Archive for the 'Medicine' category

Getting Fit - A Scienceblogs Challenge

Jan 11 2010 Published by under Medicine

As you might have seen, there's a fitness challenge going on here at ScienceBlogs. A few years ago, when I first started blogging here, my non-participation in any fitness-related activity would have been a safe bet. But that was then.

Over the last couple of years, I've come to realize that the numbers coming off the blood pressure cuff were not actually figments of the doctor's crazed imagination. I've also started to recognize that the number "2" should not be appearing in my weight twice, and it probably shouldn't be the first digit in the number. I've finally acknowledged, in other words, that I'm not that young anymore, and not that immortal.

And I've been working at a gym.

That's working as in employed, not working as in "working out". When we relocated to Alabama, I discovered that, for a number of reasons, the hours and schedule for lifeguards at the base Physical Fitness Center was the job that best matched our family circumstances. That means that I've been spending an average of 40 hours per week at the pool.

Adding some workout time to that wasn't too hard. This is good, because although I might be a lifeguard, the only way I'm going to get close to the Hoff's bodytype in the near future is with photoshop. I'd already decided that I need to get into a shape that's not round, so when Ethan proposed a fitness challenge, I actually took notice.

Some people might like calisthenics, and some might like free weights, but neither of those is my kind of thing. On land, I'm all about the machines, because the machines let me multitask my way through the workout - the thing that I hate the most about exercise is knowing that I could be doing something else that interests me a lot more. But that's the minor part of my exercise plan. Mostly, it's about the swimming. (Go figure.)

If you're looking for a whole-body workout that will get your pulse rate up without putting undue stress on your bones and joints, you might want to think about swimming. A good swim workout will simultaneously work your arms, legs, and core. Kick-boards, fins, pull buoys, and paddles can be used to focus effort on specific parts of the body, and you can set workouts that will build strength, endurance, or both.

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Cal Thomas: Health Care Reform = Hitler

Aug 18 2009 Published by under Flaming Small-Minded Stupidity, From the Right, Medicine

In his latest column, Cal Thomas takes another swing at explaining the perils of health care. Last week, you might remember, he claimed that health care proponents want to kill off the old because we're evolutionists. This week, we're Hitler:

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National Review on Health Care: Let the Poor Eat Cake.

Aug 18 2009 Published by under Medicine

If you're poor, sick, and can't afford good - or even adequate - health care, it's your own fault for being poor, and your own problem. That's the clear message of an editorial that appeared on the National Review's website yesterday:

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A story about government run health care.

Aug 06 2009 Published by under Life in an Army Family, Medicine, Politics

Yesterday, I took the kids to the doctor for their school physicals. I wouldn't normally subject you to an account of the day-to-day minutia of my personal life, but given the current debate about how we should handle health care in the United States, the details might be of interest.

We arrived - without an appointment - at a medical facility that we had not been to before. We did not have medical records with us, and the only paperwork of any kind that we had brought were the forms that needed to be filled out to enroll the kids in sports programs. When we checked in, the only thing I had to do was hand the clerk a government-issued photo ID. I did not have to fill out any insurance forms, I did not have to hand over any payment of any kind, and I didn't touch a clipboard. Within two hours, both the children had been seen by a doctor, received physical exams, had their shot records checked and brought up to date where necessary, and I'd been given the completed school and sports forms.

That's not fiction, and it's not a prediction of what could happen in the future. That happened yesterday, it happened in the United States, and it happened in a health care system that's owned and operated by the Federal Government.

That's right. I got to use the dreaded socialized medicine yesterday, because I've got access to the Department of Defense's medical system.

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Decisions Get Made By Those Who Show Up. Even If They're Teabaggers.

Aug 05 2009 Published by under Medicine

"Decisions are made by those who show up."

Around the country, right-wing activists, backed by well-funded groups working for the insurance industry, are showing up at the town hall events that Congresscritters are having in their districts during the recess. They're showing up and making their position known very clearly - in at least some cases at the expense of anyone else who wants to hear actual discussion about the issue. The GOP leadership is happier than they've been for the last two election cycles.

Over at Talking Points Memo, Josh Marshall almost asks the right question:

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Silence is the Enemy.

Jun 01 2009 Published by under Medicine, Misc

It's easy, as Nicholas Kristof points out, to think and talk about international affairs in abstract terms. Most of us are living comfortable lives in comfortable countries. We have the luxury of being able to afford to think about things that are happening beyond our own borders, even when they're unlikely to affect us directly. We can talk and think about what's happened or what is happening in Bosnia, in Darfur, in Cambodia, in the Sudan. We can think and talk about things we can do to make things better in those places, and sometimes we can carry through with our plans.

It's not as easy to talk about some of what's happening in concrete terms. It's easy to talk about what is happening in various places without overly disturbing our bourgeois happy feelings. It's not as easy to talk - or write - about what's happening to people who live in those places. That's particularly true when what's happening lies far, far outside our comfort zones. In some cases, it's harder than others. Talking about children being killed makes me uncomfortable. Talking about little girls being violently raped is harder. Even thinking about a 7-year-old named Jackie jumping rope in a center for rape victims alongside other girls in the same age group is - yuck. It's easier to talk about people being "killed, or worse".

But playing ostrich isn't going to help. When it comes to atrocities - even atrocities in places we've barely heard of and will never visit - silence is complicity.

Sheril Kirshenbaum and Isis are spearheading a blogosphere drive to try and increase awareness of rape in war-torn areas. They will be donating all the income from their blogs this month to Médecins Sans Frontièress, as will several other bloggers (including me). We'll also be discussing the issue in more detail throughout the month.

If you want to help, there are a few things you can do to help. Get in touch with your elected officials, wherever you are. (A Congressional directory for US readers is here.) A sample letter will be available shortly, and I'll link to it when it's up. I'm honestly not sure if this is a case where international pressure will slow or stop the problem in the short term, but it can't hurt.

If you want to do something that can have an impact, you can donate to Médecins Sans Frontières. They're providing help to rape victims in a number of different countries. If you can't donate yourself - or if you want to increase your impact - check with the blogs that will be donating their income often. The more you click over to Sheril or Isis' blogs, the more money they'll raise.

And if you can think of anything else that will help, let us all know about it.

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A few more measured thoughts on Dr. Tiller's life, career, and death.

Jun 01 2009 Published by under Medicine, Politics

As you might have guessed from my earlier post, I was angered and saddened when I learned of the death of Kansas doctor George Tiller earlier today. Dr. Tiller was gunned down while serving as an usher at his church while services were underway. As I mentioned earlier, the suspect arrested in the case - reportedly a 51 year old named Scott Roeder - was apparently an almost stereotypical far-right-wing extremist nutjob, with a long history of radical and potentially violent behavior.

I'm a member of a large Catholic family, and I spent 13 years in Catholic schools. I know many people who have very strong anti-abortion beliefs, and I love some of them very much. The vast majority (but not quite all) of them are extremely unlikely to be anything other than appalled by the murder of Dr. Tiller. Although I'll readily admit that I am often unreasonably optimistic, I think that's likely to be true for the majority of the people who classify themselves as "pro-Life".

Under the circumstances, I find the idea of dismissing today's homicide as nothing more than the actions of one deranged man to be quite appealing. Unfortunately, it would also be quite wrong.

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Suspect in Dr. Tiller's Assassination Appears to Have Operation Rescue Ties.

May 31 2009 Published by under Medicine, Misc

Wichita NBC affiliate KSHB-TV is reporting that the suspect being held in the assassination of Dr. George Tiller is a man named Scott Roeder. Posters in the forums at the DemocraticUnderground have identified at least one posting at Operation Rescue's website (currently down, link to Google cache here) that's written by a Scott Roeder and refers to Dr. Tiller.

