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By Elaine Schattner M.D., on July 25th, 2010
Yesterday my husband and I took a short tour of Jericho, one of the world’s most ancient cities. I’d been there once before, sometime around 1972. My firmest memory of the place, stronger than my recollection of the ruins, is of drinking warm soda straight from the bottle with a plastic straw. It was hot then, like yesterday. While we poked around the remnants of a curved, tall stone tower said to stem from the Natufian period (~ 9,000 BCE), our driver took a seat in a nearby cafe. He ordered a pitcher of lemonade. “It’s the best here,” he said as we reached the shaded table. He poured some of the slightly-sweetened, fresh juice into each of our glasses. This was a familiar dilemna…
See more The Traveler’s Dilemna
By Elaine Schattner M.D., on July 20th, 2010
Hiking, or even just walking, in the hot summer heat to see ancient ruins, national monuments or spectacular vistas can sap the energy of healthy people. For someone who’s got a health issue – like chronic lung disease, reduced heart function or anemia – or anyone who’s pregnant, elderly or just frail, summer travel can knock you out in the wrong sort of way.…Don’t plan
See more Staying Healthy in Hot Summer Travel
By Elaine Schattner, MD, on July 2nd, 2010
 I had the pleasure of seeing and hearing Carole King and James Taylor in concert on Wednesday night at Madison Square Garden. Some highlights — Carole King picking up the guitar for a dueling rendition of Smack Water Jack, a surprise and rollicking re-take of Little Eva’s Locomotion, and her dancing like a happy teenager to I Feel the Earth Move. Taylor played well and graciously, with wit to boot. They made me feel like life gets better with age. Who knows? This
See more About the Concert
By Elaine Schattner M.D., on July 1st, 2010
…the Internet as a source of medical information is a complex, evolving, powerful and largely unregulated instrument. Some key questions for the future: 1. How do we define a blog and distinguish that from, say, a website with ads and text, or from a newspaper or multimedia conglomerate with an engaging on-line section? 2. How do we distinguish a medical blog…
See more Some Notes after Grand Rounds, and Questions for Medical Blogs and the Internet
By Elaine Schattner M.D., on June 24th, 2010
Among my hundred questions about this enterprise — notwithstanding the ethics of performing clinical trials in hospice patients, as is related in the Times article – is this: does the dye harm the kidneys? As for how much it costs, that’s not said either. Because Alzheimer’s is a fairly common disease and memory loss an even commoner condition, the potential demand for this marketable diagnostic method might be great. What are we thinking?
See more The New Alzheimer’s Plaque Test (and early breast cancer detection)
By Elaine Schattner M.D., on June 23rd, 2010
…it seems unlikely that this problem is isolated to a single department in one hospital. Rather, it’s a flag. With so much new emphasis by law on restricting resident physicians’ hours, perhaps there’s insufficient attention to the workload of senior (“attending”) physicians. Their responsibilities should be limited, too, such that they can accomplish their work in a careful manner in a reasonable number of hours per week.
See more Follow-up on the Harlem Heart Tests
By Elaine Schattner M.D., on June 21st, 2010
…My point, which is really a question, is whether people who seek out or need health care should be referred to as consumers or customers. My gut feeling is that neither term is appropriate. But then again, I don’t believe that medicine can be or should be run as a business. Here’s why:
See more On People Who Receive Care From Physicians
By Elaine Schattner M.D., on June 11th, 2010
I learned of a new study implicating stress in reduced breast cancer survival by Twitter. Three days ago, a line in my feed alerted me that CNN’s health blog, “Paging Dr. Gupta,” broke embargo on the soon-to-be-published paper in the journal Clinical Cancer Research. It seems the story – that women who undergo a stress relief program live longer after breast cancer recurrence – couldn’t wait.
“Less stress helps breast cancer patients” is the title of the rushed post. What the researchers, based at Ohio State’s Comprehensive Cancer Center, report is that psychological intervention helps to increase the quality of life and survival among women with recurrent breast cancer.
The intervention at issue is this: weekly, small-group meetings of BC patients for 4 months after their initial surgery and diagnosis. Led by clinical psychologists, the women met 18 times and discussed strategies to reduce stress, improve mood, strengthen social networks, eat better, exercise
See more Mind over Matter? Don’t Kid Yourself (on Stress and BC)
By Elaine Schattner M.D., on June 6th, 2010
 My plan for today was to write on evidence-based medicine. But that can wait, at least until the morning comes.
I came upon the most wonderful recording of a concert by Carole King and James Taylor played in November, 2007 at LA’s Troubadour Club, a place I’ve never been. PBS aired the video, about an hour long in its fuller form, for its June fund-raising drive. I have tickets to see the pair at Madison Square Garden in a few weeks, and had seen yesterday morning a heartening review of the old friends’ joint concert tour.
Sweet Baby James (1970)
Even within the limits of our old TV and nothing approaching a Dolby sound system in our living room, the images – the sounds and smiles generated by Taylor and King, fixtures of my childhood – made me tremble with joy. It was lovely beyond verbal expression and I felt, among other things, glad.
