An assumption of my new web show, CBSDOC.COM, is that people are aching for mature discussions about health. This week I went to Central Park in New York City to talk to passersby about their sexuality, hoping to strike the right tone. I brought along two female gynecologists – Dr. Lori Warren and Dr. Rebecca Booth – experts who flew all the way from Louisville, Kentucky to help me out. Dr. Booth has written a book called “The Venus Week: Discover the Powerful Secret of Your Cycle At Any Age” that explains how hormones affect women from adolescence to menopause. Each has an active clinical practice and extensive experience talking to their patients about everything from memory loss following pregnancy (“my memory went out with the placenta”) to plummeting libido. And as luck would have it, total strangers we met at Columbus Circle talked to us quite openly about those very problems, eager to hear some practical advice. I hope we accomplished our goal of talking about a sensitive subject in a grown-up manner.
**Better Health readers: please let us know what you think of this new video series with Dr. LaPook. Leave a comment below. Thanks!**
Jill told me that she wrote Seductive Delusions out of sadness and frustration with her inability to protect young people from STDs. Jill saw new cases of sexually transmitted diseases in her patients every week, and wanted very badly to reverse this trend. No amount of counseling “after the fact” had a sufficient effect on new cases, so she decided to launch a preemptive strike: an educational book targeting those who never thought they could contract an STD.
Seductive Delusions uses a “case based learning” approach to educating readers about STDs. Each chapter begins with two true life stories about young people who succumb to STDs. Characters are based upon the lives of patients whom Jill has treated over the years, but stories are blended to protect anonymity. The story-telling format (followed by fact-based summaries) makes the content more entertaining and engaging to read. I doubt that a textbook could hold readers’ attention as effectively as Seductive Delusions does.
I chose to read Seductive Delusions cover-to-cover in 2 sittings, and such a concentrated dose of horror stories made me feel hesitant about ever having sex again. I can also say that there was one uncomfortable moment in an airplane (I read the book on the way back from Albuquerque) when the man sitting next to me glanced at the cover and gave me a very shifty look, and spent the rest of the flight leaning noticeably towards the seat on the opposite side.
That being said, I did enjoy the book. Jill’s characters have an innocent quality to them – like the cast from “Leave It To Beaver.” And I think that was exactly her point – you’d never expect the Cleaver family to be touched by STDs, and yet the truth is that they are succumbing to them in record numbers. Part of the danger of being one of those supposedly “low risk” individuals is that sufficient precautions against STDs are not taken due to a false sense of security.
I had assumed from the title of the book that “everyday people” would include a wider range of characters than were presented. I have been concerned about the reemergence of STDs, for example, in the retiree community in Florida, and thought that Seductive Delusions might touch on that unexpected risk group. However, the target demographic for the book is the late teen to thirty-something heterosexual male and female. I agree with Jill that there’s an educational gap there – but I would have enjoyed her casting a wider net.
The other potential short coming of the book is that the narratives describing how the various characters contracted an STD are so engaging that the reader is left disappointed at never hearing about the long-term outcomes for these individuals. I became emotionally invested in the story (for example) of how Evan contracted HIV from his very first girlfriend (a woman who had been with a man who used IV drugs prior to dating Evan). I felt as if I were there with Evan when he received the devastating news about being HIV positive, and then he drifted away from the pages of the book never to be heard from again. The lack of resolution left me with an uneasy feeling – probably the same feeling that Emergency Medicine physicians experience at the end of each shift.
Nonetheless, I would highly recommend this book to all sexually active young people. It is eye-opening and disturbing in the right sort of way. It’s the kind of book that will help people think twice before they become intimate with others, and take stock of the true health risks involved. I can only hope, along with Jill, that this book will reach the right eyeballs at the right time – and reduce the devastating spread of sexually transmitted diseases in America and beyond.
My friend and fellow medblogger Peggy Polaneczky, MD had this to say after returning from a medical conference in Salzburg:
We had lots of conversations about healthcare in our respective countries. And all I can say is, despite all the issues we have in the United States, I wouldn’t want to be practicing medicine anywhere else but here. Not when I hear tale of docs whose only way of surviving financially is to take tips from patients who pay to squeeze into the surgical schedule ahead of the cue. Or of abdominal emergencies handled in hospitals that don’t have a CT scanner. And not a single fellow has a microscope in their office, forcing them to rely on gram stain only for management of vaginitis. (A poor substitute for an in office wet prep in my opinion.)
Most of these docs would give their eye teeth to spend some time learning medicine in the United Sates, be it something as simple as an observership or as complex as a second residency. Unfortunately, visa regulations in their countries and ours make this extremely difficult. But all of them will be offered observerships in Vienna and in Germany at the Institute’s expense.
Did you know that one in three women will have a hysterectomy (surgical removal of the uterus) by age 60? It is the second most common surgical procedure among women in the United States. But the question is: are they all necessary? I had a fascinating interview with Dr. Elizabeth Stewart from the Mayo Clinic about some of the reasons behind the potential excess of this type of surgery. You may be surprised to learn that insurance reimbursement guidelines may have something to do with it.
Dr. Val: Women often undergo hysterectomies to treat painful fibroids (benign growths in the uterus). What do women need to know about their fibroid treatment options?
Dr. Stewart: They need to know that they have many different treatment options for uterine fibroids. A hysterectomy is not their only choice. Women should ask their doctor to explain all their options and also make sure that they have the correct diagnosis – menstrual cramping and heavy bleeding doesn’t necessarily mean you have fibroids.
Nowadays we can treat fibroids with hysterectomy, uterine artery ablation, or MRI-guided focused ultrasound surgery (MRgFUS). MRgFUS is a nearly painless procedure where we use focused ultrasound waves to destroy fibroid tissue via heat transfer. I know one woman who went back to work 2 hours after the procedure. Recovery from a hysterectomy or uterine artery ablation can take weeks to months.
Dr. Val: What are some of the advantages and disadvantages of treating fibroids with focused ultrasound?Read more »
I’ll admit it – when I was a kid, I admired Dr. Bones (McCoy) of Star Trek. He was a no-nonsense kind of guy who was very clear about his areas of expertise (“Damn it, Jim, I’m a doctor, not a spaceship engineer.”) But best of all, Dr. McCoy had special healing gadgets that he could wave over people for diagnostic and therapeutic purposes. Those “tricorders” fascinated me – and I always wished I could have one myself.
And now my dream could actually come true: advances in focused ultrasound technology (FUS) make non-invasive surgical procedures possible. I attended the very first international symposium about this new technology, and learned some very exciting things.
First of all, Dr. Ferenc Jolesz gave a riveting key note address about the history of focused ultrasound technology, and why modern advances have made this treatment modality feasible. Scientists have been fantasizing about heating tissues with sound waves since 1942 when the first ultrasound experiment was conducted on a liver tumor. Unfortunately back then, imaging studies (beyond X-rays) had not yet been developed – so it was virtually impossible to “see” one’s target.
However, now that magnetic resonance imaging (MRI) machines are capable of displaying our innards in exquisite detail Read more »
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