WRITING DOCTOR'S BLOG by NYHWRITER.COM

Which Would You Rather? Worry or Die?

WORRIED SICK: A PRESCRIPTION FOR HEALTH IN AN OVERTREATED AMERICA by Nortin M. Hadler (Caravan/Univ. North Carolina Press, June,2008) and OVERTREATED: WHY TOO MUCH MEDICINE IS MAKING US SICKER AND POORER by Sharon Brownlee (Bloomsbury, January, 2008)

Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com,
585-385-1515, 16 San Rafael Drive, Rochester, NY 14618

       Tim Russert is dead.  Wiped out and gone. Although doctors knew he had heart disease, they didn’t realize it was fatal. Like more than the men felled by fatal heart attacks, Russert had no chest pain. A diabetic, he was overweight.

        In 1998, a CT heart scan found Russert’s calcium was 210, which meant his risk of a heart attack was high. Should he have had an angiogram? His cardiologists didn’t think so. If the angiogram had shown the clots in Tim Russert’s vessels, would bypass surgery have saved him?. Even after his death, doctors differed on what an angiogram would have indicated. After his death, his internist asserted, “The number one predictor of mortality is waist circumference.”  Was that all?

        A week after Tim Russert’s death, Drs Ezekiel Emanual and Victor Fuchs published an article in the JAMA (Journal of the American Medical Association) deploring “The Perfect Storm of Over-utilization.” Arguing for reducing overutilization to control costs by altering the combination of physicians’ training and attitudes and patients’ wishes and worries,  vaguely they say “The best hope for reining in costs is to devise financial incentives for physicians and patients that result in greater health value.”

        In the same vein is Sharon Brownlee's book,OVERTREATED - Why Too Much Medicine Is Making Us Sicker And Poorer (Bloomsbury Press, December, 2007).  Brownlee argues that  “much of mainstream medicine's therapies and treatments are never double-blind tested and the financial structure of the current system is literally killing people.” 

        Worse yet is Nortin M. Hadler’s new book WORRIED SICK: a PRESCRIPTION FOR HEALTH IN AN OVERTREATED AMERICA ( Caravan/University of North Carolina Press, June, 2008).  Hadler’s diatribe s should not be confused with Arthur Barsky’s book of the same name, WORRIED SICK: Our Troubled Quest for Wellness ( Little Brown, 1988). A legion of other polemics on “overtreatment” ignoring undercare crowd the web sites on staying well.                       

        Claiming “they,” doctors, “health“ providers, even medical writers like me can make us sick with worry., these worry wart writers stagger readers’ imaginations.

        It’s up to you. Which would you rather? Be worried sick? Or dead? And would a cacophony of medical advisors, positive and negative, keep you well (or well-er)? Maybe yes, maybe no.

        Still, fair is fair. Warnings are in order. Books like Hadler’s and Brownlee’s, articles like Emanuel’s are hazardous to your health.

        From our point of view (a blogger's privilege), worrying sick is better than dying young. Could Tim Russert’s life have been saved by early, aggressive medical action? .. Like their patients, doctors differ. Some are aggressive, some more passive. Everyone has a point of view. That’s why there are books. And blogs like this one. Read them and see for yourself.

        But reading and warnings aren’t all we need. The night Tim Russert died, we had dinner with a Pulitzer Prize journalist. Shaken by Russert’s death, my pot-bellied husband and our girthy dinner companion skipped bread, potatoes, dessert.

        Until the next day. When the brownie brigade started marching again.

552 words

JUDAH FOLKMAN, ANGIOGENESIS PIONEER, IS GONE

Judah Folkman was too great a human being, too generous-spirited a physician, too humane a man, too brilliant a creative researcher in the field of angiogenesis and anti-angiogenesis for www.writingdoctor.typepad.com to let his death go unremarked on our pages.

Only 74, Dr Folkman was working on his computer in the Red Carpet Lounge of the Denver airport while waiting for his plane to Vancouver, where he was scheduled to give one of his unforgettable lectures. Suddenly he keeled over and died of an apparent heart attack.

He lived a long life--but not long enough. The son of a Reform rabbi in Columbus, Ohio, Judah Folkman went to Ohio State University when he was only 16 years old. There, he became the protege of Dr Robert Zollinger, an old-time surgical great. When he told Dr Zollinger that he wanted to go to medical school and become a surgeon, Zollinger put him in his surgical lab to do surgery on animals.

"You don't become a painter when you're 21," snorted Zollinger. "You don't become a composer when you're 21. You begin honing your skills when you're very young. And that's the way it should be with you and surgery."

So Judah Folkman began doing surgery in Zollinger's lab when he was 16. Four years later, when he applied to Harvard Medical School, Zollinger sent Folkman to Dr Francis Moore, the eminent chief of surgery at Boston's Peter Bent Brigham Hospital for an interview. Moore took Folkman into his lab and watched him operate on the animals there. Within minutes, Moore called the admission office to say, "Accept Folkman to the school. Now."

Thus, began his 40 years in Boston. Eleven years after begin graduated from Harvard Medical School in 1957, Folkman, at 34, became its youngest Professor of Surgery and Chair of the Department of Surgery at Boston's world famous Children's Medical Center. Director of the Vascular Biology Program at Children's Medical Center, Folkman's innovative research and unyielding determination led him to found the fields of angiogenesis and antiaangiogenesis despite the nay-saying of other physicians discounting his early theories.

