Hi, friends! I’ve been gone on a bit of a hiatus but am back and ready to weigh in on the health care news of the day. Like this eye-catching headline I recently read:
“No amount of alcohol is safe, health experts warn”
A new study was recently published that pretty much came to that conclusion. The authors did a big retrospective look at previous medical research into alcohol use and concluded that there was no amount of alcohol consumption that could be considered safe. This really made the news all over the place, like this sobering 30-second blurb:
Due to my unending dedication to finding sound medical advice . . . and even more because I had just enjoyed a nice glass of a dry rose wine on a hot summer evening and didn’t want a bunch of egghead researchers to spoil it for me . . . I had to investigate further. Read on for my take on the latest alcohol brouhaha. Continue reading “No amount of alcohol is safe. Oh, c’mon now.”→
A good part of my medical practice at Hennepin Healthcare is in mental health. Although I’m a general internist, meaning I specialize in chronic diseases of adults, I have a special interest in the intersection of medical and mental illness. Consequently, I spend a hefty portion of my days on the inpatient psychiatry units. So when a piece came out in the New York Times this week, I was immediately drawn to it. Written by Dr. Dhruv Khullar from New York-Presbyterian Hospital, it is entitled The Largest Health Care Disparity We Don’t Talk About. I strongly encourage you to read it.
This is particularly of interest to me since I have also been part of a group of five medical systems across the country who have recently published our own experience in caring for people with mental illness. You can read our very brief paper at the Annals of Internal Medicine.
Hey, everybody. Check out this fact: about 16 million people in the United States will experience an episode of depression every year. That’s about 7% of the population.By some estimates, depression is in the top 3 causes of disability (source: World Health Organization).
To help us learn a bit more about this condition, I asked my colleague Dr. Eduardo Colón to be my in-studio guest on last Sunday’s Healthy Matters broadcast. It was a great show! Dr. Colón is the Chief of Psychiatry at HCMC and he has been on the show a few times over the years. This is terrific since you will not find a wiser and kinder psychiatrist than he. I really encourage you to listen to the podcast so you can hear Dr. Colón explain things much better than I can in this written form.
You can learn more about Dr. Colón from this Minneapolis Star Tribune article which appeared shortly after he was named Chief of Psychiatry. He gives an insider perspective on mental health care in our community that is worth a read.
I’ll use this blog post as a written companion of sorts for the audio podcast of that radio show. I’ll try to encapsulate a few topics from the show and include some links for more information.
First of all, download the audio podcast here to listen to whenever you want. Once at the podcast site, select Healthy Matters show #475, February 11, 2018).
A wealth of information on depression
Here’s what Dr. Colón covered on the show, and you can click the links to jump to specific topics that interest you.
For many years I have been telling listeners and patients that “one-third of you have high blood pressure and many of you don’t know it.” Turns out I need to update that to “nearly one-half of you have high blood pressure and many of you don’t know it.”
That is because the American College of Cardiology / American Heart Association guidelines for hypertension – high blood pressure – were recently updated. Like any good scientific process, the guidelines change as our knowledge of the science changes. That is exactly what occurred this past month.
I mentioned all this on the most recent Healthy Matters radio broadcast. I started the show off with this information, all of which you can listen to on the podcast by clicking Healthy Matters show #463, November 19,2017.
Your doctor may be . . . should be . . . talking about this with you at some future visit. In this post I’ll try to break the new guidelines down for you a bit. If you read on, you’ll find:
On Sunday I am driving 430 miles from God’s country (Minneapolis) to just south of Lincoln, Nebraska to experience the total eclipse of the sun. That’s right, I’m driving to the area of “totality” along with about half the US population because it is a super cool thing to do. I’m totally pumped up for it!
Please no clouds in Nebraska, no clouds, no clouds . . .
I think we need a natural wonder to take our minds off our human-made conflicts right about now. And since this happens once every almost never, off I go with other adventurers from my family.
Now if only I could get a table reservation at a Lincoln restaurant. I’ve tried. It wasn’t easy. I have also heard that it may result in the first traffic jam in rural Nebraska history, complete with shortages of gas and bumper to bumper traffic. Yikes!
And don’t get me started on the saga of obtaining eclipse-viewing glasses. First set was perhaps counterfeit which led to a search for safe glasses only to find the entire country is sold out of them. But it all ended well as I did snag a pair of paper glasses for a mere ten bucks.
But this is a health and wellness blog, so I thought I’d look into the commonly-known advice to never look directly at the sun. I’m channeling my Bill Nye the Science Guy in this post.
