Social Media and (Pre) Medical Education

I joined Facebook back in 2004, only months after the site was launched. The internet, though I didn’t realize it at a time, was still a very disconnected place. Social media was fundamentally in its infancy, with Facebook joining only a few other social networking sites (MySpace and Friendster come to mind). Twitter and many other social media sites were just thoughts at that stage. Aside from Facebook, the only way I connected with other people was through AOL Instant Messenger, if even that.

Eight years and some 900 million Facebook users later, social media has exploded onto the scene. Rare are the websites that DON’T have a share button that allows users to share the site with users on many different social media outlets. Early on, I used Facebook exclusively to keep in touch with close friends. In contrast, I created this blog to disseminate information. Soon after I started blogging, I discovered Twitter and the medical community that was burgeoning there. I then began to explore using social media for learning more about healthcare and medicine.

People are slowly recognizing the vast potential of social media, especially in the context of healthcare. Not only is it poised to be an important tool in clinical practice, but also in training new generations of physicians. There is a hashtag #meded for a Twitter conversation that takes place weekly, where participants discuss medical education, any problems observed, and potential solutions. It, along with the #hcsm (Healthcare Social Media) Twitter conversation, represents a great forum to propose innovative ways to improve the field of medicine and medical education. I think for students, especially, it is an incredible asset. One can get a very broad perspective of medical education in general, and can reach out to others who are encountering similar problems and situations on their way to a career in medicine.

Speaking for myself, I am pre-med. When I will shed the “pre” part is unknown at this time, but that’s an entirely different topic. I am working, but I am still thinking about entering medical school down the road. I love Twitter, and I use it in part to connect with doctors and students, and to keep abreast of issues that are going on in both the education side and the clinical practice side. I tend to lurk in the background for both the #meded and #hcsm conversations, observing and learning, but not directly participating. I have learned a great deal, but this is information that will probably come in handy further down the road, when I officially start on the road to becoming a physician. What would be nice right now is a similar community for pre-meds.

There is a somewhat more cohesive community that exists on the Internet to provide a resource for pre-meds, as well as medical students and practicing physicians and other healthcare professionals to pose questions and get answers: Student Doctor Network. This is something that has been around for years, and many students have embraced. I have used this multiple times and I think it’s fantastic. However, it is somewhat static, compared to Twitter at least. Yes, people post answers, but it’s not quite the same. Twitter has the feel of a conversation among friends. The rapid-fire exchange of questions and answers feels more natural, and more human in some ways.

Now of course there is a community of sorts on Twitter. There are many pre-meds who have taken to Twitter for one reason or another, and who sometimes connect with other pre-meds along the way. Yes, we all come together to bond, complain, rage, and sometimes exult about classes, the MCAT, and medical school applications. Yet it would be nice to have a way to discuss issues that plague pre-meds from freshman year to the post-graduate years. Ideally the conversation could be fostered and archived under a hashtag. The resulting posts/tweets can be accessed readily later.

There are so many questions that arise for pre-meds even before they reach college. Which school should I apply to? Should I opt for a combined BA/MD program, or go the “traditional” route? In college, the questions can range from the general (What should my GPA be? What about my MCAT? Where should I do community service? Which doctor should I shadow?) to the painfully specific (What the heck is a racemic mixture? How much acid-base chemistry can one expect on the MCAT? What is the average GPA of students accepted to medical school X?). Pre-med is a label that encompasses a wide range of students from at least the age of 17 or 18 to those who are often in their mid to late 20s, if not older (as is the case for many non-traditional students). A social media community dedicated to pre-med issues would be a wonderful way to not only allow these questions to be answered and grievances aired, but it represents a great opportunity for mentoring of younger students by older ones who have had more experience. Having pre-medical advisers, medical school admissions staff, and medical school professors potentially join these conversations would add much needed perspective about what lies on the other side of that seemingly impervious wall called medical school admission.

