How Many of Us Are Dying Because We Go To Our Doctors? (As Opposed To Dying Because We Can't Afford To Go.)

I'm often curious about the denial of the pretty clear reality that our medical system needs serious help.  One of the denial sticking points is the number of deaths directly attributable to medical care.  Let's be clear.  Almost everyone dies under medical care at some point.  But a fair percent of patients are helped on their way unnecessarily and prematurely by the very people who want to preserve their lives. 

We rank poorly (twelfth out of fifteen) in comparison to other industrialized nations' healthcare.  Before you blame the fat Americans, we rank 3rd lowest in smokers and fifth lowest in drinkers.  U.S. men 50-70 have the lowest cholesterol of the group.  So it isn't just that we're less healthy. 

"According to several research studies in the last decade, a total of 225,000 Americans per year have died as a result of their medical treatments:


• 12,000 deaths per year due to unnecessary surgery

• 7000 deaths per year due to medication errors in hospitals
• 20,000 deaths per year due to other errors in hospitals
• 80,000 deaths per year due to infections in hospitals
• 106,000 deaths per year due to negative effects of drugs
Thus, America's healthcare-system-induced deaths are the third leading cause of the death in the U.S., after heart disease and cancer.

Where am I getting all these disturbing statistics?  From the Journal of the American Medical Association, that den of alternative radicalism (seriously, one of the most conservative medical journals on the planet).  Here's the data written out at a radical blog and here's -WAIT-where is that pesky journal article?  Oh, right here on the JAMA website.  Oh, and if you had some concerns about Starfield's credentials, she works at John Hopkins.  So that's where we get our statistics. 

If you'd like a whole book on our chilling reality, check out Money Driven Medicine.

Michael Hawkins' Spiritual Conversion: What Does It Teach Us?

I was looking for another Hawkins, Tim Hawkins who makes me laugh, when I came across Michael Hawkins’ blog and autobiography.  It doesn’t really matter if you agree with anything he says, what matters is:  How can I get all my patients this high on life?  Really.  Something like 70% of Americans are depressed.  That means basically our way of life is rotten.  We take a huge number of mind altering substances, legal and illegal, to get this high.  I think we need a bumper sticker that says:  Say no to drugs, say yes to kundalini!

Homeopathy: Science or Myth?

I was very excited to find this fine book by a Stanford Physician trained by five Nobel Laureates.  And I found it on Google books! Or you could get it via Amazon.  It's a fascinating story of a physician who put homeopathy to the test, not simply in a study, but in the emergency wards while he was a staff physician.  His stories are extraordinary, and his science is impeccable. 

What To Read This Winter: Ulysses.

After giving Homer his well deserved due, Joyce's Ulysses inspires more fear.  Homer is available in many very readable translations, but Joyce's text defies even printers.  They just found many more errors and printed an updated version, which is supposedly much clearer.  Certain passages are now much more readable, according to Joyce experts.  Could've fooled me. 

This time I started Joyce from the back.  The last chapter is stream of consciousness (no punctuation), but rewards the reader with some very vulgar things.  We've also got chapters as plays, a legal brief, and a range of other literary forms.  I really enjoyed it, because I allowed myself to skim it and didn't care that much about whether or not I "got" the plot line.  Not much really seems to happen, which is fine.  I was reminded of Tristan Shandy, who wrote a very vulgar, very wandering piece and was declared insane.  Joyce is declared a genius for doing the same thing.  Anyway, it passed a very long, snowed in afternoon this past month.  Recommendation:  skim, and see if it really is all that intimidating. 

  

Desiderata: Correcting the Errata.

I first came across the Desiderata as a poster that gave the date of production as sometime in the 17th century.  But the wording was always far too modern.  It was nicked from Max Ehrmann, a poet who lived at the beginning of the 20th century.  The story I like is that Max wrote the Desiderata as a personal set of notes for himself, and then decided to publish it.  It is different from much of his other work.  I'm reposting the poem here, for personal reference.  You can read more about Max on Wikipedia.  Or maybe even buy his book (the Multnomah county library copy had the Desiderata torn out when I went looking for it years ago).

Go placidly amid the noise and haste,


and remember what peace there may be in silence.



As far as possible without surrender

be on good terms with all persons.

Speak your truth quietly and clearly;

and listen to others,

even the dull and the ignorant;

they too have their story.

Avoid loud and aggressive persons,

they are vexatious to the spirit.



If you compare yourself with others,

you may become vain and bitter;

for always there will be greater and lesser persons than yourself.



Enjoy your achievements as well as your plans.

Keep interested in your own career, however humble;

it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs;

for the world is full of trickery.

But let this not blind you to what virtue there is;

many persons strive for high ideals;

and everywhere life is full of heroism.



Be yourself.

Especially, do not feign affection.

Neither be cynical about love;

for in the face of all aridity and disenchantment

it is as perennial as the grass.



Take kindly the counsel of the years,

gracefully surrendering the things of youth.

Nurture strength of spirit to shield you in sudden misfortune.

But do not distress yourself with dark imaginings.

Many fears are born of fatigue and loneliness.



Beyond a wholesome discipline,

be gentle with yourself.

You are a child of the universe,

no less than the trees and the stars;

you have a right to be here.

And whether or not it is clear to you,

no doubt the universe is unfolding as it should.



Therefore be at peace with God,

whatever you conceive Him to be,

and whatever your labors and aspirations,

in the noisy confusion of life keep peace with your soul.



