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How Old Is Too Old To Be An Organ Donor?

I happened to see this press release from American Society of Nephrology via Eurekalert regarding an article in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN) advocating the safety of kidney donation in individuals over 70 years old.  The press release does note that kidneys from these elderly donors do not last as long as those from younger living donors.

Currently, as noted on the University of Maryland Medical Center website:

Donors need to be between the ages of 18 and early 70s and can include parents, children, siblings, other relatives, and friends. An ideal donor should have a genuine interest in donating and a compatible blood type with the recipient.

Donors should be in good general health. Donors do not need to be Read more »

*This blog post was originally published at Suture for a Living*

Medical Ethics And The “R” Word

[Recently] a short article in the New York Times, New Kidney Transplant Policy Would Favor Younger Patients, [drew] my attention to a very basic problem in medical ethics: Rationing.

According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation of donated organs. From the Times piece:

Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies.

This all follows [the recent] front-page business story on the monetary value of life.

I have to admit, I’m glad to see these stories in the media. Any reasoned discussion of policy and reform requires frank talk on healthcare resources which, even in the best of economic times, are limited.

*This blog post was originally published at Medical Lessons*

A New Heart And A New Mission

Mr. Ron Murray, a tranplant heart recipient, tells his story:

From the video:

“If the transplant issue ever comes up for anyone listening, that’s almost the first thing they would think, too. If I had time to think about it over that year, I would have realized ‘Oh, my God.’ I would have apprehension all built up about how I would react to…I mean is it going to change my way of thinking? Is it going to alter my own thoughts? None of that holds up, ultimately.

When I realized that there was going to be forever an emotional component, and maybe a spiritual component to this thing that I hadn’t thought about, is when I became –- God, I don’t even know if I can tell you about it –- that I began to grieve for the donor, that brought me to tears several of those nights. Read more »

*This blog post was originally published at Dr. Wes*

New Hospital Policy Leaves Cancer Patient In Tears

cryingpatientA dear friend of mine (let’s call her Amanda) has metastatic breast cancer. She’s far outlived her life expectancy, thanks to advances in targeted chemotherapy, but is beginning to need more medical care. She’s the divorced mom of two teens, with a loving extended family who keeps a close eye on her.

When Amanda was recently admitted to her local hospital with abdominal pain, a new policy resulted in some unintended consequences. While she was still in the Emergency Department, a nurse came by to ask if Amanda wanted to be an organ donor. The family members – keenly aware of her grave prognosis – assumed that the nurse knew about the cancer, and was asking this question because it had been determined that Amanda was about to die.

Tearful sobs ensued. Amanda’s sister called me the next day to tell me the news. Read more »

April Is National Organ Donor Month

I was reminded that April is National Donor Month by a post over at Donorcycle.  I am a strong organ donation advocate.  My driver’s license is signed.  My family has been informed of my wishes.

It is a point of a contention in my family, hopefully a small one that will be resolved (or never come up for real).  My niece, K, who is in nursing school has signed her driver’s license to be an organ donor.  Her mother, my sister, J, will not give her permission if asked – not readily anyway.  “I don’t want my baby cut up.”  That is her reason.

My niece, K, is a giving soul.  Her wishes should be honored.  She should be allowed to make that last gift if the time ever arises.

I need to find a way to reassure my sister that we don’t “butcher” the body when donor organs are harvested.  I need to get her to read Dr Cris’ blog post “Organ Donation from the Inside

Transplant surgeons care about donors. Staff respect them, and the decision they have made. Their job in this case is to implement the wishes of the donor and not waste their sacrifice. …… I have assisted at an organ retrieval for transplant, and that is why I am on the Organ Donor Register

Another of my sisters recently was widowed when her husband died of heart failure.  He had had many heart attacks over the last several years.  In the end, he was told he needed a heart transplant.  He didn’t live long enough, but I use this to show that the need it there.  The need is great.  If we would be receivers of the organs, then we need to be givers when able.

**This blog post was originally published at Suture For A Living.**

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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