March 2011 – Medical Lessons

In Defense of Primary Care, and of Sub-Sub-Sub-Specialists

March 31, 2011March 28, 2019 Elaine Schattner, MD

An article in the March 24 NEJM called Specialization, Subspecialization, and Subsubspecialization in Internal Medicine might have some heads shaking: Isn’t there a shortage of primary care physicians? The sounding-board piece considers the recent decision of the American Board of Internal Medicine to issue certificates in two new fields: (1) hospice and palliative care and (2) advanced heart failure and plans in-the-works for official credentialing in other, relatively narrow fields like addiction and obesity.

The essay caught my attention because I do think it’s true that we need more well-trained specialists

Posted in Essential Lessons, Future of Medicine, health care costs, health care delivery, Medical Education, PolicyTagged expertise, health care costs, medical specialties, physician shortage, primary care, subspecialties, telemedicine, value of expertiseLeave a Comment

Hot Wasabi, and a Continuing Radiation Crisis

March 30, 2011May 28, 2012 Elaine Schattner, MD

a poem for Wednesday: I was touched by this headline in yesterday’s news: Japan nuclear crisis may have a silver lining for radiation health research. Yeah, and cancer is a gift. — The wasabi is too hot, NPR shared yesterday, and I agree. This radiation story has a long half-life, whether we write on it […]

Posted in Communication, language, Life, Public HealthTagged food supply, Japan, medical news, poem, poetry, radiation, radioactivity, wasabi1 Comment

Thoughts on Geraldine Ferraro, and Myeloma

March 27, 2011May 28, 2012 Elaine Schattner, MD

Like many New Yorkers, feminists?, hematologists and other people, I was saddened to learn yesterday of Geraldine Ferraro‘s death. The Depression-era born mother, attorney, criminal prosecutor, Congresswoman, 1984 Democratic VP-candidate and part-time neighbor to yours truly, succumbed to complications of multiple myeloma at the age of 75. Myeloma is a cancer of plasma cells – […]

Posted in cancer survival, cancer treatment, Hematology (blood), Oncology (cancer), Public IllnessTagged autologous transplantation, expertise, Geraldine Ferraro, hematology, multiple myeloma, Revlimid, stem cell transplant, value of expertise, Velcade5 Comments

Art, Science and Radiation Imagery on a Magazine Cover

March 25, 2011May 28, 2012 Elaine Schattner, MD

This week’s New Yorker cover pretty well sums up my thoughts lately. It’s a bleak, semi-natural image that blends art and science, offers brightness amidst darkness, and reminds us of how little most of us know about physics, nuclear energy and radioactivity. And it’s a strange, unsettling start for the Spring. — Related Posts:Considering the […]

Posted in Magazine, Medical NewsTagged art in science, Japan earthquake, New Yorker Japan cover, radiation emergencyLeave a Comment

Crowd-Sourcing a Medical Puzzle

March 24, 2011May 28, 2012 Elaine Schattner, MD

The Times ran an intriguing experiment on its Well blog yesterday: a medical problem-solving contest. The challenge, based on the story of a real girl who lives near Philadelphia, drew 1379 posted comments and closed this morning with publication of the answer. Dr. Lisa Sanders, who moderated the piece, says today that the first submitted […]

Posted in Communication, Diagnosis, Future of Medicine, Health IT, Ideas, Medical Education, PrivacyTagged clinical dilemmas, contest, crowd-sourcing, diagnosis, how doctors think, medical puzzle, New York Times, privacy3 Comments

A Good Place to Find Information on Clinical Trials

March 23, 2011May 28, 2012 Elaine Schattner, MD

If you’re thinking of participating in a clinical trial for cancer or any other medical condition, a good place to find out about the research is ClinicalTrials.gov. The site, sponsored by the NIH, NLM and FDA, is one outcome of the FDA Modernization Act (FDAMA) of 1997. The database aims to provide information on clinical […]

Posted in clinical trials, Communication, Empowered Patient, Informed Consent, Wednesday Web SightingTagged cancer research, clinical trials, ClinicalTrials.gov, FDA Modernization Act of 1997, public access, trial registrationLeave a Comment

Bristol-Meyers Says Ipilimumab Prolongs Survival in Metastatic Melanoma

March 22, 2011April 3, 2011 Elaine Schattner, MD

This morning health business mavens are chirping with bright results for ipilimumab, a monoclonal antibody that can extend life in people with metastatic melanoma. If the new data – which I haven’t seen – are true, it’s good news for patients. In 2010, melanoma affected 68,000 people in the U.S. and led to death in […]

Posted in cancer treatment, clinical trials, Medical News, Oncology (cancer)Tagged Bristol-Meyers Squibb, clinical trial, CTLA-4, immune therapy, Ipilimumab, melanoma, monoclonal antibodyLeave a Comment

A Nutritional Tidbit, on Quinoa

March 21, 2011May 28, 2012 Elaine Schattner, MD

I first heard about quinoa a few years ago, when food-sellers started marketing the stuff as a cereal-like, cholesterol-lowering nutritious substance. It’s from the Andes, I knew, and comes in some varieties. If you purchase the raw stuff or receive a gift, say, from a Peruvian person who knows her quinoa, you’ll find quickly that […]

Posted in Homemaking, NutritionTagged chenopods, homemaking, nutrition, pseudograin, quinoa, Wikispecies1 Comment

When Less Chemo is Just As Good, In Treatment for Acute Myeloid Leukemia (AML)

March 17, 2011April 6, 2011 Elaine Schattner, MD

Today’s issue of the New England Journal of Medicine includes an article with the bland title Cytarabine Dose for Acute Myeloid Leukemia. AML is an often-curable form of leukemia characterized by rapidly-growing myeloid white blood cells. Cytarabine – what we’d call “Ara-C” on rounds – has been a mainstay of AML treatment for decades. The […]

Posted in cancer treatment, clinical trials, Oncology (cancer), Under the RadarTagged acute myelogenous leukemia, AML, Ara-C, chemotherapy, cytarabine, drug dose, less is moreLeave a Comment

Change the Channel?

March 16, 2011May 28, 2012 Elaine Schattner, MD

The situation in Japan remains grim. I can’t reasonably report on this, except to say what’s evident by the photographs, videos and usually-reliable sources: a second reactor may have ruptured. There’s been another burst of radioactivity into the air. Meanwhile, thousands of bodies are being discovered in the post-Tsunami landscape along the northeast coast. The […]

Posted in Books, Communication, LifeTagged CNN effect, empathy, Japan earthquake, photography, radiation, Susan Sontag, the Pain of Others, tsunami, TVLeave a Comment

Medical Lessons