When did we start calling the whole day before Christmas "Christmas Eve?" I thought Christmas Eve was the evening before Christmas. But no. Senators voted on health care reform at 1:00 AM on Thursday December 24th. To me, that's still Wednesday night, but it was widely reported as happening on Christmas Eve. Perhaps publishers want to save ink. Or we live in such fast times that it takes too long to say "The day before Christmas."

Anyway, here's a flock of interesting stories I've come across recently.

Aging, end-of-life, and death

The Breadth of Hope, Selling Hope, and More on Quelling Thanatophobia, (Pallimed: A Hospice & Palliative Medicine Blog)
One unspoken message behind the "sell hope for a cure" ads is "we will not only cure your cancer so that you can avoid death, but we'll also make it so it's a non-issue in your life so that you can return to the way things were before. It'll kind of be like getting your car's air conditioner recharged."

I'm generally sympathetic to the benefits of alternative therapies. That's not surprising given I've studied, practiced, and taught alternative therapies, in addition to having a PhD in the History of Science and Medicine. There are times, however, when I totally understand why some members of the medical profession are so vehement in their condemnation of alternative "medicine."

Case in point: A recent post on KevinMD, in which Dr. Amy Tuteur writes: "'Alternative' health practitioners are nothing more than quacks and charlatans and their 'remedies' are nothing more than snake oil. The fact that anyone in this day and age still believes in such crackpot theories is a tribute to the power of ignorance and superstition."

This past summer, thanks in large part to Sarah Palin, we were inundated with sound bites about death panels, pulling the plug on grandma, and saving the government money by dying a little sooner.

Palin's emotionally manipulative Facebook post appeared on August 7. "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

A great deal of misinformation was bandied about, and unnecessary fears were purposely inflamed to gain political advantage. There may be a silver lining to this cloud, however.

Nearly half of students in US medical schools are female. Studies show that, compared to their male counterparts, women doctors are friendlier, spend more time with their patients, and are less likely to be sued.

According to Jorge Girotti of the University of Illinois at Chicago Medical School, women doctors are more empathetic, compassionate, and nurturing. "If you bring that attitude in, you're more likely to see the overall patient as a whole rather than just a disease."

I collect stories of how the doctor/patient relationship has changed over the last half century. There's a new generation of doctors and patients who've only known the 12-minute office visit. For them, an extended, personal conversation between a patient and her physician is as antiquated as Marcus Welby, MD.

In the 12 to 15 minutes allotted to a patient, discussion is necessarily limited to the immediate symptoms. There's no time to understand the context in which the patient lives, works, and loves. For that type of holistic understanding patients seek out alternative medicine, which they do in increasing numbers. Now that anti-depressants are more cost-effective than talk therapy, conventional vs. alternative medicine is the new division of labor.

Here's a second installment from the documentary Money-Driven Medicine. The producer, Alex Gibney, is an Oscar-winning filmmaker (Enron: The Smartest Guys in the Room). See the previous post for the first installment.

Bill Moyers: "Money-Driven Medicine is one of the strongest documentaries I have seen in years and could not be more timely. The more people who see and talk about it, the more likely we are to get serious and true health care reform."

"After I had berated the patient for his obvious failure to comply with my recommendations to correct his 'misbehavior,' he said, 'You know, doctor, there is more to life than good health.' These words have helped me rein in my sometimes overzealous attempts to force patients into that glorious state of wellness and maintain a more realistic approach to the best possible state of health." (Lewis E. Foxhall, M.D.)

Patients who fail to follow a doctor's orders are labeled noncompliant. In the current national conversation on health care reform, noncompliant patients are one of many targets blamed for rising costs. If only everyone took their meds as directed, lost weight, exercised more, and used less cocaine, we wouldn't be in such a mess.