document_title: The Good Doctor (TV series)

question_text: when does new episode of the good doctor come out

text: The Good Doctor (TV series)

text: Premise[edit]

text: The series follows Shaun Murphy, a young surgeon with autism and savant syndrome from the mid-size city of Casper, Wyoming, where he had a troubled childhood. He relocates to San Jose, California, to work at the prestigious San Jose St. Bonaventure Hospital.[2]

text: Cast and characters[edit]

text: Main[edit]

text:
Freddie Highmore as Shaun Murphy: A surgical resident with autism and savant syndrome.[3] His savant abilities include near-photographic recall and the ability to note minute details and changes. He is portrayed in flashbacks to his teen years by Graham Verchere.[4]
Nicholas Gonzalez as Neil Melendez: Attending Cardiothoracic surgeon in charge of surgical residents.[3] He was also engaged to Jessica Preston, until season 1 episode 12.
Antonia Thomas as Claire Browne: A surgical resident who forms a special connection with Shaun.[5]
Chuku Modu as Jared Kalu: A surgical resident from a wealthy family.[6]
Beau Garrett as Jessica Preston: The hospital in-house attorney and Vice President of Risk Management. She is the granddaughter of the hospital founder and a friend of Dr. Glassman.[7]
Irene Keng as Elle McLean: A resident (appeared only in the pilot)[8][9]
Hill Harper as Marcus Andrews: Chief of surgery and board member.[8]
Richard Schiff as Aaron Glassman: President of the San Jose St. Bonaventure Hospital, who has been a mentor and good friend of Shaun since he was 14.[10][11]
Tamlyn Tomita as Allegra Aoki: Chairman and Vice President of the foundation that controls the hospital.[12]

text: Recurring[edit]

text:
Dylan Kingwell as Steve Murphy: Shaun's younger brother (in flashbacks).[4] He also portrays Evan Gallico, a boy in the present that resembles Shaun's brother and is suffering from stage 4 Osteosarcoma.
Paige Spara as Lea: Shaun's love interest/ former neighbor.
Eric Winter as Matt Coyle: A suave doctor who charms the hospital's staff, until he makes explicit advances towards one of them.[13]
Christina Chang as Dr. Audrey Lim
Marsha Thomason as Dr. Isabel Barnes:[14] Marcus' wife.[15]
Fiona Gubelmann as Morgan Reznick: A new resident who joins the cast for five episodes with the possibility of becoming a regular in Season 2.[16] As a resident, Morgan will turn out to be a rival for Shaun. She debuted in "She".[17]
Will Yun Lee as Adam Park: An ex-cop who decided to become a doctor in a multi-episode arc beginning in February[18]

text: Notable guests[edit]

text:
Jasika Nicole as Carly[19]
Eve Gordon as Nurse Fryday[19]
Chris D'Elia as Kenny, Shaun's new neighbor, who moves into Lea's apartment.
Graham Patrick Martin as Blake[20]

text: Episodes[edit]

text:
No.
Title
Directed by
Written by
Original air date
U.S. viewers
(millions)

1
"Burnt Food"
Seth Gordon
David Shore
September 25, 2017 (2017-09-25)
11.22[21]

On the way to begin his surgical residency at San Jose St. Bonaventure Hospital, Dr. Shaun Murphy witnesses an airport sign fall and shatter glass onto a young boy. Another doctor is first on the scene and begins applying pressure to the child's neck. Shaun tells him that he's pressing on the wrong part of the neck for a child. With his unique ability to visualize the internal body and using improvised methods and tools, Shaun is able to stabilize the boy. On the way to the hospital, Shaun notices that the boy's vitals have changed. Hospital staff are alerted to the arrival of the boy. Shaun tries to tell the doctors about the boy's vitals, stating that he needs an echo-cardiogram. The doctors disagree and begin surgery. While operating, something goes wrong and Claire Browne, a surgical resident, recalls Shaun mentioning an echo. Thanks to Shaun's diagnosis, the boy's life is saved. Meanwhile, in a hospital board meeting, Dr. Aaron Glassman, president of the hospital, tries to convince the board to hire Shaun, despite his autism. Flashbacks give us a picture of Shaun's childhood and his motivation for becoming a doctor.

2
"Mount Rushmore"
Mike Listo
David Shore
October 2, 2017 (2017-10-02)
10.93[22]

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Dr. Melendez is doing rounds with Dr. Browne and Dr. Kalu. Melendez calls out Shaun for arriving late on his first full day. A middle aged woman is brought into the ER with abdominal pain. Shaun immediately diagnoses a malignant tumor. Melendez assigns Browne as his number two for the surgery while giving Shaun "scut work" - all the work that residents hate doing. On the operating table, the doctors find the tumor is much bigger than expected and has encased all of her arteries. Looking at biopsy results, the residents find out that she is suffering from leiomyosarcoma, making surgery seemingly impossible. Shaun's ability to visualize the internal organs allows him to figure out that removing one of her kidneys would allow a better look, enough to view and possibly remove the mass. To Browne's dismay, Kalu suggests Shaun's idea to Melendez, getting the credit for the idea. Meanwhile, Shaun's attention to detail in his scut work gets him into trouble. Instead of releasing patients ready for discharge, Shaun rechecks them and orders additional tests. Upon learning this, Melendez assigns Nurse Freydey as Shaun's "boss" for the day. Later, after rechecking a discharged young girl's test results, Shaun races to her home. The parents are annoyed that he's bothering them after midnight and at first refuse to let him in. Shaun insists he will not leave before seeing their daughter. His diagnosis is correct and they must rush her to the hospital for surgery to save her life.

3
"Oliver"
John Dahl
William Rotko
October 9, 2017 (2017-10-09)
10.69[23]

Shaun and Claire fly to San Francisco Municipal Hospital to get a liver for a transplant patient. They can't fly back due to fog and are forced to use a police escort. Several problems arise. First, the liver's temperature rises to near the allowed maximum, forcing them to stop at a local store to cool it by submerging it in slushie. As they proceed with their journey, Shaun discovers that the liver has a clot. With only two hours of viability left, the duo decides to perform an operation en route in order to remove the clot and flush the left lobe, protecting it from the ice bath. Back at San Jose St. Bonaventure Hospital, Chuck, the recipient of the liver, is discovered to have alcohol in his system, a development that could move him to the bottom of the list. Chuck later confesses that he actually took a drink at his daughter's graduation. In order to protect its reputation and its future patients, the hospital decides to deny Chuck the liver. To their dismay, Shaun and Claire arrive back, only to find out that the liver has to be taken to another patient at another hospital.

4
"Pipes"
Steven DePaul
Thomas L. Moran
October 16, 2017 (2017-10-16)
10.60[24]

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Barb Allen, 22 weeks pregnant, and her husband, Mark, come to St. Bonaventure hoping that doctors can save her baby. A large non-cancerous tumor is growing so close to the fetus that for the baby to survive it must be removed. After an ultrasound, she hears from Dr. Melendez the same thing she’s heard from two other second opinions. The safest thing to do is terminate the pregnancy. Due to a medical condition that leaves her susceptible to clots, she risks having a heart attack during surgery. Barb says she’ll do anything to save the baby. Shaun interrupts offering a way to control the clotting factor pre-operatively. His suggestion is considered and surgery is scheduled. However, Melendez is angry that Shaun contradicted him in front of a patient. Complications arise when the husband changes his mind about the surgery. After a meeting with legal staff and the board, the surgery is rescheduled. However, during the procedure Barb suffers a heart attack, causing the surgery to be aborted. In recovery, Melendez explains that the baby is fine. She insists on trying the operation again. Ultimately Jared suggests stopping her heart and putting her on life support reducing the risk of a second heart attack. Surgery is successful for both mother and baby. Meanwhile, Dr. Melendez assigns Shaun and Claire case, as a punishment, to lance a boil for a patient of Dr. Andrews. 18 year old Olivia is experiencing severe pain in her genital area. After an examination, the “boil” turns out to be an abscess needing drainage. Olivia admits to being tested every month for STD's since she does pornography for a living. During the routine procedure to drain the abscess, they discover fibroid tumor wrapped around the nerve in the genital area. Surgery will mean losing feeling in her genitalia. As Dr. Andrews and Claire discuss the surgery with Olivia, Shaun rushes in with an alternative method to reconnect the vessels in a way that would leave her with no feeling in her thigh instead of her genital area. She agrees to it and the operation is successful.