I’ve been talking about Twitter quite a bit, because that’s what I tend to use most of the time, but other social media tools can be used as well. Facebook’s potential as a teaching tool is being explored in the context of medical education. However, there are some who have reservations with regard to its use in this context, especially if educators are involved, as outlined in this great blog post by Anne Marie Cunningham of Cardiff University in the UK. Blogging, though considered antediluvian by some nowadays, represents another opportunity to detail experiences and forge bonds with others who are in similar situations, and get answers from those who have walked down the same path.

Think of how great it might have been for you to have a community right at your fingertips, where most (if not all) of your pre-med questions can be answered, and readily at that? It’s something that I definitely wished I had early on. While SDN has its benefits, at least on Twitter, there is a greater sense of openness and trust that enhances the learning experience in that context. I have communicated with students and doctors, and they have been wonderful sources of insight. I consider many of them to be friends and invaluable sources of information. It would be wonderful to see universities embrace social media as a powerful source of information and a teaching tool not only for pre-meds, but for all students. Social media participation should be encouraged, but it would be nice to see classes being offered to students that taught them about using social media wisely and managing their online reputation. Perhaps professors can get in on the act and provide information to their students on the social media groups, sites, and hashtags where conversations about topics that are being covered in their class. The possibilities are endless.

Thoughts? Comments?

Early Puberty in Girls: What We Know and What The Government Has Done (Or Not)

Can you imagine puberty occurring at around the age of 6, or even younger?

It’s happening.

Puberty is the inevitable rite of passage that everyone will go through. There are changes in shape and mood, in appearance and outlook. Its onset at around age 10 or 11, and continuation into one’s mid-teens is considered normal, with most processes wrapping up by the time high school graduation rolls around.

Early onset of puberty in girls is starting to become the new norm, and has been profiled in a recent New York Times article. Girls as young as 4 or 5 have been sprouting pubic hair and demonstrating signs of budding. At that age, most children are barely capable of putting on clothes by themselves. They are only starting to learn how to navigate their way around their social circles, and falling into the routine of school, play, and homework.

Ladies, can you imagine having to contend with the mood swings and physical changes while dealing with the mean little girls who pull your hair and call you names. Can you imagine dealing with all of that while the boys still are considered “icky” and have “cooties?”

The risks are not surprising. There is a higher risk of drinking, substance abuse, eating disorders, depression, and engaging in risky sexual behaviors. The question is, how do we protect our girls?

While there are some means of slowing down these changes through pharmacological means, preventing early onset altogether is probably the best approach. There are several potential causes, among them family problems/stress, obesity, and exogenous hormones/xenoestrogenic compounds. While the first two causes can be controlled to some extent, the last one is not necessarily something that can be controlled by the average consumer.

Hormones are chemical compounds that are produced in one site (endocrine gland) and are transported to other target sites via the blood. We are exposed to hormones through our food supply, at least in cattle, where hormones are sometimes given to boost growth. Xenoestrogens (literally foreign estrogens) are compounds that occur outside of the human body, but mimic the effects of estrogen in the human body. Many plastics can be sources of xenoestrogens, notably ones that contain a substance called bisphenol A (BPA). A Twitter follower directed my attention to her blog post, which is a wonderfully informative piece on the role these hormones/hormone mimics may be playing. While some measures have been taken on the part of states and select companies to eliminate BPA from their products, it remains a ubiquitous substance, and it is believed that well over 90% of the U.S. population has at least trace amounts of BPA in their bodies. In the New York Times article, Frank Biro (a researcher in the field) believes that based on existing data that demonstrates that endogenous estradiol levels are very low in girls with early breast growth, nonovarian sources of estrogen are likely the culprit. Perhaps these could be estrogen/estrogen-like chemicals occurring outside of the body.

