Health, Culture, and Society @ Broome

Health Blog Halloween: Horror Show Doctors
from WSJ.com: Health Blog by Jacob Goldstein

Deranged in the pursuit of knowledge, lusting for power or just stone crazy, the mad scientist is always called “Doctor” — though it’s rarely clear what his specialty might be, or whether he’ll accept your insurance.

This much is clear, though: Intentionally or not, the mad scientist has hitched his brilliance to a dark star, and the inhabitants of planet Earth — or at least a few torch-wielding villages — are in big trouble. The ivory tower types will call him (and yes, it’s basically always a him) a metaphor for science run amok. But to us he’s the bad doctor, the emblem of the Health Blog’s Halloween. Here’s a rogue’s gallery of our favorites.

Dr. Victor Frankenstein created the eponymous fiend. Frankenstein’s been a fan favorite (and cautionary tale for those who would synthesize life) since he first appeared in Mary Shelley’s 19th-Century novel. But maybe nothing about him has been as terrifying as the reported $450 it will cost to get good seats to Mel Brooks’ new Broadway production of Young Frankenstein.

Hannibal Lecter was a psychiatrist who came in for a bit of analysis himself in the scientific literature. This 2002 paper in the American Journal of Psychotherapy says he “relies heavily on schizoid defenses, such as splitting and projective identification, but is unable to avoid psychotic breaks with reality to reenact his early traumas.” Sure. Just make sure you keep that mask on him so he doesn’t bite our face off.

Dr. Henry Jekyll seemed like a nice enough guy, but his alter ego Edward Hyde was another story. Little-known fact: This split-personality fable is also a morality tale about the importance of careful record keeping in pharmaceutical manufacturing. Jekyll had to swallow a potion to keep from turning into Hyde. But when he re-ordered the ingredients for his potion, he found it didn’t work. He concluded the initial supplies were effective because an “unknown impurity.” Doomed to remain Hyde, he took his life.

Doctor Faustus reminds us that — centuries before legions of perky sales reps brought lunch for harried docs — a sole practitioner sold his soul to the devil in exchange for a look at Helen of Troy (along with unlimited knowledge and power). “Was this the face that launch’d a thousand ships, and burnt the topless towers of Ilium?” Faustus asked when he saw the mythical beauty. Yes, doc. Now if you’d just take a look at these data, which show why our drug is better tolerated than the generic alternative…

Doctor Evil said it best: “It’s Dr. Evil. I didn’t spend six years in Evil Medical School to be called ‘mister,’ thank you very much.”

An honorable mention goes to Anton Phibes, with doctorates in music and theology. Phibes, as played by Vincent Price in “The Abominable Dr. Phibes,” turns serial doctor slayer to avenge the poor care he blames for his wife’s death.

We couldn’t possibly pay tribute to all the deserving docs. Which evil doctors (fictional only, please!) did we leave out?

From Times Online


Race row Nobel scientist James Watson scraps tour after being suspended



James Watson: he said last night he was mortified about the furore caused by his comments
Helen Nugent

A Nobel Prize-winning geneticist has cancelled a string of speaking engagements in Britain after being suspended from a prestigious scientific laboratory for claiming that black people are less intelligent than whites.

James Watson is on his way back to the United States to "sort out" his job at the Cold Spring Harbor Laboratory in Long Island, NY. His comments caused a storm of controversy.

The scientist, who won the Nobel prize for his part in discovering the structure of DNA, was quoted in an interview in The Sunday Times saying he was “inherently gloomy about the prospect of Africa” because “all our social policies are based on the fact that their intelligence is the same as ours - whereas all the testing says not really.”

Although Dr Watson tried to quell the row with an apology last night, he was too late to prevent widespread condemnation of his comments.

The Cold Spring Harbor Laboratory board joined a throng of prominent researchers and institutions who said they found the remarks Dr Watson was quoted as saying to be offensive and scientifically incorrect.

In a statement, the laboratory said it had “decided to suspend the administrative responsibilities of Chancellor James D. Watson, Ph.D., pending further deliberation by the Board”.

The board went on: “This action follows the Board’s public statement yesterday disagreeing with the comments attributed to Dr. Watson in the October 14, 2007 edition of The Sunday Times UK.”

