Hispanics

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He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…

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If you have a choice and are not involved in an emergency, you can improve your chances of coming out of the hospital alive if you time it right.

I have read lots of articles suggesting that mortality in American hospitals is higher around July 1, when a new group of trainees finish medical school and start in their hospital based clinical training positions. This is not just an aberration in the USA, but apparently is also true in the U. K, where the new training programs start on August 1. Another cause of in-hospital mortality has been identified — When nursing staff falls below certain target levels, patients die. I do recall that nursing schools, at least when I was close to such things, did not have the same kind of fixed scheduling for trainees that medical schools did. When nursing students were present, they always seemed to be observing and logging in time, although whenever they had procedures, they were more rigorously monitored than physicians. Read more on How To Get Out Of The Hospital Alive…

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The death rate is down and the life expectancy is up.  “Nothing but good news,” says the statistician.

Perhaps our prevention programs and treatments are working.  Statistics are unwieldy things, but these are so general, the news of less death and more life can only be seductive. I want to look at it closer. I want to look at the differentiations among groups, which I doubt have changed. If you ever wondered about women living longer than men, both in the African-American race and the Euro-American races, you should have seen my waiting room the day I encountered a soft spoken and personable but physically-challenged African-American man.  He was surrounded by obviously smitten females bearing gifts.  Two of the three young ladies offered him homemade baked goods and made a point of telling the third she did not have a chance because she only had a dozen store-bought doughnuts. Read more on Why Do Some People Live Longer Than Others?…

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