5
"Point Three Percent"
Larry Teng
David Hoselton
October 23, 2017 (2017-10-23)
10.39[25]

Shaun notices a young boy with an indubitable resemblance to his deceased brother Steve, forming a bond with him. The boy's name is actually Evan and was brought to the hospital by his parents for reportedly breaking an arm; unbeknownst to Evan, he is in fact suffering from stage 4 Osteosarcoma. Shaun later suspects that he might have been misdiagnosed with cancer but indeed was suffering from Langerhans cell histiocytosis. In order not to give both Evan and his parents false hopes, Shaun decides to lie, attempting to perform a bone marrow aspiration, but he is caught red-handed by the parents. Subsequently, Evan starts coughing out blood, sending him to the OR. While on the operating table, Dr. Neil Menendez and Dr. Claire Browne discover that the cancer had metastasized, undoubtable proof that he is indeed suffering with terminal cancer. The other doctors are trying to find a prognosis of a 66-year old man, brought to the hospital by his estranged son, with an allergy causing him to have convulsions. Dr. Browne later finds out that the man is suffering from Echinococcus, a cyst form of tapeworms. Saddened by Evan's fate, which Evan has in fact known about the whole time, Shaun reads Evan the final few pages of To Kill a Mockingbird, a book of Steve's that he never finished reading before he died.

6
"Not Fake"
Michael Patrick Jann
Simran Baidwan
October 30, 2017 (2017-10-30)
10.60[26]

Shaun and the rest of the residents are working the graveyard shift when numerous casualties from a wedding bus crash come in. Among the victims are a woman with severe, visible burns, on whom Dr. Kalu tries an experimental procedure, and a young man with a damaged leg who can either have it amputated, or have an artificial bone inserted. The relative newness of the latter procedure causes a conflict between the man's parents and his soon-to-be bride.

7
"22 Steps"
David Straiton
Johanna Lee
November 13, 2017 (2017-11-13)
10.14[27]

Shaun encounters Liam, an autistic patient brought in to the hospital. Having to face prejudice from the young man's parents, Dr. Melendez defends him for the first time and acknowledges his exceptional abilities. On Dr. Glassman's directive, Claire continues her therapy sessions in order to curb her guilt over the death of a patient she inadvertently caused in the previous episode. On the other hand, Dr. Kalu gets a 73-year-old man with severe chest pains thus needing urgent medical attention and a pacemaker but his desire is to die; in order to give him hope on life, Dr. Kalu does everything he can to have him accept treatment, to no avail in which the latter finally lets him sign the DNR.

8
"Apple"
Nestor Carbonell
David Renaud
November 20, 2017 (2017-11-20)
9.97[28]

While shopping at a grocery mart for apples, a robbery takes place. With Shaun's communication limitations, he puts the lives of two customers on a first date at risk, leading to a young woman getting shot. Shaun's neighbor Lea hugs him after he admits that he made a mistake with someone getting hurt. During surgery, Dr. Lim questions Claire's ability to not let her emotions get the better of her because of a racist patient. This leads to an argument between the two with Dr. Lim ordering Claire to leave the operating room. Claire puts her emotions in check to save the life of the racist patient much to the satisfaction and delight of Dr. Lim.

9
"Intangibles"
Bronwen Hughes
Karen Struck
November 27, 2017 (2017-11-27)
9.25[29]

The team takes on the case of a young boy from the Congo who has severe congenital heart anomalies; Murphy's latest encounter with his neighbor Lea has him confused. He takes flirting lessons from Dr. Browne and notes and charts what he sees in regards to the "flirting trifecta". Meanwhile, Dr. Browne along with a lab tech search for a misplaced tissue sample from a woman with possible throat cancer.

10
"Sacrifice"
Michael Patrick Jann
Lloyd Gilyard Jr.
December 4, 2017 (2017-12-04)
9.03[30]

Shaun has reluctantly agreed to Dr. Glassman's repeated suggestions to meet with a therapist, but ultimately changes his mind after a new patient, Bobby Otto, convinces Shaun to stop letting people tell him what to do. At the end of the episode, a confrontation with Glassman in the hospital lobby leads to Shaun having a meltdown, causing him to strike Glassman in the face and run out of the hospital. Meanwhile, Claire runs into an uncomfortable situation with Dr. Matt Coyle, who makes unwanted sexual advances toward her during a patient consultation. Jared finds out and physically threatens him. As a result, Jared is fired. In later developments, after a tense dinner with Jessica, her father and Dr. Melendez, we learn that she doesn't want to have children.

11
"Islands Part One"
Bill D'Elia
Thomas L. Moran & William Rotko
January 8, 2018 (2018-01-08)
8.30[31]

Shaun and Lea embark on an impromptu road trip. Shaun drives, drinks Tequila, sings karaoke, all for the first time, and experiences his first kiss with Lea. He is devastated when Lea reveals that she plans to move to Hershey, Pennsylvania to work in her family's auto body shop. Melendez and Andrews operate on conjoined twins, one of which needs a kidney. Complications develop and the operation to separate them, planned for six months after the kidney surgery, must be done immediately. The operation goes well until it's discovered the twins have not awakened from the surgery. In an effort to get his job back, Jared apologizes to Coyle, who rejects the apology. Claire vows to ruin Coyle by finding all the other women he has harassed. Andrews calls Kalu the next day with the news that Coyle came forward, but while he's willing to give him a recommendation for other hospitals, he cannot overlook the physical assault, and will not reinstate him at St. Bonaventure. We also learn that Dr. Melendez decides it's more important to be with Jessica and that he can be a "father" in other ways.

12
"Islands Part Two"
Cherie Nowlan
Thomas L. Moran & William Rotko
January 15, 2018 (2018-01-15)
9.33[32]

Shaun returns to the hospital after his trip and gives Dr. Glassman his two weeks’ notice, intending on moving to Hershey to be with Lea. Glassman and Dr. Melendez give Murphy a recommendation, but Glassman promises to back off if Shaun stays. After a talk with Claire in which she says she will miss Shaun, he decides to stay and returns the letter to Glassman. Meanwhile, the twins suffer complications from their surgery; Katie is not getting enough blood flow to the brain, while Jenny’s heart is failing. Despite the doctors’ best efforts to save both twins, Jenny dies on the operating table. Jessica looks into previous misconduct at the hospital in which white doctors were only warned instead of fired, leading to allegations of racism by Kalu’s lawyer. Kalu gets his job back and is seen getting suited up for a shift at the hospital, but Dr. Andrews didn’t want him back as he felt using the racism card was setting them back. Finally, Jessica tells Melendez that she wants to break up because she feels like she is standing in his way of being a father.

