The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)

Though many argue over root causes, few dispute the existence of gender disparities across our societal landscape. Patriarchal norms consistently obstruct the flourishing of those who identify themselves as women, those who are identified by others as women, and generally those who gender-identify in ways that challenge the norms of heterosexual cis-gender male privilege. Acknowledging the limits of our analysis, here we focus on some of the disparities faced by women in particular.1 From the persistent wage gap despite women's steadily (...) increasing participation in the workforce, to the perplexing paucity of women occupying C-suite positions in business or tenured professorships in academia despite efforts to... (shrink)