Sunday, June 28, 2015

Knockeing on Heaven's Door

By Katie Butler

Butler and Her Parents

This is an honest, sobering look at what awaits so many elderly people and their caregivers, who are often family members.  It is also the story of a Medical-Industrial Complex gone wild:  doing things to people for economic gain.  Expensive procedures that have serious unintended consequences are, unfortunately, the rule.  For a variety of reasons, many physicians perform lucrative tests and interventions that do little to improve patients’ well-being.  Death is seen as the ultimate enemy, yet we all will die.  How one dies is important, yet this is not considered often enough.

Knocking on Heaven’s Door is the story of a singular family.  All families are unique.  The narrative is memorable, but there is much more.  Butler discusses American medicine and its domination of patients and families, and suggests ways we as patients and family members can try to protect ourselves.  It is also a wake-up call for physicians to try to change our behaviors from running profit centers to being caregivers in the true sense of the word.

These notes may help some of you who are too busy to read the entire book, however, should you do so, you will find much more to interest you.  I learned a lot by a fairly careful reading of Katy Butler’s book, much that will help me as a son, a caregiver and a physician.

Saturday, May 23, 2015

Chasing the Scream

by Johann Hari

Mount Hope May 23, 2015
I am sitting at Mount Hope on a cool clear day. The vista is beautiful. Not a cloud in the sky and the air is filled with birdsong. Here are some excerpts taken from the introduction to Johann Hari's remarkable book.

Lady Day
"How do we react to addicts and the war on drugs? We all know the script. Treat addicts and drug users as criminals. Coerce them into stopping. This is the prevailing view in almost every country.

Hari used to think that way but has changed his mind. He now argues instead for a second strategy – legalize drugs stage by stage, and use the money we currently spend on punishing addicts to fund compassionate care instead."

The journey that he took to research and write this book took him across nine countries and 30,000 miles and it would last for three years. The story is a compelling read.

Drugs are not what we think they are. Drug addiction is not what we have been told it is. There is a very different story waiting for us when we are ready to hear it. Pick up this book and read.

Cast of Characters (in order of appearance)
Harry Anslinger: Bureau on Narcotics "godfather."
Billie Holiday: Jazz singer hounded to death by Anslinger
Arnold Rothstein: NY drug/alcohol lord
Chino Hardin:  FTM drug dealer turned activist/reformer
Leigh Maddox:  Policewoman/lawyer who once stalked addicts and now he workswith LEAP (Law Enforcement Against Prohibition)
Sherif Joe Arpaio: Arizona reincarnation of Harry Anslinger.
Prisoner number 109416 (Marsha Powell): small time drug user and victim of Arizona "justice" system.
Gabor Mate:  Family physician from British Columbia who is helping drug addicts on the front line.
Bruce Alexander: a psychologist at SFU in Vancouver. He worked on a Rat Park study that showed it's the environment which creates addicts not biology.
Bud Osborn: An addict and an activist who organized the Downtown Eastside drug users and got them recognition and respect.
John Marks: Liverpool psychiatrist who ran a drug prescription clinic and saved many lives until the British government disbanded it.  He self-exiled himself to New Zealand.
Ruth Dreifuss as president of Switzerland, she approved the establishment of drug distribution centres.
Jose Mujica: The anarchist president of Uruguay who implemented legalization of many drugs.
Mason Tvirt: Activist in Colorado who spearheaded that states campaign to legailze marijuana.  He fought against Hickenlooper -- the CO governor.
Tonia Winchester: An attorney who led a successful campaign to decriminalize marijuana in Washington state.

The author, Johann Hari, did a masterful job here.  When I looked at his Wikipedia page, I was surprised to learn some disquieting facts about him - but feel they only make him a more scrupulous reporter her.

Tuesday, May 5, 2015

Amy Tan on Lyme Disease

This is a sobering and compelling pathography by a world-renown author.

I used to brag that I never got sick. I rarely came down with colds or the flu. I had health insurance for catastrophic illness and only used it once, for surgical repair of a broken leg, the result of heli-skiing, the sport of a vigorous and fearless person.

But in 1999, all that changed. I learned what it is like to have a disease with no diagnosis, to be baffled by what insurance covers and what it does not, and to have a mind that can’t think fast enough to know whether a red traffic light means to press on the gas or hit the brakes. I have late-stage neuroborreliosis, otherwise known as Lyme Disease. The neurological part reflects the fact that the bacteria, a spirochete called borrelia burgdorferi, has gone into my brain.

