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April 23, 2014

Fighting Words Are Rarer among British Doctors

(New York Times) – People working in health care there have been discussing military imagery for a decade, said Elena Semino, head of linguistics at the university. “There’s a lot of awareness that battle metaphors can be very harmful to patients,” she told me. “Professionals are conscious of the problems, and they’re advised not to use them.” Instead, British public health leaders and medical practitioners are more apt to talk about the end of life as a “journey” instead of a war, with “pathways” and “steps” instead of fights and weapons.

Let’s Get a Medical Tourism Certificate! Is It Worth the Paper It’s Printed On?

(IMTJ) – A new industry is developing around the business of medical tourism. It’s the certification business. You need an impressive sounding name, a web site, a decent laser printer (and a good relationship with a certificate framing service!). There’s a plethora of “get rich quick” certifications which are appearing around medical tourism. They are quick and easy to obtain.

April 17, 2014

The Antidepressant Generation

(New York Times) – Are we using good scientific evidence to make decisions about keeping these young people on antidepressants? Or are we inadvertently teaching future generations to view themselves as too fragile to cope with the adversity that life invariably brings?

April 15, 2014

I’d Seen Dementia’s Toll on My Patients. Now I Was Watching the Disease Unravel My Family.

(Washington Post) – As a geriatric psychiatrist, I understood the devastating toll dementia could take on an entire family. I had urged my mother-in-law to seek care early, which she had done, so she knew her options included activities to stay socially engaged, medication to slow the illness and possibly experimental treatment. But on a personal level, I was worried about my father-in-law, my wife, her siblings and myself. We would be my mother-in-law’s caregivers for the rest of her life. She was 76; my father-in-law was 79.

April 10, 2014

A ‘Code Death’ for Dying Patients

(New York Times) – But in this age of technological wizardry, doctors have been taught that they must do everything possible to stave off death. We refuse to wait passively for a last breath, and instead pump air into dying bodies in our own ritual of life-prolongation. Like a midwife slapping life into a newborn baby, doctors now try to punch death out of a dying patient. There is neither acknowledgement of nor preparation for this vital existential moment, which arrives, often unexpected, always unaccepted, in a flurry of panicked activity and distress.

April 8, 2014

This May Hurt a Bit

(Scientific American) – It’s okay that you don’t remember me. My name is Shara, and I’m part of the surgical team. I’m checking to see how you’re doing after your surgery. Do you know where you are right now? Actually, you’re in the hospital. You had surgery a few hours ago, for a broken hip. You used to be able to walk before you broke it, so it was important to fix it as soon as it was safe to.

April 7, 2014

Surrogate Parenthood for Money Is a Form of Human Trafficking

(Forbes) – Currently, New York State, Louisiana, Minnesota, and the District of Columbia are considering legislation that would legalize commercial surrogacy.  Last week, the New York Times featured a video segment on Baby M which asks the question: Have we solved the question of surrogacy? A look into these current legislative battles and the patchwork of varied state legislation on surrogacy around the country makes it clear that we have not.

April 4, 2014

‘Transhumanists’ Are Planning to Upload Your Mind to a Memory Stick…

(The Telegraph) – The first Cybathlon, an Olympics for robot assisted parathletes, will take place in Switzerland in October 2016. For people with disabilities who are using advanced technologies – robotic limbs or brain-computer interfaces – to compete. The “Transhumanists” are overjoyed. As the name implies, Transhumanists are people who want us to become “beyond human”. It’s an umbrella term for a broad family of ideas united by the vision that technology now, or at least soon will, allow us to greatly enhance human intellectual, physical, and psychological capacities.

March 31, 2014

Genetic Screening to Enhance IQ Should Be Embraced

(The Conversation) – There could be a way of predicting – and preventing – which children will go on to have low intelligence, according to the findings of a study researchers at Cardiff University presented on Monday. They discovered that children with two copies of a common gene (Thr92Ala), together with low levels of thyroid hormone are four times more likely to have a low IQ. This combination occurs in about 4% of the UK population.

March 27, 2014

Determining the Fate of Frozen Embryos

(CNN) – The first option we considered with our remaining embryos was to do nothing. Just leave them on ice and make a decision later. They can stay frozen for a long time — in 2005, a child was born from an embryo frozen 13 years earlier — though our clinic recommends waiting no more than seven years. We asked, “What happens if we don’t pay?” The doctor shrugged. “Would you destroy them?” The doctor shook her head. In my experience fertility doctors shrug a lot. There’s a lot of guesswork. Of course they keep billing you.

March 3, 2014

Should transhumanists have children?