Research demonstrates that many xenoestrogens, including BPA, are active at nanomolar/picomolar concentrations (1). In rats, early exposure to BPA has been correlated with an early onset of puberty, as well as increased problems with fertility, including a condition resembling polycystic ovarian syndrome (2-3). One of the mechanisms of BPA’s xenoestrogenic activity was demonstrated in non-human primate endometrial cells, where BPA co-administered with estradiol decreased the expression of endometrial progesterone receptors (4). The presence of many endocrine-disrupting compounds has been discovered in the urine of young girls, and a correlation between prenatal BPA exposure and behavioral problems among girls has been shown, though the latter results should be taken with a grain of salt given the modest sample size (5,6). Nonetheless, the fact that any correlation was shown is cause for concern at the very least, and warrants further study.

According to the Milwaukee-Wisconsin Journal Sentinel, after lobbyists from the plastics industry met with officials in the Obama administration in early 2010, BPA was left out of an Environmental Protection Agency action plan drawn up to regulate chemicals identified as dangerous. Recent efforts to regulate or ban endocrine-disruptors such as BPA, or research endocrine-disrupting chemicals have stalled at different stages:

1. In the 111th Congress, Senator Chuck Schumer (D-NY) sponsored bill S.753.IS, called the “BPA-Free Kids Act of 2009.” It died in the Senate.

2. The same bill was sponsored in the House (H.R.4456.IH) by former Representative Anthony Weiner (D-NY). It died in the House.

3. Representative Louise Slaughter (D-NY) sponsored the “Environmental Hormone Disruption Research Act of 2009″ (H.R.4160.IH). It died in the House.

4. The “Ban Poisonous Additives Act of 2011″ was introduced in the Senate by Senator Dianne Feinstein (D-CA). It has yet to be referred to committee.

5. As of January 25, 2011, the “Ban Poisonous Additives Act of 2011″ that was introduced in the House by Rep. Ed Markey (D-MA) has been referred to committee, but nothing has transpired since then.

The apathetic attitude of the government towards endocrine-disrupting agents can only spell disaster for future generations. Though research to date does strongly suggest that these are dangerous substances that can cause dramatic effects in the way the body functions, more research is needed to further understand how they may be affecting normal development. This necessitates government support. The fact that many politicians appear far more passionate about regulating women’s health rights, rather than protecting our children from a very real public health threat, is appalling and a sign that our priorities need serious rethinking.

I hope that things change. I hope that politicians will realize that addressing public health issues should always trump entertaining the whims of corporations. I hope that the government won’t continue to bow to pressure from industry lobbyists, and will eventually recognize the danger of these substances and pass the appropriate legislation to fund research and ban them from commonly-used products. If I have daughters, I want them to grow up in a world I know is safe, so that they can enjoy being girls, and won’t start the trek towards womanhood at the behest of foreign chemicals, but when they are good and ready.

1. Wozniak AL, Bulayeva NN, and Watson CS. Xenoestrogens at Picomolar to Nanomolar Concentrations Trigger Membrane Estrogen Receptor-α–Mediated Ca2+ Fluxes and Prolactin Release in GH3/B6 Pituitary Tumor Cells. Environ Health Perspect. 2005; 113(4): 431–439.

2. Fernández M, Bourguignon N, Lux-Lantos V, Libertun C. Neonatal Exposure to Bisphenol A and Reproductive and Endocrine Alterations Resembling the Polycystic Ovarian Syndrome in Adult Rats. Environ Health Perspect. 2010;118(9): 1217–1222.

3. Nah WH, Park MJ, Gye MC. Effects of early prepubertal exposure to bisphenol A on the onset of puberty, ovarian weights, and estrous cycle in female mice. Clin Exp Reprod Med. 2011;38(2): 75–81.

4. Aldad TA, Rahmani B, Leranth C, Taylor HS. Bisphenol-A exposure alters endometrial progesterone receptor expression in the nonhuman primate. Fertil Steril. 2011;96(1):175-179.

5. Wolff MS, Teitelbaum SL, Windham G, Pinney SM, Britton JA, Chelimo C, Godbold J, Biro F, Kushi LH, Pfeiffer CM, Calafat AM. Pilot Study of Urinary Biomarkers of Phytoestrogens, Phthalates, and Phenols in Girls. Environ Health Perspect. 2007;115(1):116-21.

