About this subject I do write with trepidation – as the right answers are still not known – medicine and science have not advanced far enough to let us make rational decisions. In actuality, regarding mammograms, we are living in something like medieval times.
Do mammograms help prevent cancer? No, they don’t. They do find some cancers. But they also “find” an unacceptably high number of “cancers” that aren’t cancers - false positives. For which women then undergo unnecessary treatment.
Do mammograms prevent deaths from cancer? The answer is amazingly unclear: For the longest time – basically for the entire twentieth century - namely since the advent of radical mastectomy, breast cancer death numbers didn’t budge. In the last few years, we seem to make a little dent. But it is not clear to me if it comes from therapies, or from better lifestyles that women have adopted - similar to the improvement of cardio-vascular health that happened mostly in the kitchen and the gym, not in the doctor’s office.
For thirteen years now I have not done a mammogram. Not because I try to be reckless, but because I have my doubts. In a way, I am sticking my head in the sand (breast cancer runs in my family). On the other hand, I have a history of heavy radiation as a child, and mammogram certainly is adding to my risk to develop breast cancer. You could say that I made a decision rather to die of breast cancer than from breast cancer treatment. You don’t have to follow me here – or rather, I don’t want you to follow me here because I shudder of the responsibility I would take on if I talked you out of mammograms. In reality, I always encourage my patients to have their yearly mammograms – regardless of the personal doubts I am harboring.
Because of my childhood radiation history – I had bad tuberculosis as a child with tons of fluoroscopy - my decision not to add any more radiation (I also have myself padded down at airports rather than going through the screening machines) is not applicable to everyone. In addition, I had mammograms since age eighteen every year because of lumps (and twice had lumps removed that turned out to be benign. So, I had an unusual number of mammograms - enough for a lifetime, I think. My doctors, because of my history, are basically waiting for me to develop breast or thyroid cancer. But over the years I came to realize that the real causes for breast cancer - diet, exercise and environmental pollution, including radiation - are not addressed by physicians and authorities. But I want to encourage every woman to come to her own decision. Every case has different variables.
Lately I am also changing my thinking about cancer generally - not that one person has it, and the other person doesn't have it. Truth is, at a certain age, we probably are all always having cancerous cells in us, and keeping them at bay as best as we can we good lifestyle habits seems to be much more important. - I also have a body that would react badly to any kind of treatment - so I rather am putting my energy into a good lifestyle. And cancers in later years are often less aggressive than cancer in children and young adults.
And a last thought: Medicine is yet is unable to differ between "bad" cancer and "good" cancer - we don't know which one will explode and kill a patient. So we are working with big guns on all cancers. It seems to me that surviving cancer has more to do with which type your cancer is and how good your immune system works than with any treatment. This argument is also very applicable to prostate cancer in men.
If I would find a lump, I certainly would have it removed surgically. If I get "exploding" cancer, I hope I will die gracefully. Not knowing if I already have such a time bomb inside me, I make sure I walk every day during daylight to get my daily dose of vitamin D and exercise, I eat my veggies and drink my green smoothie, I keep my animal flesh consumption low (but I don’t advocate vegetarian or vegan lifestyles), I take a daily cold shower or cold sitzbath to strengthen my immune system, and I make sure I sleep long before midnight so that my body can catch bad cells and repair what is broken – before it explodes.
The rest is not in my hands. Read More
Blog: On Health. On Writing. On Life. On Everything.
My Hospital Manifesto
October 30, 2011
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
The Roots Of Philosophy
September 9, 2011
After the summer reading extravaganza of novels, I am back at my usual non-fiction fare – medicine, Chinese history, general history, philosophy, herbs and botany, music – whatever catches my interest.
Last night, in a biography about the German philosopher Theodor Adorno I came across a sentence of his that took my breath away. Took my breath away because the “Critical Theory” is more known for its political stance than for soft-hearted fuzziness. Took my breath away also because it expressed a sentiment that I thought belonged more to my private musings than in a philosophy context.
“Philosophy actually exists in order to redeem what is to be found in the gaze of an animal.” (p. 255, Detlev Claussen, Theodor W. Adorno – One Last Genius).
The book is uneven: It suffers from the contradiction that Adorno (and Claussen) think that biography is impossible after two World Wars and the Holocaust – and then Claussen wrote a biography after all. Topped by calling it “One Last Genius.” Adorno must be a-squirming in his grave; he definitely did not believe in the concept of “genius.”
“Philosophy actually exists in order to redeem what is to be found in the gaze of an animal.”
This says we are not different, not apart from Nature – and that one day we will be asked what our responsibility was in the destruction of the Earth with all her plants, animals and humans. - Last night my nephew called from San Diego to tell about the huge power outage of southern California and parts of Arizona, Nevada and New Mexico. It had been sweltering hot there for days, and the “system” collapsed.
As a citizen, I ask myself if there were not warning signs and if this collapse could have been prevented by astute officials running the Californian power grid - and I would fire the higher ranks at the power stations. As a person I think that not everybody who had the air conditioner running on “high” really needed it for medical reasons. Neither the power station managers nor the general public had the common good in mind, it seems.
Animals have already what we have lost: The deep gaze on what is important, and what is not. I am not a died-in-the-wool animal rights defender because I still maintain that people are more important. But one can push that argument only so far before we land at the fact that we, too, are animals, and not so highly developed ones in many cases. We produce wars, famines, orphans, pollution, hatred – to name a few human accomplishments.
We need to be taught by philosophy what matters; animals know it. And in their eyes you can read it – if you want to see it. Read More