13
"Seven Reasons"
Mike Listo
David Shore & David Hoselton
January 22, 2018 (2018-01-22)
9.61[33]

While treating a Muslim patient, Shaun senses she is lying, based on his seven reasons why people lie, and makes controversial claims. Melendez punctures the bronchus of the patient during surgery and is put under investigation after Shaun questions if his personal life is affecting his work. Jared comes to a conclusion that might explain the punctured bronchus and exonerate Melendez, while Shaun maintains his belief. In the end, Shaun's suspicion that the patient was exposed to explosive chemicals was confirmed, but for a different reason. While Claire assists in a surgery on a stroke patient, who had an aneurysm, with Dr. Lim, she learns that Coyle got a new job and a raise. They inform the patient's wife that he needs surgery or he will die. The wife refuses and Claire discovers that it is because the wife was abused and does not want her husband to survive. Claire forces her to agree to the surgery and convinces her to leave her husband. Claire meets with Kristen, another former co-worker and victim of Coyle. Finally, Shaun asks Glassman to be friends, but Glassman decides to give him his own space and not be friends, which upsets Shaun. Shaun meets his new neighbor.

14
"She"
Seth Gordon
Simran Baidwan
February 5, 2018 (2018-02-05)
9.63[34]

The four residents including the new Dr. Morgan Reznick are paired off in a competition with Reznick and Browne being paired with Melendez while Murphy and Kalu are paired up with Lim. It determines their futures at the hospital. Murphy and Kalu are faced with a gender dysphoric patient, Quinn, in which Shaun feels that people are the gender they were born with. Murphy and Kalu come to determine that Quinn has testicular cancer and find out that she has fragile bones due to being on puberty blockers. This leads to the discussion about whether or not she there should be unilateral or bilateral surgery to remove one or both testicles. The grandma accuses the parents of abuse by letting Quinn go through with the bilateral surgery, but the parents say it's their decision. While the head doctors and family are discussing whether or not to go through with the surgery, Quinn ends up with testicular torsion which requires emergency surgery. They decided to not go through with the bilateral surgery. Meanwhile, Browne and Reznick have a male patient that ended up with a superbug which is resistant to all drugs, because he took leftover drugs for the wrong purpose. The permanent damage means he needs a colostomy put in, but Claire does research on fecal microbiota transplant, which Melendez approves. With how Reznick acts, it leaves Claire feeling like she is only a team player when she needs to be. Finally, Dr. Andrews and Dr. Barnes see a fertility specialist as they want to have children. Andrews blames Barnes for waiting so long. The fertility doctor says that Andrews has a low sperm count and are referred to a urologist.

15
"Heartfelt"
Regina King
Thomas L. Moran & Johanna Lee
February 26, 2018 (2018-02-26)
7.82[35]

A female teen goes through a risky surgery to implant a sternum so she can live a normal life without being confined to her house as being in crowds, falling, or hugged could be fatal. A young male teen initially rejects the idea of having a convicted killer's liver transplanted in him, but without it he has a day to live. A former 15 year veteran cop turned doctor, Alex Park, is skeptical of the convict, Boris's, motives. After a failed attempt surgery due to Boris reacting to the anesthesia, he was ordered to stand up. Boris grabs a guard and his gun threatening to kill him. Park uses his police training to keep the situation under control all while telling him he has a choice to make. Boris kills himself so he can help the boy live. They take the body to the operating room to take organs from the dead convict. Allegra talks to Dr. Andrews about a young wealthy donor, Aidan Coulter, but Andrews says being involved with him might give people the wrong idea and that she used sex to get a big donation. Morgan tells Shaun that he needs to get an expensive tux for the black tie fundraiser in order for people to respect him. At the fundraiser, Jared tells Claire he loved her and thought maybe she would one day love him, but came to the realization that isn't true leaving the status of their relationship unknown.

16
"Pain"[36]
Allison Liddi-Brown
William L. Rotko & David Renaud
March 12, 2018 (2018-03-12)
TBD

17
"Smile"[37]
TBA
TBA
March 19, 2018 (2018-03-19)
TBD

18
"More"[20]
TBA
TBA
March 26, 2018 (2018-03-26)[37]
TBD

text: Production[edit]

text: Development[edit]

text: In May 2014, CBS Television Studios began development on an American remake of the hit South Korean medical drama Good Doctor with Daniel Dae Kim as producer. Kim explained the appeal of adapting the series as "something that can fit into a recognizable world, with a breadth of characters that can be explored in the long run".[38] The story of a pediatric surgeon with autism was to be set in Boston and projected to air in August 2015.[39][40] However, CBS did not pick up the project and it moved to Sony Pictures Television, with a put pilot commitment from ABC in October 2016. The series is developed by David Shore, who is executive producing alongside Kim, Sebastian Lee, and David Kim.[41] ABC officially ordered the series to pilot in January 2017.[42]

text: On May 11, 2017, ABC ordered the show to series as a co-production with Sony Pictures Television and ABC Studios,[43] and it was officially picked up for a full season of 18 episodes on October 3, 2017.[44]

text: Casting[edit]

text: On February 17, 2017, Antonia Thomas was cast as Dr. Claire Browne, a strong-willed and talented doctor who forms a special connection with Shaun.[5] A week later, Freddie Highmore was cast in the lead role as Dr. Shaun Murphy, a young surgeon with autism; and Nicholas Gonzalez was cast as Dr. Neil Melendez, the boss of the surgical residents at the hospital.[3] The next month, Chuku Modu was cast as resident Dr. Jared Kalu (originally Dr. Jared Unger);[6] Hill Harper as head of surgery Dr. Marcus Andrews (originally Dr. Horace Andrews); Irene Keng as resident Dr. Elle McLean;[8] and Richard Schiff was cast as Dr. Aaron Glassman (originally Dr. Ira Glassman), the hospital president and Shaun's mentor.[10][43] Schiff was shortly followed by Beau Garrett as hospital board member Jessica Preston and a friend of Dr. Glassman.[7] In September 2017, Tamlyn Tomita was promoted to the principal cast as Allegra Aoki.[12]

text: Filming[edit]

text: Production on the pilot took place from March 21 to April 6, 2017 in Vancouver, British Columbia.[46][47] Filming for the rest of the season began on July 26, 2017, and is set to conclude on March 1, 2018.[48]

text: Music[edit]

text: Dan Romer serves as the primary composer for the series.[49]

text: Release[edit]

text: Broadcast[edit]

text: The Good Doctor began airing on September 25, 2017, on ABC in the United States,[50] and on CTV in Canada.[51] Sky Living acquired the broadcast rights for the United Kingdom and Ireland.[52] Seven Network airs the series in Australia.[53] Wowow, the largest Japanese private satellite and pay-per-view television network in Japan acquired the rights to broadcast the series beginning in April 2018.[54] In the Netherlands, the series began airing on January 29, 2018, on RTL 4 and on video-on-demand service Videoland.[55]

text: Marketing[edit]

text: A full-length trailer was released for ABC's May 2017 Upfront presentation, which /Film's Ethan Anderton described the concept as feeling like "House meets Rain Man, that just might be enough to make it interesting". However, he questioned "how long can audiences be entranced by both the brilliance of [Highmore's] character's savant skills and the difficulties that come from his autism in the workplace."[56] Daniel Fienberg of The Hollywood Reporter felt the trailer was "both kinda progressive and really dated". He added, "Too much felt on-the-nose—especially Hill Harper as the main character's detractor and Richard Schiff as his noble defender", while also commentating that "On-the-nose/premise is how you have to trailer a show like this, and maybe spaced out over 43 minutes it won't grate."[57] Ben Travers and Steve Greene for IndieWire called it "a serious trailer for a serious subject. The first glimpse of Highmore's character hints that they're toeing the line between presenting a thoughtful depiction of his condition and using his perceptive abilities as a kind of secret weapon."[58] The trailer had been viewed over 25.4 million times after a week of its release, including over 22 million views on Facebook.[59]

