Cell 2 Soul: The Humane Health Care Blog

Wicked Boring, Dude!

  "Close Encounters of the Cutaneous Kind"

When Williams freshman, Seth Tobolsky, told his friends about being assigned to shadow two dermatologists during his January term this past winter they replied with cautions like: "Dude, you are going to be wicked bored."  Seth was pleasantly surprised by his elective class and has written an enlightening and entertaining essay about it.  Please read his narrative and send him your thoughts.  Easy to read PDF: Download Seth- Close Encounters

Author Bio: Seth Tobolsky is a current sophomore at Williams College, and planning to be a Spanish major and Neuroscience concentrator. His post-graduation goal is to attend medical school, and he is excited to publish his first essay in Cell 2 Soul. You may reach him at mailto:sat2ATwilliams.edu. 

Marginal Notes: What's Wrong, What's Right?

In his new book Wrong, science journalist David H. Freedman asks why scientific pronouncements often turn out to be misleading, exaggerated or entirely off the mark. Freedman ponders:  “If tests of the exact same idea routinely generate differing, even opposite, results, then what are we supposed to believe?”

 

Perhaps scientists themselves possess their own set of preconceived notions, which in turn dictate how they interpret the data they measure. >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

Health Care Quality in the U.S.

June 24, 2010

According to new annual report from the Commonwealth Fund, a private foundation that focuses on health care, the U.S. health system presents a rather dismal picture in terms of overall quality of health care.

The analysis comparing the nations spending and health outcomes with seven other industrialized nations, found that despite outspending the other competitors, the Americans are getting less for their money and are languishing behind in common health issues.

The Commonwealth Fund's president, Karen Davis, stated, "On many measures of health system performance, the U.S. has a long way to go to perform as well as other countries that spend far less than we do on healthcare, yet cover everyone.

"It is disappointing, but not surprising, that despite our significant investment in health care, the U.S. continues to lag behind other countries.”

America scored poorly in most of the five key areas of health service in comparison to the other six competitors despite the country’s healthcare system being the most expensive in the world.

The rankings of the 7 countries
The Commonwealth Fund report was based on a survey of both patients and primary care doctors for the years 2007, 2008 and 2009 in Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom.

The focus of the report was five essential measures of health care- access to care, equity, quality, efficiency and the ability to live long, healthy, productive lives.

The overall winner was Netherlands scoring the highest in the list. The country topped in access and in equity, and ranked second in quality of care.
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The Dutch were closely followed by UK and Australia while Canada ranked sixth and America fared the worst in the list.
                                                                                                                                                                                                                                                             
US healthcare system the most expensive in the world
The United States scored poorly in most of the five key areas of health service despite the country’s healthcare system being the most expensive in the world.

The other six countries spend approximately half that of the United States yet are able to provide better universal care to its citizens.

In 2007, the nation spent $7290 per person which was more than double that of Canada, three times more than New Zealand and also much higher compared to the $3800 per person, spent in the Netherlands.

Some specific findings In areas of providing safe care, the United States ranks last and second last on coordinated care.

Patients with a chronic condition in the nation are most likely to be given the wrong medication and the wrong dose and delays in being informed about abnormal test results.

Another major problem is efficiency. The nation also ranks last on spending on administrative costs, use of information technology, duplicate medical testing and re-hospitalization.

In addition, the nation fared the worst in infant mortality and healthy life expectancy among older adults.

A large number of Americans go without care because of the cost. The report pointed out that the United States was the only country on the list that does not give all citizens healthcare coverage.

The authors of the report stated, "For all countries, responses indicate room for improvement. Yet, the other six countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States.

“These findings indicate that, from the perspectives of both physicians and patients, the US health care system could do much better in achieving value for the nation's substantial investment in health."

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Marginal Notes: Web and Flow

While toweling off after my shower, I noticed a grey spider descending from the light above the bathroom sink. Her spinnerets formed a nearly invisible silken thread as she dropped down to hang motionless before the mirror. Shortly, she retreated up to the light and selected another point from which to begin a new descent. This time she dropped down to the shelf below the mirror and crawled behind my toothbrush. Gingerly, I nudged it to the side to reveal the spider resting by a tiny puddle of water.  >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

For Leslie, May 7, 2010 (A Poem)

For too many
It isn't until
The red streak in our stool
The aberrant cells of jagged perimeters
The alarming number out of range
The count too low or too high
The sudden and searing pain
The slip on the ice
That we realize our fragility
And we ask,
Why me, why now?
When all along
It was a given
This flicker of light
That was our responsibility
To keep ignited.

