Thursday, April 26, 2007

Alternative Care: "Voodoo Magic" or Something to Consider?

In my teens I had the unpleasant experience of watching my father struggle with the battle against pancreatic cancer. He was diagnosed early enough, Doctor’s thought, that after surgical removal of the tumors and subsequent bouts of chemotherapy and radiation, he would win his battle. However, this was in 1996 when the chemotherapy drugs out on market were still relatively new and as result there were only a few medications present that were known to lessen the inevitable side effects; severe nausea, vomiting, sensitivity to light and sound, hair loss and overall feeling of pain. These chemotherapy-counter medications had promise of minimizing side effects in efforts to keep him healthy enough to continue therapy and radiation. Unfortunately, these new medications had their own side effects, which when compared to chemotherapy were not as bad, but still notably uncomfortable for most patients; severe to moderate constipation, lack of appetite, and moderate nausea. However, as my family discovered, yet more medications were needed to counter the side effects of the medications that were to counter the side effects, of chemotherapy and so on.

After about a year of this struggle, and a daily diet of 30 pills, the routine storm of side effects had taken its toll; my father had now reached the point where chemotherapy could no longer be continued as his body, stripped of weight, could no longer take the abuse. Fortunately, a family friend aware of the predicament my father was in, recommended him to an alternative medical healer. Though our primary physician told my father not to invest any false hopes in this “voodoo magic, mumbo jumbo,” with no other treatment available, and tired of relying on the barrage of pills for pain relief, he went.


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U.S. Healthcare In Crisis?

Currently in the United States, we spend about $1.9 trillion annually on healthcare (including physician fees, insurance fees, treatment and procedural fees etc). If this seems like a lot, that’s because it is. This conservative estimate roughly equates to spending $5,670 per person, per year. As one of the worlds most industrialized nations, we spend more on healthcare than any other country. Switzerland, for example has the second highest annual healthcare expenditure rate at $3,446 per person; $2,224 less than the United States. Considering these facts one might naturally expect that Americans are receiving higher quality healthcare for their dollar. But, is this the reality?

Thursday, April 5, 2007

The Spirit Catches You

The Spirit Catches You and You Fall Down by Anne Fadiman is an essential read for every prospective medical student. The book follows the medical trials of a young epileptic child named Lia Lee and the doctors that treated her. As a prospective medical student myself, I was astonished by the many instances of cultural collision that arose due to the disregard for the practices and beliefs of Lia’s family (the Hmong people).

One of the main themes Fadiman uses to raise concern for cultural respect centers around Hmong spirituality. She describes the Hmong people as being very spiritually focused, so much so that they believed that illness and death could all be attributed to the loss of one’s soul. Additionally, Fadiman mentions the fact that in western medical schools, there is little or no instruction on cross-cultural medicine. As such we understandably find that it was out of the realm of possibility for a western doctor to even contemplate that the disease (of Lia) was caused by fugitive souls or cured by chickens that have had their throats cut. This is just one of many problems Fadiman mentions to illustrate the need for cultural sensitivity in the medical field.

The most powerful thing about Fadiman’s book is not only its emphasis on the significance of cross cultural awareness, but on the importance of communication in the doctor-patient relationship as well; two tools that are crucial to any good doctor.