text: The pilot was screened at ABC's PaleyFest event on September 9, 2017.[60] The Good Doctor is included in the 35th annual PaleyFest LA. Scheduled to appear on March 22, 2018 at 7:30 pm are members of the cast: Freddie Highmore, Nicholas Gonzalez, Hill Harper, Richard Schiff, Tamlyn Tomita. David Shore (executive producer), and Daniel Dae Kim (executive producer) will also be on the panel. Additional guests will be announced at a later date.[61]

text: Reception[edit]

text: Ratings[edit]

text:
No.
Title
Air date
Rating/share
(18–49)
Viewers
(millions)
DVR
(18–49)
DVR viewers
(millions)
Total
(18–49)
Total viewers
(millions)

1
"Burnt Food"
September 25, 2017
2.2/9
11.22[21]
2.2
7.86
4.4
19.21[62]

2
"Mount Rushmore"
October 2, 2017
2.2/9
10.93[22]
2.1
7.21
4.3
18.12[63]

3
"Oliver"
October 9, 2017
2.0/7
10.69[23]
2.2
7.53
4.2
18.22[64]

4
"Pipes"
October 16, 2017
2.0/8
10.60[24]
2.1
7.34
4.1
17.96[65]

5
"Point Three Percent"
October 23, 2017
1.8/7
10.39[25]
2.0
7.10
3.8
17.50[66]

6
"Not Fake"
October 30, 2017
1.9/7
10.60[26]
2.0
6.93
3.9
17.51[67]

7
"22 Steps"
November 13, 2017
1.9/7
10.14[27]
1.9
6.92
3.8
17.14[68]

8
"Apple"
November 20, 2017
1.8/7
9.97[28]
1.8
6.98
3.6
16.99[69]

9
"Intangibles"
November 27, 2017
1.7/7
9.25[29]
1.8
6.66
3.5
15.91[70]

10
"Sacrifice"
December 4, 2017
1.6/7
9.03[30]
1.8
6.67
3.4
15.74[71]

11
"Islands Part One"
January 8, 2018
1.6/6
8.30[31]
1.8
7.10
3.4
15.40[72]

12
"Islands Part Two"
January 15, 2018
1.7/6
9.33[32]
1.8
6.66
3.5
16.00[73]

13
"Seven Reasons"
January 22, 2018
1.7/7
9.61[33]
1.9
6.91
3.6
16.53[74]

14
"She"
February 5, 2018
1.7/7
9.63[34]
1.8
7.07
3.5
16.71[75]

15
"Heartfelt"
February 26, 2018
1.3/5
7.82[35]
TBD
TBD
TBD
TBD

text: The series premiere earned a 2.2/9 rating in the 18- to 49-year-old demographic, with 11.22 million total viewers, making it the most watched Monday drama debut on ABC in 21 years, since Dangerous Minds in September 1996, and the highest rated Monday drama in the 18–49 demographic in 8.5 years, since Castle in March 2009.[76] Factoring live plus seven-day ratings, the pilot was watched by a total of 19.2 million viewers and set a record for DVR viewers with 7.9 million, surpassing the record of 7.67 million set by the pilot of Designated Survivor in 2016.[77] According to TV Guide's November 13-26 issue, the October 9 episode attracted 18.2 million viewers, beating out both NCIS and The Big Bang Theory for the most viewed primetime show that week.[78]

text: Critical response[edit]

text: The review aggregator website Rotten Tomatoes reports a 58% approval rating with an average rating of 5.49/10 based on 38 reviews. The website's consensus reads, "The Good Doctor's heavy-handed bedside manner undermines a solid lead performance, but under all the emotionally manipulative gimmickry, there's still plenty of room to improve."[79] Metacritic, which uses a weighted average, assigned a score of 53 out of 100 based on 15 critics, indicating "mixed or average reviews".[80]

text: Giving his first impression of the series' pilot for TVLine, Matt Webb Mitovich stated, "The Good Doctor boasts great DNA... [and] has the potential to be a refreshingly thought-provoking hospital drama, based on the buttons pushed in the pilot alone." He enjoyed the "warm dynamic" of Schiff and Highmore, while describing Thomas' character as "our emotional 'in' to Shaun's distinct, distant world". He noted that "it takes a while to build up momentum", but concluded that "the very final scene packs quite a punch, as Dr. Murphy unwittingly puts a colleague on notice".[81]

text: The New York Times television critic, James Poniewozik, notes in his Critic's Notebook column, that for the most part the drama is a "hospital melodrama with whiz-bang medical science, a dash of intra-staff romance and shameless sentimentality." Discussing the main characters of Dr. Aaron Glassman (Richard Schiff) and Dr. Shaun Murphy (Freddie Highmore), however, Poniewozik writes that "Mr. Schiff is convincing in the role and Mr. Highmore is striking in his." [82]

text: Speaking of Freddie Highmore's Golden Globe nomination on Monday, December 11, 2017, for his role in The Good Doctor, Laura Bradley, writing for Vanity Fair says: "... Freddie Highmore received the awards recognition that has long and unjustly eluded him..." Bradley feels that Highmore's performance has been "the central key" to the show's enormous success and while the show had lukewarm reviews, most critics have praised Highmore's work. [83]

text: Accolades[edit]

text:
Year
Award
Category
Nominee(s)
Result
Ref.

2018
Golden Globe Awards
Best Actor – Television Series Drama
Freddie Highmore
Nominated
[84]

Humanitas Prize
60-Minute Category
David Shore
Won
[85]


document_title: West African Examinations Council

question_text: what are the aims and objectives of waec

root

text: West African Examinations Council

text: History[edit]

text: The University of Cambridge Local Examinations Syndicate, University of London School Examinations Matriculation Council and West African Departments of Education met in 1948, concerning education in West Africa.[3] The meeting was called to discuss the future policy of education in West Africa. At the meeting, they appointed Dr. George Barker Jeffery (Director of the University Of London Institute Of Education) to visit some West African countries, so as to see the general education level and requirements in West Africa. At the end of Jeffery's three month visit (December 1949- March 1950) to Ghana, the Gambia, Sierra Leone, and Nigeria, he tendered a report (since known as Jeffery report) strongly supporting the need for a West African Examination Council, and making detailed recommendations on the composition and duties of the Council.[3] Following this report, the groups met with the governments of these countries, and they agreed on establishing a West African Examination council, fully adopting Jeffery's recommendations.

