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Record W344823094

Room for a view: Birth chasm

2002· article· en· W344823094 on OpenAlexvenueno aff
Richard Gruneir

Bibliographic record

VenueCanadian Medical Association Journal · 2002
Typearticle
Languageen
FieldHealth Professions
TopicChild and Adolescent Health
Canadian institutionsnot available
Fundersnot available
KeywordsAsideMedicineChildbirthPsychologyPregnancyLinguisticsPhilosophy
DOInot available

Abstract

fetched live from OpenAlex

My patient is from a developing country. She speaks no English, and I do not speak her language. We communicate through her husband and the female friends who sometimes accompany her. It is clear that the translation is imperfect. It is hard for it to be otherwise: we have completely different sets of cultural norms to work with. My patient will not allow herself to be seen undressed by a male physician, even with her husband and a female chaperone in the room. She does not allow a pelvic exam. She experiences everything as a maximal stimulus. Every ache and pain, even every fetal movement in the first months, prompts an office visit without appointment. She complains of these problems to her husband, who responds by bringing her to me. Yet vaginal bleeding at 17 weeks, which generates genuine fear in her husband, is brushed aside as unimportant when she is told it necessitates a vaginal exam. She does not convey to me where her worries come from. Any form of questioning that I pursue through her husband, who appears genuine, concerned and, most important, unimposing, is generally met with a shrug. He asks good questions. But they seem to come from him, not from her. I get the distinct impression that she is relying on other women for the real lowdown on being pregnant and what to expect in childbirth. I don't know what she knows and I have no way of finding out. At 23 weeks she delivers a stillborn child. This tragedy has a history: bad endometriosis with surgery twice in her native country, attendant relative infertility and late maternal age. Compounding her grief is the fact that this was a son, a highly desirable first child in her culture. She grieves in a way I don't understand. I am sure that my empathy and concern do not survive the translation. I hate the fact that I sound clinical with my explanations and discharge instructions, even to myself. I can find no way to reach her across the chasm that divides us. Richard Gruneir Obstetrician-gynecologist Leamington, Ont.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.024
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.059
Threshold uncertainty score0.197

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.024
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.000
Science and technology studies0.0120.004
Scholarly communication0.0050.006
Open science0.0020.009
Research integrity0.0060.020
Insufficient payload (model declined to judge)0.0590.011

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.034
GPT teacher head0.345
Teacher spread0.312 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2002
Admission routes1
Has abstractyes

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