Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Kids Gone Wild: Intimidation Of Parents In The ER

Ah, the benefits of sand therapy!

Time for little Bettina’s daily afternoon face plant!

Not only does it appear my colleague is about to lose her grip on her patient, I’m concerned about her choice of body mechanics.

I predict a lumbar strain in 3…2…1……

(This photo is from the Library of Congress collection.)

**********

I love my pediatric patients. While it is hard to see children feeling sick, they can be bright spots in occasionally hellacious shifts.

I’ve blogged before on my observation that the kids seem to be the adults in the some families.

  • They don’t want to undress for an exam, so they fight the parents who are helpless in the face of taking a shirt off a three-year-old.
  • They have to be restrained so they don’t run rampant in the ER, and they slap their parent across the face. The parent doesn’t respond.
  • They are told they need to cooperate with a procedure and they answer their parent with a loud, clear, “F*** YOU!” At the age of five. The parent retreats. Read more »

*This blog post was originally published at Emergiblog*

Father To Daughter: The Lessons Of Illness

Ruthie and Andrew

When I was diagnosed with leukemia my daughter, Ruthie, was just two and a half. She has vague memories of our household being turned upside down with worried, hushed conversations and friends and relatives calling A LOT. Because a leading specialist, Dr. Michael Keating from MD Anderson Cancer Center, advised against having treatment right away (something better was coming along), I did not have treatment for more than four years. By then Ruthie was seven. She has vivid memories then of me going off to Houston, accompanied by her mom, for a week of initial treatment and then successive weeks of treatment every month for quite a while back here in Seattle. She also remembers me tired, nauseous and, some days, in bed.  The better memory is me participating in a clinical trial that worked and then returning to a full and active life.

Ruthie and I had never really talked about her observations of this until last night. Now, almost 18, Ruthie will be headed to college soon. It’s been a “journey.” As with many teenagers, they can be rebellious and oppositional, at times. But, in most cases, they eventually return to that loving person you remember. Ruthie has been making that return and, as she does, we’ve been talking more.

Last Friday night Ruthie called me in a panic. Read more »

*This blog post was originally published at Andrew's Blog*

Abortion Doesn’t Cause Mental Illness

Here’s yet another study showing that abortion does NOT lead to future psychiatric problems. From The New York Times:

The New England Journal of Medicine has taken on one of the pillar arguments in the abortion debate, asking whether having the procedure increases a woman’s risk of mental-health problems and concluding that it doesn’t. In fact, researchers found, having a baby brings a far higher risk.

The study, by Danish scientists (and financed in part by the Susan Thompson Buffett Foundation, which supports research on abortion rights), is the most extensive of its kind to date. It studied 365,550 Danish women who had an abortion or gave birth for the first time between 1995 and 2007. Of those, 84,620 terminated their pregnancies and 280,930 gave birth.

In the year after an abortion, 15.2 out of 1,000 sought psychiatric help (defined as admission to a hospital or clinic), which was essentially the same as the rate of that group (14.6 per 1,000) in the nine months before the abortion. In contrast, among women who went on to give birth, the rate at which they sought treatment increased to 6.7 per 1,000 after delivery from 3.9 per 1,000 before.

Why do first-time mothers have a lower overall rate of mental illness both before and after pregnancy than those who choose termination? The researchers suggest that those who have abortions are more likely to have emotional problems in the first place. Compared with the group who give birth, those who have abortions are also statistically more likely to be struggling economically, and to have a higher rate of unintended pregnancies.

And why do first-time mothers seem to nearly double their risk in the year after giving birth? That is likely to have something to do with the hormonal changes, decreased sleep, and increased stress of parenting, which women who terminate do not experience.

Can we please talk about something else? Like maybe how to help these young women with the issues and unmet contraceptive needs that led to unplanned pregnancy in the first place?

*This blog post was originally published at The Blog That Ate Manhattan*

Are Plastic Products Safe? Ask Chemistry Professor, Joe Schwarcz, Ph.D.

Have you heard the new urban legend about plastic products? A growing number of celebrities and websites have been fueling a plastic paranoia, striking fear in the hearts of parents, fitness buffs, and microwave container users. Concerns reached such a fever pitch that I wondered if there may be something to this buzz: Can certain plastics harm our bodies or even cause cancer?

But like the buzz surrounding vaccines and autism (there is NO link between the two), plastiphobia (as I like to call it) is not backed by any clear evidence of human harm. Chemist, Dr. Joe Schwarcz of McGill University (who has no financial ties to plastics manufacturers, by the way) has reviewed the scientific literature and has found plastics to be an extremely unlikely candidate for human injury. (Well, unless you hit someone over the head with a water bottle.) Dr. Schwarcz reviewed plastics safety in a live health chat on December 8th. You can review the entertaining conversation here.

Plastiphobia has fueled an entire industry of plastic-free baby bottles and “microwave safe” containers. Read more »

“Laxative Tantrums” In Kids?

This “Fletchers Castoria” ad from 1941 is priceless. And as someone who spends his days working with bound-up grumps like Mary, I was reassured to know that horrific constipation is not a me-generation problem born of chicken fingers and Goldfish. ”Laxative tantrums,” however, are new to me. I seem to have pretty good luck with Miralax and Kristalose in my office. Your mileage (or tantrums) may vary.

*This blog post was originally published at 33 Charts*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »