My friend and former Chair of the CFAH Board of Trustees, Doug Kamerow, has written a book that I think you will like.

Besides being a mensch and witty as heck, Doug is a family doctor and a preventive medicine specialist.  In his new book, Dissecting American Health Care: Commentaries on Health Policy and Politics, these four characteristics constitute the lens through which he comments on scores of events, controversies and changes in public health and health policy that have taken place over the past four years. For example, Doug writes about last year’s debate over the H1N1 vaccine, the papal position on condoms and HIV, how prevention fared in the health care reform act (ACA) and his attempt to (more…)

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Recently, I had a conversation with Shannon Brownlee (the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation) about whether men should continue to have access to the PSA test for prostate cancer screening, despite the overwhelming evidence that it extends few, if any, lives and harms many more men than it benefits. She felt that if patients could be provided with truly unbiased information and appropriate decision aids, they should still be able to choose to have the test (and have it covered by medical insurance). Believing that one of the most important roles of doctors is to prevent patients from making bad decisions, I disagreed.

After reading Your Medical Mind, the new book by Harvard oncologist and New Yorker columnist Jerome Groopman, I think he would probably side with Brownlee’s point of view. Groopman, whose authoring credits include the 2007 bestseller How Doctors Think, and wife Pamela Hartzband, MD have written a kind of sequel to that book that could have easily been titled How Patients Think. Drawing on interviews with dozens of patients about a wide variety of medical decisions – from starting a cholesterol-lowering drug, to having knee surgery, to accepting or refusing heroic end-of-life interventions – the authors (more…)

*This blog post was originally published at Common Sense Family Doctor*

Food Truths, Food Lies,

Marcotte writes for the average American – his simple language, matter-of-fact tone, and regular reminders of what the reader has learned, make for a quick and memorable read.  Although it’s clear that Marcotte has carefully distilled his dietary advice from the scientific literature, he refrains from burdening the reader with too many footnotes and references. Instead, he has created a kind of Cliff’s Notes of nutrition, having done the “heavy sifting” for us. What remains are the most basic principles underlying all healthy eating, such as:

*You can’t exercise your way to weight loss (i.e. you can’t outrun your own mouth – it’s much easier to eat more calories than you burn) (more…)

Well, not my heart.

I was contacted awhile ago and asked if I wanted the chance to read and review Tilda Shalof’s new book, Opening My Heart.  (Amazon link, but NOT an affiliate link – I live in California and due to a new law, Amazon has cut all ties with us).

I had the chance to include a story in a book that Tilda edited a couple of years ago called Lives in the Balance.  So I had fond memories

I’ll say up front that I enjoyed the book.  I had a range of emotions while reading it – frustration, worry, happiness.  Frustration because although Tilda is a very experienced ICU nurse, she doesn’t take her own health seriously at all.  I read with disbelief as she described her incredible denial of the obvious need to treat the heart condition she was born with.

I was amused at her doctor’s and husband’s reactions when she tried to tell them that if anything went wrong with her surgery, she didn’t want to be kept alive on machines.   She explained that she used to have a dog and her husband absolutely refused to euthanize the miserable thing.  I liked this passage in particular:  “To Ivan, love means never stopping love or giving up.  This is what families say.  They can’t let go because of love.  I hope no one loves me this much, ICU nurses often say to one another.”

Amen, sister.

Tilda writes about (more…)

*This blog post was originally published at code blog - tales of a nurse*

Rob Dobrenski, PhD. is a psychologist who blogs over on ShrinkTalk.net.  He’s written a book about what it’s like to be a psychology graduate student, a psychotherapy patient, and a psychologist.  Oh, we like the folks who go from Shrink blog to Shrink book — it somehow feels familiar — and so I agreed to read his book: Crazy: Tales on and Off the Couch.

