Medical Money

It turns out that a standard treatment for thyroid cancer—swallowing radioactive iodine—could cause problems for people other than patients. According to a recent article in The New York Times, “Scientists have estimated that . . . a secondhand dose could exceed an average American’s annual level from all natural sources, and three or four times the safe level recommended for a pregnant woman.”

Patients undergoing radioactive treatment used to be quarantined in the hospital (as they still are in Europe). But in 1997 our Nuclear Regulatory Commission dropped the requirement; now patients go home, encountering any number of vulnerable people along the way, and some check into hotels, where another group of strangers could be exposed.

Not everyone thinks there’s a danger, however, as the Times article reports. "'We’re talking about really small doses,' said Dr. Henry D. Royal, the associate director of nuclear medicine at the Mallinckrodt Institute of Radiology at Washington University. 'Who is it going to harm?' added Dr. Royal, who is on the executive board of the American Nuclear Society."

Who will it harm? How do we know?

This is one of our biggest problems in medical care today: who do we believe? In this case, do we believe a group of scientists and endocrinologists? Or do we trust nuclear medical doctors? Don’t we at least question the recommendation of those most invested in the status quo?

These sorts of questions arise every day. Is the information gleaned on a CT scan worth the dose of radiation received? Is it necessary for an 80-year-old patient to undergo a colonoscopy? Is the long-term use of any drug unequivocally safe?

The answer to all of these questions is muddied by money. In every case, industries and individuals make a bunch of money from the recommended treatment. In many cases the industries that stand to benefit fund the research itself. Conflicts of interest in medicine can make you dizzy.

We’re left with this fundamental problem of our medical care: As long as our health depends on profitability, we will never be the healthy society that we could be.

Medical Menus

"Please listen carefully as our menu options have changed."

No matter which clinic you call at Duke University Medical Center, you're greeted with this recorded message. It's offensive on several fronts. First, the admonition to "please listen carefully" feels like you're in kindergarten. No doubt many choose the wrong option, but this probably has less to do with careless listening than with honest confusion.

Second, the phrase "menu options" suggests that you are at a restaurant, which you most certainly are not. Navigating the menu--whether it's to reschedule an appointment or to resolve a bill--is about as far from enjoying a delicious dinner as you can get.

Finally, the statement that the "options have changed" is fundamentally dishonest. If it were true, the options would change constantly, on a daily or weekly basis. They don't. Rather, the phrase is a ploy to reinforce the opening directive to "please listen carefully."

So we're back where we started. Irritated and annoyed and distracted: primed to choose the wrong option.

Liberty Central's Olive Branch

Just when the stories of bizarre behavior of political candidates seem to have crested, along comes the news of Virginia Thomas contacting Anita Hill for an apology. Readers’ opinions expressed on the internet are as varied and as strange as the story itself. But make no mistake: anyone who thinks that Ms. Thomas’s action is personal and not political is naïve.

When Anita Hill testified in 1991 against Clarence Thomas—current Supreme Court Justice and husband of Virginia Thomas—three main undercurrents in American culture came out from hiding. The ugliness of race, gender, and power intersecting with sexual harassment could not be denied. Whether or not you believed Anita Hill’s testimony at the time, the tension was as real as it gets.

Fast forward to 2010, when a black man sits at the top. Those of us who are white and accustomed to people of color tipping their hats to us and saying, “Yes, ma’am” and “Yes, sir,” are now on the other side of the hat. Our troops salute a black man, and our fashion magazines highlight a black woman.

Anyone who thinks that the current rage among Tea Partyers and other angry Americans isn’t driven by this race reversal is naïve.

Virginia Thomas, the founder of a new conservative, activist group called Liberty Central, knows what she’s doing. Married herself to a black, powerful man and an experienced politico in her own right, she commands all of the necessary tools to exploit the racial tension that lies at the heart of America—and that lies at the heart of this November’s election. Digging up Anita Hill, under the guise of an “olive branch,” was a brilliant move.

There’s a war going on. And it’s not just in Afghanistan. It’s right here in America, on the internet, on FOX news, and on talk radio. It’s as obvious as Republican candidate Sharron Angle telling a classroom of Hispanic children in Las Vegas that “Some of you look a little more Asian to me” or as subtle as Ginni Thomas leaving a voicemail message that says, “O. K., have a good day.”

Anyone who thinks that this war is going away any time soon is naïve.

Summer Days Driftin' Away

As the leaves start to fall and the earth travels far from the sun, I remind myself to keep alive the memory of the summer. Melancholy takes hold. A simple bucket of flowers can help.

Pretty in Pink

Pink is everywhere this month, even on the golf course. But as lovely as this muhly grass looked yesterday, I couldn't help but think of all the breast cancer pink we see in October. It may be too much, and it may not be the right shade of pink.

As Barron Lerner describes in his discussion of Gayle Sulik's new book--Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health--many of the corporate sponsors of Breast Cancer Awareness Month are themselves pharmaceutical companies invested in the manufacture of cancer drugs. With cancer funding heavily weighted towards treatments and awareness rather than prevention, these sponsors may represent a conflict of interest. Indeed, a key part of Sulik's book is her analysis of the “financial incentives that keep the war on breast cancer profitable.”

Lerner does not dismiss the efforts of the Komen Foundation and other fund-raising groups. He captures, though, the frustration that many activists feel with a funding culture that doesn't sufficiently sponsor research into the causes of breast cancer.

Ubiquitous pink is a reminder of a devastating disease. Perhaps someday it can be the symbol of successful eradication.

Dolls, Dolls and More Dolls

The Doll and Miniature Museum in High Point, North Carolina, is a reassuring place to visit. Tended by staff who clearly love dolls, it manages to survive in our inhospitable economic climate.

Worn out by so much disturbing news--from millions of secret dollars spent on political campaigns to mean-spirited violations of privacy on the internet--I was glad to be somewhere innocent and wholesome.

Hooray for all of the little museums around the country doing simple, humble work. Heroes still exist; you just don't find them on the news.

A Dog's Life: Sundance

Even the word "regal" doesn't do him justice.

Karkinos

My hairdresser is offering pink highlights this month, the proceeds of which will support breast cancer research. A friend told me today of two women with ovarian cancer. Family members are ill with this disease. Does it seem to anyone else that cancer is everywhere?

Wondering why the name cancer springs from the Greek word for crab, I discovered that Hippocrates coined the term based on the crab-like appearance of tumors. The website About.com provides us with this additional historical information:

"Today, we know so much about the human body; however early Greek physicians weren't so fortunate. Hippocrates believed that the body was composed of four fluids: blood, phlegm, yellow bile and black bile. He believed that an excess of black bile in any given site in the body caused cancer."

This statement gives me pause. Do we really know much more about the origins of cancer than Hippocrates did? As one who has suffered this disease, I think he's on to something. Cancer often comes roaring out of nowhere with no discernible cause. It follows its own unpredictable course, having stumped generations of doctors and scientists.

An accumulation of black bile in the body seems as accurate as anything else I've ever heard.