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Cardiology | Communication | Informed Consent | Medical Ethics | Patient Autonomy | Under the Radar

Informed Consent on Paper, but Not in Reality

Over the long weekend I caught up on some reading. One article stands out. It’s on informed consent, and the stunning dis­connect between physi­cians’ and patients’ under­standing of a procedure’s value.

The study used survey methods to evaluate 153 car­di­ology patients’ under­standing of the potential benefit of per­cu­ta­neous coronary inter­vention (PCI, or angioplasty)…

See more Informed Consent on Paper, but Not in Reality

Ideas | Life | Life as a Patient | Patient Autonomy

The Author Chooses Not to Go to the Emergency Room

Yes­terday the author of ML wasn’t feeling too well. She had (and has) what’s probably a recurrent bout of diver­ti­c­ulitis, a con­dition when a little pouch stemming from the colon becomes inflamed and causes pain and fever. This can be serious if infection of the colon’s wall pro­gresses, or cat­a­strophic if the colon ruptures.

So I’m thankful, today, among other things that I’m feeling better with antibi­otics, extra fluids by mouth and a good dose of rest. I’m glad, also, that I avoided the hos­pital for eval­u­ation and treatment, as were de rigueur for this ailment 20 years ago. I’m lucky that, so far, I’m doing OK. And I’m reminded that illness is not a metaphor for anything.

Really it’s a crap­shoot — hard to know some­times when it’s worth going to the ER or staying home and enjoying Thanks­giving with your family, as I did.

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Related Posts:Blood and Hip Surgery: New Study Sup­ports Fewer Trans­fu­sionsTwo Minds on Medical Think­ingTh­oughts on the Death of Amy Wine­houseThe Trouble With Place­bosLooking Back on ‘The Normal Heart,’ and Patients’ Activisim

Communication | Empowered Patient | Ideas | Palliative Care | Patient Autonomy | Social Media

Talking About the Hard Stuff

When I prac­ticed oncology, I rel­ished time talking with patients and their loved ones about tough deci­sions – when an indolent con­dition accel­erated and it seemed time to bite the bullet and start treatment, or when a cancer stopped responding to treatment and it seemed right to shift gears and, perhaps, emphasize pal­li­ation instead of more chemo, and at every value-​​loaded decision check­point in between.

These con­ver­sa­tions weren’t easy; speaking of levels of care, pal­li­ation and end-​​of-​​life wishes are dis­cus­sions that many doctors, even oncol­o­gists, still avoid.

See more Engage with Grace: Talking About the Hard Stuff

Life | Life as a Patient | Medical News | Privacy | Travel

The T.S.A. Screens Travelers Inside and Out

I’ll be staying near my home in Man­hattan this week. But if I did have plans to travel by air­plane for the holiday, I think I’d be appre­hensive about the new screening pro­ce­dures imple­mented by the Trans­portation Safety Authority (TSA).

My concern is not so much with the scanners…Rather, I’m worried about screening errors — false pos­itive and false neg­ative results, and about harms – physical and/​or emo­tional, that patients and people with dis­ability may expe­rience during the screening process.

See more The Trans­portation Safety Authority Screens Trav­elers Inside and Out

cancer survival | cancer treatment | Informed Consent | Medical Ethics | Oncology (cancer) | Patient Autonomy | TV | Women's Health

Does Cathy Make a Sound Decision in the Big C?

bigC taking the plunge

“I don’t want to get sicker trying to get better and then just end up dying anyway” – Cathy, the 42 year old pro­tag­onist, with advanced melanoma, on the Big C.

Spoiler alert: Don’t read this post if you don’t want to know what happens to Cathy in the Big C…After months of unusual and comfort zone-​​breaking behavior, Cathy

See more Does Cathy Make the Right Cancer Treatment Decision in the Big C?

Cardiology | Communication | Medical News

Why Such a Fuss Over Anaceptrapib?

I’m a bit puzzled by all the excitement about Merck’s new drug, Anace­trapib (MK-​​0859), that’s said to lower risk for car­dio­vas­cular disease by low­ering bad cho­les­terol. Earlier this week at the annual meeting of the American Heart Asso­ci­ation, researchers pre­sented promising findings on the drug, including results from the phase III DEFINE trial. The list of dis­clo­sures for that abstract is long and fairly shocking. On Wednesday, the results were pub­lished on-​​line in the NEJM.*

The new drug interests me, as an oncol­ogist, because it’s an enzyme inhibitor …

See more Lots of Excitement about Ana­cep­trapib, a Cholesterol-​​​​Lowering Drug

Communication | from the author | Social Media

Medical Lessons is One Year Old!

Today Medical Lessons is one year old. That’s an important mile­stone in any blog’s life, as I suppose it is in this author’s.

Why blog, a mother in med­icine might ask me. I’m having fun with this project, for starters. Since November 17, 2009, I’ve taught myself how to use Word­Press, learned the ins and outs of website hosting com­panies and faulty servers, exper­i­mented with Twitter – on which I’m now hooked and, best of all, engaged a growing on-​​​​line group of inter­esting people.

What I like best, I think, is the freedom of modern pen­manship in this strange, new mode. “It’s my blog and I’ll write what I want” is my motto in this ongoing real life-​​​​segment. How cool is that?

Where ML is headed, I’m not entirely sure. It’s been picked up by the ACP Internist blog and, as of today, the Get Better Health network. I’m a firm believer in the concept that anything

See more Medical Lessons is One Year Old!

Oncology (cancer) | Reviews | TV | Women's Health

First Season Ending of the Big C

Big C - cathy_200x238

Last night I stayed up late to see the season finale of the Big C. For the first time in watching this series about a 42 year old woman with advanced melanoma, in a near-​​final scene involving the pro­tag­onist Cathy’s teenage son, I cried.

The sto­ryline is moving, finally, in a real and not nec­es­sarily happy direction.

See more First Season Ending of the Big C

Communication | Health IT | Social Media

Links Add Value to On-Line Reading and Medical Blog Content

This post is intended mainly for medical bloggers, but it has appli­ca­tions else­where. It’s about links and uniform resource locators (URLs), terms that I didn’t fully appre­ciate until the last year or so. That’s because like most of my col­leagues and readers, I grew up reading printed books, news­papers and mag­a­zines. Now, perhaps as much as 90 percent of the non-​​fiction I read is on-​​line. The Web has a lot of advan­tages for readers – you can see mul­ti­media pre­sen­ta­tions, or double-​​click to enlarge a graph of interest. What I think is best, though, is the third

See more Links Add Value to On-​​​​Line Reading and Medical Blog Content

Life as a Patient | Patient-Doctor Relationship

Hospital Fashion News from AARP and the Cleveland Clinic

The November AARP Bul­letin high­lights a promising devel­opment in hos­pital couture: trend­setter Diane von Furstenberg has designed new, unisex gowns ready for wearing in hos­pitals. The new gowns provide style and full cov­erage, with options for opening in front or back according to the bul­letin. A trial is underway at the Cleveland Clinic.

See more Hos­pital Fashion News from AARP and the Cleveland Clinic

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