So bear with me while I tell you that the book rubbed me wrong at the outset.  Dr. Dobrenski begins by saying something to the effect that he describes things that all shrinks feel, and if they say they don’t, they aren’t being honest.  I really hate it when people tell me what I feel.  It’s like saying that Prozac made your depression better and if it didn’t, then you just didn’t recognize it.  And then the book gets off on a provocative start — Rob discovers that many people in his life, from a patient, to a colleague, to himself — are “f***ing crazy.” The asterisks are mine. Dr. Dobrenski had no trouble using the word — I counted 19 times in the 39 pages, including in direct quotes of discussions he has with both a patient and one of his supervisors.  Not in a million years.  I wasn’t sure what the point was.  To let people know he knows obscene words?  To be (more…)

*This blog post was originally published at Shrink Rap*

I have had the privilege of working at an organization which is actively improving the lives of its members and also was mentioned by the President as a model for the nation.  Over the past few years, I have also demonstrated to first year medical students what 21st century primary care should look and feel like – a fully comprehensive medical record, secure email to patients, support from specialists, and assistance from chronic conditions staff.

But as my students know, there are also some suggested reading assignments.  I’m not talking about Harrison’s or other more traditional textbooks related to medical education.  If the United States is to have a viable and functioning health care system, then it will need every single physician to be engaged and involved.  I’m not just helping train the next group of doctors (and hopefully primary care doctors), but the next generation of physician leaders.

Here are the books listed in order of recommended reading, from easiest to most difficult.  Combined these books offer an understanding the complexity of the problem, the importance of language in diagnosing a patient, the mindset that we can do better, and the solution to fixing the health care system.

Which additional books or articles do you think current and future doctors should know?

Overtreated – Why Too Much Medicine Is Making Us Sicker and Poorer (more…)

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Narouze SN, ed. Atlas of Ultrasound-Guided Procedures in Interventional Pain Management.  Springer 2011, 372 pages, 465 illustration, $189.00.

In 1941, Dr. Karl Theodore Dussik of Austria introduced the idea of using ultrasound waves as a diagnostic tool. Over the next few decades he, along with others like Professor Ian Donald of Scotland, developed the practical technology and applications of ultrasound in the field of medicine. Since then, ultrasound (US) has become progressively more useful across a wide range of medical specialties, for both diagnostic and therapeutic procedures. US is quickly becoming the imaging modality of choice to guide practitioners in pain management and musculoskeletal interventions. Although fluoroscopy has long been a mainstay in image-guidance for such procedures, US provides an attractive alternative given its superior soft tissue resolution, allowance of real-time needle guidance, absence of iodinated contrast and lack of ionizing radiation.

The Atlas of Ultrasound-Guided Procedures in Interventional Pain Management by Narouze et al. is a comprehensive review of the principles of US-guidance as an aid in current pain management practices. It is divided into six parts and 30 chapters arranged by system and discipline. Leading experts in each discipline have contributed to this body of work, providing an extensive literature review encompassing each chapter. This text is meant to serve as a user-friendly manual, covering the anatomy, treatment rationale, and technical aspects of US-guided interventional pain management procedures. (more…)

*This blog post was originally published at AJNR Blog*

Hall WA, Nimsky C, Truwit CL. Intraoperative MRI-Guided Neurosurgery. Thieme 2010, 272 pages, $159.95.

This book is a multiauthored text edited by three senior authors who have a tremendous experience in the use of intraoperative MRI technology. The book is divided into five sections that describe the various iterations of iMRIs that are available, its application for minor procedures, the resection of neoplastic lesions, and its role in the management of nonneoplastic disorders. The last section focuses on the future improvements in design that are likely to improve surgical access and utility of this burgeoning technology.

