Quote of the Day: Marcia Angell Reviews Atul Gawande’s BEING MORTAL

This is the opening sentence of Angell’s review, which appeared in The New York Review of Books in 8 January 2015:

  • In his newest and best book, the surgeon Atul Gawande lets us have it right between the eyes: no matter how careful we are or healthful our habits, like everyone else, we will die, and probably after a long period of decline and debility . . .  Furthermore, the medical system will be of very little help at the end.

 

#amreading: About Folk Remedies

  • So the right eye of a serpent, being applied to the soreness of the eyes, cures the same, if the serpent be let go alive. So, likewise, the tooth of a mole, being taken out alive and afterwards let go, cures the toothache; and dogs will never bark at those who have the tail of a weasel that has escaped. Democritus says that if the tongue of the chameleon be taken alive, it conduces to good success in trials, and likewise to women in labour; but it must be hung up on some part of the outside of the house; otherwise, if brought into the house, it might be most dangerous.

— Sax Rohmer, The Romance of Sorcery

WSJ Bookshelf: 24 January 2017

William F. Bynum begins a review of Is It All In Your Head? by Suzanne O’Sullivan with this amazing paragraph:

Over a century ago, Alice James (1848 – 1892), sister of the novelist Henry and the psychologist and philosopher William, spent her life going from doctor to doctor with vague symptoms, tiredness and pains most prominent among them. Like Henry, she eventually gravitated to England, where she was happier, because “the god Holiday (was) worshipped so perpetually and effectually.” There at last she got a definite diagnosis: breast cancer. Although it was her death sentence, she was ecstatic, recording in her diary: “Ever since I have been ill, I have longed and longed for some palpable disease, no matter how conventionally dreadful a label it might have.”

Stay tuned, dear blog readers. Stay tuned.

A Surgeon’s Life

Fascinating review by Joshua Rothman in The New Yorker of 18 May 2015 (Self is sooo behind in her reading!) of a memoir by London neurosurgeon Henry Marsh. It’s an unflinching look by Marsh at his medical career and the failures that haunt him (“It’s not the successes I remember, but the failures.”) Incredibly, so much of his success or failure depends on, not training, not intelligence, not skill, but luck.

Rothman compares a neurosurgeon’s life to a soldier’s. Both are “deeply shaped by” something called “moral luck.” To perform under the burden of this awareness is impossible unless Marsh can successfully control “his own emotions. If he can’t control how a surgery turns out, he will control how he feels. He tries not to let his feelings add to his patients’ fear and unhappiness; at the same time, he tries never to lie. He yearns for feelings that are strong but realistic, fully voiced but even-keeled.”

In writing his book, “Marsh has seemingly violated his code; he expresses many of the feelings that he’s worked very hard to keep hidden.”

Fascinating.

Marsh’s book is called Do No Harm: Stories of Life, Death, and Brain Surgery.

Subsequent research on Goodreads shows that it’s garnered a number of nominations and one prize: the J. R. Ackerley Prize for Autobiography.

Stay tuned.

Typhoon Haiyan (Yolanda) Update: Tacloban, Leyte, the Philippines

Still urgently needed:  infant formula

According to Danny Ecarma, a doctor at City Health Clinic in Tacloban, and quoted in an article in the Weekend edition (Nov. 30 – Dec. 1, 2013) of the Wall Street Journal, “It’s starting to appear now in roadside shops, but it’s at triple the price and there’s not enough.”

from the article, by Chun Han Wong:

  • Infant and child-care problems are particularly pressing in the Philippines, a predominantly Catholic country with one of the world’s highest birthrates.  The U.N. estimates that roughly 865 births occur daily in typhoon-affected communities with about 15% developing potentially life-threatening complications.
  • Only 18% of children in the Philippines are “fully immunized against measles, and 83% against polio, as of 2012.”
  • Typhoon Haiyan (Yolanda) killed 5,598 people and injured 26,136, according to official data.

Stay tuned, dear blog readers.  Stay tuned.

