Stem Cells, Breast Reconstruction and a Magazine Cover

The cover of the November print edition of Wired features large, unnatural-appearing cleavage. Inside and toward the back of the issue, a curious article ties together stem cells and the future of breast reconstruction. It got my attention. The detailed and admittedly interesting piece, by Sharon Begley, describes what’s science or science fiction: first humans, […]

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Notes on Cholera, Old and New

Dr. John Snow, an anesthesiologist and founder of public health, recognized the mode of cholera’s spread more than 150 years ago in London, where he became famous for mandating the closure of the Broad Street Pump. Snow died at the age of 45, of what was said to be apoplexy, old jargon for a stroke.

In 2009, there were 221,226 cholera cases reported and 4,946 cholera deaths in 45 countries, according to the CDC. Based on information put together by the World Health Organization,

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Copiapó Dreaming – The Copper Miners’ Tale

The 33 Chilean miners – mainly middle-aged and of modest means – zoomed up in high-tech capsules from the deep, would-be tomb where they’d been waiting for 69 days underground…

The amazing and nearly-too-good-to-be true news is that a top-notch team of engineers, doctors including the NASA/Johnson Space Center Deputy

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Word of the Week: floccinaucinihilipilificationism

ML learned a new word upon reading the newspaper: floccinaucinihilipilificationism. According to the New York Times now, Moynihan prided himself on coining the 32-letter mouthful, by which he meant “the futility of making estimates on the accuracy of public data.”

She’s not exactly sure how the term, said to be the longest non-technical word in the English language, might be used in medical communication, but it seems that it might be relevant to estimating health care costs, and – possibly by extrapolation – to understanding the hidden ambiguousness of inferences drawn from vast amounts of seemingly hard data.

Posted in Communication, language, StatisticsTagged , , , , , 1 Comment on Word of the Week: floccinaucinihilipilificationism

A Lead Poisoning Outbreak in Nigeria, Plumbism and Anemia

Over 400 Nigerian children have died from lead poisoning this year…lead poisoning is sometimes called plumbism, stemming from plumbum, the Latin term for lead (Pb, atomic number 82), a metal used by plumber. A rarer term is Saturnism, based on the metal’s association with that planet and ancient Roman god.

Posted in Diagnosis, Hematology (blood), Medical News, Public Health, Under the RadarTagged , , , , , Leave a Comment on A Lead Poisoning Outbreak in Nigeria, Plumbism and Anemia

Swedish Mammography Report Finds Benefit In Screening Younger Women

The Swedish study with its positive findings should be scrutinized, yes, but no more or less than the other papers on the same subject that have been highlighted, selectively, in the media. How journalists cover mammography studies, and that they do so with an open mind, matters a lot.

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What’s Missing in the Recent Mammography Value Study

I’d say the oppo­site is true: It’s pre­cisely because there are effec­tive treat­ments for early-stage dis­ease that it’s worth find­ing breast can­cer early. Oth­er­wise, what would be the point?

Metasta­tic breast can­cer is quite costly to treat and, even with some avail­able tar­geted ther­a­pies, remains

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Stepping Back, and Thinking Forward to October

A question central to today’s discussion – which does at least acknowledge the decline in breast cancer mortality – is the extent to which mammography is responsible for this trend, as opposed to other factors such as increased awareness about cancer, better cancer treatments and other variables.

Posted in Breast Cancer, cancer awareness, cancer screening, clinical trials, health care costs, Medical News, Oncology (cancer)Tagged , , , , Leave a Comment on Stepping Back, and Thinking Forward to October

No More Clipboards

“This caught my interest because it doesn’t diminish physicians’ autonomy,” Blumenthal said. It just enables them to make decisions for their patients in the context of additional, current information. “The end goal is not to adopt technology, but to improve care.”