6. Braun JM, Kalkbrenner AE, Calafat AM, Yolton K, Ye X, Dietrich KN, Lanphear BP. Impact of Early-Life Bisphenol A Exposure on Behavior and Executive Function in Children. Pediatrics. 2011;128(5):873-882.

One Nation…On Meds

I should probably start out by saying I’m not entirely sure what to make of the readiness with which doctors prescribe a pill for anything and everything. This is mostly based on my observations and what I’ve heard. I’m not a doctor (though I want to be) and I’m trying to understand this as best as I can given my relative lack of medical knowledge. Yet my gut instinct is to say that doctors are all too willing to find a condition to fit a pill, or a pill to fit a condition (and for everything else, an antibiotic). This seems to especially be the case with psychiatric conditions. Everyone that’s depressed seems to be prescribed pills. I concede that are some that legitimately need medication in order to function, but for the vast majority, it seems unnecessary.

I’m going to stick with antidepressant/stimulant meds for this one. Fibromyalgia and antibiotics deserve their own post.

So What Were Your Views on Alternative Medicine?

This is from a post I did about two months back.

Out of the 18 people that responded (which means the results are not remotely statistically significant), 72% (13 people) believe in using alternative medicine in conjunction with allopathic therapies. 17% (3 people) discounted alternative medicine entirely. 1 person believed in alternative medicine alone and 1 person didn’t realize there was such a thing as alternative medicine (I find that hard to believe).

Nonetheless, it was a fun little poll. More polls to come in future posts!

No Welcoming Open Arms For Us

I spent most of my formative years in the nurturing cocoon of the Clinton administration. I was vaguely aware of Bush 41, but the first president I chose (in my head) was Clinton, so he was really my president. I didn’t really know what war was. I had heard of the first Gulf War, but it seemed less a war, more a way to keep a madman at bay. I knew something of Bosnia and Serbia, but these were minor engagements (especially compared to what we’re involved in now). All I was aware of was economic excess and of prosperity. I assumed that everything always came easily, not necessarily without work, but without worry. I realize now that I was wrong to assume. This is not to say Bush 43 is entirely at fault, or that Clinton is blameless. There were mistakes being made everywhere, on Capitol Hill, on Wall Street, in banks, and in our own living rooms. Now the fruits have been borne from our mindless sins of ignorance.

I was talking to a sixth grader I tutor yesterday and we ended up discussing various things. At one point, she asked me about medicine and how long it takes to become a doctor. I laughed and went through the whole spiel. I told her that if she doesn’t take any breaks in between, she’ll probably be in her late twenties by the time she starts working. It was the truth; the road to becoming a doctor is a long, winding, pothole-ridden road. She sighed before declaring the world was probably going to end before then. I was taken a little aback by her pointedly frank pessimism, especially given her age. Pessimism wasn’t supposed to kick in until at least the angst-ridden teen years. Yet as I thought about it more, I realized she was right to assume, and right to worry. We have become conditioned to fear.

I’m not saying the world is going to end. Obviously that’s not what I’m saying. What I’m saying is that the smooth sailing we have had for the last decade or so has come to an end in the most unceremonious and clumsy fashion possible. Gone are the times when wide-eyed, college graduates can expect a job waiting for them within months after their graduation, followed by buying their first home, setting up their children’s trust fund, and letting their 401(k)s bloat with money. Employers no longer are waiting at the end of the college road with open arms and a fat paycheck. Instead we are seeing college grads moving back with their parents, as they wait and wait for employers to come calling. Over 2.6 million jobs were lost in 2008, and the number continues to grow. As the economy shrinks, states are now cutting spending in places that could have drastic consequences (like Paterson cutting hospital spending in New York State in a time where healthcare is suffering). Again I used to assume that doctors were at least a little immune to economic crises; after all, there’s always a need for doctors right? Yet when hospitals can’t afford to take on new doctors, and when people can’t afford to get healthcare, even doctors are finding it difficult to find work. There is no real certainty in the current economic climate, and the possible ramifications are frightening.