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text: The Establishment of the Council[edit]

text: The legislative assemblies of Nigeria, Ghana, Sierra Leone, and the Gambia passed an ordinance (West African Examinations Council Ordinance NO. 40) approving the West African Examination Council in Dec 1951.[4] The Ordinance agreed to the coordination of exams, and issuing of certificates to students in individual countries by the West African Examination Council. Liberia later issued their ordinance in 1974, at the annual meeting held in Lagos, Nigeria.[4] After the success of forming an examination council, the council called a first meeting in Accra, Ghana on March 1953. In the meeting, the registrar briefed everybody about the progress of the council. In that same meeting, five committees were formed to assist the council. These committees are: Administrative and Finance Committee, School Examinations Committee, Public Service Examinations Committee, The Professional, Technical and Commercial Examinations Committee, and the Local Committee.[3] The total number of people present for this meeting was 26.[3]

text: Attendance of first meeting[edit]

text: Below is the list of people who were present during the first meeting held by the West African Examination Council.[3]

text:
Mr. A. N Galsworthy (Chairman of the Council)
George Barker Jeffery (Chief Secretary of the West African Inter-Territorial Secretariat)
Mr. J. L. Brereton (Secretary of the Cambridge Syndicate)
13 members nominated by the governments of Nigeria, Ghana, Sierra Leone, and the Gambia.
10 Observers, one of whom was Constance Rulka, who would later become the Chief Examiner, and, appointed Assistant Registrar of the West African Examinations Council, and put in charge of examinations in English at all levels in Nigeria, Ghana, Sierra Leone and the Gambia.

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text: 50th birthday celebration[edit]

text: On March 2002, the Council celebrated their 50th anniversary in Abuja, Nigeria. The theme of the Anniversary was "WAEC: 50 years of Excellence".[3] All member countries joined in the celebration in their respective countries, apart from the general celebration in Abuja, Nigeria. During this anniversary the book, "The West African Examinations Council (1952-2002): Half a century of Commitment to Excellence and Regional Cooperation", was launched.

text: Structure of the Council[edit]

text: The West African Examination Council is notable to have a strong committee. The structure of the council is divided into three major parts: International committees, National Committees, and Subcommittees.[5]

text: The International Committee treat matters affecting all member countries and also harmonizes national views pertaining to policies of the council as a whole. The National committees handle matters relating to specific member countries. It also assist in the articulation of national views on issues affecting the policy of the council as a whole. The Sub committees work on various aspects of the Council’s activities. The Finance committee for example is in charge of WAEC’s financial status. There are many sub committees, and they assist both the International and National committees.

text: Examinations conducted[edit]

text: The council conducts four different categories of examinations.[3] They are International Examinations, National Examinations, Examinations conducted in collaboration with other examining bodies, and Examinations conducted on behalf of other examining bodies.[6] The International exams are exams taken in the five countries with the WAEC ordinance. It consists of:

text:
WASSCE (West African Senior School Certificate Examination):
SC/GCE O’ levels, and
HSC/GCE A’ levels.[7]

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text: The National examinations are taken in individual countries. They include:

text:
the Junior Secondary School Certificate for Nigeria and the Gambia,
Junior and Senior High School Certificate Examinations for Liberia,
National Primary School and Basic Education Certificate Examinations for Sierra Leone,
Basic Education Certificate Examinations for Ghana, and
Senior School Certificate Examinations for Ghana.[3]

text: The council also coordinates examinations in collaboration with some trustworthy examination bodies. These include:

text:
City and Guilds of London Institute
Royal Society of Arts [7]

text: The council also conducts examination in West Africa on behalf of international examination bodies. These include:

text:
University of London GCE
Scholastic Aptitude Test and Graduate Record Examinations for Educational Testing Service, Princeton, USA, and
JAMB (Joint Admissions and Matriculations Board) examination in countries outside Nigeria.[7]

text: The council issues credible and reliable certificates to candidates that participate in the Examinations. And the standard of this certificates matches with that of the United Kingdom. This is because the WAEC Ordinance empowered the council to conduct Examinations and award certificates, provided the certificates don’t have a lower standard compared to their equivalent certificates of examining authorities in the United Kingdom.[3]

text: The Endowment Fund[edit]

text: A major achievement of the council, apart from several examinations it has conducted is the establishment of the Endowment Fund. The council created the Endowment fund in Monrovia, Liberia in 1982.[3] It was established for two main reasons: to promote educational projects,[8] and to give annual lectures.[3]

text: So far, the educational projects have been on

text:
buying books for the less privilege. Like Mr. Saaka (2006) said "the decision to donate books was due to the poor performance of students.",[9] and
awarding students who perform excellently in their examinations.

text: WAEC awarded seven students that performed excellently in their 2004 SSCE. According to the report, the award was in two categories: distinction and excellence category, and the amounts ranged from $250–$550 alongside certificates of honor. This aspect of the project is meant to bring in competitions among students, in other to improve education.

text: Lectures given[edit]

text: The Endowment fund started giving lectures on March 1996. Below are the lectures and the names of the speakers.[3]

text:
1996 - "The Role of WAEC in the Promotion of Democracy, Sustainable Development and International Cooperation in West Africa" by Prof. E.A. Boateng of Ghana.
1997 - "The Dual Mandate: Teaching and Examining" by Prof. Eldred Jones of Sierra Leone.
1998 - "Not in Our Stars" by Prof. V. Chukwuemeka Ike of Nigeria.
1999 - "And Miles to Go Before I Sleep" by Dr. Lenrie Peters of the Gambia.
2000 - "Encourage the Best, Support the Rest" by Mr. Moore T. Worrel of Liberia.
2001 - "The Language Factor in Education- Teaching, Learning and Examining" by Prof. Florence A. Dolphyne of Ghana.
2002 - "Education for National Redemption" by Prof. J. A. Ayoade of Nigeria.
2003 - "The Role and Relevance of the West African Examinations Council within the Context of the Realities and Challenges of our Times" by Dr. M. B. Joof of the Gambia.
2004 - "Developing and Strengthening a Sustainable Modern Science and Technology Human Resource Base and Culture in West Africa" by Prof. Ernest H. M. Wright.
2005 - "Taking Stock of the Remnants after the Years of the Locust" by Monsignor Dr. Robert G. Tikpor
2006 - "Quality Assurance in Public Examinations" by Prof. Ivan Addae-Mensah
2007 - "The Teacher in Leadership" by Prof. I.E.Nwana
2008 - "Enhanced Agricultural Education: An Inevitable Necessity for our Survival" by Rt. Rev. Dr.S. Tilewa Johnson
2009 - "Globalization and the Challenges for Education in a Post-Conflict Situation: A Sierra Leone Perspective" by Prof. Abdullah A. Mansaray
2010 - "The West African Examinations Council: Pan-Africanism, Gender and Development" by Dr. Evelyn S. Kandakai
2011 - "Towards Excellence in the Teaching and Learning of the Language of Science" by Prof. D. A. Akyeampong
2012 - "Nipping Educational Failure in the Bud" by Prof. Pius Augustine Ike Obanya
2013 - "Rethinking Teaching, Learning and Examining for Quality Enhancement in Sub-Saharan Africa: The Roles, Challenges and Prospects of Digital Technologies" by Prof. Mohammadou M. O. Kah
2014 - "Last to be Hired, First to be Fired: Addressing the Challenges of Teacher Management in the Provision of Quality Education in Sierra Leone" by Prof. E. J. D. Thompson
2015 - "What Are We Writing on the Slate: A Holistic Preparation of the Youth" by Hon. Augustine Kpehe Ngafuan, Minister of Foreign Affairs, Republic of Liberia

text: Vision of the Council

text: To be a world class examining body, adding value to the educational goals of its stakeholders.

text: Mission of the Council[edit]

text: Generally, the Council have several missions, most of which is to maintain the standard they have achieved. The Missions of the West African Examination Council are:

text:
To maintain internationally accepted procedures
To keep providing qualitative and reliable educational assessment
To keep encouraging Students in getting academic excellence
To keep promoting sustainable human resources development, mutual understanding and international cooperation.[10]

text: Heads of Office[edit]

text:
The Gambia: Mr. E. M. S. Njie, B.Sc., Ed; M.Ed (Eval.) Ag. Head of National Office.
Liberia: Mr. E.M. Lumei, B.Sc., M.Sc., M.A. Head of National Office.
Ghana:Rev. J.A. Adotey B.Sc (Edu).
Nigeria: Mr Olutise ADENIPEKUN B.Sc., M.Sc., M.PA., Head of National Office
Sierra Leone: Mr. V.A.V. James, B.A. (Ed), M.Ed. Head of National Office.