Posted in Communication, Future of Medicine, health care costs, health care delivery, Health IT, Policy, Public HealthTagged , , , , , , , Leave a Comment on No More Clipboards

Perspective on Screening for Sickle Cell Trait in Student Athletes

In some ways this seems like a pro-active, well-intentioned policy that could save lives. On the other hand, as discussed in the NEJM piece, the new screening policy raises a host of challenging issues:

* how will colleges inform minor players’ parents about results?
* how will the schools handle players’ privacy?…

Posted in Diagnosis, Genetics, Hematology (blood), Medical News, Under the RadarTagged , , , , , , , 2 Comments on Perspective on Screening for Sickle Cell Trait in Student Athletes

Why Physicians Shouldn’t Tweet About Their Patients Or O.R. Cases

As a patient who’s been there, under anesthesia more times than I care to remember, I can’t imagine anything much worse than knowing while I’m unconscious my doctor might be on-line or even just dictating tweets instead of concentrating on me, my arteries and veins and spine and…

Posted in Communication, Health IT, Life as a Doctor, Medical Ethics, Privacy, Social MediaTagged , , , , , 6 Comments on Why Physicians Shouldn’t Tweet About Their Patients Or O.R. Cases

On Patient Empowerment and Autonomy

…I think the answer is inherent in the goal of being engaged, and that has to do with the concept of patient autonomy – what’s essentially the capacity of a person to live and make decisions according to one’s own set of knowledge, goals and values.

Autonomy in medicine, which borders on the empowerment idea, can be an aim in itself, and therefore valuable regardless of any measured outcome.

Posted in Communication, Empowered Patient, Neurology, Patient Autonomy, Patient-Doctor Relationship, Social MediaTagged , , , , , , , , , 3 Comments on On Patient Empowerment and Autonomy

Eye Care

…the office has expanded and become so systematized that when I go there I don’t feel like I’m visiting a doctor, the kind of professional who sincerely cares about my health. Instead I feel like a commodity, which I suppose I am.

Posted in health care delivery, Life as a Patient, Patient-Doctor Relationship, Physical ExaminationTagged , , , , , , , , 1 Comment on Eye Care

New NY State Law on Information for Women Undergoing Mastectomy

The reality is that many women, particularly poor women without newspapers or internet access in their homes, don’t know about any of this. They don’t know their insurance covers pretty much all of these options, by law. Now they will, or should as of Jan 1, 2011. Good. The other curiosity is that …

Posted in Breast Cancer, cancer treatment, Communication, Medical News, Patient Autonomy, Plastic and Reconstructive SurgeryTagged , , , , , , , 2 Comments on New NY State Law on Information for Women Undergoing Mastectomy

First Take On the Big C

The Big C’s plot includes at least two “atypical” and potentially complex features. First, Cathy chooses not to take chemotherapy or other treatment. This intrigues me, and may be the show’s most essential component – that she doesn’t just follow her doctor’s advice. Second, she doesn’t go ahead and inform her husband, brother or son about the condition, at least not so far…

Posted in cancer awareness, Communication, Informed Consent, Oncology (cancer), TV, Women's HealthTagged , , , , , , , 1 Comment on First Take On the Big C

The Physical Exam’s Value is Not Just Emotional

But what’s also true, in a practical and bottom-line sort of way, is that a good physical exam can help doctors figure out what’s wrong with patients. If physicians were more confident – better trained, and practiced – in their capacity to make diagnoses by physical exam, we could skip the costs and toxicity of countless x-rays, CT scans and other tests.

Posted in Diagnosis, Essential Lessons, Medical Education, Patient-Doctor Relationship, Physical ExaminationTagged , , , , , 4 Comments on The Physical Exam’s Value is Not Just Emotional

Doctors Not Using Email Like It’s 2010

There’s been a recent barrage of med-blog posts on the unhappy relationship between doctors and electronic communications. The first, a mainly reasonable rant by Dr. Wes* dated August 7, When The Doctor’s Always In, considers email in the context of unbounded pressure on physicians to avail themselves to their patients 24/7. That piece triggered at […]

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The “Survivor” Term After Breast Cancer: Is There a Better Expression?

The question is, what’s the right, PC and emotionally-sound, sensitive but not sappy term to describe the situation of a person who’s living after breast cancer?

Some might say, who cares if you’ve had it?

Posted in Breast Cancer, cancer awareness, cancer survival, Essential Lessons, language, Oncology (cancer), Psychiatry, Women's HealthTagged , , , , , , 35 Comments on The “Survivor” Term After Breast Cancer: Is There a Better Expression?
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