The newspaper also quoted Dr Watson, 79, claiming that people should not discriminate on the basis of colour, because “there are many people of colour who are very talented, but don’t promote them when they haven’t succeeded at the lower level.”

Dr Watson shared the 1962 Nobel prize for medicine with Francis Crick and Maurice Hugh Frederick Wilkins for their description of the double helix structure of DNA.

Last night Dr Watson told an audience in London that he was mortified by the public response.

At a book launch at the Royal Society, Dr Watson said: “To all those who have drawn the inference from my words that Africa, as a continent, is somehow genetically inferior, I can only apologise unreservedly.

“That is not what I meant. More importantly, there is no scientific basis for such a belief.”

He went on: “I cannot understand how I could have said what I am quoted as having said. I can certainly understand why people reading those words have reacted in the ways they have.”

Dr Watson has said before that there is a genetic basis for intelligence – something undisputed by other scientists. But experts deny there is any such thing as race on a genetic level.

Scientists expressed their disbelief at Dr Watson’s comments.

"They are wrong, from every point of view, not the least of which is that they are completely inconsistent with the body of research literature in this area,” Dr. Elias Zerhouni, director of the National Institutes of Health in the US, said in a statement.

“Scientific prestige is never a substitute for knowledge. As scientists, we are outraged and saddened when science is used to perpetuate prejudice.”

Another group of Nobel laureates also expressed revulsion.

“The Federation of American Scientists is outraged by the noxious comments made by Dr James Watson that appeared in the Sunday Times Magazine on October 14th,” said the group, founded by Manhattan Project atomic physicists.

Federation of American Scientists President Henry Kelly added: “At a time when the scientific community is feeling threatened by political forces seeking to undermine its credibility, it is tragic that one of the icons of modern science has cast such dishonour on the profession.”

Prior to Dr Watson’s departure, the Science Museum had decided to cancel a talk by the scientist, organised as part of his speaking tour to promote his new book “Avoid Boring People: Lessons From a Life in Science”.

A spokeswoman for Dr Watson’s publisher said: “Dr Watson feels he needs to go home and sort things out.”

from the NYT

8 States Plan to Press Bush on Health Bill
By SARAH KERSHAW

Gov. Eliot Spitzer said yesterday that New York, joined by six other states, would file suit against the Bush administration, challenging stricter eligibility rules for the government health insurance program that covers poor children. Separately, Gov. Jon S. Corzine announced yesterday that New Jersey filed a similar suit against the administration.

The protests from the states come in the wake of President Bush’s threat to veto legislation that would loosen those rules and increase federal funds for the State Children’s Health Insurance Program, or Schip. The bipartisan bill would expand coverage to 10 million children from the 6.6 million covered now.

More than 40 states have urged Washington to act quickly to reauthorize funds for the program, which has been the subject of angry debate in Congress over how much the federal government should contribute.

In their legal challenges, the eight states contend that the new eligibility rules, which went into effect in August and limit coverage to children living at or below 250 percent of the poverty level, will either force out children in the program or leave tens of thousands without coverage who would be eligible.

In August, federal health officials informed states that they could no longer receive federal matching funds for children in families living above 250 percent of the poverty level, except under special conditions that the states say would be almost impossible to meet. Three weeks ago the federal health officials denied a request by New York to insure more children by covering those in families with incomes up to 400 percent of the poverty rate, or $82,600 for a family of four.

“Despite every effort to negotiate in good faith, the Bush administration did nothing but put roadblocks and poison pills in our path,” Governor Spitzer said at a news conference yesterday. “The president was out of touch with the reality on the ground.”

Mr. Spitzer said that Maryland, Illinois and Washington would join New York in the lawsuit, with Arizona, California and New Hampshire filing amicus briefs in the case. He has argued that the new rules violate the intent of the federal law that created the children’s insurance program in 1997.

Jeff Nelligan, a spokesman for the federal Centers for Medicare and Medicaid, which administers Schip, issued a statement saying, “We are confident that our requirements are appropriate and will be sustained in a court of law.”