text: Works cited[edit]

text:
Jump up ^ Dr. Adeyegbe, S. (2004). Retrieved April 12, 2006, from http://www.waecnigeria.org/home.htm
Jump up ^ Achievement of WAEC. (2004). Retrieved April 12, 2006, from http://www.ghanawaec.org/about3.htm
^ Jump up to: a b c d e f g h i j k l Brief history of the Council. (2004). The West African Examinations Council Diary. Lagos. Academy Press Plc.
^ Jump up to: a b History. (2004). Retrieved April 12, 2006, from http://www.waecnigeria.org/history.htm
Jump up ^ Committee structure of the Council. (2004). Retrieved March 27, 2006, from http://www.ghanawaec.org/about3.htm
Jump up ^ Exams. (2004). Retrieved April 12, 2006, from http://www.waecnigeria.org/exams_1.htm
^ Jump up to: a b c Overview. (2004). Retrieved April 12, 2006, from http://www.waecnigeria.org/overview.htm
Jump up ^ WAEC is determined to produce excellence in education. (2006 March). Ghana Agency. Retrieved March 27, 2006, from http://www.highana.com/hgsite/education/read_news.php?nid=6495
Jump up ^ Mr. Saaka, B. (2006 March). Retrieved March 27, 2006, from http://www.businessghana.com/portal/finance/index.php?op=getNews&news_cat_id=&i d=37791
Jump up ^ WAEC’s mission. (2004). Retrieved March 27, 2006, from http://www.ghanawaec.org/about2.htm


document_title: Obstetrics

question_text: when did the field of obstetrics first emerge in the field of medicine

text: Obstetrics

text: Main areas[edit]

text: Prenatal care[edit]

text: Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests:

text:
3D ultrasound of 3-inch (76 mm) fetus (about 14 weeks gestational age)

Fetus at 17 weeks

Fetus at 20 weeks

text: First trimester[edit]

text:
Complete blood count (CBC)
Blood type
General antibody screen (indirect Coombs test) for HDN
Rh D negative antenatal patients should receive RhoGam at 28 weeks to prevent Rh disease.
Rapid plasma reagin (RPR) to screen for syphilis
Rubella antibody screen
Hepatitis B surface antigen
Gonorrhea and Chlamydia culture
PPD for tuberculosis
Pap smear
Urinalysis and culture
HIV screen

text: Genetic screening for Down syndrome (trisomy 21) and trisomy 18, the national standard in the United States, is rapidly evolving away from the AFP-Quad screen for Down syndrome, done typically in the second trimester at 16–18 weeks. The newer integrated screen (formerly called F.A.S.T.E.R for First And Second Trimester Early Results) can be done at 10 plus weeks to 13 plus weeks with an ultrasound of the fetal neck (thicker nuchal skin correlates with higher risk of Down syndrome being present) and two chemicals (analytes) PAPP-A and βHCG (pregnancy hormone level itself). It gives an accurate risk profile very early. A second blood screen at 15 to 20 weeks refines the risk more accurately. The cost is higher than an "AFP-quad" screen due to the ultrasound and second blood test, but it is quoted to have a 93% pick up rate as opposed to 88% for the standard AFP/QS. This is an evolving standard of care in the United States.

text: Second trimester[edit]

text:
MSAFP/quad. screen (four simultaneous blood tests) (maternal serum AFP, inhibin A, estriol, & βHCG) – elevations, low numbers or odd patterns correlate with neural tube defect risk and increased risks of trisomy 18 or trisomy 21
Ultrasound either abdominal or transvaginal to assess cervix, placenta, fluid and baby
Amniocentesis is the national standard (in what country) for women over 35 or who reach 35 by mid pregnancy or who are at increased risk by family history or prior birth history.

text: Third trimester[edit]

text:
[Hematocrit] (if low, the mother receives iron supplements)
Group B Streptococcus screen. If positive, the woman receives IV penicillin or ampicillin while in labor—or, if she is allergic to penicillin, an alternative therapy, such as IV clindamycin or IV vancomycin.
Glucose loading test (GLT) – screens for gestational diabetes; if > 140 mg/dL, a glucose tolerance test (GTT) is administered; a fasting glucose > 105 mg/dL suggests gestational diabetes.

text: Most doctors do a sugar load in a drink form of 50 grams of glucose in cola, lime or orange and draw blood an hour later (plus or minus 5 minutes) ; the standard modified criteria have been lowered to 135 since the late 1980s

text: Fetal assessments[edit]

text: Obstetric ultrasonography is routinely used for dating the gestational age of a pregnancy from the size of the fetus, determine the number of fetuses and placentae, evaluate for an ectopic pregnancy and first trimester bleeding, the most accurate dating being in first trimester before the growth of the foetus has been significantly influenced by other factors. Ultrasound is also used for detecting congenital anomalies (or other foetal anomalies) and determining the biophysical profiles (BPP), which are generally easier to detect in the second trimester when the foetal structures are larger and more developed. Specialised ultrasound equipment can also evaluate the blood flow velocity in the umbilical cord, looking to detect a decrease/absence/reversal or diastolic blood flow in the umbilical artery.

text: X-rays and computerized tomography (CT) are not used, especially in the first trimester, due to the ionizing radiation, which has teratogenic effects on the foetus. No effects of magnetic resonance imaging (MRI) on the foetus have been demonstrated,[1] but this technique is too expensive for routine observation. Instead, obstetric ultrasonography is the imaging method of choice in the first trimester and throughout the pregnancy, because it emits no radiation, is portable, and allows for realtime imaging.

text: The safety of frequent ultrasound scanning has not be confirmed. Despite this, increasing numbers of women are choosing to have additional scans for no medical purpose, such as gender scans, 3D and 4D scans. A normal gestation would reveal a gestational sac, yolk sac, and fetal pole. The gestational age can be assessed by evaluating the mean gestational sac diameter (MGD) before week 6, and the crown-rump length after week 6. Multiple gestation is evaluated by the number of placentae and amniotic sacs present.

text: Other tools used for assessment include:

text:
Fetal screening is used to help assess the viability of the fetus, as well as congenital abnormalities.
Fetal karyotype can be used for the screening of genetic diseases. This can be obtained via amniocentesis or chorionic villus sampling (CVS)
Foetal haematocrit for the assessment of foetal anemia, Rh isoimmunization, or hydrops can be determined by percutaneous umbilical blood sampling (PUBS), which is done by placing a needle through the abdomen into the uterus and taking a portion of the umbilical cord.
Fetal lung maturity is associated with how much surfactant the fetus is producing. Reduced production of surfactant indicates decreased lung maturity and is a high risk factor for infant respiratory distress syndrome. Typically a lecithin:sphingomyelin ratio greater than 1.5 is associated with increased lung maturity.
Nonstress test (NST) for fetal heart rate
Oxytocin challenge test

text: Intercurrent diseases[edit]

text: A pregnant woman may have intercurrent diseases, that is, other diseases or conditions (not directly caused by the pregnancy) that may become worse or be a potential risk to the pregnancy.