(Huffington Post) – Transhumanists are people who desire to use science and technology to improve the human being. While the international movement of transhumanism is rapidly growing and diversifying, its most important goal remains the same: overcoming human mortality. Many experts believe some sort of indefinite sentience for individual human beings, whether via age reversal or by mind uploading into computers, will be achieved around 2045. Such incredible advances will change the way the species views itself. Procreation, the foundation of human civilization, will be one activity that is dramatically affected.

February 25, 2014

A morbidly obese patient tests the limits of a doctor’s compassion

(Washington Post) – The patient is large. Very large. At more than 600 pounds, he is a mountain of flesh. “My stomach hurts,” he says, his voice surprisingly high and childlike. It is 10 p.m. in the emergency room, and I am already swamped with patients I’m trying to move through the ER before my shift is over. Asked if he’s ever felt this kind of pain before, he says, “No, never. At least, not like this.” “Well, what’d you expect?” the unit secretary mutters, only half to herself.

February 24, 2014

IVF treatment: Better, but not yet good enough

(Forbes) – On the occasion of the CDC’s yearly release of IVF clinic success rates, I remind myself and my old colleagues that we should always strive to do better. Every baby, whether conceived by in vitro fertilization or dropped by a stork down the chimney, is a miracle.  As a reproductive endocrinologist, I had a unique opportunity to make small contributions to some of these miracles. But as I constantly reminded myself and my colleagues: the miracles are the babies, not the procedures. That is still true today. Assisted reproduction as it exists in the year 2014 is still a pretty primitive set of procedures and tools.

Is genetic testing humans playing God?

(CNN) – “It’s a miracle,” she told me. “We can now have a baby that won’t have Huntington’s disease. I thought I’d never be able to have any kids — because of the disease.” Her father had died from this disorder, which results from a gene mutation. She feared that she might have the mutation, too. But she was too scared to undergo testing for it. She also worried that if she had it, she might pass it on to her children.

February 20, 2014

The lies that doctors and patients tell

(New York Times) – The doctor-patient relationship is ideally an intimate partnership where information is exchanged openly and honestly. That is seldom the reality, however. Deception in the doctor-patient relationship is more common than we’d like to believe. Deception is a charged word. It encapsulates precisely what we dread most in a doctor-patient relationship, and yet it is there in medicine, and it often runs both ways.

February 19, 2014

House calls to the homeless

(CNN) – In the homeless camps and in the alleys, I found people who had suffered extremes of weather, violence and prejudice. Many were older, confused people; some were war veterans holding on to the last shreds of their dignity; others were simply people who had fallen on hard times and lost hope. I saw hideous leg ulcers and cancers that were untreated. But mostly I saw human beings who had minimal access to loving, effective services.

February 18, 2014

I never wanted to be a cancer expert, but then my wife got sick. A caregiver’s tale.

(Washington Post) – It was my wife’s first colonoscopy; it turned out to be the only one she ever had. She was 53. Whether Cheryl would have lived longer if she’d had the exam earlier I’ll never know. She died in the fall of 2013, in her sixth season with cancer. Cheryl had exhibited no symptoms prior to the test. Absent a family history of colon cancer, the standard protocol is to have the test after turning 50. Needless to say, we were shocked when the doctor showed us the scans indicating that the test was positive for cancer.

February 12, 2014

Opinion: The real crisis in America’s ERs

(CNN) – If you doubt there’s a dental health crisis in America, walk into any emergency room. Every day, thousands of people without access to a dentist are looking for dental care in our ERs, most of which cannot provide the care these patients need.

February 10, 2014

The cost of IVF: 4 things I learned while battling infertility

(Forbes) – That’s when I found out I would be one of more than 85,000 women in the U.S. annually who undergo in-vitro fertilization, or IVF, as a way to create a family. Utilizing IVF and pre-implantation genetic diagnosis or PGD, the team of doctors and embryologists at our infertility practice would be able to create embryos, and then biopsy those embryos to ensure that only those not affected by Tay-Sachs were among those selected to create a pregnancy. As I began researching IVF, I also dove into the financial details of the treatment.

February 6, 2014

At 90, this doctor is still calling

(New York Times) – Catherine Hamlin, an Australian gynecologist who has spent most of her life in Ethiopia, is a 21st-century Mother Teresa. She has revolutionized care of a childbirth injury called obstetric fistula, which occurs when the baby gets stuck in the birth canal and there is no doctor to perform a cesarean section. As many as two million women (and often young teenage girls) worldwide suffer from fistulas. The babies die, and the woman is left incontinent with urine and sometimes feces trickling through her vagina.

February 3, 2014

Stem cell donation: Make a friend, save a life

(The Guardian) – If a stranger saved your life, wouldn’t you want to meet them? Many stem cell recipients do – and forge lasting friendships with their donors. Somewhere in London is my perfect match. He is well-built, a year older than me, popular with my friends and family – a real hero. We’ve never met.


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