:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Thursday, September 30, 2004  

Presidential debate drinking party at our place, and the soft bigotry of low expectations

Tonight, we're inviting some folks over to our apartment to drink with us as we watch the first presidential debate. It's going to be a depressing experience overall, as it's going to have the atmosphere of buzzwords and fanfare and paragraphs carefully pre-prepared. No excitement in that. And the media will undoubtedly repeat their awful behavior in the 2000 presidential elections, with their fond amazement of Bush (example: "look, he was able to finish a sentence!"). Here's part of the article I was going to write, inspired by Bush's remarks at the RNC when he mentioned that our public school system has a soft bigotry of low expectations. For some reason, after the speech I was more incensed by those remarks of his than his stupid remarks about liberating Iraq, maybe because his "leave no child behind" crap is full of bigotry, AND because he's been treated with soft bigotry of low expectations by the media for his whole life.

Anyway, since we've been busy, we haven't had time to create our own rules for the drinking games, but thanks to wonderful bloggers and writers, we've got some handy. When the guests arrive, we'll vote on a set of rules. Should be fun! Though, we may be passed out by9:30 with these rules. And for the 5 regular readers of this blog, if you'd like some good drinking games, here are a few:

Wonkette's debate drinking game
Jonathan Boeke's debate drinking game (nice chart format ready for printing)
David Martin's official 2004 drinking game, from the Chicago Tribune

And...a new site I came across -- Drinking Liberally.

Lastly -- some fun presidential debate humor (more here):
"Everyone is talking about the debate ground rules. Kerry wants his podium to be tall enough so he can rest his hands. And President Bush wants it to be wide enough to hide Dick Cheney." --Conan O'Brien

"The first debate will actually take place in Miami, Florida. Boy, first all those hurricanes, now Bush and Kerry ... Haven't these people suffered enough?" --Jay Leno

"Both candidates now are trying to lower expectations for how they'll do on the debates. For example, Kerry tried to lower expectations for himself by saying Bush has never lost a debate and that he is a formidable opponent. Then Bush lowered expectations for himself when he said, 'Hey, what does "formable" mean?'" --Jay Leno

Update: Just saw this -- the 5 step Bush response to questions -- linked from the blog An Old Soul. Hilarious...

posted by Anjali Taneja | 9/30/2004 02:46:00 PM | (0) comments |


Friday, September 24, 2004  

re: the upcoming election. what if we voted on issues? interesting post as food for thought..especially the parents' reaction to their children's unwitting choices.

posted by Rahat | 9/24/2004 10:49:00 AM | (0) comments |


Wednesday, September 22, 2004  

Asthma as a symptom of GRIEF?

i was doing a night shift this week, earning my whole-grain bread and organic butter, as a hospitalist. my job there is to admit patients from the ER and hang with them until the morning shift MD's come on. it's good money and fairly light work. average of 3-7 admits a night in a system that actually works, except for getting old medical records...

so a lady came in to the ED with two weeks of an asthma exaccerbation. non-smoker. she had tried everything at home from mdi's to nebs. she was buzzing on albuterol and still feeling like she couldn't get her air in. when i saw her, she had already spent about eight hours in the ED getting high dose nebs and IV solumedrol with no resolution. she was able to speak full sentences and her O2 sats were okay but her chest sounded tight with wheezing and poor air movement. x-ray negative, blood work normal.

classis asthma exaccerbation. well, what had caused it? i asked all the usual questions about illness, environmental factors, work factors... no hints.

so i'm interested in these body pressure points and i've been learning reflexology. since she'd had everything done that western medicine could do, i offered her a reflexology treatment while still in the ED. she accepted, it's baasically just a foot massage anyways, who wouldn't want one?

there are points around the mtp joints that represent the heart and lungs. i started working these areas, which were painful for her, but tolerable and the most amazing thing happened. her story started to unfold. she shared with me that two weeks prior she had had a dream of her sister who had died while giving birth to her third child. the child had also died at the same time. tragic. this lady was raising her sister's two other children. after that dream, she had been unsettled and had taken a road trip to go visit the grave of her sister and her mom, who are buried together in Roswell, NM. (where all the aliens are!)

