Demystifying Medicine One Month at a Time

Tag: twitter

Tweeting Sons & Moms

By now you’ve probably heard tale of NPR’s Scott Simon and his tweets heard round the world.

HIs 84 year-old mother was hospitalized in the ICU in Chicago, having gone through an emergency operation because of longstanding cancer.

In real, time-sequenced fashion, Simon used his Twitter stream to share his thoughts and sentiments to more than a million followers. Many mainstream media outlets ran the story because of the poignancy of what was happening.

Scott Simon and his Mom.

Scott Simon and his Mom.

Alas, Patricia Lyons Simon Newman died from complications of her condition. Simon was at her bedside for days, holding her hand, sharing her thoughts, her humor, and pathos.

Many pundits have called it “Twitter’s finest hour,” showing that the micro-blogging tool that is so popular (but often thought so inane) has some real use in conveying emotion, sentiment, and a sense of community. [Of course, Twitter’s also been known to play a role in revolutions amidst government internet crackdowns.]

Another blogger-cum-Twitter personality, Dr. Bob Wachter, also blogged and Tweeted about his own mother’s illness. Wachter is a well-known name in academic medical circles, credited with having coined the “hospitalist” concept in the late 1990s. He’s also the immediate past president of the American Board of Internal Medicine. Suffice it to say that he has clout.

So it’s well worth a read of his synopsis of his mother’s stay (ordeal?) at his own medical center, the University of California at San Francisco, always considered one of the nation’s best training grounds for doctors. As he says in the post, he’s “eaten at [his] own restaurant many times,” having had other family members treated at UCSF.

It makes an interesting read to hear an elite faculty member describe the care received by his own elderly mother from doctor-colleagues in another specialty (in this case, surgeons).

The very quick takeaway–lots of good things happened, but much could be improved upon. If you are interested in why health care is both so challenging and at times so NOT patient-centered, his post is worth reading.

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One other note: GlassHospital readers will enjoy a blog post that I wrote for NPR’s “Shots” blog, which offers a slice-of-life of daily doctoring and some hope for the future. Essay linked here.

The Medical Skeptic

I’ve become a big fan of the “Medical Skeptic” genre.

The idea is that while modern medicine provides many marvels, sometimes we do too much–and that can be counterproductive.

A whole magazine!?!?

Case in point: Screening for (and sometimes even treating) prostate cancer.

In a nutshell, though it seems counterintuitive, it’s a bad idea to invasively look for or treat a cancer that won’t cause suffering or death. The side effects (erectile dysfunction, urinary incontinence) are far worse than living with the condition. (The difficulty is that of course there are exceptions to this. Some people do die from prostate cancer. It’s just that the science of knowing whom hasn’t developed to where we’d like.)

Excellent books in this genre that I’d recommend include Overdiagnosed, by Gilbert Welch, et al., and How we do Harm, by Otis Brawley & Paul Goldberg.

Due to my interest, I search the web for this kind of information. As I’ve also become more active on Twitter, I’ve started locating tips on good reading material there.

In particular, I’ve started following the tweets of a particular tweeter (Twitter-er?) who calls himself “Medical Skeptic” (@Medskep).

I’ve noticed that he’s prolific-he tweets dozens of times a day. It’s impossible to keep up with the flurry of information. But to me, his tweets are almost always educational. His method is to look at a problem of medical over-use, and search for high-powered evidence of its harm (though he will tout benefits when they are there. Gotta call ’em as he sees ’em).

If there’s a common theme, it’s this: Eating the right food, exercising, and getting enough sleep are the three most important behaviors for maintaining health. Regardless of whether you’re healthy to begin with or suffer from a chronic condition, the same advice applies. All the other medical interventions we provide would be relatively unnecessary if we could abide by these three principles.

In a given week, @Medskep might tackle the physiologic underpinnings of coronary disease–and he’ll link to writings that show that if we lived by healthier standards, we’d almost entirely obviate the need for stents or bypass surgeries. Another day he’ll explore the validity of using SSRIs (Prozac, Paxil, Zoloft, etc.) for depression, and demonstrate that their overuse is a triumph of marketing and politics over sound science.

Heavy stuff.

I went to his blog and didn’t find anything about him (it hadn’t been updated in years, like a fallow field). So I direct-messaged him on Twitter, and we struck up a phone conversation.

I asked him if he’d heard of the blog “Science Based Medicine,” whose writers are doctors and scientists with an agenda of debunking spurious claims about alternative medicine. It seemed to me that he was engaged in a similar pursuit.

He’d heard of them, but for many reasons (chief among them that he considers himself an informed lay-person rather than a scientist or practitioner), he’s chosen not to go that route.

Of course, the biggest difference is that @Medskep turns his spotlights on “conventional” medicine, something the folks at SBM do less regularly.

@Medskep is a man of protean interests. He’s held many jobs in different fields, and demonstrated that you’re never too old (in contrast to last week’s post) to gain deep new knowledge. In sum, I’d say he’s a man driven to find truth–for the love of pure knowledge and no financial gain.

If you’re interested in learning more, I’d encourage you to sign up for Twitter (it’s free) and follow @Medskep and @GlassHospital.

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