Tag Archives For: medicine

11 Apr, 2017

Epic Measures

/ posted in: Reading Epic Measures Epic Measures: One Doctor. Seven Billion Patients. by Jeremy N. Smith
Published by Harper Wave on April 7th 2015
Genres: Biography & Autobiography, Nonfiction
Pages: 352
Format: Paperback
Source: Book Tour, From author/publisher
Goodreads

Moneyball meets medicine in this remarkable chronicle of one of the greatest scientific quests of our time—the groundbreaking program to answer the most essential question for humanity: how do we live and die?—and the visionary mastermind behind it.
Medical doctor and economist Christopher Murray began the Global Burden of Disease studies to gain a truer understanding of how we live and how we die. While it is one of the largest scientific projects ever attempted—as breathtaking as the first moon landing or the Human Genome Project—the questions it answers are meaningful for every one of us: What are the world’s health problems? Who do they hurt? How much? Where? Why?
Murray argues that the ideal existence isn’t simply the longest but the one lived well and with the least illness. Until we can accurately measure how people live and die, we cannot understand what makes us sick or do much to improve it. Challenging the accepted wisdom of the WHO and the UN, the charismatic and controversial health maverick has made enemies—and some influential friends, including Bill Gates who gave Murray a $100 million grant.
In Epic Measures, journalist Jeremy N. Smith offers an intimate look at Murray and his groundbreaking work. From ranking countries’ healthcare systems (the U.S. is 37th) to unearthing the shocking reality that world governments are funding developing countries at only 30% of the potential maximum efficiency when it comes to health, Epic Measures introduces a visionary leader whose unwavering determination to improve global health standards has already changed the way the world addresses issues of health and wellness, sets policy, and distributes funding.


Christopher Murray is originally from New Zealand but he grew up around the world.  His parents ran a clinic in west Africa for a year.  The clinic was so understaffed when they got there that Chris and his older siblings had to do a lot of the care.  During their time there the family noticed that malnourished people who were fed got sick from malaria.  They found out that the virus requires iron to thrive.  When people are starving they don’t have the iron stores for their bodies to support the virus.  When they are refed, they are again good hosts for the disease.  The family published their findings in Lancet.  This led to Chris’ lifelong interest in scientific research – especially research into whether or not conventional wisdom is correct.

At the World Health Organization, he found that a lot of the health data used to make policy decisions was based on numbers that were made up.  He worked with another researcher to develop a formula that figured out the true cost of disease in each country.  He also took into consideration not just the deaths from that disease but the damage done from a disease causing less than optimal health in the population.  I also appreciated his focus on adult health statistics and not just childhood disease.

Using this data lets countries and NGOs decide where the most effective places to put their money are.  Does it help more people to treat malaria or diarrhea?  If you can only vaccinate for one is it better to give polio vaccine or measles?  Measles kills more people but if you survive it you are fine.  Polio doesn’t kill as many people but survivors have more disability.  These are the kinds of questions that they try to answer.

I found the subject matter interesting but the book got bogged down in a lot of interdepartmental politics in the middle.  It picks up again at the end with ideas for living a better life based on the findings of the Global Burden of Disease study.  If you are interested in the real life applications of science and mathematics, this is a great book for you.

Tuesday, March 28th: Lit and Life
Thursday, March 30th: bookchickdi
Tuesday, April 4th: Sapphire Ng
Wednesday, April 5th: Readaholic Zone
Thursday, April 6th: Man of La Book
Monday, April 10th: Doing Dewey
Tuesday, April 11th: Based on a True Story
Wednesday, April 12th: Kissin Blue Karen
Friday, April 14th: Read Till Dawn
Friday, April 14th: Jathan & Heather

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08 Jul, 2016

Black Man in a White Coat

/ posted in: Reading Black Man in a White Coat Black Man in a White Coat: A Doctor's Reflections on Race and Medicine by Damon Tweedy
Published by Picador on September 8th 2015
Genres: Biography & Autobiography, Medical, Nonfiction, Personal Memoirs
Pages: 294
Format: Hardcover
Source: Library
Goodreads
Set in North Carolina

When Damon Tweedy begins medical school,he envisions a bright future where his segregated, working-class background will become largely irrelevant. Instead, he finds that he has joined a new world where race is front and center.

