Cell 2 Soul: The Humane Health Care Blog

Walk Your Walk

K'Naan, in a remarkable Op-Ed piece in the NY Times, relates a Somali fable which speaks to all of us:

"The fox, they say, once had an elegant walk, for which the other animals loved him. One day, he saw a prophet striding along and decided to improve on what was already beautiful. He set out walking but could not match the prophet’s gait. Worse, he forgot his own. So he was left with the unremarkable way the fox walks today."

In the remainder of Censoring Myself for Success, he describes how he has been pressured to change his Somali "walk."  How many of us, especially those still in school or professional training feel compelled to imitate the gait of others? 

K'Naan - Wavin' the Flag

Cure for the Common Cold

A fine essay by David Watts appeared in a recent issue of the New England Journal of Medicine.  Unfortunately, it is not available free to the public.  It begins with this paragraph.

image from migraine-livinginpain.blogspot.com/

"Rumor has it that the medical profession suffers from too many cold and distant doctors. Studies have attempted to subject this notion to the scrutiny of science, and although we could argue over their degree of success, we know it's true. We need only ask our patients in order to be regaled with stories confirming the accusation. Cold. Yet we didn't start out that way."

 

Some of you will have access to NEJM, but those who don't can contact Dr. Watts for a copy.  Congratulations, Dr Watts!  This is an article that all of us will mull over and benefit from reading.

Cure for the Common Cold
David Watts
New England Journal of Medicine, September 27, 2012, p. 1184-85

 

Smoking and Poverty

The NY Times Journal of Medicine described a recent study documenting the smoking habits and the poor. It reported that "Low-income smokers in New York spend 25 percent of their income on cigarettes according to a new study, which led advocates for smokers’ rights to say it proved high taxes were regressive and ineffective."

This is an important article to read.  A couple of our Cell 2 Soul members are international experts on smoking and health and we will ask them for their comments.  The implications of spending 25% or more of a family's income on cigarettes are mind-boggling.

Lest one think this is a problem for the U.S. alone, there have been ample studies of smoking habits in poor countries as well.  See: "Tobacco: Uphill Battle for Antismoking Campaigns in Poor and Middle-Income Countries" by Donald G. McNeil.

America's Health Worker Mismatch

In the U.S., we rely on foreign-trained physicians, nurses and other professionals to care for our citizens.  Our professional schools have not taken on the responsibility of traing health care workers in sufficient numbers.  An Op-Ed essay in the NY Times (September 14, 2012) discusses this topic and concludes:  "It is irrational and immoral to recruit health workers from countries where one in five children die before their fifth birthday when we could be recruiting and training workers domestically."

Please read this informative article:  "Health Worker Mismatch."

The Appointment: Then and Now

Dr. E. Ceriani ~ 1948

Sue Mayfield Geiger submitted a fine essay to us on how the doctor's visit has changed over the years.

Basho has a haiku:

Chrysanthemum growers --
you are the slaves
of chrysanthemums

one might say

Doctors --
you've become the slaves
of corporate medicine

Please read Ms. Geiger's fine essay:  The Appointment:  Download The Appointment Geiger

Author Bio:Sue Mayfield Geiger writes and edits for regional and national publications, and lives on the Texas Gulf Coast. Her first book of prose and verse (with photos) is now available. www.gibbonsstreet.com.  You can email comments to her at:  SMG

 

The Factory as Metaphor

Dr. Jeremy Graham, a Spokane physician, has written a provocative essay comparing the Factory to the modern medical Clinic.  As you read it, think about the role you play as patient, family member, care giver.

Dr. Graham writes: "Industrial throughput and productivity are the watchwords of contemporary US healthcare.  Striving to deliver care, administrators and doctors advocate “lean management,” “best practices,” efficiency, and production. A spirit averse to waste rides high upon the elimination of  “non-value-added” activities.  It seems that with sufficient abstraction, medicine is an industry which can learn to be lean, like any other. Factory and farm, hospital and clinic, are ultimately interchangeable."  To read more  Download The Factory_Graham

Author Bio: Jeremy D Graham MA, DO, FACP writes,  "I am a teaching Internist on the faculty of Internal Medicine Residency Spokane with a clinical emphasis on Inpatient wards and hospital medicine.  With my background and prior training in cultural anthropology, my academic interests include incorporating the social and material costs of illness as relevant outcome considerations of humane medical care. Email:  Jeremy Graham.

Silver Dragons by Phil Delrosario

Stanford undergraduate, Phil Delrosario, does an amazing job of getting into the mind of a four year-old at a doctor's office.

"Momma, why is she hurting me? Momma wouldn't say anything. She just held me there. The lady stabbed me again with another silver dragon. Stop I yelled out. I was still crying. Why are you hurting me I screamed. She said she needed to give me two more and then she'd be done. She came closer and closer. I kicked her in her face. That's what Aladdin would have done..."  Download Silver Dragons

 

Author Bio:  Phil Delrosario is a junior in Human Biology with a concentration in Psychological Development in Children and Adolescents at Stanford University in California.  He enjoys writing, making short films, and playing his violin/piano/ukulele. He can be reached at pdel@stanford.edu.

Pediatric practitioner Brian Maurer has this comment:  "This unfortunate scenario is repeated daily in pediatric primary care practice.  An interesting twist: told through the eyes of a 4-year-old as imagined by a pre-medical student. see Brian's full comment"  Download Maurer
 

Our Moral Stain

"When it comes to health care, most liberals are committed above all to ensuring that every American has insurance. In their view, the greatest achievement of the health care reform act is to finally erase the moral stain of the United States' being the only major developed country without universal coverage. But we also hold the questionable distinction of having the world's most expensive health care system - what about cost control?

This is a fine opinion piece by a thoughtful academic physician.  Reading it made me think, "We have met the enemy and it is us."  As a physician, I particpate in the scandalous cost of health care every day.  All of us do unnecessary tests.  All of us prescribe expensive meds when cheaper ones would work.  All of us do more procedures than needed because that's where our reimbursement comes from.  It's one thing to recognize this in the quiet of one's home -- it's another reality in the clinic.

Emanuel's essay is a good springboard for thought.  See: Download What We Give Up for Health Care

 Image is from CartoonStock.com

Bring Medical Care Home!

Jack Resnik, a physician practicing on Roosevelt Island, New York, had an eloquent and impassioned Op-Ed piece in the December 5, NY Times.

"[In 1998], one of my patients called me with a high fever, chills and dropping blood pressure. He was 48 and had been a quadriplegic since he was shot during a robbery in the hardware store he owned. I called an ambulance and admitted him to the hospital, where we soon brought his urinary tract infection under control. But he developed a bedsore, which became infected with an antibiotic-resistant bacterium that breeds in hospitals. He didn’t survive the hospitalization."

Dr. Resnick has learned a few things since then.  Read:  Bring Health Care Home.  It may save your life!!