March 22nd, 2007 by Dr. Val Jones in True Stories
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Growing up in Canada, my family spent a lot of time in the car. While my European friends would tell me how they could drive through 4 countries in a matter of hours, in Canada I couldn’t get part of the way through our smallest province in the same time period. Canadians have to travel long distances to get anywhere, which is part of the reason why they’re such a tolerant and patient lot.
So on these long drives (long before the days of portable entertainment devices) my family would have to think of ways to pass the time. Our favorite game was inspired by “20 questions.” We called it “the animal guessing game.”
It basically worked like this – you thought of the most unusual animal you knew of (perhaps something you’d seen on Animal Kingdom or in an animal encyclopedia) and the rest of the family would ask yes and no questions until they guessed what it was, or all agreed to being stumped.
Now, most of us would systematically narrow the field of possibilities by asking typical questions related to size, territory, habitat, skin type (fur, scale etc.) and so on. But my younger sister would always begin by asking the same question:
“Does it have fangs?”
At the time I thought she was hopelessly silly and incapable of systematic analysis. So few animals, after all, would fall into that category. Surely that wasn’t a good lead question.
But as I reflect on my sister’s perseverance on fangs, I realize that she was using an emotive hierarchy. To her, animals with fangs were so frightening, that she wanted to get it out of the way first thing – to be sure that we weren’t going to be spending time reviewing the life cycle and eating habits of animals with sharp teeth.
You know, it may seem funny, but I think that when it comes to matters of medicine some patients feel the way my sister did about the animal guessing game. They’re in unfamiliar territory, they are afraid of a real or perceived threat of a painful test or procedure, and they are internally focused on that threat to the exclusion of the big picture.
Doctors have the natural tendency to be removed from the emotional priorities of patients. We think that the patient is most interested in the evidence behind certain tests, the statistics, the technical aspects of a procedure – but sometimes as they try to comprehend the details of your informed consent, they really have one burning question:
Does it have fangs?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 21st, 2007 by Dr. Val Jones in News
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As spring approaches, we can expect a new onslaught of pollen, bugs, and mud puddles. Mosquito eggs will hatch in stagnant water, and a new generation of hungry little disease vectors will be lurking in wooded areas, awaiting their first meal.
Luckily for those of us who live in North America, those annoying mosquito bites are unlikely to infect us with malaria.
A team of scientists committed to eradicating malaria (one of my personal favorite parasites) has taken a new approach to reducing transmission rates: creating a strain of malaria-immune mosquitoes.
I had been under the mistaken impression that mosquitoes lived in perfect harmony with malaria parasites, but apparently the organisms can make them quite ill as well. Not ill enough to die immediately (hence their ability to spread the disease) but ill enough to die prematurely.
So if we could create a malaria immune mosquito, we could give them a survival advantage over their peers, thus slowly influencing the mosquito population in favor of the new strain. This could result in a new population of mosquitoes who could not harbor malaria.
In humans, malaria parasites have learned how to attach themselves to red blood cell proteins and incubate inside the cells. In mosquitoes, the parasites latch on to a protein (called SM1) on the surface of epithelial cells of their gut lining. Through the miracle of genetic engineering, we’ve managed to alter the SM1 proteins in certain mosquitoes, making them immune to invasion by parasites they ingest through infected blood.
Although the immune mosquitoes are not ready for prime time release in malaria endemic countries (the research only showed that the scientists could genetically engineer resistance to one strain of malaria), it sure would be interesting to see if we could use mosquitoes themselves to fight a disease that claims the lives of over one million people per year.
This is a rare case of a problem becoming the solution!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 8th, 2007 by Dr. Val Jones in Opinion
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A Turkish friend of mine told me that he had saved for several years to bring his grandmother to America for a visit. His pre-teen son had met her only twice in his life (via trips to Istanbul) but they corresponded frequently and had a very close bond. My friend said he wanted to surprise his son by having his grandma at home when he came back from school on his 14th birthday. The only hesitation, my friend said, was that his mom didn’t speak any English and he was worried that she might get lost during an airplane transfer or in the airport. He worried that she would be afraid and alone.
Being in a foreign country where you don’t speak the language can be a frightening experience. When I was a teenager, I flew to Zaragoza, Spain to visit a friend of my mother’s. I felt excited at take off from the US, but as the plane approached the unfamiliar red soil of our destination, a sense of uneasiness settled in. The flight attendants started messaging in Spanish, and as we touched down I knew that I wasn’t home anymore. All I knew how to say was “hola.”
As I made my way through the airport, all the signs were in Spanish, I knew I needed to get a cab, but I wasn’t sure where to wait – and the Spaniards didn’t seem to respect queues. Once I fought my way to the front of a gaggle of natives, I realized that the cab driver needed to ask me clarifying questions about my friend’s address. I responded in English, to which he repeated his question with increased volume. I felt really stupid and quite helpless.
My experience was kind of similar to the feeling that patients have when they are thrust into a medical situation with a sudden, life threatening illness. Healthcare professionals can forget how foreign everything is to the patient, and go about their activities without explanation, or with jargon-rich “medicalese” that is virtually inscrutable to the person with the illness. When questioned, they repeat the jargon, raising their voice for emphasis and “clarity.”
Hospitals spend lots of money on translator services for foreign languages, but many healthcare professionals forget that medicine itself is a kind of unique language that requires translation. As the consumer driven healthcare movement takes wing, it will be more and more important to provide a kind of translator service for those who need to make educated decisions about their medical options. The accuracy of the translation can be a matter of life or death, and so healthcare consumers need to be very selective in where they get their information. Considering the source of your information has never been more important. Don’t let your health be lost in translation.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 4th, 2007 by Dr. Val Jones in News
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In a recent poll, 80% of consumers (along with the British Medical Association) preferred a simple “stop light” food label to a long list of percentage figures of recommended daily amounts. The stop light icon simply categorizes food as containing low (green), medium (yellow), or high (red) levels of the following ingredients:
- Fat
- Saturated Fats
- Sugar
- Salt
The guideline daily amounts (GDA – the rough equivalent of America’s RDA system) supporters argue that the stop light is an oversimplification, and does not effectively convey all the important nutritional value of food.
What do you think? Would you like to see this sort of labeling in the US?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 22nd, 2007 by Dr. Val Jones in News
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Recent research suggested that circumcision may reduce the rate of HIV transmission by 50% (foreskin cells are particularly vulnerable to infection with the virus). In response to this news, adult men in Uganda and Kenya have been undergoing the procedure in the hope of reducing their risk of HIV infection.
Some young boys in Kenya were actually expelled from school for not being circumcised. Their parents were asked to bring them back to school once the deed was done.
HIV rates have decreased in Uganda from 15% to 5% after aggressive public health initiatives raised awareness of the importance of safe sexual practices. This is an incredibly positive achievement.
One would hope, however, that circumcision in infancy would become the preferred target age for future procedures.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