Black Man in a White Coat examines the complex ways in which both black doctors and patients must navigate the difficult and often contradictory terrain of race and medicine. As Tweedy transforms from student to practicing physician, he discovers how often race influences his encounters with patients. Through their stories, he illustrates the complex social, cultural, and economic factors at the root of many health problems in the black community.


Damon Tweedy was offered a full scholarship to medical school at Duke University in North Carolina in the 1990s.  That was a deal too good to pass up even though it was well known that Duke had a history of being extremely racist.  Early in his time at Duke a professor mistakes him for a maintenance man and when he says that he isn’t there to fix the lights the professor can’t figure out any other reason why he should be in the classroom.  This spurs him to work even harder to prove that he belongs there.

He is frustrated because over and over in lectures he hears that diseases are more common in blacks than whites.  He worries that frustrating interactions with black patients will turn his white coworkers against black people.

He tells stories about what it is like to be both a black doctor and a black patient.

He talks about volunteer work at a clinic for the uninsured and whether or not the Affordable Care Act could help these people.  He had always assumed that people were uninsured because they didn’t work before helping at this clinic.  That’s a pet peeve of mine.  I’ve had this argument with my middle to upper middle class family members who were against universal healthcare and who have always had jobs that offered insurance.  I’m a veterinarian.  Until July 1 of this year when my practice was bought by a large corporation, I’ve never had a job that offered health insurance.  At least I could afford to buy it when I wasn’t married.  Most of my coworkers who make just above minimum wage didn’t have any health insurance.  Most of them still aren’t opting to get the available insurance now because it is very expensive with huge deductables.  /rant

A photo posted by @dvmheather on

He talks about how he was treated as a black man in sweats and a tshirt with a knee injury and how his treatment changed when he revealed that he was a doctor.

Should doctors be discussing sterilization with a drug addicted woman who just miscarried?

How do you deal with patients who don’t want to have a doctor of a different race than them?

How does poverty and cultural attitudes tie into poor health in the black community?


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17 Dec, 2015

Rabid

/ posted in: Reading Rabid Rabid on 2012
Genres: Medical, Science
Pages: 275
Format: Paperback
Source: Owned
Buy on Amazon (affiliate link)
Goodreads
three-stars

A maddened creature, frothing at the mouth, lunges at an innocent victim--and, with a bite, transforms its prey into another raving monster. It's a scenario that underlies our darkest tales of supernatural horror, but its power derives from a very real virus, a deadly scourge known to mankind from our earliest days. In this fascinating exploration, journalist Bill Wasik and veterinarian Monica Murphy chart four thousand years in the history, science, and cultural mythology of rabies.
The most fatal virus known to science, rabies kills nearly 100 percent of its victims once the infection takes root in the brain. A disease that spreads avidly from animals to humans, rabies has served throughout history as a symbol of savage madness, of inhuman possession. And today, its history can help shed light on the wave of emerging diseases, from AIDS to SARS to avian flu, that we now know to originate in animal populations. 
From Greek myths to zombie flicks, from the laboratory heroics of Louis Pasteur to the contemporary search for a lifesaving treatment, Rabid is a fresh, fascinating, and often wildly entertaining look at one of mankind's oldest and most fearsome foes. 


I’ve had this book forever and finally read it after a staff member starting insisting that she had rabies. A stray cat bit her and died a few days later. (In my mind there is an equal chance that the staff member was poisonous to the cat.) The cat was tested and was rabies-free so all was well for the humans involved. It didn’t change things for the cat.

The first few chapters caused mass giggling in my office.

First up this is description of how Louis Pasteur collected saliva to use in developing his vaccines.

“.. watching Pasteur perform this trick with a glass tube held in his mouth, as two confederates with gloved hands pinned down a rabid bulldog.”

 

My confederates can’t hold a mildly pissed off cat with gloves on sometimes.  I pointed this out to them.  They pointed out that the next paragraph discusses how they had a loaded gun on hand in case someone got bit.  They postulated that they could shoot me and get a new job if I tried to get them to do something as stupid as holding a rabid bulldog.