We all know not to look at the sun. Heck, your mother could tell you that. But why is this so?
True story. . . This past Saturday I set three alarm clocks in preparation for getting out of bed to do my Sunday morning Healthy Matters radio broadcast. It was the start of Daylight Saving Time here in the United States and the broadcast is done live. None of that sissy pre-taped business for me. Oh no. I drag my can down to the WCCO studios in chilly downtown Minneapolis to mumble my way through the show every Sunday morning.
But with that “spring forward” business with the alarm clock, I’m always worried that I’ll miss the show on this particular Sunday. So I set three alarm clocks.
You know what complicates the adjusting of the clocks ritual? It’s that the clocks are smarter than me. It used to be that before I went to bed on DST Saturday, I manually adjusted all the clocks. But now, most of them do it automatically. The nightstand alarm clock does. So does my backup alarm clock on my smartphone. But the microwave doesn’t. Neither does the one on the watch. So I go to bed not sure which device is going to change automatically and which ones aren’t so I get confused and some of them are correct and some aren’t and holy cow am I going to be an hour late and if I wake up at 3:00 a.m. and look at the clocks some are accurate and some are not and I’m going to miss the radio show and there will be the dreaded “dead air” time on the radio and . . . .
Quick, picture in your head a highly competent physician. What does that person look like?
Does your doctor image look like this?
Or like this?
For the record and the recognition, that’s Dr. Gibson-Hill, a doctor in Bristol, England. You probably know the guy in the top photo.
History has maybe ingrained in us the image of doctors as many things, but first of all they have been men. The reality, even dating back over a hundred years (Elizabeth Blackwell, anyone), is that women have served as physicians for a great long time.
And the reality today is that women are a huge part of the physician workforce in the United States. I remember vividly one moment during the first hour of the first day of my Medical School education at the University of Minnesota some 20 years ago. The Dean stood up in front of the nearly 200 of us eager young medical students and announced that for the first time in that school’s history, more than half the medical students were women. The room erupted in applause that day.
My current practice bears this out. In my group of hospitalist physicians at HCMC, we have 17 women and 14 men. So when you see a doctor in our hospital and I presume at all other hospitals in the country, you are likely to be cared for by a physician who happens to be a woman.
I was reading the paper this morning over my tea and crumpets when this headline caught my attention:
“First-year doctors would be allowed to work 24-hour shifts under new rules”
Now there’s a topic near to my heart, so I decided without much forethought to subject you to my ramblings about physician training and the unbelievably long work hours that our society subjects physicians to all the time. But you may be surprised about what my conclusions are on the topic.
For those of you who read my last post Insomnia Part 1 and are looking for Insomnia Part 2, please bear with me because that second part is coming next week, complete with more insights from Samantha Anders, sleep expert from the Sleep Center at HCMC. I’m hoping to get some video interviewing done with Dr. Anders about behavioral therapy for insomnia, so stay tuned for that.
Why should you care about work rules for doctors-in-training?
That headline was from a Washington Post article covering the a proposed relaxation of work-hour restrictions for interns in hospitals. So here are some stories from my own experience about the rigors of medical training. Hopefully you’ll find something in here to get you thinking. Continue reading “The 36-hour shift”→
Fifteen years ago today at around 8:00 Minneapolis time, I was in the Intensive Care Unit at HCMC. I was a medical resident on that day doing my rotation in Nephrology and was visiting a critically-ill patient in the ICU with really bad kidney problems. My attending physician on that day was my med school adviser and my residency program director, Dr. Morris Davidman. Though no longer practicing, he’s still a mentor, role model and friend. He was the first person I talked to about what was certain to be a much-changed world that day.
I remember that day well, and today marks its 15th anniversary. That is long enough that my own kids were too young to remember and a whole generation is growing up not having been born yet in 2001. To me that’s a strangely weird thought. I’m not going to write about those events per se, as enough is already written and said about it and I have no insight whatsoever that each of you reading this doesn’t already have. And I’m not posting pictures of the tragedy after reading a provocative blog post from a New Yorker basically saying that the none of that is helpful . . . we all know what it looked like. Instead, I’m showing the NYC skyline as it looks now from my recent ride on the Staten Island Ferry. I do love New York.
That being said, I think it therapeutic and natural for us to remember where we were, what we were doing, and then stop and remember those who were impacted so directly – people in New York City and Washington, people on those planes, their loved ones, the firefighters and cops and first responders. Perhaps take a few deep breaths and remember that though we cannot prevent bad things from happening, we can still dedicate ourselves to doing good in the world and remember the terrific and loving people in our lives.
