Cell 2 Soul: The Humane Health Care Blog

Medicine as Theatre

Medicine and the Movies
Musings from Rob Norman

Medicine is like theater, there is a lot of behind the scenes production before you enter the stage of the patient room.

Sometimes I think we should have popcorn all the time at the office, because it is like a movie with an often challenging array of characters. Most of the time I work inside a creative movie I can step into and change the plot and action, and the good guys generally win. Bit players come and go, performances light up the exam rooms, speeches and quips rivaling Shakespeare at times erupt, and the potential for drama is always at hand. Problems are handled with equanimity, and like a good plane flight, we get through any turbulence and land safely at the end of the day.

Contact Rob Norman (Dermatologist, Tampa, Florida)

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

 

From Student to Doctor

James Channing Shaw, one of our C2S family, has just published a new book, “Room for Examination: True Tales of a Disillusioned Dermatologist.” It chronicles his path from naïf to dermatologist. It is wise, philosophical, honest, poignant, humorous, engagingly written, never self-serving and riveting.  Dr. Shaw is Division Head of Dermatology at the Women's College Hospital, University of Toronto, Canada.

The book is available for Kindle only.

Here is a short review: Download Shaw-book-review

To Purchase: Room for Examination· 
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How Children Succeed

We've been reading Paul Tough's important new book, “How Children Succeed” and find it to be mandatory text for those who are parents or grandparents of young children.  Instead of waxing enthusiastic, please turn to David Brooks' Op=Ed piece devoted to Tough's book in the Friday, September 28 New York Times.

Brooks calls “How Children Succeed” an  "essential book."  "Childhood stress can have long lasting neural effects, making it harder to exercise self-control, focus attention, delay gratification and do many of the other things that contribute to a happy life."  Brooks essay is a great introduction and precis of required reading for many of us.

Medicine Men by Elaine Zeichner

I have an otolaryngologist
Who treats my sinusitis.
An orthopedic surgeon who’s
In charge of my bursitis;
A gastroenterologist
Who probes and writes Rxs
Whenever my complaints are lodged
Around my solar pìexus.
A trusted ophthalmologist
who sees to how I'm seeing,
A psychiatric expert for
Emotional well being;
A noted rheumatologist
To manage my arthritis,
And yet another specialist
For warts and dermatitis;
A leading cardiologist
To regulate the heart of me,
A team of radiologists
Who've pictured every part of me.
And yet, with all their wherewithal,
They heal themselves, I’m told,
With aspirin, tea, and chicken soup
Whenever they catch cold.

Download Zeichner Poem

Author Bio:  Elaine Zeichner was born in New York City and is a graduate of Hunter College.  While at Hunter, she honed her creative talents writing lyrics for “Sing.”  She and her husband lived in Fresh Meadows, Queens, NY where they raised their two children.  After 25 years as a NYC schoolteacher, Elaine and her husband relocated to South Florida. She continues to enjoy dabbling in poetry and creative writing.

Photo is on Jainworld.com site.

Ms. Zeichner's poem reminded me of the parable of the blind men and the elephant.  Each of her specialists sees only a part of her.  Where is the generalist of old?

Romney's Moochers

Berkshire Eagle 9.20.12

Red Fox

On a morning run, I come across red fox.  We stand still, appraising eachother, then as I get my camera ready, another runner comes from opposite direction -- a quick shot and this beautiful ellusive beastie darts into the bushes leaving me alone in wonder and appreciation.

The Knolls, Williamstown 9/20/12

 

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.

Louis Simpson Obit

There was a moving obituary in the NY Times about Louis Simpson, a Pulitzer Prize-winning poet who told characteristically American tales of common people and often cast a skeptical eye on the American dream.

Simpson was born in Jamaica of a Russian-Jewish mother and an aristocratic white father who hid is African ancestry.  He moved to New York as a teenager and left Columbia College, as so many other young med did, to serve in World War II.  His life storyy is tailor made for a spell-binding book.

I had never heard of him.  My loss.  You can access his obit here.

Written in the early 1960s. his cynical poem “In the Suburbs” seems apt for today.

You were born to waste your life.

You were born to this middleclass life

As others before you

Were born to walk in procession

To the temple, singing.

TBI Poster Person

""Gabby Giffords, whose political career was cut short when she was seriously wounded by a gunman in Phoenix on Jan. 8, 2011, took the stage at the Democratic National Convention on September 6, 2012 to lead the crowd in reciting the Pledge of Allegiance."  Ms. Giffords showed true grit in doing so, and puts persons with Traumatic Brain Injuries (TBIs) in center stage.

Gabby's Pledge (on YouTube)

Julia Fox Garrison had a promising career in the computer industry when she suffered a massive brain hemorrhage and paralyzing stroke. While recovering, she realized that she had a lot to say. Her book, "Don't Leave Me This Way" is worth reading for anyone with an interest in TBI or Acquired Brain Injury (ABI).

Here are Julia's comments on Gabby's pledge:

"I watched Gabby Giffords deliver the Pledge of Allegiance with a mixture of awe and admiration. This was not just an example of one person's will to overcome, for Gabby has become a role model to the nation that whatever adversity we face, we must never give up or give in to  the obstacles placed before us. Think of all the anonymous Gabbys out there persevering in the face of life-altering hardships.

I regularly encounter survivors at brain injury conferences who educate and inspire me by their resolve to get better. They all demonstrate an ability to reach deep within themselves to find the strength to continue the struggle to improve and recover. But they are not alone, for they share the struggle with a support network of family, friends, caregivers, and therapists who encourage and motivate the survivors. Those in the network have their own affliction by association and share a diagnosis of helplessness.

As I watched the broadcast, I couldn't help but contrast Gabby's return to the public spotlight with Dick Clark returning to his New Year's Eve special following his stroke. I recall the public discourse being divided, on the one hand admiring his courage, and on the other, wishing he had not returned to the airwaves. I, of course, aligned with the former, but I understand the latter position. People with no direct link to brain injury don't know what to expect or how react, and so they do not want to be confronted with its impact. The difference, of course, in these two cases is that Dick Clark's speech was seriously impaired, while Gabby spoke forcefully and deliberately, thus gaining the love and admiration of the audience. Clearly, she had worked long and hard to master her delivery. Also remarkable is that Gabby is only some 20 months out from her injury.

The road to recovery from brain injury is slow and arduous, often measured in baby steps. Day to day, we, as survivors, feel like we aren't making any progress, but then we compare where we are to where we were at the time of injury and we realize that all those baby steps add up to a leap. The hard part is realizing and accepting that no matter how much we recover, we will not be the same person we were. How could we be, after what we've been through; we, like Gabby, are so much wiser, stronger, more resilient, and grateful to still be here, making a positive impact."

You my contact Julia at JFG Email.