As I was buying my ticket to Penn Station from my home station, I saw a man who asked me for a buck or two towards a train ticket. This wasn’t your typical bum though, and this wasn’t the city. This was Long Island. He looked like any other Joe Schmo who lived on Long Island. Maybe I’m naive to have even entertained the idea that Long Island was somehow, immune, from the economic downturn. I can’t help but think that the number of people booted onto the streets will increase as the economy continues to sink.

Many of you must be reading this and thinking, “She is such a pessimist” and “This is so depressing.” It’s the truth. No one wants to envision a world where we have to be fearful for our livelihood as well as for our lives. Certainly we don’t want that for ourselves, and we definitely don’t want that for our children. We want our children to know that they can do anything they want, with little worry, assuming they put in the effort. Yet it’s something to keep in the back of your mind. To continue assuming that everything is perfectly peachy is a sign of sure insanity.

Yet to those that say, “Why bother doing anything if we’re just destined for a rough road to employment in the end?” the point is not to give up, the point is to work harder. Employers (presumably) will favor the more qualified candidates over the guy or girl who just scraped through with a bachelors degree. Go for the unpaid internships to get your foot in the door. Network as much as you can, a resume and transcript can only tell so much about a person. Do whatever you can, short of stepping on another guy’s toes.

We’ll have to make some changes to the way we conduct our lives now. We can’t continue the same wasteful practices that landed us here in the first place. We can’t allow the market to operate of its own volition. We need strict regulations to rein everything back to some sort of stable state. It’s important to note that all situations are temporary, good times, and bad. I’m just hoping that, for the time being, the stimulus plan passed by Congress will have its intended effect sooner rather than later.

Until then, we have to work hard and stay positive. This, too, shall pass.

Confessions of a Lapsed Pescatarian/Vegetarian with Benefits

My friends were right. I like chicken just a little too much. Admittedly, I’m a little embarrassed to be writing this, especially after I had written this. In my defense though, it took me a year and a half to cave.

It wasn’t so much the need for chicken, or meat in general, that made me cave. It may have had something to do with the fact that my hair was falling in record amounts everyday, owing very much to a diet severely deficient in protein. Living on my own was fine, I could tailor my diet to ensure I was getting protein sans meat (minus fish). Yet living at home with a family that finds vegetarianism, or anything remotely like it, just a little bit alien made it difficult to meet my needs when the default meal almost always included chicken. It may have also had something to do with my mother bemoaning the fact that I was somehow betraying the family by treading the path towards vegetarianism. Yet in all actuality, maybe it may have been because I just missed meat. It proved incredibly difficult to stay away from it, especially chicken, since I had been raised on it since I was born. Maybe I’m just weak.

Am I a bad person for becoming (something close to a) vegetarian? Am I even worse for lapsing?

Nairs traditionally eat meat. Maybe that’s why it seemed so unusual to most of my family that I would eschew meat. I kept fish because I thought that keeping at least that form of protein would ensure that my diet was complete, and would ensure that I maintained my intake of omega-3s and vitamins more commonly found in fish than vegetarian sources. Keeping fish–a Malayalee staple–also kept my family somewhat at ease, though not completely.

So why did I even pursue a path to vegetarianism to begin with? There are a few reasons:

1. Animal cruelty: The news is full of stories of meat processing plants mistreating their animals. Mistreating is probably the understatement of the year. PETA and vegetarianism were ubiquitous in the crunchy-granola environment of Ithaca, so it did rub off on me a little.

P.S. PETA wants to rename fish “sea kittens” in an attempt to make the public view fish differently, and perhaps stop eating fish. What do you think?

