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By Elaine Schattner, MD, on November 30th, 2011
 The other evening I stayed up watching Frida, a 2002 movie about the Mexican artist Frida Kahlo. She sustained debilitating spinal injury in a trolley accident as a teenager and had many surgeries. Among other interesting things about her life, she had a tumultuous marriage to the then-more-famous muralist Diego Rivera, and if this movie be true, a brief affair with Leon Trotsky.
Her story is one of pain, psychological and physical, and of a beautiful woman who uses art to express what that’s like. She’s astonishing, still, if you ask me.
Speaking of pain, or “algia” in Greek, as some of reviewed on Twitter yesterday -
Today I came upon a blog, Pain Sufferers Speak, put together by an on-line friend, Liz Hall. Liz maintains a related Facebook page, a LinkedIn network for pain sufferers, runs Tweet chats @painspeaks and more. There’s a “Facebook Pain Family Group with NO judgment and NO criticism PLUS Unconditional Love plus 24–7 support for
See more A Blog About Pain
By Elaine Schattner, MD, on November 29th, 2011
 The latest issue of the Annals of Internal Medicine contains 2 noteworthy papers on cervical cancer screening. The first, a systematic review of studies commissioned by the USPSTF, looked at 3 methods for evaluating abnormalities in women over 30 years:
high-grade cervical cell dysplasia (Dr. E. Uthman, Wikimedia Commons)
1. Conventional cytology (as in a Pap smear; the cervix is scraped and cells splayed onto a microscope slide for examination);
2. Liquid-based cytology (for LBC, the NHS explains: the sample is taken as for a Pap test, but the tip of the collection spatula is inserted into fluid rather than applied to slides. The fluid is sent to the path lab for analysis);
3. Testing for high-risk HPV (human papillomavirus). Currently 3 tests have been approved by the FDA in women with atypical cervical cells or for cervical cancer risk assessment in women over the age of 30: Digene Hybrid Capture 2 (manufactured by Quiagen), Cobas
See more Cervical Cancer Screening Update: on Pap Smears, Liquid-based Cytology and HPV
By Elaine Schattner, MD, on November 23rd, 2011
 Dear Readers,
I’m going to take a break from blogging for the holiday and possibly a while longer. For tomorrow, there’s lots in store, with family and old friends.
Macy’s Thanksgiving Day Parade, Times Square, Nov 25, 2010, photo attribution: asterix611 (Flckr)
I wish everyone a wonderful Thanksgiving and long weekend!
ES
Related Posts:Real Life Interrupts ML, In a Good Way!A Change of PaceCelebrating a HolidayAbout this WeekLive Every Week Like It’s Shark Week, Again!
By Elaine Schattner, MD, on November 22nd, 2011
A neat story in today’s Times points to the paradoxically increasing smallness of our world, in the digital and, maybe, personal sense. We’re getting nearer, one to one another. Or at least some of us are through Facebook and other technologies.
Our average degree of separation is said to be only 4.74, according to a new study posted on-line yesterday, where else but on Facebook? According to the Times report on the Facebook work:
… The researchers used a set of algorithms developed at the University of Milan to calculate the average distance between any two people by computing a vast number of sample paths among Facebook users. They found that the average number of links from one arbitrarily selected person to another was 4.74. In the United States, where more than half of people over 13 are on Facebook, it was just 4.37.
The caveat, of course, is that the study examined connections
See more New Math in a Digital World: Implications for Patients?
By Elaine Schattner, MD, on November 21st, 2011
A short note on Cutting for Stone, a novel I’ve just read by Dr. Abraham Verghese. He’s an expert clinician and professor at Stanford. The author uses rich language to detail aspects of Ethiopian history, medicine and quirks of human nature. The book’s a bit long but a page-turner, like some lives, taking a strange and sometimes unexpected course.
For today I thought I’d mention one passage that haunts me. It appears early on, when the protagonist, a man in middle age reflects on his life and why he became a physician:
My intent wasn’t to save the world as much as to heal myself. Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound.