in 13 years, she had never let herself experience GRIEF. the treatment relaxed her enough to be able to name the process she was in and helped her breathe more easily. GRIEF can be overwhleming and scary, as many of us human's already know. it was a privilege to be able to help her transition from 13 years of fear of grieving to a healthy engagement with her feelings and her natural life process. somehow that treatment helped her frame her "illness" in a way that gave her insights and therefore, some level of control and comfort. the ED is an intimidating place. certainly some people share really intense things there, but generally, the setting is so hostile to care and love that people find it almost impossible to talk about the sory of their lives.

so was it an asthma attack or not? hell yes, and an ER doctor could have just treated it with nebs and steroids and been done with it. her grief is her problem, it's not going to kill her. but the real question here is how deep down the rabbit hole do you want to go? blue pill or red pill?

there are techniques and tools and skills and ways of relating to people that open and connect and empower. and there are styles of practice that minimize and limit and control and define the parameters of exchange. ideally the choice would be based on the notion of what's therapeutic for the patient but often it's based on what's comfortable for the provider. and in a racialized, classist world with most providers coming from positions of unexamined privilege. sometimes we have to get uncomfortable as providers, to sit next to people who are in places of consciousness that we cannot even begin to understand.

for medical students and nursing students who often feel like leaches with nothing to give and way too much to learn in a fairly intense environment, consider spending a few days learning reflexology, or any other touch technique, and you may find yourself a more valuable memeber of the care team than the attending physician. with that being said, you probably are a more valuable member of the team than most attending phsycians anyways... :>

aziwa

posted by andru | 9/22/2004 10:02:00 AM | (1) comments |


Tuesday, September 21, 2004  

For all my C-Span loving sisters and brothers...

For all my play-by-play Congressional subcommittee loving, senate hearing loving, filibuster "action" loving friends...today's Over the Hedge cartoon is meant for us.

posted by Anjali Taneja | 9/21/2004 07:52:00 PM | (0) comments |


 



Here's another photo I took at the United for Peace and Justice March on August 29th, right before the start of the Republican National convention in NYC. The Raging Grannies are a wonderful group of older folk (and some younger folk) who create political lyrics to the beats of classic rock or oldies tunes and sing them at protest events -- they've got SO much energy and are a fun bunch to hang out with. These folks were from Rochester. There are Raging Grannies organized for peace in a bunch of other cities including Boston, Pittsburgh, Detroit/Windsor, and Denver (and they're organized in other countries too!)

posted by Anjali Taneja | 9/21/2004 07:46:00 PM | (0) comments |


Monday, September 20, 2004  

Missing Persons: Minorities in the Health Professions report

The lack of diversity in the health professions may be a greater cause of health disparities than lack of uninsurance. Discuss amongst yourselves...

Today, the Sullivan Commission released a many paged report (something like 200 pages...suffice it to say I've only had time to skim through the executive summary) entitled Missing Persons: Minorities in the Health Professions. Three of the report's principles are:
  • To increase diversity in the health professions, the culture of health professions schools must change. Colleges, universities, health systems and other organizations must examine the practices of their own institutions.
  • New and non-traditional paths to the health professions must be explored. Major improvements in the K-12 educational system are needed but health professions schools cannot remain stagnant while these improvements take shape.
  • Commitments must be made at the highest levels. Change can happen when institutional leaders support change.

The report also identifies 37 specific action steps (yup, that's thirty-seven. and specific. they're not fuckin' around) including:

  • Shifting the financing of health professions education from student loans to scholarships.
  • Reducing dependency on standardized testing for admission to schools of medicine, nursing and dentistry.
  • Enhancing the role of two-year colleges in preparing students for a career in the health professions.
  • Substantially increasing federal funding to support diversity programs within the National Health Service Corps, and Titles VII and VIII of the Public Health Service Act.

There's something very refreshing about actual "action steps" spelled out in a fancy report. And were these actions to be carried out, we'd have a VERY different health professions workforce than we currently have. The diversity would be fascinating -- not only rightly bringing more "minorities" (I don't like that word, personally, as it makes non-white folks seem lesser), but also bringing in more diversity in economic backgrounds and life-experiences.