Here’s the
See more A Tapestry, and Double-Dose of Magic (on Carole King and James Taylor, Troubadour and Breaking Addiction)
By Elaine Schattner M.D., on May 31st, 2010
 Harlem Hospital Center stands just three miles or so north of my home. I know the place from the outside glancing in, as you might upon exiting from the subway station just paces from its open doors. The structure seems like one chamber of its neighborhood’s heart; within a few long blocks’ radii you’ll find rhythms generated in the Abyssinian Baptist Church; readings at the Schomburg Center and artery-clogging cuisine at the West 135th Street IHOP. So I was saddened to hear about the missed heart studies. Or should I say unmissed? No one noticed when nearly 4,000 cardiac tests went unchecked at the Harlem center,
See more About Those Skipped Heart Test Results
By Elaine Schattner M.D., on April 27th, 2010
 Yesterday I visited my internist. I had no particular complaint. My back hurt no more than usual. The numbness in my left foot was neither better nor worse than it was last month. I wasn’t suffering from vertigo or abdominal pain. I went because I had an appointment to see her, nothing more. Until just a few years ago, I rarely
See more A Routine Visit
By Elaine Schattner M.D., on April 20th, 2010
 As pretty much anyone traveling in Europe this week can tell you, it’s sometimes hard to know what will happen next. Volcanologists – the people most expert in this sort of matter – simply can’t predict what the spitfire at Eyjafjallajokull will do next. It comes down to this: the volcano’s eruption could get better or it could get worse…
See more Uncertainty Rules (on Eyjafjallajokull, volatility and a patient’s prognosis)
By Elaine Schattner, MD, on April 10th, 2010
(in the Style of a Magazine Cover) If patients knew more: 1. they’d understand more of what doctors say; 2. they’d ask better questions; 3. they’d be more autonomous; 4. they’d make better decisions (ones they’re comfortable with, long-term); 5. they’d spend less money on care they don’t want or need. If doctors knew more…
See more Ten Ways to Better Our Health (Magazine Cover Style)
By Elaine Schattner M.D., on April 5th, 2010
Recently in the Times’ “Patient Money” column, Lesley Alderman shared nine physicians’ views on how we might reduce our country’s health care mega-bill. Here, I’ll review those comments, add my two cents to each, and then offer my suggestion (#10, last but not least!) regarding how I think we might reduce health medical costs in North America without compromising the quality of care doctors might provide. The “answers” from…
See more 9 + 1 Ways to Reduce Health Care Costs
By Elaine Schattner M.D., on April 3rd, 2010
If there’s one obvious thing I didn’t learn until I was well into my forties it’s this: Don’t let a day go by without doing something you feel good about. This message is not unusual, cryptic or even interesting. It’s simple, really so trite you could find it in most any “how having cancer changed my life” book available in bookstores and on-line. Why say it again? Everyone knows we should relax and enjoy sunny weekend days like this. Because it’s a reminder to myself, as much as for some readers and maybe a few fledgling doctors out there. One of my…
See more An Ordinary Day
By Elaine Schattner, MD, on March 22nd, 2010
The program promises to continue “its look deep inside the complicated heart and soul of a functioning addict, a loving wife, mother, and a first-class nurse.” I’m curious but must admit that last year I watched only part of one episode and didn’t return…The program promises to continue “its look deep inside the complicated heart and soul of a functioning addict, a loving wife, mother, and a first-class nurse.” I’m curious but must admit that last year I watched only part of one episode and didn’t return…Today she beckons half-smiling, an aura of pills and syringes above and syringes above her head. Maybe she’s happy about …
See more A New Nurse Jackie in Preview
By Elaine Schattner, MD, on March 17th, 2010
 Am I pro– or con– colonoscopy for routine screening, you might wonder. Well, that depends. Am I pro– or con– famous singers and other celebrities extolling the benefits of particular medical interventions? Well, that depends, too. But I’m sure I prefer “Puff the Magic Dragon.” Also “Leaving on a Jet Plane” fills me with imperfect memories of 6th grade.
See more Peter Sings Colonoscopy
By Elaine Schattner M.D., on March 15th, 2010
Last week the journal Cancer published a small but noteworthy report on women’s experiences with a relatively new breast cancer decision tool called Oncotype DX. This lab-based technology, which has not received FDA approval, takes a piece of a woman’s tumor and, by measuring expression of 21 genes within, estimates the likelihood, or risk, that her tumor will recur. As things stand, women who receive a breast cancer diagnosis face difficult decisions…
See more A Small Study Offers Insight On Breast Cancer Patients’ Capacity and Eagerness to Participate in Medical Decisions
By Elaine Schattner M.D., on March 10th, 2010
If patients can take a drug without a catheter, it might be less costly – there’s no nurse to hire, no catheter to purchase and insert and there’s no billing for an infusion per se. And there’s less cost to the patient in terms of hassle and some untoward effects of IV treatment. With oral drugs (capsules, pills or tablets — anything taken by mouth) there’s no need to go to the doctor’s office or medical center every week or every other week…
See more Some Targeted Therapies for Cancer Come as Pills
By Elaine Schattner M.D., on March 5th, 2010
I first heard about STI-571 (Gleevec, a targeted cancer therapy) from a cab driver in New Orleans in 1999. “Some of the doctors told me there’s a new cure for leukemia,” he mentioned. We were stuck in traffic somewhere between the airport and the now-unforgettable convention center. His prior fare, a group of physicians in town for the American Society of Hematology’s annual meeting, spoke highly of a promising new treatment. It seemed as if he wanted my opinion, to know if it were true. Indeed, Dr. Brian Druker gave a landmark plenary presentation on the effectiveness of STI-571 in patients with chronic myelogenous leukemia (CML) at the conference. I was aware of the study findings. “Yes,” I said. “There is a new drug for leukemia.” Since then, oncologists’ enthusiasm for targeted therapies – medications designed to fight cancer directly and specifically – has largely held. But the public’s enthusiasm is less apparent. Perhaps that’s because many people are unaware of these new drugs’ potential, or they’re put off by their hefty price tags.
See more Considering Targeted Therapies For Cancer
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