Read full article: SLyme Disease: How A Speck Changed My Life Forever

Image from the article

Missoula (2015)

Krakauer's book, Missoula, is focused on the most common type of rape:  non-stranger sexual assault.  While it reports from a Montana college town, Missoula's rape statistics are about average for the U.S.

The book has been criticized which is not surprising, however, I have read it twice and find it convincing and sobering.  Alcohol seems to be an almost-constant factor.  Alcohol, jocks and naive students -- female and male.

This is a hugely important topic and Missoula is an important introduction.  Probably, everyone in high school, college, or with children at these stages should read it.  Educators are another important audience.

Tuesday, March 10, 2015

Witness to Resilience: Stories of Intimate Violence

Witness To Resilience is about everyday women who have endured domestic violence in silence and secrecy. They're your mother, sister, daughter, friend, neighbor, and colleague. Jane  Seskin's poems chronicle her more than twenty years working as a psychotherapist with survivors of intimate violence. These are brutal stories told with compassion and love.

I found this slim volume to be moving beyond what words can express.

Monday, February 23, 2015

Even Doctors Cry by Alvin Reiter, M.D.


1. Redemption: There is a belief in restorable health.
2. Quest: A person journeys through and faces suffering head on in the belief that something is to be gained from the illness experience
3. Chaos: When people are overwhelmed by the intensity of their illness, to speak coherently becomes impossible.   This is the most frequently unheard narrative because listening to chaos stories can be painful and frustrating

Add caption
Alvin Reiter's book, Even Doctors Cry, is, for the most part, a "chaos" narrative. It tells the story of an E.N.T. surgeon from his upbringing in the Bronx, through college, medical school and training as a head and neck specialist concentrating on cosmetic facial surgery, through personal illness (non-Hodgkin's lymphoma) legal problems stemming from billing irregularities, to his wife's complicated breast cancer trajectory.

In some ways, this book reminded me of Saul Bellow’s picaresque novel The Adventures Augie March. There were many unexpected twists and turns and Dr. Reiter was on a strange and tragic voyage from the Bronx to Beverly Hills. He paints himself as a naif swimming with the sharks of private medical practice and academia.  His, and his wife Karen's, encounters with the medical system are frustrating, maddening, and ultimately tragic. Are they the norm for Doctor-Patient relationships in our country?

Dr. Reiter learned a lot from his misadventures as a physician and a patient.  Along the way, he has become a patient advocate. I, for one, would like to hear more of his suggestions on improving communication and care.

Even Doctors Cry is a captivating book that kept my interest from one vignette to the next. Mostly is set in the strange and materialistic venue of Beverly Hills. The small towns that I have spent my professional life in are quite different, however, many of the physicians that I have encountered have doppelgängers in Southern California.

Reiter tells us, "In our society, we trust our tax returns to accountants, our wills to lawyers, our food to farmers, our cars to mechanics. To physicians, though, we entrust our very lives, without which the rest doesn't matter. As a doctor who loved his practice, his patients and prided himself on the care he provided, I was unprepared to find a medical profession so flawed, falling so short of any level of care, that it caused the death of my wife, Karen.

Earlier, he quotes Ellie Wiesel, "Whoever survives a test, whatever it may be, must tell the story." Reiter does this in a captivating way and all who read this book will learn important lessons.

(reviewed by David Elpern)

Tuesday, May 27, 2014

My Path Leads to Tibet (2003)

The Inspiring Story of How One Young Blind Woman Brought Hope to the Blind Children of Tibet, by Sabriye Tenberken
Defying everyone's advice, armed only with her rudimentary knowledge of Chinese and Tibetan, Sabriye Tenberken set out to do something about the appalling condition of the Tibetan blind, who she learned had been abandoned by society and left to die. Traveling on horseback throughout the country, she sought them out, devised a Braille alphabet in Tibetan, equipped her charges with canes for the first time, and set up a school for the blind. Her efforts were crowned with such success that hundreds of young blind Tibetans, instilled with a new-found pride and an education, have now become self-supporting. A tale that will leave no reader unmoved, it demonstrates anew the power of the positive spirit to overcome the most daunting odds.

Can be obtained from ABE Books for $0.01