A friend of mine sent me this neat link. It’s an interactive page that shows you where all the presidential candidates stack up on major healthcare issues, and by answering a few questions, you can see where YOU fit on the graph. Check it out!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
A coworker (we’ll call her Tina) approached me yesterday for what she called “pseudo medical advice.” Apparently she had gone to a local sandwich shop with a friend, and purchased some bottled water to compliment her deli item. As the two sat down at a table and prepared to have a leisurely lunch, Tina twisted off the water top and took a big swig.
To her horror, she had taken a large gulp of what tasted like lemon soda instead. She checked the plastic bottle – it was marked as pure water. She instantly recalled that the bottle top had come off rather easily and she heard no characteristic suction noise as air first entered. She was gripped with fear – could this be a poisoning? Did someone tamper with the bottle to inflict harm on unsuspecting victims?
Tina’s friend advised her to call the Poison Control Center. The woman who answered asked if Tina was having any symptoms – nausea/vomiting, headache, dizziness, abdominal pain… She denied each of these, complaining only of some tingling around her mouth (probably because Tina was so worried that she was hyperventilating). The Poison Control Center recommended that she keep the bottle, call the water manufacturer, and go to the ER immediately if she experienced any symptoms.
Tina asked me if she had done the right thing and if I thought she might have been poisoned. I told her that calling the Poison Control Center was a good idea, and although the thought of drinking out of a stranger’s water bottle is fairly disgusting, here’s what I thought about her actual risk:
1. The most likely scenario is that someone was using the water bottle for their daily drink – refilling it with soda from home and taking it to work each day. They probably left it on a counter by accident and a clerk reshelved it in the cooler. I give this an 80% chance of being the cause of the SNAFU.
2. The second most likely scenario is that some kids wanted to pull a prank and intentionally filled the water bottle with soda to see what would happen when someone drank it. I give this a 19.99% likelihood.
3. The third potential explanation for what happened, which is very unlikely, is that a nefarious random killer is masking poison with Sprite or 7-Up in water bottles around the city. I give that a 0.0001% chance on the high side.
The reason why I don’t think Tina’s drama is consistent with a poisoning is three-fold:
1. Most poisonings are directed towards specific individuals – renegade spies, abusive spouses, unwanted kids, that sort of thing. It’s quite rare for people to bother to try to poison random individuals. In the rare cases where this has happened (take the Tylenol debacle of 1982 for example – where cyanide was carefully planted in non-tamper resistant bottles) the idea was to make the person think that the product they were taking was totally NORMAL. Otherwise, why would the person take the full dose? A water bottle filled with soda is a real red flag.
2. The most common deadly poisons are flavorless and odorless (cyanide and arsenic) so there would be no need to use lemon soda to cover the taste. Styrchnine is incredibly bitter and can’t be covered up easily – anthrax, ricin, and sarin have to be inhaled so they wouldn’t be as successful in a bottle form.
3. Tina had no immediate symptoms. Arsenic poisoning causes symptoms within 2-24 hours of exposure, with abdominal pain, headache, weakness, dizziness being the most common initial symptoms. They are followed by bloody urine, jaundice, and severe abdominal pain. For cyanide, the effects are very rapid – causing confusion, fainting, collapse and potential coma. Again, after 24 hours Tina was completely asymptomatic.
After discussing this with Tina she said she felt much better and she perked up nicely. Then tilted her head thoughtfully and asked, “could I catch an infectious disease from drinking out of someone else’s bottle? Like, could I get herpes?”
“Oh yes, that’s possible. Cold, flu, and herpes viruses can be transmitted from glasses and bottles.”
A look of horror crossed her face.
“Um… well (I tried to save all the reassuring I’d done about the poisoning) it’s probably unlikely… I uh, don’t know how long the bottle was sitting in the fridge, maybe the viruses dried up and died?”
“Well, thanks, Val. I guess we’ll just have to wait and see what happens.”
“Yep. You’ll probably be just fine. Did you have your flu shot this year?”
“Uh, no.”
“Oh, never mind.” I said.
And Tina turned around and left with about the same level of anxiety that she had arrived. We’d just switched poisoning for herpes or the flu. Oh well?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
– The US Declaration of Independence, July 4, 1776
When I was in college I spent my summers working with mentally and physically disabled adults in group homes and camps. Many of the patients had IQs<75, which presented a unique communication challenge. Emotional outbursts were not uncommon as the adults used the only form of communication that seemed to draw attention to an immediate need. I spent a lot of my time trying to predict needs before frustrations bloomed, and after getting to know the peculiarities of each individual, I could generally keep the group in a fairly content state.
Most of the adults were on a long list of medications – some were for epilepsy, others were for heart defects, but many were antipsychotics and sedatives. At the time I didn’t realize exactly what each medicine was for, and wondered why these relatively young men and women needed so many pills.
In retrospect I believe that many of the medicines were a misguided attempt to control behavior. It’s analogous to giving someone, with their hand in a bucket of very hot water, a pain medicine instead of removing their hand from the bucket. And now new research in the Lancet suggests that antipsychotic medications (such as haldol or risperdal) do little or nothing to control aggressive behavior in the mentally disabled (though not psychotic) population.
So why have we been giving mentally disabled individuals antipsychotics for decades? Sadly, we thought that these pills would provide a quick and easy way to conform their behavior to our sensibilities, without having to get to know the reasons for their frustrations. And of course, these people weren’t intellectually sophisticated enough to question the utility of this approach or to decline the use of such medications.
