medicine

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I enjoy having friends, like just about everyone does. But that’s not why I’m in this business. When a patient needs help, I will do my best for them every single time.  And if a few colleagues get bruised egos along the way, so be it.

She was a 53-year-old woman, but I don’t think she even would have liked to hear me to refer to her as a woman.  We’re talking about someone who was short and stout and wore the kind of cap one would expect to see on a newsboy during World War I.  She wore a very male looking zipper jacket, and told me she had the name of the other woman to whom she had dedicated her life tattooed on the back of her neck.

Regardless of all this, her face was red and she was crying. She told me she was chronically suicidal and never thought about anything else.  Despite being medicated, her depression seemed to have gotten worse. Read more on What is there to Treat?…

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Ever heard of capitation?  In healthcare, it can mean that a clinic makes more money by following more patients.  Payments are per person, rather than per service.  I guess I shouldn’t be surprised, then, that they refused to dismiss this guy from their care.

He was a 32 year old young man who was diagnosed with an anxiety disorder.  He had been working independently as a pool cleaner but he couldn’t stand it anymore.  He was always nervous.  As a matter of fact, this man was nervous about everything he did.  Perhaps it was a generalized anxiety disorder, but surely something a great deal more.  He wasn’t having panic attacks, and he exhibited far more than the usual one or two things found in generalized anxiety disorder.

I tried to start him on some medications — as much as I didn’t like the medications he had been started upon.  He had been given regular Xanax in slowly increasing doses.  As nervous as he was, he wasn’t stupid.  He said, “It’s really funny.  The medication makes me sleep, but it sure doesn’t stop me from being nervous.” Read more on The Nervous Pool Cleaner…

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I have spent as little time as possible on the staff of hospitals.  The interface between doctors and administrators has always seemed to be dominated by petty politics.  People are interested in money, and secondary to that, some vague sort of reputation or power.

A large and prestigious Midwestern hospital used to have a certain kind of meeting every few months.  This hospital had only the vaguest of University associations — just enough to make it look academic and research oriented.  I knew perfectly well it was neither.

It was a luncheon meeting of the medical staff and a few administrative types — uncommonly well-catered. There were about 25 folks, but only two other women who looked as uncomfortable as I was.

The meeting was to discuss certain hospital statistics, including some case details.  As the meeting agenda was passed around, the head of the hospital reminded us of the meeting “rules.”  We were gently reminded that no recordings were permitted and neither were extraneous notes.  We each received an agenda, which were carefully counted out as they were distributed.  We were told that at the end of the meeting they would be collected — and counted — before any of us could leave. Read more on Hospital Accountability Is An Ideal (Not Always Reality)…

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As it turns out, this whole bit about the use of antibiotics in livestock and poultry is a complex issue.  It’s well beyond anything that anyone would guess at first blush.  The best online summary is the position paper put out by Food Marketing Institute.  Curiously enough, it doesn’t have a year on it.  Based on the references, I’d guess it was probably around 2005.

The Food and Drug Administration has approved the use of therapeutically low doses of antibiotics in feed.  However, very few studies were conducted.  They decided that giving little bits of antibiotics to animals would help avoid illness.  What this means in practical life is that they will grow faster and produce more meat prior to being slaughtered and eaten.

Everybody agrees that using too many antibiotics in humans can cause humans to become resistant to those antibiotics.  This has been blamed on everything from patients who want a prescription for an illness that isn’t caused by bacteria to doctors feeling they need to give a prescription to justify their fee.  This kind of talk has been around for a long time. Read more on Antibiotics in Livestock Feed Endanger The Entire World…

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Britney Spears doesn’t make the news much anymore.  Her career is probably still going strong, but her wild ways and scrapes with the law are old news.  The media has latched on to new starlets and scandals, and they will never run out.

However, I noticed recently a story about conservatorship of this once-superstar (perhaps now only a mega-star?), and wanted to take the occasion to talk about this very serious legal step of conservatorship.

Miss Spears’ father is her conservator, and he wants her boyfriend appointed as a co-conservator over her well-being, and this might be a sign that he’s getting ready to marry her.  There is something very wrong with this picture.

People having conservatorship over other people should not be taken lightly. Read more on Brittany Spears, Conservatorship and the Abuse of Power…

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I read a joke once about a husband’s preemptive strike in the bedroom.  He walks in holding two aspirin and a glass of water.  When his wife asks what it’s for he says it’s for her headache.  She replies “But I don’t have a headache.”  “Gotcha!”

Headaches are no fun, so we might as well get a little chuckle at their expense.  And if you suffer from sinus headaches, there might be quick and inexpensive relief your doctor hasn’t shared with you.

Listen, I have had allergies since I was small but sinus headaches have been rare.  That is, until I got my complete dental implants.  They have wildly improved my quality of life, but I have had more intense and regular sinus headaches as a result.  My surgeon had removed teeth prior to the implants and freely admitted he had been up in my sinus area.  He said I could see an ear nose and throat specialist if the sinus headaches became too much of a problem.  He tried to ignore my laughter as I told him I could fix this myself. Read more on What Your Doctor May Not Tell You About Sinus Headaches…

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Take two Tylenol and call me in the morning? Research now suggests that our emotional and physical pain are interrelated. Maybe Tylenol really is good for more than just headaches.

This is the dichotomy between even the best experimental science and real life as we clinicians see it.

Who has not seen a kid put his or her hand on the umbilicus and say “my tummy hurts” when he or she doesn’t want to go to school?  That child is likely trying to avoid something unpleasant like a bully or a difficult assignment.  Oh, our beliefs in the separation of body and mind are so deeply engrained that adults might even think they are faking.  But perhaps children are just more open and direct. Read more on Mind-Body Connection Proven at Last?…

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It’s always convenient to have somebody else to blame, but I’m afraid that doctors are mostly to blame on this one.   They call them hospital acquired infections” and they are killing patients who should otherwise be just fine.

Like this writer’s father, who walked into a ritzy New York academic hospital with what used to be called “walking pneumonia.”  He went on to die of – you guessed it – a “hospital acquired infection.”

Walking pneumonia is basically an infection of the lungs that may cause a cough — or even a painful cough — and makes it hard to breathe. Typically, it does not hurt the patient’s general well being enough to make her or him an invalid, a hospital inpatient, or certainly not an intensive care inpatient. This guy’s dad should have easily made it home. Read more on Medical Science Develops Harmful Products…

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This air traffic controller thought the pilot declaring an emergency was full of baloney.  I’m afraid the only baloney in his future might be the stuff he’s eating while he waits in the unemployment line.

I cannot be the only person who got angry reading this.  An airline sends an emergency plea for help to air traffic control down below.  The air traffic control decides that this is a hoax and does nothing.

The fact that everyone survives is not a defense — don’t even mention it. Read more on Crying For Help vs. Crying “Wolf!”…

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Hello health care system.  This is weird, to put it mildly.

As far as anyone seems to be able to figure out what happened, this 38 year old nurse killed five dialysis patients and “assaulted” five others by putting sodium hypochlorite – bleach — in their dialysis tubing.

She had some problems with domestic violence and public intoxication and such.  But according to the relevant statements, that was all resolved before she did this.

Jurors have convicted her of capital murder, but she is not going to get the death penalty.  Mostly, this is because she is deemed to be of no further danger if she’s kept out of health care.  Her daughter seems to be taking it hard.  This is an indication for counseling, but not a change in Mommy’s sentence. Read more on When Nurses Kill…