GlassHospital

Demystifying Medicine One Month at a Time

Category: communication (page 2 of 5)

Medical Me-Tooism

mediacalmetooism4b_wide-cf5d190b9eea4633b75292465de7ecb0d66a1bcf-s800-c85My father turns 78 in a few weeks. Though in my medical (and filial) opinion he’s aging well, he begs to differ — seeing his own aging as the piling on of indignities and infirmities.

Everything is relative, though, as he’s often taught me. When he compares himself to his peers, he often wonders if he should be undergoing the same medical routines and procedures that they are. My advice when he feels that impulse: Take a heavy dose of caution.

I wrote about this in an essay for NPR, accompanied by a wonderful collage by Katherine Streeter. Please click on the picture and take a look.

Sticking to Basics

I’m often asked for medical advice by friends, family members, even new acquaintances. It comes with the territory: What about this diet? What should I do about this symptom? What about this medication?

People are usually disappointed when I don’t share their enthusiasm about the latest health fads. Members of my family, in particular, are often underwhelmed by my medical advice.

I’ll be the first to admit that I do a poor job of conveying why I’m skeptical about the newest medical technology, reports of the latest health news and fashions, and even people’s symptoms. Most symptoms, after all, aren’t explainable, at least to the level of detail we all want.

“What’s causing my symptoms?” Is it a virus? Bacteria? Arterial blockage? In spite of all the science and technology in medicine, what we do is more about taking educated guesses (“playing the probabilities”) than providing precise diagnostic information.

But prevention is different. We know a lot about it, based on huge bodies of epidemiological research. Most of prevention is fairly straightforward. You’ve heard the advice again and again — so much so that it’s easy to tune out. There really aren’t shortcuts:

  • Get enough sleep.
  • Move your body — throughout the day.
  • Eat well — a healthy assortment of foods. Mostly plants, and not too much. [An idea popularized by author Michael Pollan.]
  • Interact socially. Isolation is not good for the body, soul, or mind.
  • Take some time to reflect.

Recently I’ve come across a couple of ‘content items’ that do a much better job of conveying these messages. One is a set of books and ideas around the world’s so called “Blue Zones.” If you haven’t heard about them, Blue Zones are the places in the world where people both live the healthiest and longest — people in these communities often live well beyond 100 years.bz_zones

  • Okinawa, Japan
  • Ikaria, Greece
  • Sardinia, Italy
  • Nicoya, Costa Rica
  • Loma Linda, California

In all of these places, people have preventive medicine embedded in their lives, without even having to think about it. Their daily activities involve walking most places, eating healthy diets rich in local plants, with a lot of intergenerational social interaction. Interestingly, folks in these communities do drink alcohol — but limit it to 1-2 drinks/day maximum. And they do eat meat — but not very often and in small portions. One thing that won’t surprise you: Blue Zoners do not eat refined sugars (all the convenience and packaged foods that we’re trained to eat because they’re cheap and widely available).

Summarizing these themes visually in under two minutes is another gem from the idea lab of Dr. Mike Evans from Toronto. You’ve seen some of his other videos here. I love them. Just watch the one below, and follow his advice. That’s what I’m trying to do in my own life.

From the Evans Health Lab:

What are your thoughts on Blue Zones and Dr. Mike’s advice?

Radio as Public Health

micMany of you know of GlassHospital’s passion for radio. Recently, I blogged about a radio-doctor colleague named Anne Hallward, a psychiatrist from Maine whom I was fortunate to interview.

Hallward is the creator and host of “Safe Space Radio,” now in it’s seventh year, a show that’s a back-to-back winner of the Maine Association of Broadcasters’ Public Affairs Award.

She recently gave a TED talk at an event in Maine. It’s compelling viewing, deeply personal, and gives a window into how one caring and empathic doctor has taken her skills to a broader, community-wide, public health level.

It’s well worth a listen.

Radio Days

We here at GlassHospital Media have just completed Season 2 of the public radio program “Medical Matters,” the show about Health Care and the Human Condition.

It’s a limited series of 4 episodes. You can stream them anytime from the show’s webpage, or there’s a convenient link at the top of this page with an index of the episodes.Anne_Hallward_0

One of the standouts of this 2nd season was an interview with Dr. Anne Hallward, a Maine-based psychiatrist who has taken to the airwaves herself in an effort to ease suffering by covering “subjects we would struggle with less if we could talk about them more.” Her program, “Safe Space Radio” is now in it’s seventh season. It’s well worth a listen.

Hallward is a marvelous interviewer, and the name of the show says what it provides—a haven for people to talk about things that shame them: things like medical illnesses, psychiatric conditions, caregiving for loved ones with said issues, or relationship difficulties. Bringing shame out of the shadows is empowering for afflicted individuals; really, though, it is for all of us. She’s on to something here.

Our interview with Hallward was the first time she’d had the mic turned around on her. Her vision of where this show will go is inspiring—a radio program in pursuit of social justice. To understand it better, give it a listen.

Age is Just a Number, Right?

In case you missed them, a couple of lay press articles hammered home the idea of our lifespans being finite.

ezekiel_emanuel_0First there was Zeke Emanuel’s provocatively titled “Why I Hope to Die at 75” in the Atlantic.

The title was unnecessarily inflammatory. A lot of people saw that and thought “Health Care Rationing…” and “what a jerk!

One of the core points of his article is well-taken: when we hit a certain age (75? 80? 85?), it no longer makes sense to “look for disease.”

Health care must continue improving and striving to reflect and honor the wishes of patients, but in addition, we should be more rational about whom we screen for disease and how often. It makes no sense to perform colonscopies in octogenarians to “screen” for colon cancer. Even if they have it, the colonoscopy  is unlikely to extend their life or improve its quality.

I think readers are right to quibble with Emanuel’s contention that at 75 creativity takes a nose dive. He was using that opinion, and the statistical evidence of age-related slowdown, in support of his point about the cutoff age for aggressive medical care. I hope sensible debate is not lost because of his tone and the fact that he’s seen as too political. He did work for the administration during President Obama’s first term, after all.

cohen-01-by_david_boswell

Cohen in younger days.

That same week, the New York Times published an opinion piece by Jason Karlawash of Penn, who wrote about musician Leonard Cohen’s decision to resume smoking (something he’d quit) upon turning 80. Titled “Too Young to Die, Too Old to Worry,” Karlawash examined how the 80+ population has grown from a half of one percent of the population to more than 3.5%. Doesn’t seem like a huge percentage, but it is certainly a significant increase and a huge demographic shift.

As Karlawash writes in the key paragraph of his piece

…Mr. Cohen’s plan presents a provocative question: When should we set aside a life lived for the future and, instead, embrace the pleasures of the present?

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