The first section describes the characteristics of iMRI machines that are available in the low, medium and high field strength. The reader gets a very good idea about the relative benefits and limitations of each of these machines. Hospitals that may be in the process of deciding which technology to go in for may use this information as a good guide. This section also highlights the optimal pulse sequences that may help differentiate tumor-brain interface, perform intraoperative fMRI and DTI tracking and detect complications related to brain ischemia and hematoma formation.  The chapters in this section are well illustrated and show both the technology and the images obtained with various units. The chapter on optimal pulse sequences is very well written and discusses the specific pulse sequences that can help obtain the maximum intraoperative information with the least amount of time. These sequences can be tailored to provide not only anatomical details but also to help obtain both DTI and functional activation data for intraoperative neuronavigation, thereby accounting for brain shifts and movement of eloquent tracts during surgery. The authors describe the challenges of this methodology. Specific anesthetic challenges that restrict the use of standard monitoring equipment have been outlined. These include patient access, length of operative procedure, influence of magnetic field and RF currents on the functioning of the equipments and the images obtained, and risk of migration of ferromagnetic instruments, among others. This has led to the development of MR compatible anesthesia and monitoring equipment. Safety issues and steps needed to ensure reliability of equipment have been described. (more…)

*This blog post was originally published at AJNR Blog*

Chocolate and vicodin? No, it’s not the latest Ben & Jerry’s flavor. “Chocolate & Vicodin: My Quest For Relief From the Headache That Wouldn’t Go Away” is the latest book by author, blogger, web designer, and busy woman Jennette Fulda.

I became acquainted with Jennette’s blog during BlogHer 2008, where I had purchased her first book, “Half-Assed: A Weight-Loss Memoir.” When she asked if I would like a copy of “Chocolate & Vicodin” to review, I jumped at the chance.

In “Half-Assed,” Jennette chronicled her journey to a near-200 pound weight loss. Just prior to that book’s release, she began another journey — one whose goal proved elusive. On February 17, 2008, Jennette went to bed with a headache. She still has the headache.

Name a diagnosis, she’s heard of it (brain tumor, dead twin in the brain, etc.) Name a treatment, she’s tried it (meds, massage, marijuana, mint chocolate chip ice cream, etc.) In “Chocolate & Vicodin,” Jennette is on a journey to find relief from chronic headache. Writing in a comfortable style, Jennette has a subtle humor that will have you laughing out loud. Trust me, her description of using marijuana “for medicinal purposes only” will have your beverage of choice coming out your nose! (Cover the book!)

But it will also choke you up. Under the humor, under the crazy e-mails from readers that suggest the crazy remedies, this is a serious story of chronic pain disrupting life. Persistent, excruciating pain and the work of coping with it takes a toll on Jennette, and when it becomes too much you find yourself sobbing with her. (more…)

*This blog post was originally published at Emergiblog*

This post is a bit of a diversion from my usual posts, but I think it may still be worthwhile. You see, I want to promote a book.

I’ve just read the book, “Steeped in Blood: The Life and Times of a Forensic Scientist“ by David Klatzow. What a stunning book. It really gives insight into the South Africa of old and possibly what South Africa of future may end up being like. I suggest that everyone get ahold of it and read it.

However, David, I do feel I must challenge you on one point. Towards the end of your book, you say one of your surgeon friends told you a story of one of our Cuban import surgeons who tried to do a tonsillectomy through the neck rather than through the mouth, the normal way of doing it. I know this story and have heard it often myself in the corridors in Pretoria. Unfortunately it’s urban legend and nothing more.

I have worked with the Cubans, and they aren’t too shabby. Don’t get me wrong — they aren’t a scratch on a South African specialist (although the standards are dropping as you rightly point out, and quite soon they may be far better than homegrown specialists), but the point is that they wouldn’t do something so bizarrely stupid. I even suspect I know who your surgeon friend might be, especially if he presently finds himself in Pretoria rather than Johannesburg, where you no doubt got to know him.

Anyway, still an absolutely brilliant read for anyone who wants to get a peek into the workings of the apartheid government of old. Go and buy it now.

*This blog post was originally published at other things amanzi*