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

Latest Posts

Are Doctors More Likely To Refuse Certain Medical Care?

No CPRA must-read piece from Ken Murray:

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

Worth the full read.

And so true. I’ve joked about getting the above tattoo when my times comes. (I would quibble that the modern CPR success rate is better than infinitesimal, especially with hypothermia, but it still ain’t great.)

It may have to do with Read more »

*This blog post was originally published at Movin' Meat*

Handling One’s Emotions In A Survival Situation

Perhaps the greatest thrill in attending a summer meeting of the Wilderness Medical Society (WMS) is listening to new, enthusiastic and exciting speakers. They bring new insights and opinions to numerous topics and discussions, which is an essential part of the educational process. This past summer, at the 2010 Annual Meeting of the WMS held in Snowmass, Colorado, Dr. Drew Watters from the Indiana University School of Medicine approached the audience with his observations about neurobiology and survival. It was an innovative approach to a very common topic within wilderness medicine. How does one account for and handle emotions in a time of stress, including the most stressful situation of all—namely, a survival situation? When is it better to think, rather than to react? The objectives of his presentation were to understand to a certain extent survival, the anatomy of thought and perception, the neurobiology of emotions, behavior, emotive and cognitive decisions, and implementation of interventions in situations dominated by emotion.

Anyone who has practiced wilderness medicine knows that bad things happen, sometimes despite the best preparations and intentions. People make bad decisions that can too often be characterized as dumb. If they follow with more bad decisions, the situation Read more »

This post, Handling One’s Emotions In A Survival Situation, was originally published on by Paul Auerbach, M.D..

How Cancer Survivors Are Picking Themselves Up And Moving Past The Worry

Thank God television and movie script writers are starting to “get it.” Cancer, “The Big C,” doesn’t always kill people, or maim them, or steal their dreams. Lately there have been new TV shows acknowledging cancer as part of life that many can live through. There’s a new movie coming called 50/50 about a young adult man with cancer (important to acknowledge it in this age group!). I hope he doesn’t die in the end. But from the preview, it’s clear he talks to people about it – including young women he is trying to date. It’s a comedy. On Showtime on cable TV there’s a series, The Big C, where actress Laura Linney plays a teacher with melanoma and a year to live. The good news is they had a second season!

My point is there are now nearly 12 million cancer survivors. Three of work them at Patient Power (one is me, almost 61, one is in her 50’s, one is just 18). More and more of us do not have just months or a year to live. We are true survivors. We have to start watching our cholesterol and taking baby aspirins, we have to watch our weight, plan for retirement or manage a fixed income. For the young one, it’s plan for college. We have to think about who we might vote for in the next election. We are LIVING! Maybe for a full lifespan, maybe not, but living each day with purpose.

Yes, it’s true there could be “another shoe” that drops, Read more »

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

When To Accept That “The Beast” Is Winning

Steve Jobs in 2010

It was a bombshell that shouldn’t have been unexpected. Steve Jobs resigning. Anyone who saw him knew he was sick and, just watching him on television, it was obvious to me he was getting sicker. When you get so thin, when your color is not good, when you are probably taking heavy duty drugs that have side effects, you certainly don’t feel good. And when you don’t feel good, it is tough to think clearly, and make decisions with certainty. That is not a good thing for the CEO of one of the most successful corporations. It is actually a tribute to his will that he carried on so long. Many of the rest of us would be on a beach, taking it easy and celebrating every day. Steve Jobs celebrated every day by running Apple.

But at some point, given life is a terminal condition anyway, you have to accept that “the beast,” whatever it is in your case, is winning. I know that for myself. I have had a long remission with leukemia. But I know it could come back and even newer drugs might not “win.” I am thankful for the success treatment has had for so long. And I am sure Steve Jobs is thankful his diagnosis several years ago didn’t lead to his demise right then. We thank him, too, for iPhones and iPads and several other wonderful gizmos he has in the works that will blossom in the future.

Knowing when to call it quits – not accepting death – but accepting disability or a need to spend time differently – is a hard part of being a patient, it stinks. But it is reality. Read more »

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

Why I’m Afraid For Anyone To Enter The Healthcare System… Ever

Alright, I admit that the title of this post is a little dramatic. But it really does seem that most people I know socially have had a bad experience with the healthcare system lately. Take for example my friend whose 3- year-old went to the hospital for a common pediatric procedure – the little girl was overdosed on a medicine, aspirated, got pneumonia, went into respiratory distress (noticed first by her mom) and remained in the pediatric ICU for several days. The hospital staff swept the overdose under the rug, and outright denied it happened when faced with direct questioning. As outrageous as that all is, my friend chose not to pursue action against the hospital and staff for their error and behavior. She just “let it go” because no permanent harm had occurred.

Another dear friend was recently misdiagnosed with having a pulmonary condition when he was in heart failure from an arrhythmia… and almost had a stroke during a contraindicated pulmonary stress test. His simple conclusion: “doctors suck.” Was anyone held accountable for this? No. Again because no permanent harm had occurred.

Just the other night I was having dinner with some visitors from out of town. They both told me Read more »

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 »