He added, “Our chief goal with Schip is to ensure that the poorest kids and those with no health insurance are placed at the front of the line.”

An expansion of the national program passed by both the House and Senate would provide $60 billion over the next five years, $35 billion more than current spending. President Bush has proposed adding $5 billion to current spending.

New Jersey, which estimates that 10,000 children will lose health insurance under the new eligibility rules unless the Congressional version prevails, filed its lawsuit yesterday in federal court in Trenton.

Governor Corzine, speaking at a news conference, criticized the White House for both the veto threat and the eligibility rules, saying: “The Bush administration has gone far beyond its regulatory rights. I think there’s going to be major, major pushback.”

New York health officials said that the Congressional version would allow the state to add 70,000 children to the 396,000 currently covered.

Diluting the Benefits of Tea
(NYT, Oct 1)


Tea is getting a lot of good press these days. Many studies have linked regular tea drinking to a lowered risk of cancer, heart disease and hypertension. But where health is concerned, all teas are not created equal.

Many consumers who’ve taken to popular bottled teas and the hot chai served at coffee houses have the mistaken notion that they are low-calorie and good for you, noted Lisa R. Young, a nutritionist at New York University. But a 16-ounce bottle of the popular Arizona Green Tea with Ginseng and Honey, for instance, contains 140 calories and 34 grams of sugar. (By comparison, a similar amount of Coke has 194 calories and 54 grams of sugar.) A grande Tazo chai tea latte at Starbucks packs 240 calories and 41 grams of sugar.

“I see so many educated people who, when I tell them it has calories, look at me and say, ‘It does?’” said Dr. Young. “These are people who wouldn’t get the whole milk cappuccino, but they get the venti chai because it’s only tea.'’

The health benefits of tea have been observed mostly in populations regularly consuming simple brewed teas, usually around three cups per person per day, according to Harvard Women’s Health Watch. Traditionally made tea is loaded with antioxidants that fight heart disease and cancer, the newsletter notes. Instant teas and bottled, decaffeinated preparations contain fewer of the compounds that make unadulterated teas so good for you.

*via the Gothamist.

Recently Williamsburg doc Jay Parkinson unleashed his revolutionary idea onto Brooklyn -- a doctor for the uninsured, medical advice through emails, and the return of the housecall. The word spread fast and now much of the world is looking his way to see if he can change the way healthcare is provided.

How did your non-conventional idea come about and become a reality?
I don’t really fit in very well to the traditional doctor mold and don’t have a lot of doctor friends. Many of my friends are youngish like myself, involved in the creative industries, and don’t make a hell of a lot of money. They’re often coming to me for medical advice trying to save the absurd amount of time and money it takes to see a doctor when not insured or under-insured. Many of my friends make too much money or are otherwise disqualified from obtaining low-cost health insurance. Most of the time, they would IM, email, or video chat me. I thought it would be a great idea to treat this demographic -- young, uninsured or under-insured, wired, health conscious, and those who are sick of paying too much to wait four hours for a five minute doctor visit. Many people in this age group have acute illnesses and injuries that need timely treatment. Timely doesn’t seem to be in the vocabulary of the modern healthcare system unless you consider paying $2,000 for an ER visit “timely.” I figured I could develop a high quality medical practice based on very accessible low-cost, nearly immediately available house calls, for people who have been priced out of the absurdly expensive traditional health insurance plans. Of course, this type of practice couldn’t survive in a place that wasn’t as densely packed as Brooklyn and lower Manhattan. I’m obviously very mobile and very wired. My schedule is integrated on my website via Google Calendar. My patients can see an open slot, text me with their desired appointment time, and I’ll come see them...even if it’s the next hour. My entire practice, including my electronic medical record, runs on my iPhone. My practice depends on instantaneous communication and mobility.