I hope to actually read the report in the coming week or two, and I'll keep a link to it on the upper right side of the To the Teeth site (the "check one, check two..." area). I anticipate some good media coverage of the report in the coming weeks too, but it's hard to tell how much or how little. And lastly -- two other links -- the American Medical Student Association put out a press release supporting the report's findings, especially on a few issues that AMSA has devoted much energy and money towards. Also, if you've got a high-speed connection, you can watch the webcast of the release of the Sullivan Commission report (thanks to Kaiser Network's healthcast system).


posted by Anjali Taneja | 9/20/2004 06:34:00 PM | (0) comments |


Friday, September 17, 2004  

Integrating Health Paradigms

i was a disbeliever for years, all thru medical school and most of my residency, alternative medicine was a shi-shi woo-woo wealthy person flirtation with touchy feely expensive self-delusionary forays into mind-body misconnection. well, okay, i wasn't really that skeptical but i never saw myself as doing anything more than learning about all "those modalities" so that i could offer "neutral" advice to my patients about utility and efficacy.

during my FP residency training I was impressed and depressed with how little we could do to help the huge number of people with chronic pain, PTSD, depression, anxiety, fibromyalgia, chronic fatigue, etc. then, over the last few years working in the other real world (the world after residency ends when there isn't a huge corporate-academic medical complex hanging over your head) i've had a chance to spend alot of time working with traditional pratitioners of various "other" medical systems from places far and wide and old. it's a life long learning to study many of these traditions, so i just started by incorporating some of the pressure points and massage work into my practice, skills which are fairly easy to pick up for those of us trained in physiology and anatomy.

let me set the scenario for you. i work in rural ER's where the volume of patients seens is fairly small in any given 24 hour period but the problems presented are typical of all ER's. I see 'migraine' patients, drug seekers, auto collision victims, stroke, MI, etc. After seeing the fairly toxic way that pain patients are treated in inner-city ER's I was hoping that i would be able to find a more humane way of engaging with these folks. guess what. there are other ways. if you can take the time, approach non-judgementally, and aren't afraid to risk exposing your limitations as a human being learning how to help other's in their suffering, you can work your way past the thick prejudicial relational patterns that exist in most chronic pain patients to something akin to the root of their understanding of their pain and from that point, instead of throwing narcotics at the person, a few well placed pressure points, or trigger point therapy or even massage, can bring a "migraine" headache from a 10 to a 3 in a few minutes. just with your fingers and some non-judgement. there are pressure points on the hands, the ears, the feet, behind the knees, on the calves. the body is full of reflexes to treat all kinds of symptoms.

i had a really fun experience on a plane. there was a brand-new stewardess, airsick with nausea. i wound up sitting next to her in the back row of the plane on a short flight home. we talked a bit and after getting her permission, i held a point on her wrist for nausea. she promptly fell asleep and rested the rest of the flight until we landed with nothing but gentle pressure, symptoms totally relieved.

in the rural ER, I spent an hour with an elderly lady with a terrible headache, "for days," and high BP. after assessing her neuro status and checking some labs to rule out hypertensive emergency, i worked some points on her hands and back of her head. this was a really interesting case for me. this lady was in the process of learning how to help people in her community with pressure points for pain, and she recognized what i was doing fairly quickly. it started a conversation between us about the limitations of allopathic medical training and her own journey to learn some health skills. after her headache resolved with pressure points only, she was even more resovled to continue learning how to help her people, and help them stay out of the ER. no cost medicine... I wonder how the AMA will feel about that. If history is any indication, they don't like it.

:>

so all you skeptics, I encourage you to learn a few points for pain and nausea and try them out on the wards and in the ER's. just realize that aside from the empirical reality of the pain, there is usually a huge layer of disbelief and fear of judgement. people tend to think that if their pain resolves easily with simple things, then their illness isn't real. you gotta explore this belief system until you feel comfortable challenging yourself and patients past the prejudices and fears already part of our world.

it's a much bigger world than our AMA father's would have us believe. and thank god for that cause our shit don't work for alot of the suffering out there. and it causes a fair amount on it's own.

aziwa





posted by andru | 9/17/2004 10:36:00 PM | (0) comments |


 

Social contact -- a win-win solution for patients and hospitals!

In my time working with patients in the hospital this month, during my acting internship (where I'm a 4th year med student "acting" like and taking on some responsibilities of a 1st year medical resident), I've found that patients often are stuck in a plain hospital room by themselves for several days, while medical tests are performed and docs and nurses come and see them for a bit each day. Some patients have the wonderful luck of having loving families or friends around who can visit them and share the love. Others don't, and I can't help wondering if their relative isolation and lack of contact with people are either not helping or outright worsening their medical situation. A friend forwarded me an article about a recent study published in the journal (get this...) Psychoneuroendocrinology, in which hamster wound healing times were measured when amounts of social contact were varied. It would be neat to see more hospitals implementing proven programs for increasing social contact with patients -- possibly through volunteers who could "hang" with patients; pet therapy; touch therapy; massage therapy, etc... Here's some info from the study:
The researchers conducted a series of experiments to learn how social interaction affects health, and to better understand the mechanisms by which it does so. Female Siberian hamsters were housed with a sibling or isolated during the three-week study. All animals received minor skin wounds about the size of a sunflower seed on the backs of their necks. The researchers photographed and measured the wounds each day...