With all its sham, drudgery, and broken dreams,

it is still a beautiful world.

Be cheerful.

Strive to be happy.

Positive Spirituality: A Handbook of Practical Guidance.

I listened to a CME (continuing ed.) on "soul sickness" yesterday.  Dr. Craigie's book came up.  I've always had the greatest respect for Dr. Craigie as a deeply committed doctor and human being.  Just looking through the sample chapter of his book, I learned new contexts for some of the things I've already been doing.  He gives such detail that a relatively new clinician could use this book to effectively increase competence in the critical area of patient compliance.  But it also gives experienced clinicians new thoughts and frameworks for how to deal with ongoing issues. 

Allergies: The Time to Start Treating Is Now

From Allergies Update, at Maloney Medical (all abstracts available there):

Deep winter is the perfect time to start treating for allergies in the spring.  We have a range of different plans that will down regulate the histamine response, but don't wait to start sneezing.  That's like waiting for a flat tire before you go out and get a spare. 

Currently the standard program to desensitize patients involves injections. But the state of the art is now drops under the tongue. “Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma…New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients.  ” But, you ask, is it as effective as the injections? “The mean peak expiratory flow result (how much air you can exhale) was significantly higher in the active group than in the control group after 10 years.

But can I go off my inhaler? Unfortunately, we don’t know, because: “when mild-moderate asthmatic children are optimally controlled by pharmacologic treatment and HDM (human dust mite) avoidance, SLIT does not provide additional benefit, despite a significant reduction in allergic response to HDM. Under such conditions, only a complete, but ethically unfeasible, discontinuation of inhaled corticosteroid would have demonstrated a possible benefit of SLIT.”  It could be dangerous to remove the inhalers, so we’ll keep people on them for life. Of course, the long term effects of steroids…

Penelope Trunk: An Underused Superstar.

I'm one of the few people who can claim to have purchased both Timothy Ferriss' Book and Penelope Trunk's book.  Unfortunately Ms. Trunk's book I purchased at a dollar store.  I did so because I wondered specifically why her book was there and Ferriss' book was a best seller.  Here is someone who did everything right, but still her book is at the dollar store.  So when I came across her delightful discussion of Ferriss, I was really pleased.  Her book is not representative of her writing as a whole.  It is dense, doesn't flow, and makes you feel excluded from the cool people before you even start.  Ferriss' allure is that he claims his book is for everyone, which is complete nonsense (gramma isn't web savvy, and uncle Joe needs his dialysis).  But he also generated an enormous upswell for his book from blogs like Trunk's.

Check out Trunk's blog for really useful tips from someone who looks like they should be the life of the party while hiding in the broom closet. 

Probiotic Capsules: A New Pharmacy Section in the Supermarket.

I'm suddenly seeing a great number of probiotic products on the supermarket pharmacy section shelves.  Looking through the claims and labels, these products are overwhelmingly similar to health food store offerings with one exception.  They are not refrigerated. 

Consumer reports did an analysis of probiotics some years back and found that the die off from manufacture date to purchase time was pretty extraordinary.  An equivalent metaphor would be packaged fish.  It might be possible to package fish well enough that they wouldn't start to stink, but that would be a pretty gamey fish by the time you got it. 

For any and all of you considering probiotics, either go to a refrigerated product or use the yogurts in the dairy aisle.  Ounce for ounce probiotic capsules are more concentrated, but we generally eat far more yogurt at a sitting.  So they work out to be equivalent.  Consumer reports found that all yogurt brands continued to have live bacteria. 

If you are determined to buy probiotics, consult someone like me.  I can at least tell you what brands are doing independent testing at the consumer end to make the little guys are still alive. 

The Value of Real Fats.

We've got a group of NDs who really like good fats and point out that fat doesn't necessarily mean disease or obesity.  It's hard to reconcile this viewpoint with the reality of obesity in our society.  On the other hand, all the low fat foods we've been stuffing ourselves with haven't made us any thinner. 

I'm not a convert to high fat, but I think it's worth thinking about real food vs. processed food. 

Here's the link to the AANP article. 

A Book I Should Have Written: Prostate Cancer Expose.

I haven't even read this book, but I already love it because of the title alone.  I've added some of my own data on alternative treatments at my website. 

Carpal Tunnel: Just a spot in a very dark tunnel.

What most young people don't understand (because we've lost most of our manufacturing jobs) is that repetitive motion leads to problems.  This is especially true for the fine bones of the hand.  Long before there were electronic devices to mess up your hands, musical performers knew of a thing called carpal tunnel, a small subsection of repetitive strain injury.  I've written about this and posted the research.  But the master wrote a book that really helped my family.  Here it is. 

Rabelais: A Time For Folly.

If you can wrap your noggin around the thick prose, this book has it all.  We've got pranks and wits and urinating off towers.  We've got enough graphic love to make Chaucer's Miller blush.  And all this from the 15th century.  Who says the classics have to be stuffy?

Back pain: Nonsurgical Options.

I just did an update on long term outcomes for back pain surgery and we still aren't seeing large studies.  The patients are there, but no one is doing follow up over a couple years.  In the meantime, there are a great many home treatments that are available. 

The little guy on the left is a TENS unit, every person with chronic pain's best friend (unless you have an inflammatory condition, in which case stay away).  Clinicians can get these for about $45 and they run on a nine volt battery.  I just don't see them being used instead of pain drugs, which is sad, because they are a much better option for specific pain.