If I would decide how hospitals are governed (and I don’t), these would be important points for me:
1. Food: Thy food be thy medicine – and vice versa – Hippocrates said. What is served as “food” in hospitals these times, is mostly abysmal and just goes to show that conventional medicine is not interested in really finding out the root cause of disease. In many cases, it is nutrition, stupid!
2. Cafeteria: Same for the place where all the visitors come and eat. It could be an educational experience, instead just another gorging with inferior foodstuff, filled with chemicals, trans-fats, sugars and dairy.
3. Quiet: When I was a child in Germany, and my father was a doctor, he used to take me on his rounds. Hospitals then were very quiet places. The nurses (often nuns) would walk on their rubber soles like on cushions, and they spoke with low voices. The doors to patient rooms were double doors – the patient had privacy and quiet.
4. What hasn’t changed much: That the hospital routine is not geared toward patient recovery but to a ward schedule convenient for doctors and nurses: Then as now patients are pulled out of sleep to measure their temperature or draw blood tests at four am. I would like to see more concern for the patient’s wellbeing than for the organization’s.
5. No TV in patient rooms: My guess is that at least seventy percent of all illness is self-inflicted. It used to be that being in the hospital was a time for contemplation about what brought one there. Not any longer – as TV is squeaking and squealing day and night.
6. Conventional and complementary medicines are BOTH used. There should be no bias toward the one or the other – what has been proven to work should be applied: Hydrotherapy, movement therapy, food, herbal medicine and art, music, journaling, acupuncture, massage, and so on – they all should be used to make patients better. As they are in most European hospital. And paid for by national health insurance. And, no, they are NOT going to be broke …
7. More cleanliness in the facilities. More cleanliness of the patients. Used to be that hospital were spic-and-span places where you could eat from the floor; not any longer. Instead of on cleanliness we trust in antibiotics – to our detriment. Same with patients’ cleanliness: Used to be that nurses washed the patients daily; not any longer. Nurses have gone scientific (necessarily so – but who is now responsible for caring?); the paperwork has become overwhelming. Housekeeping has been out-sourced. And simple ideas like a washing and cleaning have become obsolete. But hospital infections are skyrocketing.
8. More friendliness and caring toward the patient. The patient has become a moneymaking device.
9. Less care and resources to be spent on very old, very sick people in their last days of life – more on pediatric and under-served populations. DNR (Do Not Resuscitate orders discussed with every patient and/or every family). It will lead to savings of money and will allow people to die with dignity.
10. In medical schools, only half of the students should be A+ nerds; the other half should be people who really want to become doctors and patient advocates from all walks of life. We need very brilliant students because they push medicine’s frontiers ahead. But we also need caring primary care physicians. And putting them together in medical school will hopefully lead to a dialogue between them.
As I am thinking more about this, I might come up with more ideas. What would you wish to implement in the hospitals of the future? Read More
Blog: On Health. On Writing. On Life. On Everything.
Ibuprofen And Aplastic Anemia
October 16, 2011
This is the story of a friend’s friend – no statistics behind it, no big scientific study double-blind, randomized, placebo-controlled - nothing but anecdotal evidence (and you won't see a study done on this soon!). But a poignant story anyway, and a reminder:
A woman in her forties was in quite good health, as it seemed, until one day, she got weak and ill, and was diagnosed with aplastic anemia.
Aplastic anemia is a very serious diagnosis. It means the bone marrow is not churning out the required number of blood cells necessary for survival, and her physicians recommend a bone marrow transplant to her.
One of the doctors told her that her platelet count was so low that she might start bleeding anytime (most worrisome is bleeding into the brain), and said that, as a minimum, she should stop all aspirin or ibuprofen (or any drug in that family of painkillers) as those might increase the bleeding risk.
Now this woman had taken high doses of ibuprofen on the advice of her GYN doctor for uterine fibroids and terrible cramps. She heeded the advice, stopped all pills, and slowly but surely, her blood cell count crept higher and higher, until it became clear that she did not need new bone marrow at all.
When I came to this country many years ago, I found that in a drugstore one could buy bottles of a thousand aspirin or ibuprofen pills. In Germany, one bought them in little tubes with ten or twenty each. That’s not only a difference in size: It is a difference in cultures: When you have a headache in Europe, you ask why you have the ache (nagging husband, too much sun, too much TV, too much booze, too little sleep, no exercise – the list is endless). You try to change the root cause of the pain. Here, you take a pill.
This woman had a good reason to take ibuprofen – her fibroid cramps – and took them under the supervision of a physician – and still, it nearly killed her. Ibuprofen can have bad effects on the kidneys, the liver, the stomach lining – and thousands people die each year of internal bleeding. Aplastic anemia is exceedingly rare. But this story illustrates that no drug is without side-effects and we need to have a healthy respect of any drug we put in our bodies.