I find it terribly sad that it has taken us this long to realize that giving anti-psychotics to mentally impaired people is not in their best interest. Surely more evidence would have been gathered prior to subjecting “normal” adults to such treatments. In this imperfect world, it does seem that those without a voice are less often heard. It is our responsibility as healthcare professionals to look after their interests and not take the easy way out. Mentally disabled individuals have the right to express themselves, and to be free of unproven and unnecessary drug treatments. Life, liberty, and the pursuit of happiness. Our own Declaration of Independence argues as much.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
Last night I watched the premier of VH1’s new “Celebrity Rehab” reality show with Dr. Drew Pinsky, an M.D. and popular TV and radio personality. Before turning on the TV, I had my own reservations about making a spectacle out of alcohol and drug addiction. But I hoped that the show would help to unglamorize the Hollywood drug culture and dissuade young men and women from idolizing bad behavior. As a physician who helped run a detox unit in New York City, I was also curious to see whether or not this “rehab” resembled real-world drug rehabilitation.
Overall, I was sorely disappointed. The only realistic part of the show involved actor Jeff Conaway (of “Grease” and “Taxi” fame), who was the most impaired and ill of the group. His speech and behaviors were typical of a man so wracked by drug and alcohol addiction that he needed a wheelchair for mobility. It was tragic to see him in such a self-destructive state, and witnessing his condition was a real wake-up call for anyone considering starting down that path. As for the rest of the stars, they seemed to be more interested in getting attention from the camera than turning their lives around and breaking their addictive behaviors.
The good
“Celebrity Rehab” may have some “shock value,” as it offers viewers some footage of individuals whose addictions have destroyed their lives. Although Jeff Conaway’s situation is certainly tragic and unappealing, the other stars still maintain some degree of “coolness” -which may be counterproductive for a young audience.
The bad
Overall, the dialogue is quite dull – which comes as no surprise since the individuals being videotaped were often inebriated or high on cocaine. The desire for true change does not come through in the celebrity stories, as best evidenced by a conversation between Dr. Drew and former professional wrestler Chyna (aka Joan Marie Laurer). Dr. Drew asks Chyna why she has come to “Celebrity Rehab,” and she responds with a shrug and says: “I don’t know.” Not compelling television.
I had the feeling that empathetic counseling is not Dr. Drew’s forte. In his attempt to show tough love mixed with detailed history taking, he comes off as aloof and uncaring. He is neither believable nor inspirational as a change agent. This disconnect makes it hard to believe that “Celebrity Rehab” is going to turn anyone’s life around.
Of course, the plush set, the comfortable celebrity quarters and the trendy clothing bear no resemblance to real drug rehab centers, where facilities are bare-bones and clinical and all patients wear standard uniforms. The lack of case managers, nursing staff and therapists was also notable – as the normal team approach was spun unconvincingly as a one-man Dr. Drew show. And of course, inpatient drug rehabilitation centers in the real world are NEVER co-ed.
The ugly
Some of the footage was so clearly contrived as to be annoying. Provocative pseudo “conflicts” were created in an attempt to maintain viewer interest. At one point, porn star (and attention-grabbing yet unrealistic 2003 California gubernatorial candidate) Mary Carey makes a fuss about having her dildos confiscated and then asks fellow patient Seth Binzer (lead singer of the rap-rock band Crazy Town) if he’ll have sex with her. This type of interaction really devalues the show and further undermines the credibility of the ongoing rehabilitation. Parents should wonder if exposure to this sort of material is more of a harm than a help to their tweens and teens.
In the final analysis, “Celebrity Rehab” has all the makings of a failure “me-too” reality show, relying on sensationalism to lure viewers. Recycled reality TV celebrities prance about the show in low-cut dresses while Dr. Drew makes uninsightful therapeutic gestures in a rehabilitation setting that’s not designed to truly affect change. I believe that drug and alcohol addiction deserves a more sincere and thoughtful analysis — something that an experienced documentary producer could achieve more effectively. I fear that the screenwriter’s strike will result in even more poor quality reality shows in the near term.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
I guess all the enthusiasm from Iowa and New Hampshire have translated themselves into the blogosphere. Not only have I been made a finalist in the Best New Medblog of 2007 award contest, but my alter ego – Mindy Roberts of The Mommy Blog has been nominated for the “Hottest Mommy Blogger” in the Blogger’s Choice awards. Please vote for her when you get a chance. You may remember Mindy from my blog posts about her new book called, “Mommy Confidential: Adventures from the Wonderbelly of Motherhood.” Mindy is a fantastic writer with a terrific sense of humor. I’ve posted excerpts here and here. My favorite one is this:
Will is obsessed with size differentials among animals and the relative strengths and weaknesses of each as they relate to other predators. He wants to know exactly how big everything is so that he can determine how many predators it takes to bring down each type of prey. Among the factors are: height, weight, speed, habitat, how far it can jump, whether it can rear up, whether it can swim, and how sharp the teeth are. Usually he wants to know if, say, 20 wolves can take on 10 tigers, but this morning’s question took the cake. “Daddy, can 10 monkeys take down a zebra?”
Many thanks to Cooper and Emily at The Motherhood who have posted a request for folks to vote for my blog in the blog award contest. It’s so great to be loved by MOMs!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
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