Until the bad news
Delivered in a hospital gown
We have lived as if forever
Would never go away.
Should we be granted time
To come to terms
With knowing we are not exempt,
We should be so lucky
To ask ourselves the question:
Have we gotten closer
To the meaning of our lives?

That grace that quivers the leaves
Sparkles the ocean
Aligns the stars
And flows as eternal breath. 

Deborah Golden Alecson

PDF Version for printing:  Download Alecson For Leslie   

Deborah Alecson is a regular contributor to Cell2Soul.  She writes: "Leslie is a dear friend who had had a mammogram. Suspicious cells were found that were eventually removed surgically.  Her mother and aunt had died of breast cancer so the news from the mammogram caused her great concern and projections of dying.  Even before the results of the biopsy, she was planning her funeral.  The outcome: 'benign clusters.'  She is fine."

You can contact Deborah at: EMAIL. or see her website: DeborahGoldenAlecson

Marginal Notes: The light within

We sat in silence for a moment.  An entire era flashed through my mind: the hurricane of 1938, the snows in upper Michigan, sailing on San Francisco bay, the civil rights movement, the Vietnam war and Woodstock, a boat in Belize, the Tallahassee penitentiary, death and dying in Dallas—somehow all coming together over a Saturday morning breakfast of bacon, eggs and homefries.  >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

 

Notes on "Social Pharmacy" from Penang

We would like to welcome a new author, Shazia Jamshed, to Cell 2 Soul.   She is fortunate to be researching and studying Social Pharmacy on the magical island of Penang, Malaysia.  "Simply put, social pharmacy relates medication use to individuals and to society at large by using the methodology of the social sciences. In this field, pharmacy is coupled with psychology, economics and sociology. It is truly a blend of science and art.  Social pharmacists advocate for radical change in the recognition of pharmacists' status.  They initiate policies to change the system and attempt to become an integral part in developing and implementing such policies." 

This is an emerging field that holds great promise for us as patients and caregivers.  To read Dr. Jamshed's brief discussion of Social Pharmacy see.  Download Social Pharmacy--edited    

Marginal Notes: Memorial Day, 2010

 

At the northwest corner of the food court inside Atlanta’s CNN building, a small bronze plaque attests to the valor of First Lieutenant Gary C. Jones, United States Army, killed in action in the Republic of Vietnam, February 9, 1968. According to the inscription, LT Jones was awarded the Distinguished Service Cross posthumously.

 

I had taken a plane to Atlanta over the Memorial Day weekend to attend a professional conference.  As I waited in the departure lounge at the airport near my home, I noticed a number of military personnel coming down the concourse.  They were dressed in camouflage Army fatigues and combat boots.  All of them carried massive packs on their shoulders.  Several walked with significant others:  wives or girlfriends, I supposed. One military couple ambled more slowly than the rest. >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

Hibiscus!

Full many a flower is born to blush unseen

And waste it's sweetness on the desert air. 

Picture taken by Mark White, Omao, Hawaii.  email:  MWhite.

By The Sea: a boy, a dog

It's a beautiful time of year in the Northeast.  Mellow summer.  A  time when peace comes dropping slow.  Our friend, Joan Shaw, from the laid-back isle of Kauai, sent us a video that will have you smiling.  Lucas & Shadow Surf Session. It features Shadow, a Jack Russell Terrier, and his human bruddah, Lucas Angulo, a surfer-grom from Hanalei, Kauai, catching some tiny waves at Retros in Hanalei Bay.

Emily Dickinson has a poem, By the Sea which begins:

"I started early, took my dog,
And visited the sea;
The mermaids in the basement
Came out to look at me."

Freud wrote:  "Where ever I go, a poet has been there first."  Who would have guessed it was the Maid of Amherst who also wrote?

I never saw a moor,
I never saw the sea;
Yet know I how the heather looks,
And what a wave must be.

Way to go Shadow, Lucas, Emily too!!