So I remember standing next to Dr. Davidman watching the TV above the head of a critically-ill and comatose patient.
Do you remember where you were?
National Preparedness month
“Americans have been tested by trial and tragedy since our earliest days — but year after year, no matter the hardship, we pull through and forge ahead.”
President Barack Obama
September is National Preparedness month so that was the topic today on our Healthy Matters radio broadcast. I guess it was apropos given that today is September 11. To help me, I invited Mark Lappe, the Director of Emergency Management here at my hospital. Did you know most hospitals have a Department of Emergency Management? I knew my hospital does, given that it is a major Level I trauma center, but I guess I didn’t know that most other hospitals do as well.
We talked about community-wide preparedness as well as the steps hospitals take to stay prepared for bad situations. Like the generators that kick in at HCMC (my hospital) within 2 seconds of a power outage across a campus spanning 6 downtown city blocks. Wow. Then we moved to emergency preparedness in your own homes, so as promised, I’m going to put some links here for more information. You’ll find them in a bit. In the meantime, listen to Mark on the podcast if you wish.
To read President Obama’s full proclamation, click here.
When I think about 9/11 and about the other disasters that we hear about just about every week in the news, I often wonder if it makes any difference whether we plan for them or not. Have you ever felt that way? After all, between flooding in Louisiana and shootings in Orlando and terrorism on the French Riviera, it’s easy to feel like we live in a whole new world in which we are powerless to defend ourselves.
But I resist that thought whenever it hits.
Certainly, there are loads of events that we are powerless to either predict or prevent. That being the case, I think I find myself drawing two conclusions:
I am not deterred by awful events in living my life. I will continue to travel, attend big celebratory events, meet new people, welcome the immigrant to our community, learn about new cultures, enjoy fine art, and most of all see new places in the world.
But I think it wise to listen to those among us who have expertise in keeping us safe, like Mark Lappe on my radio show today.
The first point reflects my belief that we need to keep on living boldly and not let scary things paralyze us.
I know terrorism is real but the terrorists score a victory when we demonize immigrants, pre-judge people in the name of safety, allow the government to invade our privacy and scale back our liberties . . . all out of fear. Benjamin Franklin was right when he said:
“Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety”
And the Zika virus is also real and scary. But we have the knowledge, if perhaps not the willpower, to do something about it, so let’s do it! See below for one suggestion on how you can act.
And earthquakes and tornadoes and flooding are real as well. But we can do something about climate change and when natural disasters do occur, we can do like we always do and help each other out.
Which leads me to the 2nd point above, now that I’ve been on my soapbox a little bit (sorry!) and that is that a bit of advance planning seems to make some sense. So now onto some resources you may wish to check out in keeping your family safe and secure during emergency situations.
Great resources and a call for action
A good place to start is ready.gov which is a comprehensive site from the US Department of Homeland Security. Click around the site for a while; it is really comprehensive with information on a variety of topics for you and your family.
One of the recommendations from the experts to prepare your own family for emergencies is to make an Emergency Plan. Get help with making a plan for your family here from FEMA. There are printable checklists of supplies you should have in an Emergency Kit. (One aside . . . those of you who watch The Big Bang Theory may know that Sheldon has not one, but two, emergency kits in his apartment. And he’s a genuine genius.)
We learned on the show that texting is preferable to calling on the phone if you or a loved one is caught in a disaster situation. Teach your kids to text you “I’m OK and I am currently at location here” if you ever find yourself separated. Phone lines, even cellular lines, often don’t work in disasters! It’s also a great idea to write down all your contact information. The FEMA site has some downloadable sheets to help with as well.
A call for action
I encourage you to contact your member of Congress and US Senator and urge funding for overcoming the Zika virus. We have the medical knowledge and the public health knowledge to solve the spread of Zika. We just need our leaders to act! Or if you don’t favor such an approach (hey, people have different views on how best to act and that’s OK) then tell your elected officials your own view. It’s no longer just in other countries (though we should have acted to help other countries long before this), it is our neighbors in Florida and Puerto Rico we are talking about with Zika.
So some thoughts on risk and planning, disasters and planning for disasters. I admit you probably have as much insight into these issues as I do, which I’d love to hear! Next post will be about something medical. Since this is a medical blog and all.
OK, before I say one thing about this topic, we need to set the mood by playing this very short audio clip. Make sure the sound is turned up on your computer or mobile device and click the “play” arrow.
This is going to be epic:
Hallelujah! Yes, indeed, the medical community has determined that drinking coffee is not only probably not bad for you, it may actually be good for you.
Here I am celebrating (undoubtedly after having had a couple cups):