Most painkillers are taken against headaches and menstrual cramps. Why not try natural methods first? More sleep, more movement, healthy fresh foods, water instead of soft beverages, less sugar and salt before periods, skullcap tincture against cramps – one has so many healthier options! Read More
Invasive Plants 2: List
October 11, 2011
My home state publishes a list on invasive species for Massachusetts, and also defines which criteria a plant has to meet to be labeled “invasive”:
1. It is not native to Massachusetts
2. Must have the “biologic potential for rapid and widespread dispersion and establishment”
3. Must have the “biologic potential for dispersing over spatial gaps away from the site of introduction”
4. Must have the “biologic potential for existing in high numbers” away from gardens
5. Must have been introduced to Massachusetts already
The real text is a bit more cumbersome and bureaucratic – but we get the idea. There are tons of species on the lists, but here are a few from the list I would add to my list (this is arbitrary and based on my very personal experiences as a gardener at a single spot in Massachusetts – you might have a different opinion; it is worthwhile finding the list of invasive plants for your state!):
1. Japanese barberry – it stayed a single beautiful bush in my garden. But of course I can’t know to which places birds dispersed its seeds
2. Bittersweet. There are two bittersweets, with orange berries. One Celastrus scandens, the "American bittersweet" is non-invasive. The Asian or Oriental bittersweet is Celastrus orbiculatus, highly invasive. And it is the plant I called euonymus which I was familiar with from Europe. It seems, celastrus and euonymus are related species, and it is really the Celastrus orbiculatus that is so overly invasive. This vine’s berries are spread by birds, and the plant can strangle even trees. One of the worst I know – I would not plant it, and I am hacking it down wherever I meet it.
3. Purple loosestrife: Years ago, I bought a “butterfly bush” by mail order. It turned out to be purple loosestrife. As much as I try to eradicate it, it comes always up somewhere.
4. Wild rose (Rosa multiflora) is pretty while in bloom. But it flowers only once, and after flowering I always cut it of so it doesn’t set seeds. The rootstock, however – I’ll never get it out of my garden again.
5. Privet (Ligustrum vulgare) – it was in my garden when I moved in. It also might be another species as they are notoriously hard to identify. As often as I cut it back, it always pops up again.
6. Pennisetum, a vertically striped grass. Beautiful white and green. It is not invasive according to the Massachusetts definition, but like wisteria, it wants to take over my garden. There is a horizontally striped grass (Miscanthus sinensis) that might also become invasive – luckily, I never planted it.
7. White mulberry (Morus alba). Twice I planted a mulberry tree in my garden – mail orders. Twice they were not what they were advertised at: black mulberries. I wanted one in my garden desperately so that for once we can harvest our cherries before the birds do. Twice I had to hack down the tree because it grew as fast as Jack’s beanstalk – and did not deliver.
Now, our alphabetical list looks like this:
1. Bamboo (more than 70 genera in the Poaceae family)
2. Bermuda grass (Cynodon dactylon, also: Panicum dactylon, Capriola dactylon)
3. Bindweed (many species from the Convolvulus or Calystegia families)
4. Bittersweet (Celastrus orbiculatus)
5. Blackberries (Rubus spp.)
6. Burdock (Arctium lappa, and other species of Arctium)
7. Canada thistle (Cirsium arvense)
8. Chickweed (Stellaria spp.)
9. Crab grass (Digitaria spp. )
10. Dandelion (Taraxum officinale)
11. Ground ivy (Glechoma hederacea, also: Nepeta glechoma, Nepeta hederacea)
12. Japanese barberry (Berberis thunbergii)
13. Johnson grass (Sorghum halepense)
14. Kudzu (Pueraria lobata)
15. Miscanthus (Miscanthus sinensis)
16. Nightshade vine, bittersweet nightshade (Solanum dulcamara)
17. Pachysandra (Pachysandra terminalis)
18. Pennisetum (Pennisetum spp.)
19. Pokeweed (Phytolacca americana)
20. Privet (Ligustrum vulgare).
21. Purple loosestrife (Lythrum salicaria)
22. Purslane (Portulaca oleracea)
23. Quackgrass, also: couch grass (Elytrigia repens, also: Triticum repens, Agropyron repens, Elymus repens)
24. Raspberries (Rubus spp. – like the blackberries)
25. White mulberry (Morus alba)
26. Wild rose (Rosa multiflora)
27. Wild wine (Vitis labrusca)
28. Wisteria (Japanese: Wisteria floribunda; Chinese: Wisteria sinensis)
29. Wormwood (Artemisia absynthium)
Sorry, compiling all this, takes longer than thought. In the next installment, we will hopefully discover the medicinal value of some of these invasive plants – the idea being, if we harvest and eat them, they will be less invasive. Read More