Next it discusses getting the head removed from a rabies suspect.

“The first part of that process — capturing and humanely dispatching a deranged animal — is fairly standard stuff for your local vet.”

 

Well, thanks for the vote of confidence but, yeah, no.  Not routine.  At least not the deranged animal part.

“If the vet is lucky, her hospital has seen enough suspected rabies cases that it has thought to keep a hacksaw handy.”

 

Lucky?  Is that her definition of lucky?  Where does this woman practice?  I think I’m lucky in that I’m not handling rabies suspects every day.

One of my favorite vet school memories though involves putting a head back on after the brain was tested.  I was in my pathology rotation and someone had mistakenly told the owners of a large dog that they could have the body back in pristine condition after the brain was removed.  The pathologists were furious but couldn’t say no after it was promised.  I was just learning to quilt so I volunteered and spent an afternoon hand sewing a head back onto a body.  I matched points and gathered as needed.  The hair laid over the sutures to hide it.  He looked amazing, if I do say so myself.

Anyway, back to the book.  I liked the chapters about the medical aspects of the disease even if some of them made me doubt my medical training.

“Dogs, (Aristotle) wrote with an odd confidence, suffer from only three diseases:  lyssa, or rabies; cynanche, severe sore throat or tonsillitis; and podagra, or gout.”

 

Well, there’s four years of my life in vet school wasted if that’s all they get.

Other portions of this book discuss the idea that fear of rabies inspired the legends of the werewolf and the vampire.  I wasn’t as interested in those aspects as the medical ones.  Your experience may be different.

The end discusses a rabies outbreak started when someone smuggled a dog that ended up having rabies onto the previously rabies-free island of Bali in 2008.  The government’s first response was to order all dogs killed but of course, people hid their pets so that didn’t work.  Vaccination protocols were set up to contain the disease.  And that’s why governments don’t let you just bring pets into their countries just willy-nilly, even if you are a celebrity and think that laws don’t apply to you.

 

 

 

 

three-stars
13 Apr, 2014

My Name is Mary Sutter

/ posted in: Reading

My Name is Mary SutterMy Name is Mary Sutter by Robin Oliveira

My rating: 4 of 5 stars Historical Fiction

Mary Sutter is a midwife in Albany New York who dreams of becoming a surgeon.  Her applications to medical colleges are ridiculed and her attempts to apprentice herself to local doctors are met with scorn.  When nurses are called for at the beginning of the Civil War, she volunteers in order to learn more about medicine. 

At this time Florence Nightingale had just published her account of nursing during the Crimean War.  It was considered extraordinary to have trained females in the hospitals.  Of course, many surgeons considered women who wanted to do this to be prostitutes as women who have wanted to do anything outside the home where so often considered.  Hospitals were unsanitary at best and deadly at worst but no one understood the link between cleanliness and disease.

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This book was an interesting study in what passed for medicine in the 1860s.  I spent most of the book yelling, “Wash your hands!”

When the U.S. Civil War started, Dorothea Dix wanted to set up a nursing corp based on Nightingale’s.  In order to not be accused of being a cover for prostitutes she required that they be between 30 and 50 and plain looking.  Women who didn’t meet her requirements were not allowed in.  Of course, the needs of the war overcame the number of “suitable” volunteers much to Ms. Dix’s consternation.

In this book Mary Sutter is not suitable.  She was too young.  She went and volunteered directly in an overwhelmed make-shift hospital in Washington D.C.  She also went to the front to distribute the meager supplies that the medical staff had.  She learns to do amputations out of necessity because of the huge number of wounded soldiers.  She learns how to judge healing of wounds.  Pus is good because all wounds heal like that.  (“WASH YOUR HANDS!”)

There are some emotional story elements in here too but to me they were very secondary to the medical aspects because I’m like that.  Besides, her family was just hateful so I’m ignoring them.

I’m giving this book four stars because I learned about the history of nursing in the United States which was a topic I didn’t know much about in the course of this historical fiction book.

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