There is also information that indicates that a suspected Freeman named Scott Roeder was arrested in Topeka in 1996 for parole violations related to his having bomb making materials in his car trunk. At that time, he was identified as being 38, which would make him 51 today. Another recent news report gives the current age of the suspect in Tiller's assassination as 51.

The information currently available strongly suggests that this Scott Roeder is exactly the kind of radical right-wing extremist that was discussed in a recent Homeland Security report - you remember that report, right? It's the one that various semi-mainstream conservatives got all self-righteously irate over a couple of months ago.

Update (semi-): I've got some additional thoughts on the matter, including the question of how much (if any) responsibility the broader anti-abortion movement shares with the gunman, here.

Update 2: Daily Kos has some commentary up on a McClatchy article that goes into more detail on Roeder, his history, and his associates.

I also added a link to Tarc's original thread at DU that had the link to the Google Cache for the Op Rescue post. I should have had that link up before now - sorry I missed it.

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The Torture Memos, Medical "Professionals", and the Hippocratic Oath

Apr 16 2009 Published by under Medicine, Science and Politics

I just finished reading the torture memos that were released today. I cannot remember ever in my life being as ashamed of my country as I am at this moment. The contents of the memos are so insanely wrong that I'd like to believe that they're fiction, but they're clearly not. While I understand President Obama's desire to move forward, I am appalled by his decision to rule out prosecutions for anyone who relied on the excuse that these memos said that what they were doing was OK.

Of course, prosecutions aren't the only possible consequences, and there are some disciplinary options that the President does not actually have any control over. In particular, the President doesn't have the right obligation that professional societies have to enforce the professional and ethical standards of their professions.

Reading these memos, it's very clear that there are quite a few CIA employees who are allegedly medical professionals. Those people need to find new professions. I would strongly suggest that you take a few minutes - particularly if you're a doctor or a psychologist - to suggest to your colleagues at the American Medical Association and the American Psychological Association that it might be good to take some formal steps along those lines.

The first of the memos provides a good example of the role doctors played both in the torture and in the legal justification used to excuse the torture. That memo outlines the torture of one specific prisoner - Abu Zubaydah. The various torture techniques that the CIA was seeking permission to use were detailed in excruciating detail, as was the involvement of medical staff:

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Anti-Vaccination Stupidity, Expertise, and Feeling "Empowered" by Risking Kids Lives

Mar 31 2009 Published by under Flaming Small-Minded Stupidity, Medicine

Your sink is leaking all over your bathroom floor. Whose advice do you take on how to fix it - your plumber's or your accountant's? I suspect that the sane among us would typically go to the plumber. If we were suspicious about the first plumber's advice, we'd probably call another plumber. Similarly, the rational among us would not look to a plumber as a source for informed commentary on the economy, foreign affairs, or journalism.

We understand that expertise matters.

We don't consider experts to be infallible, we don't bow down and worship at their feet, or uncritically accept everything that every expert says, but we understand the importance of knowledge and experience. Experts are not born, they're made through a long process that involves spending enormous amounts of time and effort to study a field. It's been suggested that it takes a minimum of 10,000 hours to gain expertise in a field, and that's not a bad lowball estimate for a lot of fields.

There are many fields, though, where 10,000 hours is not enough training to be considered an expert. That much time and effort might be enough for people to consider you to be competent, but only just.

Take medicine, for example. Residency is an enormously intense period of training - most programs officially limit interns and residents to 80 hour work weeks, but in a lot of places that's treated the way most people treat speed limits. Even if you assume that residents only average 70 hours a week, the vast majority of doctors will have worked for far more than 10,000 hours before they sit for board certification exams. The intern who sees you on his or her first day on the job has probably spent at least four or five thousand hours on clinical rotations as a med student.

Want to get a Ph.D in any of the sciences? After you're done with your undergrad, you should plan on spending at least five years in grad school. After that, plan on spending another few years as a postdoc before you even think about applying for a tenure track Assistant Professor job somewhere.

With that in mind, I'd like to share the source of my current irritation with you.

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