Reading from the Pile of “Stuff” : The New Yorker, 9 September 2013

This morning, self is reading “The Return,” an essay by David Finkel, about “the traumatized veterans of Iran and Afghanistan” :

If war is accidental, so is what happens afterward.  Two million Americans have fought in Iraq and Afghanistan.  Most of those who have come back describe themselves as physically and mentally healthy.  They move forward.  Their war recedes.  Some are even stronger for the experience.  But studies suggest that between twenty and thirty percent of returning veterans suffer, to varying degrees, from post-traumatic stress disorder, a mental-health condition triggered by some type of terror, or a traumatic brain injury, which occurs when the brain is jolted so violently that it collides with the inside of the skull, causing psychological damage.  Every war has its after-war:  depression, anxiety, nightmares, memory problems, personality changes, suicidal thoughts.  If the studies prove correct, the wars in Iraq and Afghanistan have created roughly five hundred thousand mentally wounded American veterans.

The article focuses on the experiences of a war veteran named Nic.

“Nic had been taking forty-three pills a day —  for pain, for anxiety, for depression, for nightmares.”  His pregnant wife wonders:

“Were there fewer pills now?  Was he still having flashbacks?  Thrashing around in his sleep?  Sleepwalking into closets, looking for his rifle?  Could he start telling her what had happened during the war?  And could she tell him about what was happening to her?  The other night she dreamed that she had given birth , and for some reason she took the baby and put it into a pressure cooker.  Could she tell Nic that soldiers aren’t the only people who have nightmares?”

Stay tuned, dear blog readers.  Stay tuned.

Dentistry in Edinburgh

Today self has decided to write a really awesome post about Dentistry in Edinburgh.

That is because writer Jill Widner has just left a comment about the author of Mary Poppins, who seems to be in a kind of zone —  the Paris Review and The New York Times Book Review are quoting people who have something to say about P. L. Travers, the author of aforementioned classic work.  Self, never having read the book, now decides that she will read it.  So that she will stop remembering the scene where Julie Andrews in the movie version slides up the banisters.  And will instead think of the words of P. L. Travers.

And also, today, self is thinking of Hawthornden.  Over a month ago, as self was seated on the plane headed for Bacolod, she began to remember Hawthornden.  For some reason, when she returned from Europe in July, she just couldn’t seem to summon the energy or the will to process everything she had experienced there.  But on the plane to Bacolod, she suddenly began to remember specific conversations.  She remembered the dining room, the food, the cook, the housekeeper, the various gardeners, Hamish.  She remembered everything with great clarity, and it made her nostalgic.

So, this gray afternoon, self pokes through a humongous pile of unread mail, and pulls out a flyer she must have picked up in the Surgeons Museum in Edinburgh.  It is specifically about “dentistry in Edinburgh.”  Self never had time to read it before.  So, better late than never.

In the course of perusing the thing, self learns the following (Just a Note:  Some of what follows is extremely gross —  even, stomach-churning)

  • James IV of Scotland “was interested in all aspects of medicine and was known to have practiced dentistry on his subjects, paying them to extract their teeth!”
  • Before the 19th century, patients seeking the help of “a dental operator” would have their teeth extracted with instruments like “keys and forceps.”  (Self thinks back to a recent passage in Charles Cumming’s excellent thriller, Typhoon, which mentions political prisoners being tortured by having their toenails torn off.  She thinks it would be much more effective to resort to tooth extraction.  For instance, wasn’t there a movie in which Laurence Olivier played a malevolent dentist and tortured Dustin Hoffman by asking, repeatedly, “Is it safe?” while doing all kinds of dastardly things inside poor Dustin’s mouth?  Once again, self, you digress!)
  • “For thousands of years, humans have tried to improve the smile by replacing lost teeth.  Nearly 3000 years ago, the Etruscans, one of the world’s earliest civilisations, made dentures to replace lost teeth by wiring artificial teeth to neighbors.”  (On this page, there is actually an accompanying illustration of 3,000-year-old Etruscan bridge work.  Of course, since the teeth are no longer attached to a face, but are supported by some kind of yellowish pedestal, it is very hard to appreciate their aesthetic beauty.  But self can see gold wiring between the teeth and is sure whoever had this work done was very rich)

There is more, much more, but self has to get back to her writing!

Stay tuned.

Self’s Very Own List: Favorite Authors (Thus Far) 2012

  • Nicholson Baker, for Human Smoke
  • Louise Erdrich (Self is reading her novel, The Plague of Doves.  So far, have loved every page)
  • F. Scott Fitzgerald, for The Beautiful and The Damned
  • Adrian Goldsworthy (What a name, that!  Self only realized after she had finished typing G-o-l-d-s-w-o-r-t-h-y), for Caesar:  Life of a Colossus (See the Goodreads list of “Best Books About Ancient Rome”)
  • Jerome Groopman, M.D., for How Doctors Think
  • Colin Harrison, for The Finder, the first New York-set thriller that self has enjoyed in a very, very long time
  • Ian McEwan, for Atonement
  • The 9/11 Commission:  for The 9/11 Commission Report, 600+ pages of analysis that reads like a thriller.  Albeit one with a very sad ending.

