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Demystifying Medicine One Month at a Time

Category: disaster relief (page 1 of 3)

Reducing Harm in Health Care

Gary Cohen, Co-Founder and President Health Care Without Harm, photographed in Charlestown, Mass., Friday, Sept 18, 2015, at The Spaulding Rehabilitation Hospital, one of the first hospitals built embracing Cohen's advocacy of self-sustaining, environmentally responsible healthcare networks. (Credit: John D. & Catherine T. MacArthur Foundation)

credit: MacArthur Foundation

When we talk about harm in the world of health care, we’re usually referring to patients and the facilities in which we provide care. These are the ‘typical’ things we hope to avoid, not only because they are bad outcomes, but because they now carry the specter of financial penalties when they occur:

  • medication errors
  • wrong side surgeries
  • hospital mishaps, like falls
  • missing a diagnosis
  • hospital-acquired infections and those induced by medical hardware

But Gary Cohen of the advocacy coalition Health Care Without Harm takes a much broader view of the harms that health enterprises can cause. Founded in 1996, HCWH is now a multi-national coalition of health care enterprises, governmental and non-governmental agencies, and other advocacy groups.

Cohen and HCWH have had some amazing successes. In less than two decades, HCWH has been able to reduce the number of medical waste incinerators in the U.S from more than 5000 to fewer than 100. Why should we care? It turns out that burning medical waste pours tons of the harmful chemical dioxin into the environment.

Another example: The formerly ubiquitous mercury thermometer. They used to break all the time. Fun to play with the drops of mercury, but highly toxic. Neurotoxic, in fact. And when mercury gets in our water supply, the fatty fish we eat (salmon, swordfish, tuna, mackerel, even shark) slowly poison us — which is why pregnant women and children are advised to avoid eating fresh fish in more than minute quantities.

HCWH was able to make the case that there are technological alternatives to mercury thermometers — that work just as well and are much, much safer. And they’ve been successful. When’s the last time you saw or used a mercury thermometer?

For this tireless advocacy, which also includes making hospital food supplies safer and hospital buildings themselves green and super safe (think natural disasters), Cohen was awarded a MacArthur Foundation Fellowship (think ‘genius grant’) last Fall.

You can hear an interview with Cohen here — give a listen and broaden your perspective on reducing harm in health care.

Contagion of Yesteryear

Ebola seems to have taken up a significant portion of the news stream as of late.

sars-2003_custom-1ec2de788947040b25f2065b83f3b0e087fe0768-s40-c85

NPR–>Kevin Frayer/AP

It’s understandable, given the breadth of the epidemic (largest ever), the fact that it’s hit our shores, and that it’s so frightening: hemorrhage! death!

I wrote a first-person account of the time I was asked to evaluate someone for SARS, a 2002-2003 novel disease outbreak that originated in China and spread quickly to the West (in the end, only 27 U.S cases and no deaths; in Canada, 251 cases and 44 deaths).

SARS is a descriptive name: Severe Acute Respiratory Syndrome. We subsequently learned that it’s caused by a corona virus and that it’s spread by contact and respiratory droplets.

The outbreak died down as quickly as it flared up, and it’s nary been heard from since.

Here’s the concluding graf from the story–as true for Ebola as it was for SARS:

Today’s Ebola crisis makes clear what the many of us were slow to accept in 2003. It takes clear thinking, painstaking preparation, flawless execution and clear communication to protect the public health.

We can only hope that Ebola recedes and becomes a distant memory, also.

From the Mailbag

Yes, we’re baaaa-aack. Here’s a letter from one of our readers:

Dear GlassHospital,

media hysteriaWhile I am a firm believer in the infallibility of doctors and modern medicine, I am desperately struggling with the Dallas handling of an Ebola patient. Sure, sometimes there’s that perfect storm of things gone wrong, opportunities missed, etc (think about the assassination story of Archduke Franz Ferdinand – seems it was destined to happen) but the spread of infectious diseases need not be history-making-world-changing-events in today’s “modern” era, should it? Is there that much of a divide between the knowledgeable and the uninformed – a gap that rivals our economic disparity? Is politics playing a role here, like [Texas Gov. Rick] Perry won’t allow any federal coordinated oversight/CDC management?

I used to watch silly action movies (“Whitehouse Down” for example) and think, “that would never happen! there’d never be such a dumb-ass breach of security like that!” Now I question if I’m the silly dumb-ass who believed there was a working system in place.

So tell me Dr. Glass: while I retain confidence in individuals and continue to hold doctors in high esteem, should I/can I trust hospitals?

Sincerely,

A Lost Patient

Medical Fright: Ebola [UPDATED]

Amidst the clatter of the Middle East, children fleeing danger to come across our borders, and lawsuits against the White House, there’s this:

Ebola virus.ebola virus

Like a steady drumbeat getting slowly louder, we now know that the current outbreak of Ebola, which causes hemorrhagic fever and is highly fatal if contracted (some outbreaks kill 90% of those infected), is the largest ever.

If you haven’t been too frightened or bothered by it (“it’s only in Africa, after all…“), you should know that somehow two unfortunate Americans who’ve risked their lives to fight the outbreak have caught the dreaded pathogen. Very recently it’s “been decided” (note the use of passive voice) to evacuate them home to our shores for treatment. Ford Vox, a doctor and journalist, poignantly asks, “Who invited Ebola to Atlanta?”

Social media (Twitter, etc.) is alive with information and speculation about all of this. As scary as Ebola is, I found this a compelling tweet that helps put things in perspective:


Let’s get those vaccines when they are available, recommended, and required. And let’s hope this Ebola outbreak peters out.

UPDATE: The first U.S. Ebola patient has already arrived at an Atlanta hospital.

Oklahoma Strong

BKwS7ETCAAAxLt7.jpg largeA Twitter photo of Moore Medical Center (Okla.) after the tornado: All patients survived.

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