June 11th, 2007 by Dr. Val Jones in Announcements
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Not sure how many of you are aware of this touring
anatomical science exhibit – but it’s been making its rounds through major cities in the U.S. and Europe. I finally went to see it this weekend in DC, and it was both amazing and slightly disappointing.
It was amazing because of the meticulous dissection work done by the Chinese scientists. It was disappointing because, after months of viewing the awe-inspiring marketing photos of colorful cadavers playing soccer, football, conducting an orchestra, etc. I had some sort of unconscious expectation that there would be movement in the exhibit, or at least some medical animations and multi-media. Instead, the exhibit was flat – nothing moved, no multi-media, and much of it was comprised of cadaver slices and organ sections. The attractive, eye catching cadavers made up a very small portion of the exhibit.
Now, I wondered how these cadavers could be unscented (I was told beforehand that there was no odor problem – the way there was in anatomy lab in medical school), and as it turns out it’s because they are not cadavers at all. No, the Bodies are actually plasticized fossils. So the reason they don’t smell is the reason why dinosaur “bones” don’t smell – there are no bits of tissue left.
All that being said – I really have to tell you that seeing these meticulously dissected fossils made me realize how useless medical school anatomy lab really is. A surgeon once told me that he found anatomy lab “a total waste of time” since the anatomy of living flesh bears little resemblance to the greasy beef jerky (sorry to be so graphic – but it’s true) we poke through for months on end at medical school. These Bodies were incredibly beautiful – and I truly saw (and understood) for the first time the exact relationship of every nerve, muscle, tendon, artery and vein to the greater picture. How I wished I could take one of the bodies home with me to study it! Netter is great – but there’s nothing like 3-D to really understand the relationships.
So I can only hope that medical schools will seriously consider offering courses conducted on these beautifully dissected fossils, rather than the smelly, obese cadavers that we muck through today (no disrespect meant to the donors – they are kind to offer their bodies to science). Anatomy is critically important in medicine – but I’m not convinced that the current educational system is set up for maximum impact. Skip anatomy lab – spend some time at the Bodies Exhibit.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 10th, 2007 by Dr. Val Jones in Humor, True Stories
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I’ve been thinking about skin cancer lately. A young, fair skinned friend of mine
recently had a small mole removed from her leg.
It turned out to be melanoma! It
didn’t take me too long to make the connection between her complexion and mine,
and the fact that I’d been avoiding the dermatologist for several years,
worried that I’d come out like a punch biopsy pin cushion since I have quite a
few freckles and moles (and I’ve heard that dermatologists like to err on the
side of caution and biopsy anything remotely suspicious). But the melanoma story galvanized me into
action. I made an appointment with a
dermatologist (yes, I had to wait 4 months to get an appointment!) and got a
skin check. Luckily for me, all was fine. But I started to reflect on various conversations
I’ve had about my skin recently. All you
Irish types out there will relate…
Conversation 1
Coworker A: Val, are you ok?
You look kind of sick.
Me: I’m just fine.
Coworker A: But Val, you look a little… bluish…
Me: That’s just my skin color. My veins show through my skin because it has
no melanin.
Coworker A: (Appearing sympathetic) Oh, well glad you’re
alright.
Conversation 2
Coworker B: (in the middle of a conversation with me, sitting
across from one another on chairs. I’m wearing a skirt. Suddenly she lunges forward
and touches my knee and gasps). Is that
your real skin?
Me: Um… yes. What
else would it be?
Coworker B: Well, I thought you were wearing white pantyhose.
Me: Nope. It’s too
hot for pantyhose so I just go bare legged.
Coworker B: (still in shock). But that’s your skin? Just like that?
Me: Yeah. I don’t
tan.
Coworker B: (appearing sympathetic) Oh, wow.
Conversation 3
Dermatologist: Hi, I’m Dr. XXX. (Peering at me, seated on the examining table
in a paper gown.) Are you Scandinavian?
Me: No, I’m part Welsh – you know, “Jones.”
Dermatologist: Oh, well the Vikings probably invaded Wales
at some point.
Me: (to myself) well thanks for alluding to the raping and pillaging
of my ancestors.
Dermatoligst: You’re high risk for skin cancer. People like you need to have careful skin
exams every year.
Me: Yes I know. But
please don’t take any unnecessary biopsies!
I think my moles are all fine.
Dermatologist: Well let’s see…(tearing the paper gown in two). You definitely need to wear SPF 50…
Me: Sigh. I know…
Conversation 4:
Husband: (giving me what I thought was a tender look. He leans in…) Your eye lids are kind of pinkish purple
Me: Yes, that’s the color of the capillaries that show
through my lid skin. Hard to get a tan
there you know.
Husband: You don’t need a tan – I like your color. Kind of pastel pink and blue. (He leans in even closer to inspect my eye lids.)
Me: Yeah, not exactly attractive in a bathing suit. (I pull away. He laughs.)
Husband: Well, yeah.
It’s better not to be out in the sun or on the beach, but you can still
go outside!
Me: Thanks.
Conversation 5:
Asian manicurist: (looking at my hands) Your skin is so white!
Me: Yes, I’m afraid my past efforts to alter that have failed.
Asian manicurist: How did you get your skin so white?
Me: I didn’t do anything.
It’s like that naturally.
Asian manicurist: (looking closer at my hands) I wish I had skin like yours.
Me: Why? (Hoping she’d say something flattering after all).
Asian manicurist: It looks clean.