Stay tuned, dear blog readers.  Stay tuned.

Serious Sunday: Reading Andrew S. Ross’s THE BOTTOM LINE in the San Francisco Chronicle

Self reading the San Francisco Chronicle of Friday, 13 July 2012.  There’s a very interesting column by Andrew S. Ross in the Business section.  Here are some salient points:

  • Hospitals in the San Mateo area charged a median price of $48,000 for a cesarean section in 2010; in San Diego, the same procedure was priced at $20,000.
  • A hip replacement in Alameda County cost $133,000, while in Orange County the same procedure cost $58,000.
  • A knee replacement in San Jose’s Regional Medical Center cost $165,000.  In the Santa Clara Valley Medical Center on Bascom Road, the same procedure cost $76,000.
  • The six most expensive hospitals “are all in the Bay Area, with Alameda and San Mateo counties tying for the top spot, Contra Costa County close behind and San Francisco coming in sixth.”  Alameda County’s hospitals “charge the highest prices in the state, although it’s far from the state’s most affluent region and is not known for vastly superior health care services.”

This information is contained in a report by the California Public Interest Research Group Education Fund in San Francisco, and is “based on prices charged at 236 hospitals in 24 regions for 12 of the most common elective procedures, including C-sections, hip and knee replacements, hysterectomies, angioplasties and radical prostatectomies.

Stay tuned, dear blog readers.  Stay tuned.

And the Doctor Will See You Now . . .

Self has been a voracious consumer of writing by doctors, for over two decades.

For a while, her short story, “Lenox Hill, December 1991” (published in the first Charlie Chan is Dead anthology) was taught in a Pennsylvania medical school, in an “Ethics of Medicine” class.  It wasn’t really a short story, self will admit right now.  It was memoir.  It was about her sister.

Now, she is reading the latest in a long line of fascinating books that began with Sherwin Nuland’s How We Die, and included books by Oliver Sacks, Atul Gawande, Abraham Verghese (many of whose writings she first encountered in The New Yorker) and Stanford psychiatrist Irwin Yalom.  The last such book she read (before How Doctors Think) was Christine Montross’s Body of Work:  Meditations on Mortality From the Human Anatomy Lab, which was one of her favorite reads of last year.  She liked the Montross book so much, she even recommended it to her nephew William, Dear Departed Sister’s second child, who’s now in medical school in Washington University in St. Louis.

And now she’s reading Jerome Groopman’s How Doctors Think.  And she simply can’t put it down.

In the section self just finished reading, a middle-aged single woman named Rachel decides to go the solo mothering route and adopts a baby from Vietnam.  The baby was supposed to have been “released” at six months, but two months before Rachel was expecting to fly to Vietnam, she received a call that the adoption had been expedited, and she could pick up the baby in July.

Rachel arrived at the hospital in Vietnam, and was momentarily confused because the baby she was shown was much thinner than in the photographs she had been receiving.  She was so overjoyed, however, that she didn’t question the hospital staff, and took the baby back with her to the United States.

On the flight home, the baby hardly slept, and hardly sucked.  Rachel was fortunate that she had a relative who was a pediatrician, and she asked for advice.  The relative said it sounded as if the baby was dangerously dehydrated.  “Take her to an emergency room right now,” the relative advised Rachel.

And this was the beginning of a long, long excruciating journey in which the baby’s mouth was discovered to be covered in fungus, which was spreading, and that her lungs were clotted with pneumonia virus.  And the woman Rachel absolutely never gave up.  Then, shortly after dawn on September 11, 2001 —

Yes, you read right, dear blog readers.  Shortly after dawn on September 11, 2001, the latest tests on the baby showed her to be at last free of infection!

And Rachel was so overwhelmed with joy that she decided to share the news with a member of her church, and called her from a payphone in the hospital.  The woman seemed to hesitate and then told Rachel:  “Turn on your TV.”

!!!!

Rachel brought her baby daughter home, 45 days later.  This story, at least, has a happy ending.

Stay tuned, dear blog readers.  Stay tuned.

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