The point is, a physician may be immersed in his work in a manner that he is, in
See more ‘Cutting For Stone,’ and Considering the Experience of Practicing Medicine
By Elaine Schattner, MD, on November 18th, 2011
Today’s breaking breast cancer news is on Avastin. The FDA has just announced, formally, that it will rescind approval for the drug’s use in people with metastatic breast cancer. Commissioner Dr. Margaret Hamburg writes this her statement:
I know I speak on behalf of the many physicians that have been involved with this issue here at the Food and Drug Administration and elsewhere in saying that we encourage patients, and those who support them, to ask hard questions and demand explanations concerning the drugs that are recommended to treat serious illnesses.
On this much I agree with Dr. Hamburg – that patients and others, including doctors who prescribe treatments to patients with likely incurable illnesses, and all medical conditions, for that matter, should ask hard questions.
Others have already, immediately expressed that the FDA did the right thing. Because they think the FDA’s decision was rational, and it was. Likely there’ll
See more Final Word on Avastin, and Why We Need Better Physicians
By Elaine Schattner, MD, on November 17th, 2011
Today’s ML comes straight from the Oval Office. President Obama talks about smoking, and how hard it is to stop, and what can be done to reduce the use and long-term health consequences of tobacco.
What I like about this Presidential health advisory:
He credits the ACS, which is sponsoring a smokeout today.
He’s clear about the problem’s scope: “Today 46 million Americans are still hooked, and tobacco remains the leading cause of preventable, early deaths in this country.”
He doesn’t deny his own history. His experience lends credibility to his words; he understands how hard it is to stop smoking once you’ve begun.
He considers a solution: “We also know that the best way to prevent the health problems that come from smoking is to keep young people from starting in the first place.”
He reflects on the power of tobacco companies, which are fighting requirements for candid warning labels on their
See more President Obama Talks About Smoking and Tobacco
By Elaine Schattner, MD, on November 16th, 2011
Yours truly, the author of Medical Lessons, is listening to music while she writes. A live version of the Stones’ “Silver Train” has just come on, and she’s happily reminded of something that happened 30 years ago. Distracting? Yes. Calming? Yes. Paradoxically helps to keep me on track? Yes.
My iPod keeps my mind from wandering further. And it lifts my mood.
And so here, on my blog, which is not peer-reviewed or anything like that, I put forth the medical concept of “iPod therapy.”
“When you’re weary, feeling small…” Music can help.
Today’s news reports that 1 in 5 Americans take drugs for psychiatric conditions. That sounds like a lot to me, but I’m no pharmaceutical surveyor. Of course many people need and benefit from medical help for depression and other mental illnesses.
But, in all seriousness, I wonder how many people might use music like a drug to keep them relaxed, happy, alert…
Why not prescribe music? It
See more iPod Therapy — Why Not Prescribe It?
By Elaine Schattner, MD, on November 14th, 2011
A funny thing happened at my doctor’s appointment on Friday. I checked in, and after confirming that my address and insurance hadn’t changed since last year, waited for approximately 10 minutes. A worker of some sort, likely a med-tech, called me to “take my vitals.”
She took my blood pressure with a cuff that made my germ-phobic self run for self-regulation, i.e. I stayed quiet and didn’t express my concern about the fact that it looked like it hadn’t been washed in years. I value this doctor among others in my care, and I didn’t want to complain about anything. Then the woman took my weight. And then she asked if she could take my picture, “for the hospital record.”
I couldn’t contain my wondering self. “What is the purpose of the picture?” I asked.
“It’s for the record,” she explained. “For security.”
I thought about it. My picture is pretty much public domain at this point in my life,
See more Thoughts, on Getting My Photo Taken at a Medical Appointment
By Elaine Schattner, MD, on November 10th, 2011
This week at Scientific American’s Observations, reporter Katherine Harmon asks: Does science need more compelling stories to foster public trust?
This excellent question came my way, rephrased on Twitter, as this: “Should scientists fight misleading anecdotes w/ their own?”
The @SciAm piece starts like this:
The touching stories that advocacy groups are so good at telling—the 49-year old mother whose breast cancer was detected by an early mammogram before it had spread; the 60-year-old neighbor who had a prostate tumor removed thanks to a routine PSA test—should inspire scientists to use anecdotes of their own, argue two doctors from the University of Pennsylvania.
So we’ve got a battle metaphor on Twitter (scientists would ‘fight’) while doctors at a prestigious medical school advocate the use of anecdotes to “inspire” (i.e. manipulate) peoples’ views on information.
I agree with Katherine Harmon that the question of whether or not to use anecdotes in health and science reporting is
See more How Do You Know What’s True?
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