And so I guess despite all the people I’ve worried with my vaguely cyanotic appearance, there’s one thing for sure: I look clean. I guess I can live with that.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 9th, 2007 by Dr. Val Jones in True Stories
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My grandmother was a kindly woman. She grew up in a frontier town in Alaska, the daughter of
a photographer. She lived simply, and
spent the majority of her waking hours figuring out how to stay warm. Much to her delight, her mother eventually
moved to San Francisco,
where she was able to thaw out and bloom.
She went on to marry a charismatic business man (one of the
early founders of Technicolor Films) and had 6 children, the first of whom was
autistic. It was a great challenge
taking care of all those kids, with her husband away on business much of the
time. And there were no special services
for children with autism then. So it
came as no surprise when my grandmother seemed a little forgetful and frazzled. But that forgetfulness was not so innocent as
it turns out.
Memory lapses grew into more advanced confusion, as her
children noticed that she was becoming unreliable. She would forget to pick them up from school,
couldn’t remember where they were going next, and didn’t recall what they had
told her only moments prior. My
grandmother had early onset Alzheimer’s disease – and it would take her on a
path of no return.
By the time I was old enough to know my grandmother she was
being cared for by home health aids. She
was still extremely sweet and gentle, and could have short conversations that
were interesting and engaging, but she had no idea who I was, or why we were
speaking. Still, her Victorian
upbringing caused her to be extremely well mannered – never letting on that she
secretly wondered why this “nice young girl” (a perfect stranger) was spending
time with her in her house.
But the strangest part of grandma’s journey with Alzheimer’s
was that it took her on a reverse tour of her former life. She seemed to be reliving each day that had
had the most emotional impact on her – in descending chronological order. So that some weeks she believed that each day
was her 60th birthday… and then she’d move on to each day being her
58th birthday, and so on… But the most heart-wrenching span of weeks
were when she thought it was the day of her husband’s death. She wept all day long, reliving the
experience. We would ask her why she was
crying, and she’d look at us incredulously, “Well, don’t you know that Kay died
today?” Our lack of appreciating that
obvious fact added to her extreme loneliness… as if she had lost her husband
and no one else cared or noticed. We
would try to dissuade her of that notion, reminding her of the actual date and
who each of us was. But alas, the
neurons that housed her emotions seemed to outnumber those that ordered her
memories, and so only time could change her of her perception of reality.
We all watched grandma deteriorate over the years, being
dragged backwards through time by some invisible force, verbalizing her
experiences as she relived them. It was
a kind of bizarre way to learn about her life – through the eyes of a woman who
told old stories as if they were currently occurring.
But eventually the stories ceased, and she regressed to a
non-verbal state. Her mind had finished
its story telling long before her body was ready to let go.
Grandma lived until the age of 96, and passed away
peacefully in her sleep. I can only hope
that she was dreaming of pleasant events in her early childhood when she
slipped into the ether – a baby in a shadow of memory.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 8th, 2007 by Dr. Val Jones in Announcements
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This has been a really interesting week for me. My “Top 10 Tips for a Healthy Wedding” really struck a nerve – and in an unparalleled flurry of interest, I have been speaking to groups of people on the radio and in podcasts about weddings, marriage, and the medical angle on this wonderful celebration of human connectedness.
I was speaking with Gordon Deal from the Wall Street Journal Radio Show (Gordon is a truly affable interviewer) and I got a question that I had not anticipated but in retrospect makes a lot of sense. I was telling him about my decision to buy a wedding dress on the fly, picking one off the shelf in the first store I went to. He transitioned nicely to: would you say that your financial decisions follow your style for purchasing dresses? How have you and your husband worked through financial planning together?
Wow. I had to think on my feet on that one – leave it to a Wall Street journalist to get a financial angle on a story. My answer was truthful and brief – yes, my husband is more conservative than I am, but we have worked hard to get on the same page, thanks to a great financial advisor. (Squirm)
Kristi King at WTOP (partnered with the Washington Post) was up next – and we had a nice chat about the do’s and don’ts of wedding diets.
Then I got to speak to a Randy & Ken in Oklahoma City on KOKC. The weather report preceded my interview, and I couldn’t help but worry about the severe wind conditions down there. When asked about some good tips for a healthy wedding I mentioned that having a plan B is critical – especially if you’ve planned an outdoor wedding with a tent in Oklahoma!
On the eve of my second wedding anniversary I participated in a blogger call with Dr. Charles Foster (who is an amazingly insightful psychologist and relationship counselor – you should definitely listen to this podcast because it is very well worth it if you have any problems whatsoever with in-laws or your own family). We spoke with Rhonda from “Our Wedding Plus” blog and fielded questions from others remotely.
On I moved to a live show in Chicago with Theo & Gerrard at WVON (host to the Al Sharpton show) where we had a warm conversation about the meaning of marriage and the importance of a strong family nucleus for the fabric of American society.
There is at least one more interview awaiting (a contemporary music radio station in Hawaii) and I have to say that this has been one wild ride. As a physician I feel totally privileged to have been given the chance to speak with such a wide variety of Americans about a joyful, complicated subject that unites us all – the wedding.
Now if my taxi hijacking post sparks this sort of interest, I suppose I might need to hang up the stethoscope and focus on social commentary and relationships.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 6th, 2007 by Dr. Val Jones in Health Policy
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I’ve blogged previously about how unhelpful most Pay for Performance measures are for improving healthcare outcomes and “rewarding” physicians who provide evidence-based care. But this sentence (spotted by Kevin, MD) summarizes my pages of opinions perfectly:
“Judging medical quality from claims data is like judging a restaurant by looking at its grocery bill.”
And if that didn’t sum it up perfectly, consider this:
The amount of “pay” for performance is so small that it is not incentive enough for physicians (or hospitals) to change their clinical practice behavior. In effect, as JAMA says, “the carrot is not big enough.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
