The big health story of the week, headlining the business news, is that Steve Jobs, Apple’s founder and usual CEO, is taking another medical leave. This is hardly a surprising development, given that the 55 year old corporate leader has had a complex medical course since at least 2003. In August, 2004 he told Apple employees he’d undergone surgery for an islet cell tumor of the pancreas. He received a liver transplant, said Methodist University Hospital in Memphis in the spring of 2009. According to multiple reports, lately he’s been looking tired and gaunt.
There’s a lot to learn from this case without delving into the private details. First, about cancer pathology – that not all cancers of the pancreas (or any organ) are the same. The NCI estimates that approximately 43,000 people (roughly half men, half women) are found to have pancreatic cancer, and over 36,000 adults will die
See more Steve Jobs Takes a Medical Leave
I wish that more physicians would speak out in favor of stricter gun control laws. Firearms present a public health issue in the U.S. According to the CDC, over 12,000 Americans die each year from homicide involving firearms. The number of non-fatal gunshot wounds requiring hospital care approximates 48,000 per year.
See more Honoring MLK by Advocating Gun Control
roviding health care is or should be unlike other commercial transactions. The doctor, or other person who gives medical treatment, has a special professional and moral obligation to help the person who’s receiving his or her care. This responsibility – to heal, honestly and to the best of one’s ability – overrides any other commitments, or conflicts
See more Why the Term ‘Patient’ Is So Important in Health Care
There’s hematology news today, x 2 (at least):
flexible hydrogel particles resembling RBCs in size and shape (Credit: Timothy Merkel and Joseph DeSimone, University of North Carolina at Chapel Hill)
1. Progress in developing synthetic red blood cells -
A University of North Carolina, Chapel Hill-based research group has created hydrogel particles that mimic the size, shape and flexibility of red blood cells (RBCs). The researchers used PRINT® (Particle Replication in Non-wetting Templates) technology to generate the fake RBCs, which are said to have a relatively long half-life. The findings were reported on-line yesterday in PNAS (abstract available, subscription required for full text). According to a PR-ish but interesting post on Futurity, a website put forth by a consortium of major research universities, tests of the particles’ ability to perform functions such as transporting oxygen or carrying therapeutic drugs have not yet been conducted.
Developing competent, artificial RBCs is
See more Artificial Red Blood Cells and Platelets from Stem Cells!
This is an unusual entry into a discussion on the limits of patient empowerment.
In late December the Times ran a story, beginning on its front page, about a portrait in the Metropolitan Museum of Art by Diego Velázquez, the 17th Century Spanish painter. The news was that the tall representation of the teenage Prince Philip IV would be back on display in the European paintings galleries after a 16-month cleaning, restoration and re-evaluation of the work. And, in case you weren’t up on your art history news – the painting really is a Velázquez.
label (ikonic’s Flickr)
I learned this morning that the museum received the painting in 1913. It was a gift of Benjamin Altman (that would be B. Altman, as in the department store of my childhood…). The 7-foot portrait was considered a true masterpiece for hundreds of years, its authenticity supported by a receipt signed
See more On a Velázquez Portrait, and the Value of Expertise
Today’s will be a light post:
Over lunch I was reading the current, Jan-Feb 2011 issue of AARP the Magazine. After some predictable chat about the smart and sassy Betty White, a Beatles update, a truly-scary mention of an uptick in teenage teething (kids are biting each other, vampire-style, and potentially sharing bad germs like HIV and hepatitis) and some super-sensible ideas for how adults might lose weight and feel better (by dancing, among other fun suggestions, and by eating less food), there’s a hemi–Seinfeld reunion in two parts:
1. Jason Alexander (George Costanza) has lost 30 pounds since he celebrated his 50th birthday back in 2009. “You get your vibrancy back,” he told the magazine.
2. Julia Louis-Dreyfus (Elaine Benes) turns 50 next week. I’ll leave my readers guessing as to which Elaine is the better dancer, now that we’re in our 50’s -
A Seinfeld DVD cover
See more Partial Seinfeld Reunion in AARP the Magazine
So many others have written on Wakefield’s fraud, and considered the role of the press in perpetuating the notion that vaccines cause autism, I wasn’t going to cover it here on ML. But I do think there are a few instructive points from this “lesson” about medical communication and news:
1. People aren’t always rational in their decisions about health care. (This is an understatement.)
See more Lessons from the Wakefield Case
The Obama administration will cut a new Medicare provision to compensate providers for discussing end-of-life care, according to the New York Times. This is an unfortunate reversal.
Too-often, doctors fail to have these discussions with their patients. This happens for many reasons including some physicians’ discomfort with the topic, their not wanting to diminish patients’ confidence in their healing powers, conflicts of interest (infusing chemotherapy is profitable; prescribing palliative home care is barely so, if at all) or simply being too busy to get around to the subject before a patient becomes critically ill and approaches death in an ICU setting. Most physicians need incentives to discuss palliative care options and end-of-life planning with patients in a thoughtful, not-rushed way.
The Medicare provision, which would have provided a small amount of compensation for doctors to spend time communicating with their patients about their preferences – whether they’d want to be
See more A Reversal on End-of-Life Planning
A tweet hit me on Sunday evening, from a stranger:
I’m saddened by how many ADULTS can’t get their #rheum 2 understand the level of severity of their pain.What hope is there for my daughter?
I half-watched an on-line exchange about the issue, and then went about my family’s dinner preparations.
The message came from Amy Cunningham, who blogs about her daughter’s experience with juvenile rheumatoid arthritis and uveitis to the starting tune of Van Morrison’s “Brown Eyed Girl.” I couldn’t bear the tracks that followed, playing automatically and disjointedly in multiple browser windows, so I shut them off. But I kept on thinking about the girl’s pain, and the mother’s despair.
I wasn’t alone in that. Turns out that Rheumatoid Arthritis Warrior Kelly Young (@rawarrior) was all over the matter. She’s got a Facebook discussion going on the topic and a post today called Some Rheumatologists Don’t Understand
See more I Feel Your Pain (not)
Three recent stories lead me to my opening topic for the year: the value of open-mindedness. This characteristic — a state of receptiveness to new ideas — affects how we perceive and process information. It’s a quality I look for in my doctors, and which I admire especially in older people.
Story #1 – on the questionable effects of echinacea
Echinacea Purpurea flower (Wikimedia Commons)
The first article, published in the Dec 21 Annals of Internal Medicine, considers the potential of echinacea in treating the common cold. The results of a 4-armed, randomized study involving 719 patients with symptoms of an acute respiratory infection (“a cold”) were inconclusive, at best. A skeptic might say of the trial, sponsored by the National Center for Complimentary and Alternative Medicine (NCCAM), that it proves once and for all that echinacea is therapeutically useless. Another reader, perhaps versed in the flower-derived substance’s purported
See more On the Value of Open-Mindedness