His work on angiogenesis and antiangiogenesis lead to the development of many drugs that have saved the lives of patients with cancer and restored the vision of people with degenerative retinal diseases. Many cancer survivors are alive today, many victims of retinal disorders can see today because of Dr Folkman's dogged research and creativity.

But what the patients remember best is the kindness and communication of his patient care. He was always available, never cut patients short, listened, listened, and listened, and then advised and followed through afterwards. Dr Folkman found no detail too small, no chore too great a burden. He was never too busy for anyone's questions or problems.

Even though Judah Folkman had been on the short list for the Nobel Prize for several years, death beat the Nobel Committee to the punch.

We shall not see his like again. We can only hope that the countless medical students, residents, and researchers throughout the planet who were mentored and inspired by Judah Folkman, the man, and Dr Folkman, the great medical visionary and research activist, will burnish his memory by following in his very big footsteps.

Save Books and Book Reviews before It's Too Late

Like Miniver Cheevy—and me, today’s book reviewers have been “born too late.” As daily newspapers condemn the halcyon days of ubiquitous book reviewing to one “downsizing” one after another, books and their reviewers go by the wayside.

Since my days as a weekly book reviewer for the LA Times under the stern eye of Art Seidenbaum, book reviews and their reviewers have joined the league of buggy-whip manufacturers. The question is bigger than the dark future facing reviewers: Will books themselves, like horses who have run their race, be consigned to the soap factory—before the Kentucky Derby has even begun?

A headline in the New York Times asks pointedly: “Are book reviewers out of print?” More to the point, will BOOKS be out of print?. Can blogs replace printed reviews in newspapers as a resource? The answer is no, even from a blogarino like me. Too many blogs, too few readers, too sketchy a distribution leave book reviews—their reviewers and books themselves—on the outside looking in.

More questions arise than the Times addressed. Where, pray tell, will the books to be reviewed come from? Will publishers pick and choose among the plethora of blogs, seeking those that will come up smiling, with applause in every review? Can the random world of blogospheres produce thoughtful, non-partisan reviews? Or will books for review only go to a few golden-haired reviewers? Have free-lancers been lanced forever?

How will book clubs, much given to mid-list books, find literary analyses—NOT 50-100 word PR paragraphs—to advise them about the best books for discussion?

America has become the Land of Dumbing Down. Not only is our president semi-illiterate, but our media is following in his footsteps. Don’t blame Bush. It’s time to blame ourselves.

Whether you live in Atlanta, LA, San Francisco, or any place else where you have a daily paper, join the protest. Here’s the information to make a difference (we hope):

The NBCC campaign has over 4200 signatures on the petition protesting the cutbacks in Atlanta, a protest planned for Thursday down there -- if you're in the area and want to come, email me! -- and a whole slew of future events and panels set to go on the topic. If you haven't signed or seen the petition you can find it here:

http://www.petitiononline.com/atl2007/petition.html

Please do sign it and forward it, especially to friends in the Atlanta area. I believe we have a chance to make a difference.

Don’t just sit there. Hit those keys and do something.

Like Miniver Cheevy—and me, today’s book reviewers have been “born too late.” As daily newspapers condemn the halcyon days of ubiquitous book reviewing to one “downsizing” one after another, books and their reviewers go by the wayside.

Since my days as a weekly book reviewer for the LA Times under the stern eye of Art Seidenbaum, book reviews and their reviewers have joined the league of buggy-whip manufacturers. The question is bigger than the dark future facing reviewers: Will books themselves, like horses who have run their race, be consigned to the soap factory—before the Kentucky Derby has even begun?

A headline in the New York Times asks pointedly: “Are book reviewers out of print?” More to the point, will BOOKS be out of print?. Can blogs replace printed reviews in newspapers as a resource? The answer is no, even from a blogarino like me. Too many blogs, too few readers, too sketchy a distribution leave book reviews—their reviewers and books themselves—on the outside looking in.

More questions arise than the Times addressed. Where, pray tell, will the books to be reviewed come from? Will publishers pick and choose among the plethora of blogs, seeking those that will come up smiling, with applause in every review? Can the random world of blogospheres produce thoughtful, non-partisan reviews? Or will books for review only go to a few golden-haired reviewers? Have free-lancers been lanced forever?

How will book clubs, much given to mid-list books, find literary analyses—NOT 50-100 word PR paragraphs—to advise them about the best books for discussion?

America has become the Land of Dumbing Down. Not only is our president semi-illiterate, but our media is following in his footsteps. Don’t blame Bush. It’s time to blame ourselves.

Whether you live in Atlanta, LA, San Francisco, or any place else where you have a daily paper, join the protest. Here’s the information to make a difference (we hope):

        The National Book Critics Circle campaign has over 4200 signatures on the petition protesting the cutbacks in Atlanta, a protest planned for Thursday down there -- if you're in the area and want to come, email me! -- and a whole slew of future events and panels set to go on the topic. If you haven't signed or seen the petition you can find it here:

http://www.petitiononline.com/atl2007/petition.html

Please do sign it and forward it, especially to friends in the Atlanta area. I believe we have a chance to make a difference.

PLEASE! Don’t just sit there. Hit those keys and do something save books.