text:
Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, feotal obesity (macrosomia), polyhydramnios and birth defects.
Systemic lupus erythematosus and pregnancy confers an increased rate of foetal death in utero and spontaneous abortion (miscarriage), as well as of neonatal lupus.
Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on foetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Demand for thyroid hormones is increased during pregnancy, and may cause a previously unnoticed thyroid disorder to worsen.
Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood clots). Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent post partum bleeding.[2] However, when combined with an additional underlying hypercoagulable states, the risk of thrombosis or embolism may become substantial.[2]

text: Induction and labour[edit]

text: Induction is a method of artificially or prematurely stimulating labour in a woman. Reasons to induce can include pre-eclampsia, foetal distress, placental malfunction, intrauterine growth retardation and failure to progress through labour increasing the risk of infection and foetal distresses.

text: Induction may be achieved via several methods:

text:
Disturbance of cervical memebranes
Pessary of Prostin cream, prostaglandin E2
Intravaginal or oral administration of misoprostol
Cervical insertion of a 30-mL Foley catheter
Rupturing the amniotic membranes
Intravenous infusion of synthetic oxytocin (Pitocin or Syntocinon)

text: During labour, the obstetrician carries out the following tasks:

text:
Monitor the progress of labour, by reviewing the nursing chart, performing vaginal examination, and assessing the trace produced by a foetal monitoring device (the cardiotocograph)
Provide pain relief, either by nitrous oxide, opiates, or by epidural anaesthesia done by anaesthestists, an anaesthesiologist, or a nurse anaesthetist.
Caesarean section, if there is an associated risk with vaginal delivery, as such feotal or maternal compromise.

text: Complications and emergencies[edit]

text: The main emergencies include:

text:
Ectopic pregnancy is when an embryo implants in the uterine (Fallopian) tube or (rarely) on the ovary or inside the peritoneal cavity. This may cause massive internal bleeding.
Pre-eclampsia is a disease defined by a combination of signs and symptoms that are related to maternal hypertension. The cause is unknown, and markers are being sought to predict its development from the earliest stages of pregnancy. Some unknown factors cause vascular damage in the endothelium, causing hypertension. If severe, it progresses to eclampsia, where seizures occur, which can be fatal. Preeclamptic patients with the HELLP syndrome show liver failure and Disseminated intravascular coagulation (DIC). The only treatment is to deliver the foetus. Women may still develop pre-eclampsia following delivery.
Placental abruption is where the placenta detaches from the uterus and the woman and foetus can bleed to death if not managed appropriately.
Foetal distress where the foetus is getting compromised in the uterine environment.
Shoulder dystocia where one of the foetus' shoulders becomes stuck during vaginal birth. There are many risk factors, including macrosmic (large) feotus, but many are also unexplained.
Uterine rupture can occur during obstructed labour and endanger foetal and maternal life.
Prolapsed cord can only happen after the membranes have ruptured. The umbilical cord delivers before the presenting part of the foetus. If the foetus is not delivered within minutes, or the pressure taken off the cord, the foetus dies.
Obstetrical hemorrhage may be due to a number of factors such as placenta previa, uterine rupture or tears, uterine atony, retained placenta or placental fragments, or bleeding disorders.
Puerperal sepsis is an ascending infection of the genital tract. It may happen during or after labour. Signs to look out for include signs of infection (pyrexia or hypothermia, raised heart rate and respiratory rate, reduced blood pressure), and abdominal pain, offensive lochia (blood loss) increased lochia, clots, diarrhea and vomiting.

text: Postnatal care[edit]

text: Postnatal care is care provided to the mother following parturition.

text: A woman in the Western world who is delivering in a hospital may leave the hospital as soon as she is medically stable and chooses to leave, which can be as early as a few hours postpartum, though the average for spontaneous vaginal delivery (SVD) is 1–2 days, and the average caesarean section postnatal stay is 3–4 days.

text: During this time the mother is monitored for bleeding, bowel and bladder function, and baby care. The infant's health is also monitored.

text: Certain things must be kept in mind as the physician proceeds with the post-natal care.

text:
General condition of the patient.
Check for vital signs (pulse, blood pressure, temperature, respiratory rate, (pain) at times)
Palour?
Oedema?
Dehydration?
Fundus (height following parturition, and the feel of the fundus) (Per abdominal examination)
If an episiotomy or a C-section was performed, check for the dressing. Intact, pus, oozing, haematomas?
Lochia (colour, amount, odour)?
Bladder (keep the patient catheterized for 12 hours following local anaesthesia and 24–48 hours after general anaesthesia) ? (check for bladder function)
Bowel movements?
More bowel movements?
Follow up with the neonate to check if they are healthy.

text: Veterinary obstetrics[edit]

text: History[edit]

text: Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women, and rigorously excluded men. The expectant mother would invite close female friends and family members to her home to keep her company during childbirth.[3] Skilled midwives managed all aspects of the labour and delivery. The presence of physicians and surgeons was very rare and only occurred if a serious complication had taken place and the midwife had exhausted all measures at her disposal. Calling a surgeon was very much a last resort and having men deliver women in this era was seen as offending female modesty.[4][5]

text: Before the 18th century[edit]

text: Prior to the 18th and 19th centuries, midwifery was well established but obstetrics was not recognized as a specific medical specialty. However, the subject matter and interest in the female reproductive system and sexual practice can be traced back to Ancient Egypt[6]  and Ancient Greece.[7] Soranus of Ephesus sometimes is called the most important figure in ancient gynecology. Living in the late first century A.D. and early second century, he studied anatomy and had opinions and techniques on abortion, contraception –most notably coitus interruptus– and birth complications. After his death, techniques and works of gynecology declined; very little of his works were recorded and survived to the late 18th century when gynaecology and obstetrics reemerged as a medical specialism.[8]

text: 18th century[edit]

text: The 18th century marked the beginning of many advances in European midwifery, based on better knowledge of the physiology of pregnancy and labour. By the end of the century, medical professionals began to understand the anatomy of the uterus and the physiological changes that take place during labour. The introduction of  forceps in childbirth also took place at this time. All these medical advances in obstetrics were a lever for the introduction of men into an arena previously managed and run by women—midwifery.[9]

text: The addition of the male-midwife (or man-midwife) is historically a significant change to the profession of obstetrics. In the 18th century medical men began to train in area of childbirth and believed with their advanced knowledge in anatomy that childbirth could be improved. In France these male-midwives were referred to as accoucheurs, a title later used all over Europe. The founding of lying-in hospitals also contributed to the medicalization and male-dominance of obstetrics. These early maternity hospitals were establishments where women would come to have their babies delivered, as opposed to the practice since time immemorial of the midwife attending the home of the woman in labour. This institution provided male-midwives with endless patients to practice their techniques on and was a way for these men to demonstrate their knowledge.[10]

text: Many midwives of the time bitterly opposed the involvement of men in childbirth. Some male practitioners also opposed the involvement of medical men like themselves in midwifery and even went as far as to say that male-midwives only undertook midwifery solely for perverse erotic satisfaction. The accoucheurs argued that their involvement in midwifery was to improve the process of childbirth. These men also believed that obstetrics would forge ahead and continue to strengthen.[4]

text: 19th century[edit]

text: 18th century physicians expected that obstetrics would continue to grow, but the opposite happened. Obstetrics entered a stage of stagnation in the 19th century, which lasted until about the 1880s.[3] The central explanation for the lack of advancement during this time was the rejection of obstetrics by the medical community. The 19th century marked an era of medical reform in Europe and increased regulation over the profession. Major European institutions such as The College of Physicians and Surgeons[disambiguation needed][where?] considered delivering babies ungentlemanly work and refused to have anything to do with childbirth as a whole. Even when Medical Act 1858 was introduced, which stated that medical students could qualify as doctors, midwifery was entirely ignored. This made it nearly impossible to pursue an education in midwifery and also have the recognition of being a doctor or surgeon. Obstetrics was pushed to the side.[11]

