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By Elaine Schattner, MD, on September 15th, 2011 Watching the Big C feels like a chore lately.
It reminds me of the feeling I used to get when I had to see and examine a patient in the hospital, under my care for some administrative non-reason, who didn’t need to be in the hospital IMO, and whose hospital presence took time my time away from patients who needed my attention. But because I was responsible, I’d go and see her every day just the same, and listen and examine, make notes and occasional suggestions.
The show is terrible. There, I said it on the Internet.
In the most recent episode, Cathy (the melanoma patient who’s said to be responding to a treatment about which viewers know nothing) runs into her oncologist at the pool where she symptom-freely coaches a swim team. The doctor, portrayed by Alan Alda, has a young wife who talks openly about sex with her
See more ‘The Big C’ is Failing
By Elaine Schattner, MD, on September 14th, 2011 Last week I wrote a simple post on eating yogurt with fresh fruit for lunch. It wasn’t until later that I realized why it’s a medical lesson.
It happens that yesterday morning I was up and out early. I saw a former colleague walking along the street. He’d gained weight, and walked slowly. I thought about how hard he works, and what a good doctor I know him to be. And yet any citizen or patient might size him up as heavy, maybe even unhealthy.
The problem is not that he’s uneducated or can’t afford nutritious foods. He knows fully about the health benefits of losing weight and exercise. The problem is the stress and long hours of a busy, conscientious physician’s lifestyle.
When I worked as a practicing doctor and researcher at the hospital, I rarely ate a nutritious breakfast or lunch. My morning meal, too often, consisted of
See more Maybe We Should Teach Medical Students About Healthy Living
By Elaine Schattner, MD, on September 12th, 2011 
A Labor Day break in broadcasting afforded some respite from the Big C. The latest episode continues with its focus on normal and not-so-normal life among Cathy’s family and friends.
On the family front, her teenage son “Adam” goes with the woman he met on-line in a cancer kids’ support forum to her high school reunion and has a good time there, despite a strange blip in which she calls from the ladies’ room and asks him to buy her tampons. Cathy’s brother, said to have manic depression but to this doctor-TV-critic seeming more like a schizophrenic, continues to deteriorate off his meds. Cathy’s overweight husband buys a fancy scale with a computerized voice that tells him his “metabolic age” is too high.
About cancer, there’s little on screen: Lee, Cathy’s “cancer friend” and clinical trial companion, is coughing, but that detail goes unmentioned. He mentions that Dr. Sherman, the
See more The Big C Continues: on Family Life and Friendship, Season 2, Episode 10
By Elaine Schattner, MD, on September 12th, 2011 An article caught my attention in the September AARP Bulletin:
The Caregiver’s Dilemma considers the 61.6 million people in the U.S. who care for older relatives or friends. People with jobs are, understandably, unsure if they should let their boss or supervisor know they’re caring for someone who’s sick. This indirect cost of illness and aging in America is said to tally $33.6 billion each year.
The pressure on workers is tough, writes Sally Abrahms:
Many employees are in that elder care-giving boat, yet workers with work-family conflicts are often reluctant to raise the issue with superiors. They fear they’ll be viewed as not committed enough, or receive bad year-end reviews. They may also think that discussing their personal life is unprofessional or sense resentment from colleagues and the boss, who may have to pick up the slack during their absences…
The article reminded me of the dilemma faced by
See more Should You Tell Your Employer When a Loved One Is Ill?
By Elaine Schattner, MD, on September 11th, 2011 
—-
Hard to live in Manhattan and not note the fact that it’s 9/11/11.
Here we are, a decade later: some progress, and some opposite-of-progress.
Watching the family members, in pairs, reading the names. So many Smiths, among all I never knew.
Each hurts.
