsing cultural stereotypes of disability. As a counterpoint to the scholarly literature of these issues, Alison Piepmeier interviewed twenty-nine parents of children with Down syndrome, asking them about their pregnancy, prenatal testing, and their families. The responses of these parents illustrate how families need more support than just individual rights to raise a child with a disability. Although reproductive decisions may rest on an individual woman, she must also consider community support and health services in her decision to raise a child, particularly one with a disability.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89082330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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