CHART: Compulsion to Complain When the Waitress Brings You Ketchup Instead of Hot Sauce

CHART: Things That Annoy Me About NGOs Working In Malawi

Can't afford healthcare? Rob a bank for $1 and reap the rewards in jail.

You've got chronic back pain, and nowhere to turn for relief. Thousands of American work their butts off day in and day out are turned down for insurance coverage despite paying their taxes and living civilly obedient. There are only two demographics in our country that are guaranteed health care, active military personnel and inmates (and even the lines for these groups is blurred at times). So you can either continue to suffer without health insurance or you can achieve coverage by joining the military or going to jail. That's what this guy did.  His plan was flawed, as you'll discover in the article, but the care he's receiving in jail is better than nothing.  The important point to take from this article is that a system that leads a guy to do this is clearly broken.  He's not lazy or worthless; he's sick. 

 Read the full article HERE (1).  and HERE (2)

Video:

TIA, bambo

I trust that you’ll

allow me the space

to share my thoughts

for a moment regarding

the uninhibited grace

of your tempt, Love.

The olfaction of

the trip has quartered

me in your arms.  The

sweet aroma of red dusted

roads runs miles through

my mind of memories past.

The sound of your straw

bristles across my stoop,

linens flapping in the breeze.

The warmth of your

beating bossom has grabbed hold

again with the site of your

barren landscapes.  I accept

your embrace, as in years past.

The smoky drip of your

charred flesh, the

gritty swig of your social circle,

a part of which I somehow belong.

With the wave of your hand

hesitation fades

revealing wholesome

sunrises burning like fires

speckling the horizon.

TIA, bamboo.  Welcome home,

my wayward friend.

Jeffrey Brenner's brilliant idea.

The majority of health care reform critics cited the assumed impossibility of reducing health care costs while improving care as reason to abandon efforts.  But what if we could have our cake and eat it, too?

Jeffrey Brenner is a physician in Camden, NJ.  He had a brilliant idea after analyzing crime data from the city, which revealed "hot spots" of crime in various parts of the city.  The presence of such a trend suggested that the deployment of police around the city to model these patterns of crime found in the data would both reduce costs and increase the effectiveness of the police force.  Naturally, he then considered applying the model to health care.

He crunched through some data and found that there were hot spots of sick people in Camden that were not only the sickest but also receiving the worst care.  If we took this population out of the hospitals and brought them into specialized clinics that would help them improve their health through lifestyle changes, could we save money systematically while indeed improving the the quality of care that they receive?

Thus far, Brenner's program - and similar programs that have popped up around the country - seems to be achieving what the critics thought was impossible.  Granted, they've only been in operation for a year or so, but, down the line, if the results are positive, Brenner may have uncovered a part of the solution to our nation's healthcare crisis.

A few points about his program that stand out to me:
-24-hour emergency hotline (would reduce costs by limiting calls to 911 in non-medical emergencies such as falling over and not being able to get back up)
-health coaches, recruited from backgrounds outside of healthcare
-morning meetings to get all of the staff on the same page about scheduled patients' recurring health problems and the barriers to their well-being
-constant nagging from clinical staff about patients' unhealthy habit: smoking, diet, exercise, etc.

Read the whole article ("The Hot Spotters" by Atul Gawande) HERE.

Petrichor-doux

After a long drought, I'm ready to rain down some sweet rain in the form of some blogging.

I’m finished with my first year of med school, which makes me 25% MD. At this point, we've adjusted to the idea of accumulating $250k in debt. There's no turning back now. We're all going to be doctors. What isn't clear is what the hell that actually means in the grand scheme of things.

The waters have been muddied by the biomedical scientific flurry of information that has been forced into our brains. Many fresh MDs admit that, during your preparation for board exams at the end of your second year, you will have the ability to recall greater fundamental medical details than you will for the duration of your practicing years.

But one thing that can't be instilled in us is a sense of purpose. Since my time on Semester at Sea, I've felt some calling to the world, though I still don't know where I'm heading. Other friends that pursued medicine have described how the process has beaten the altruism out of them. My friend at Harvard Dental - who also happens to have been on the Semester at Sea voyage with me - told me that he held an altruistic view of dentistry until very recently. Now, he merely hopes to achieve a comfortable life for himself while performing his job as best possible. This is coming from a guy that has devoted a great deal of his time over the past years to servicing the poor.

I'm on a path to change the way that we think about health. The current stream of thinking in society is that our bodies either work well or they don't, which, in my opinion, isn't really a terrible way to simplify things. On the other hand, take, for example, the study of epigenetics. A great deal of research is now focused on how factors in our environment – including pollution, diet, and exercise – affects the expression of our genome. All of these things can influence the way that we feel and perform.

Cancer is a dysfunction that arises from within the body itself. It deals with the uninhibited division of cells, a process that is highly regulated in a normal cell. This dysfunction is usually the result of damage to genes that regulate cell division. Free radicals or some DNA-damaging agent such as radiation causes this damage. While inheritance of certain cancers must be mitigated by our role as physicians, providing the tools for people to minimize this damage by reducing the stresses on our bodies that cause them. Epigenetics research has shown that these agents range dramatically…from the food we eat to the amount of time that we spend on our cell phones.

This isn't about money, politics, economics, or health care policy. This is a throw back to what makes life possible. We must do our best to preserve our bodies. It’s the only way to optimize our wellness in spite of a poor genetic hand. The food, sleep levels, stress levels, and activity that we constantly expose our bodies to can and will affect gene transcription, and thus alter our mood, energy levels, focus, and general well-being.

A recent lecturer suggested we decide now where our interest lies in medicine: taking care of sick apples or preventing apples from getting sick in the first place. While care for already sick patients is critical, I think that we as medical professionals owe it to society to begin taking prevention more seriously. Considering the potential of epigenetics, this battle is not solely against obesity. It’s a battle to preserve our wellness and morbidity by devoting more resources and energy to mapping out an optimal way of life most appropriate for maintaining the integrity of our genome.