—-
Related Posts:What Underlies the Costs of DementiaNo Room For Emotion or Exceptions to the Rule (on Avastin)Dietary News UpdateA Brief Note On StyleHot Wasabi, and a Continuing Radiation Crisis
By Elaine Schattner, MD, on September 9th, 2011 
For today I thought I’d skip writing a formal post and try a picture, instead, of yesterday’s lunch – fruit with yogurt, honey and crumbled cereal:
Ingredients:
Plain, low-fat yogurt (I use Fage brand, 2% fat, 1⁄4 — 1⁄3 cup)
Honey, less than 1⁄2 teaspoon
Cereal (a fistful of your preference – I like “Smart Start,” roughly 1⁄4 — 1⁄3 cup)
Fruit – whatever’s ripe and in the ‘fridge: in this case I included cut honeydew melon and a nectarine, grapes cut in halves and some blueberries
Easy to prepare:
1. Transfer yogurt to a cereal or soup bowl. I usually use a tablespoon to take 3–4 dollops.
2. Add the honey and use a teaspoon to swirl it through the yogurt.
3. Crumble the cereal in your fist, above the bowl — so that the small pieces fall into the yogurt. Mix everything with the spoons.
(You may
See more Lunch with Yogurt, Honey, Crumbled Cereal and Cut Fruit
By Elaine Schattner, MD, on September 8th, 2011 
the character Celia, in “The Help”
Last weekend I saw The Help, a movie on race relations in Jackson, Mississippi 50 years ago with lingering implications for people who hire “help” to take care of their children and tend to their personal business anywhere in the world, including now. It’s a heavy-handed, simple-message and nonetheless very enjoyable film, with fine acting and imagery, based on the book of the same title by Katherine Stockett.
One element of the narrative interested me from the medical perspective, having to do with the plight of a pale, thin and sexy young woman who’s marginalized by the white Jackson social elite. The character Celia, portrayed with flair by Jessica Chastain, lives, isolated, on an out-of-town plantation. She spends her days alone while her husband’s at work. The nominally proper women in town, while playing bridge and otherwise gathering, call her “white trash,” and
See more Medical Aspects of ‘The Help’: The Plight of a Woman with Recurrent Miscarriages
By Elaine Schattner, MD, on September 7th, 2011 
A tweet last week led me to look up the fact that September is indeed National Prostate Cancer Awareness month. It turns out the U.S. Department of Health and Human Services sponsors a website listing official National Health Observances (NHO).
You can see the YEAR 2011 AT A GLANCE, chock full of disease dates. What’s curious is that some and possibly all of the campaigns are sponsored by private foundations. Some examples listed for this month, September 2011 (except for the proclamation, all links by the NHO):
ITP Awareness Month
Childhood Cancer Awareness Month (and a related Presidential Proclamation)
Leukemia & Lymphoma Awareness Month (Link to the LLS.org yields no ready details on September.)
Ovarian Cancer Awareness Month
Prostate Cancer Awareness Month(Link to zerocancer.org gives no front-page info on September.)
There are plenty of other conditions and treatments listed, but some of the linked-to sites don’t provide details on the
See more September is Busy, National Health Awareness Observance Calendar
By Elaine Schattner, MD, on September 6th, 2011 Well, it’s the day after Labor Day, time to resume our discussion of Bending the Cost Curve in Cancer Care.
We’ve reached the end of the list, on ideas to reduce oncology costs put forth by Drs. Smith and Hillner in the May 25 issue of the NEJM. Really this 10th and final point intended for oncologists is two-in-one: “The need for cost-effectiveness analysis and for some limits of care must be accepted,” they chart. So doctors should embrace studies of comparative effectiveness and cost effectiveness.
Hard to argue with reason — they’re correct, of course. They write:
… The national imperative is to empower a transparent, acceptable, equitable, politically independent agency for guidance in making tough choices in the public interest so that doctors do not have to make them at the bedside.60 Ultimately, we will have to make decisions based on some criteria, and comparative-effectiveness61 and cost-effectiveness62 analyses
See more Reducing Cancer Care Costs by Comparative and Cost-Effectiveness Research (CER)
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connections…