text: By the late 19th century, the foundation of modern-day obstetrics and midwifery began developing. Delivery of babies by doctors became popular and readily accepted, but midwives continued to play a role in childbirth. Midwifery also changed during this era due to increased regulation and the eventual need for midwives to become certified. Many European countries by the late 19th century were monitoring the training of midwives and issued certification based on competency. Midwives were no longer uneducated in the formal sense.[12]

text: As midwifery began to develop, so did the profession of obstetrics near the end of the century. Childbirth was no longer unjustifiably despised by the medical community as it once had been at the beginning of the century. But obstetrics was underdeveloped compared to other medical specialites. Many male physicians would deliver children but very few would have referred to themselves as obstetricians. The end of the 19th century did mark a significant accomplishment in the profession with the advancements in asepsis and anaesthesia, which paved the way for the mainstream introduction and later success of the Caesarean Section.[12][13]

text: Before the 1880s mortality rates in lying-hospitals would reach unacceptably high levels and became an area of public concern. Much of these maternal deaths were due to puerperal fever, then known as childbed fever. In the 1800s Dr. Ignaz Semmelweis noticed that women giving birth at home had a much lower incidence of childbed fever than those giving birth by physicians in lying-hospitals. His investigation discovered that washing hands with an antiseptic solution before a delivery reduced childbed fever fatalities by 90%.[14] So it was concluded that it was physicians who had been spreading disease from one labouring mother to the next. Despite the publication of this information, doctors still would not wash. It was not until the 20th century when advancements in aseptic technique and the understanding of disease would play a significant role in the decrease of maternal mortality rates among many populations.

text: History of obstetrics in America[edit]

text: The development of obstetrics as a practice for accredited doctors happened at the turn of the 18th century and thus was very differently developed in Europe and in the Americas due to the independence of many countries in the Americas from European powers. “Unlike in Europe and the British Isles, where midwifery laws were national, in America, midwifery laws were local and varied widely”.[15]

text: Gynaecology and Obstetrics gained attention in the American medical field at the end of the nineteenth century through the development of such procedures as the ovariotomy. These procedures then were shared with European surgeons who replicated the surgeries. This was a period when antiseptic, aseptic or anaesthetic measures were just being introduced to surgical and observational procedures and without these procedures surgeries were dangerous and often fatal. Following are two surgeons noted for their contributions to these fields include Ephraim McDowell and James Marion Sims.

text: Ephraim McDowell developed a surgical practice in 1795 and performed the first ovariotomy in 1809 on a 47-year-old widow who then lived on for thirty-one more years. He had attempted to share this with John Bell whom he had practiced under who had retired to Italy. Bell was said to have died without seeing the document but it was published by an associate in Extractions of Diseased Ovaria in 1825. By the mid-century the surgery was both successfully and unsuccessfully being performed. Pennsylvanian surgeons the Attlee brothers made this procedure very routine for a total of 465 surgeries–John Attlee performed 64 successfully of 78 while his brother William reported 387– between the years of 1843 and 1883. By the middle of the nineteenth century this procedure was successfully performed in Europe by English surgeons Sir Spencer Wells and Charles Clay as well as French surgeons Eugène Koeberlé, Auguste Nélaton and Jules Péan.[16]

text: J. Marion Sims was the surgeon responsible for being the first treating a vesicovaginal fistula [16]–a condition linked to many caused mainly by prolonged pressing of the feotus against the pelvis or other causes such as rape, hysterectomy, or other operations– and also having been doctor to many European royals and the 20th President of the United States James A. Garfield after he had been shot. Sims does have a controversial medical past. Under the beliefs at the time about pain and the prejudice towards African people, he had practiced his surgical skills and developed skills on slaves.[17] These women were the first patients of modern gynecology. One of the women he operated on was named Anarcha Westcott, the woman he first treated for a fistula.[18]

text: Historical role of gender[edit]

text: Women and men inhabited very different roles in natal care up to the 18th century. The role of a physician was exclusively held by men who went to university, an overly male institution, who would theorize anatomy and the process of reproduction based on theological teaching and philosophy. Many beliefs about the female body and menstruation in the 17th and 18th centuries were inaccurate; clearly resulting from the lack of literature about the practice.[19] Many of the theories of what caused menstruation prevailed from Hippocratic philosophy.[20] Midwives of this time were those assisted in the birth and care of both born and unborn children, and as the name suggests, this position was held mainly by women.

text: During the birth of a child, men were rarely present. Women from the neighbourhood or family would join in on the process of birth and assist in many different ways. The one position where men would help with the birth of a child would be in the sitting position, usually when performed on the side of a bed to support the mother.[21]

text: Men were introduced into the field of obstetrics in the nineteenth century and resulted in a change of the focus of this profession. Gynaecology directly resulted as a new and separate field of study from obstetrics and focused on the curing of illness and indispositions of female sexual organs. This had some relevance to some conditions as menopause, uterine and cervical problems, and childbirth could leave the mother in need of extensive surgery to repair tissue. But, there was also a large blame of the uterus for completely unrelated conditions. This led to many social consequences of the nineteenth century.[19]


question_text: who wrote king arthur and the knights of the round table

text:
King Arthur and His Knights of the Round Table
1955 editionAuthor
Roger Lancelyn GreenIllustrator
Lotte ReinigerCountry
EnglandLanguage
EnglishSubject
The legends of King ArthurGenre
Fairy talesFolklorePublisher
Puffin BooksPublication date
1953Media type
PrintPages
330

tag: table

text: King Arthur and His Knights of the Round Table is a novel for children written by Roger Lancelyn Green. It was first published by Puffin Books in 1953 and has since been reprinted.[1] In 2008 it was reissued in the Puffin Classics series with an introduction by David Almond (the award-winning author of Clay, Skellig, Kit's Wilderness and The Fire-Eaters),[2] and the original illustrations by Lotte Reiniger.

text: Green attempted to weave together the many legends surrounding King Arthur in a single narrative, claiming that Thomas Malory's version of the story, Le Morte d'Arthur, was a loose collection of separate stories.  Green attempted to relate each legend so that the entire story would have a beginning, middle and end. Green used many sources in addition to Malory.

text: Summary[edit]

text: After Uther Pendragon's death, Merlin the magician forms a stone and in it a sword. After many years, the young Arthur, secretly the son of Uther Pendragon, pulls the sword out of the stone and becomes King. Together with Merlin, he constructs a round table, at which only the best knights of England may sit.[3] More and more knights come to join the brotherhood of the Round Table, and each has his own adventures.[3]

text: Eventually, the holy knight Galahad, the son of Sir Lancelot, comes to Arthur's court. With his coming, all the knights ride throughout Europe in search of the Holy Grail of Jesus Christ. Only five knights see the Grail: Sir Lancelot, Sir Percival, Sir Bors de Gaunnes, Sir Galahad and Sir Gawain.[3]

text: After the Grail is found, the last battle of the Knights of the Round Table is fought. In this battle many knights die, and with them King Arthur, Sir Gawain, who is Arthur's nephew, and Mordred, the wicked son of King Arthur, and his half-sister Morgana le Fay.[3] King Arthur is taken away to Avalon, a secret island after he is terribly wounded by Mordred while he was making the final stab with his sword to kill Mordred.[3]