2. Religious reasons: Compassion is a cornerstone of Hinduism, which explains why so many Hindus are vegetarian.

3. I guess I just wasn’t into meat for a while.

Vegetarianism of course carries with it a long list of benefits, from better health (losing weight, lower LDLs, more fiber, etc.), to a healthier environment (less livestock being raised for meat, less methane emission). I still hold that reducing our meat intake is the only way to ensure some sort of humane treatment for animals, since much of the tactics being employed today are the result of the maddening demand for meat and the need to industrialize the process of raising and slaughtering livestock.

Vegetarianism is still the best option, but clearly I wasn’t ready for it on some level. I probably should have known when I was so reluctant to give up seafood.

I don’t think I entirely expected I’d lapse. Yet I think once I started to have very vivid dreams of eating meat again, I needed to address it. My diet was severely lacking in protein and it was affecting my health. Yes, I still ate seafood, but preparing decent seafood enough times per week was not something I was able to do. So I slipped and fell, or returned to my normal diet, however you’d like to look at it.

Do I feel a little guilty? Oh yeah. Do I think I’ll try to become a vegetarian again? Probably, though further down the road. Do I regret lapsing? Not entirely. I needed to address my health, that was the main reason I went back…though yes, some of it was caving into the general need for non-vegetarian fare. It’s not like I’m about to swing to the other end of the spectrum and go completely carnivorous and eat all kinds of meat. It’s just returning to what I would normally have before my experiment with pescatarianism. This translates to seafood, some chicken, but never beef. I’m trying to stick with organic sources, or at least theoretically organic sources (halal/kosher), though it’s so unfortunate that organic products are much more expensive than the run-of-the-mill variety.

Maybe once I’m living on my own, and have enough time to devote to preparing meals, I’ll venture back into vegetarian territory. Until then though…

Headbanging is Bad for Your Health

This seems kind of obvious to me…but in case it wasn’t clear:

http://blogs.discovermagazine.com/discoblog/2009/01/06/health-hazard-alert-head-banging-may-hurt-your-brain/

There are far less vigorous things one can do that would cause whiplash, concussions, and possible stroke. I don’t really get the point of headbanging to begin with. Doesn’t it just feel hurt at all, feeling your brain sloshing around like a marble in a bottle of water? It just didn’t feel logical to do that. There are better ways to keep time with music. Then again, it’s woven into the fabric of heavy metal.

Don’t get me wrong, I like metal…well some bands here and there…the ones that sing more than scream.

So I guess all that’s left is throwing the goat…which I guess doesn’t have quite the same effect as combining it with headbanging.

Random post, I know, but a little randomness never hurt anyone.

Sanjay Gupta Poised to Become Surgeon General

So in the news today, Barack Obama has approached Sanjay Gupta–host of CNN’s “House Call” and noted neurosurgeon–to become the Surgeon General. For some reason this has pissed people off. Why? It’s viewed as a “celebrity” pick.

Here’s my argument.

This is not like Arnold Schwarzenegger, who swaggered into office with nothing more than being head of the President’s Council on Physical Fitness and Sports under his belt. This is not like Ronald Reagan, who was an actor by profession before he entered politics. To put Sanjay Gupta in the same category is ridiculous.

Sanjay Gupta’s training is in medicine, and he is a neurosurgeon–a field that is defined by its demand for perfection, since anything less than that could be fatal. The position he was tapped for was the position of Surgeon General. It’s not a terribly unusual situation.

Ok, so he is a CNN health correspondent. So? Chris Matthews is eyeing a run for Senator from Pennsylvania. He is a heavyweight in the world of political media, currently as the host of Hardball on MSNBC, and as a political writer and commentator in other media venues. He had a long political career that spanned several administrations before taking his place before a camera to comment on politics, rather than participate in it. Is Chris Matthews not worthy of a government position because of his celebrity status?

What are your thoughts?

We Are Incredibly Vain

I was reading the New York Times Sunday Magazine, and came across an interview with Joan Rivers. I think it’s fair to say she is the poster-child of plastic surgery, and plastic surgery gone wrong. She justifies her various plastic surgery procedures by citing the fact that she is in an industry where youth is prized. Perhaps. But is it really worth it?