Hamsters were separated into four groups for one of the experiments: socially isolated, non-stressed; socially isolated, stressed; paired, non-stressed; and paired, stressed. As soon as a single day after injury, the wounds on the socially isolated, stressed animals remained about 25 percent larger than the wounds of the other three groups, and stayed this way for about a week.


posted by Anjali Taneja | 9/17/2004 03:43:00 PM | (0) comments |


 

India and South Africa working together on HIV/AIDS issues?

This, from today's Kaiser Daily HIV/AIDS Report... it could be lip-service but in theory sounds wonderful:
"Indian President Abdul Kalam on Wednesday while visiting South Africa proposed that India and South Africa -- the two countries with the largest number of HIV-positive people -- begin working together to fight HIV/AIDS, Indo-Asian News Service/newkerala.com reports. Kalam, who is the first Indian president to visit South Africa and address its parliament, said that the two countries should work together to fight HIV/AIDS and other problems common to both nations -- such as poverty and other diseases -- and become a model for partnership between developed and developing nations."


posted by Anjali Taneja | 9/17/2004 03:14:00 PM | (0) comments |


Thursday, September 16, 2004  

Those women, doin' it again...



I finally downloaded a few pics from my camera, from the United for Peace and Justice March, Aug 29th, that a few of my friends and I attended, along with over 400,000 other wonderful people. Here's a shot of the Code Pink demonstration giving Bush the "pink slip". More photos to come in the coming days...

posted by Anjali Taneja | 9/16/2004 05:09:00 PM | (0) comments |


Sunday, September 12, 2004  

Checkin' out of the nursing home

I'm catching up on old emails and articles I've put aside to be read, and I found an inspiring article on disabilities activism in the Washington Post from July 31st. It describes the work of Ellen Archie, an activist who is paraplegic herself and dealt with nursing homes for a while before leaving to live independently in the community. She's now working to educate nursing home residents about their rights to live independently and have Medicaid pay for home care instead of nursing home care. Check out the whole article, it's worth reading, and it's still available on the washington post's website. Here's a teaser:
Sitting in the courtyard with her old neighbors, she acknowledges the struggles of daily life in a paralyzed body, with its spasms, sweats and tics. But mostly she speaks of the small joys of living again in the world: a trip to the coffee shop, a visit to the park or, in the evening, a sip of merlot.

She knows the thought of freedom can be scary to some.

"A lot of people just give up," she says. She understands. They are not old, yet they have suffered terrible trauma. Their monthly Supplemental Security Income checks are turned over to the nursing home. And they have come to depend on the institutions for all their needs.

"Your life will change, " she tells them again and again. "But you have to want it to change."

Some have taken the leap of faith.

"We've gotten 145 out," Archie reported proudly this month. The cases of those 145 people took more than two years of hard work by the state's six nonprofit centers for independent living. A nationwide network of such centers has been charged with protecting the rights granted by the 1990 Americans With Disabilities Act and the U.S. Supreme Court's 1999 Olmstead v. L.C. decision, which directs states to offer programs for the disabled "in the most integrated setting appropriate."


posted by Anjali Taneja | 9/12/2004 02:42:00 PM | (0) comments |


Monday, September 06, 2004  

Lost and Found

It's been almost 3 weeks since we last posted on this site. Been crazy busy. Out in Albuquerque, Andru's renovating a house that is the future site of his fair and just medical/holistic clinic. And on the eas' coas', I've been taking gruesome written and computer exams (surgery exam and step 2 of the medical boards), then protesting together with 450,000 beautiful people at the United for Peace and Justice march in NYC last weekend, following the protests during the week, speaking on a neat panel at the Health Care Crisis and Elections 2004 conference last week, and completing week 1 of finding out the fascinations and perils of being an "acting intern" at a hospital in NJ (so many stories to share). More on ALL of this to come this week, possibly in some kind of chronological order of events.

posted by Anjali Taneja | 9/06/2004 11:54:00 AM | (0) comments |


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