I’ve never been a fan of plastic surgery for cosmetic enhancement, with rare exception. Plastic surgery seems to serve greater purpose in such cases as reconstructing the faces of burn victims, or allowing the patient who has had a mastectomy to retain some sense of womanhood. Filling lips with Restalyne to make them more pouty or increasing someone’s cup size three cup sizes so they look good in a bikini top doesn’t seem worth it.

Or is it?

I guess the main argument for most of the cosmetic procedures is boosting self-confidence. It’s a valid argument in some cases, but not all. Scar removal, for example, is valid. Removing moles and birthmarks, too, is valid (especially when they are suspected of being cancerous). Cheek implants? Butt implants? Not too sure about that.

Most cosmetic procedures are not permanent solutions, and require years of follow-ups, and sometimes repeat treatments. They are painful and potentially dangerous, in some cases. Breast implants, for example, almost always calcify (as is the case with most foreign objects introduced into the body), causing breasts to become hard and distended. In the case of silicone implants, the calcification carries the risk of causing rupture and leaking of the silicone gel into the body. Lip plumping agents are often temporary, and require visits every 6 months for more injections of collagen, Restalyne, or some other compound. Why go through that if you really don’t need to?

To a greater extent, people flock to creams and lotions that promise a reduction of wrinkles and a more youthful appearance. Everyday, we’re bombarded with ads promising youth in a bottle, jar, or a tube. Each has limited success, yet the bottles, jars, and tubes fly off the shelves everyday, in staggering numbers.

Here are a few numbers:

- In 2007 11,701,031 surgical and nonsurgical cosmetic procedures were performed in the United States. A little over 2 million of those were surgical procedures.
- Since 1997, surgical procedures have increased 123%, nonsurgical procedures have increased 749%.
- The 35-50 demographic makes up the most procedures.
- Yes, even men are getting work done, though not at remotely the same rate as women (ex. 300,472 Botox procedures in 2006 for men, versus 3,181,592 for women).

(Source: Cosmetic Plastic Surgery Statistics)

I think the worst part is that, while some procedures do a decent job at mimicking the natural state, when the procedure goes wrong, it goes horribly wrong. I’m not going to cite examples, because I think we can all think of at least one or two that fit the bill.

Why are we forever after this standard of youth and beauty that, after a while, becomes harder and harder to achieve? Why are women invariably the ones that head for the skin cream, Botox injections, and surgeries at greater rates than men?

What are your thoughts?

Part Deux of My Last Doctor Post…An Interesting NY Times Article

This seems like the next logical step after that last New York Times article I commented on.

Here are the steps the author proposed:

• Ask permission to enter the room; wait for an answer.

• Introduce yourself; show your ID badge.

• Shake hands.

• Sit down. Smile if appropriate.

• Explain your role on the health care team.

• Ask how the patient feels about being in the hospital.

Sad to say, I can’t think of one doctor that fulfilled even two out of these steps, let alone all six. Usually, this is how most of my appointments go:

1. Doctor barges in. Clothes/hospital gown may or may not be on.
2. I squint to read the name on his badge. The resulting squinting-wrinkles will probably require another doctor’s visit.
3. I don’t like shaking hands, so it’s ok if they don’t with me. I suppose though, as a matter of politeness, it should be encouraged.
4. Actually this one doctors do make an effort to do. I’ll admit that. However, that does not mean that there’s necessarily a friendly personality behind the smile all the time.
5. This one’s sorely lacking. Most doctors either briefly say “I’m your doctor/neurologist/surgeon,” and leave it at that. I don’t know many that go extensively into their role.
6. Thankfully I haven’t had to worry about this one yet, but I’m sure this is something that is sorely lacking among doctors in hospitals. People are skittish about being in hospitals, generally, and at least if a doctor acknowledges that if even tangentially, it makes the experience less harrowing.

How have your experiences with doctors differed, if at all? Anything notably positive or negative?