Aside from offering the uninsured masses healthcare, you also offer housecalls and consulting via IM, email and video conferencing. Do you think you'll run into a lot of electronic patient/doctor scenarios where you'll need to see the patient in person?
Nothing can replace the value of seeing a patient when making a diagnosis. When someone signs up for my service, I make an appointment to come to their house and perform a physical exam, talk with them about their health history, discuss how to use my service, and ways to optimize their health. After this first meeting, I will still almost always visit the patient in person at their home or work. However, there are some diagnoses that are just so obvious I won’t need to go see them. Acne, depression, allergies, and a growing list of other conditions are successfully being managed in a rapidly emerging field called Telemedicine. At the same time, say someone falls on their wrist and thinks it may be broken...most people would go immediately to the ER and get an X-ray. Say it’s not broken...they just spent $2000 on a negative X-ray. If you are my patient, you would call me and describe what happened. I’ll ask you some questions to assess the injury and then send you to a radiologist I know who charges $80 for an X-ray. If it’s not broken, hot damn you just saved $1920. If it is, I’ll be on the phone with orthopedists finding one who can see you in their office to cast your wrist for $400.

I use IM, email, and video conferencing as a supplement to a person’s care to follow up on patients I saw recently and to manage how well a treatment is working. It’s one of the most fulfilling things in the world to wake up in the morning and read an email from a patient I treated yesterday that says she’s feeling so much better.

You've traced your publicity from Noah Kalina's Flickr account to the NY Post in just ten days, did you expect that kind of attention so fast?
I knew I was doing something that had the potential to be revolutionary. One thing that makes me so angry about the healthcare system is a concerted, widespread policy of keeping their prices hidden from the public until you receive your bill a month later for services already rendered. I’ve called a few thousand physicians, radiologists, ERs, and pharmacies to get their prices they charge for certain services and tests. Healthcare prices are absolutely unregulated and the prices vary tremendously. For example, the cost of a brain MRI (same quality facilities mind you) ranges from $500 to $1750. This is absurd. If you are unlucky enough to have chosen the one that charges $1750, you just made a $1250 mistake. I hope that the general public becomes aware of this issue and forces the Industry to be more up-front with their prices. There needs to be more of a free market system in healthcare services and tests. I hope that, through this media exposure, I’m able to raise the issue enough to force the healthcare industry to stop taking advantage of people who are willing to spend anything just to get back on their feet.

But, yes, the offers I’ve gotten from the media and entertainment industry has blown me away. They don’t teach you how to find an entertainment lawyer in medical school.

How many patients do you currently have? Are you feeling a little overwhelmed with the recent response?
I’m feeling more overwhelmed with the media response. Keep in mind, the demographic I’m trying to treat are essentially pretty healthy people. The healthcare industry calls them the invincibles. Young people unfortunately don’t see the value in having their own doctor until they absolutely need medical care. I’m waiting for people to get sick who have heard about me either through the internet or word of mouth to sign up for my service. Once they do experience what it’s like to have such an accessible physician, they’ll understand what they’ve been missing for so long. I promise. Everyone I’ve treated so far thinks it’s the best thing since wheels on luggage.

Have you really been offered a tv show? Would you think about saying yes to such an offer?
I’ve been offered an ungodly amount. Books, TV series, a full feature romantic comedy from one of my favorite producers who produced some of my favorite movies (who actually personally called me). Yes, I would consider these offers. Especially if I could use some of the money I make from these ventures to make my service even more affordable.

Do you think your press schedule will now offer you less time to treat your patients?
I’m a multi-tasker. All of my press began three days before I “opened” my practice. In reality, “open” means, I enabled the link where people could sign up. As in every type of new business, it takes some time to build a client base. Fortunately, the press I’m getting is happening when my client list is small but growing.

What is the number one/most common ailment you treat?
That has yet to be discovered. But I have some hunches. All I know is that this entire experience in treating patients this way will allow me to save people a hell of a lot of money AND meet some very lovely people who are doing some interesting things with their lives.

What is the general age group and occupation of your patients?
I only see patients age 18-40. Generally, everyone who has contacted me so far has been freelancing creative professionals.

Do you keep certain hours or have a staff?
I do routine house calls with patients on Monday through Friday 8 am to 5 pm. I’ll definitely make some exceptions. It’s not really set in stone. It’s dependent upon the individual case.

Please share your strangest "only in New York" story.
I used to be friends with this guy who was the manager of a popular clothing store in Soho. He was the biggest David Bowie fan and told me how he listened to only Bowie for something like three years straight. He just wanted to immerse himself in Bowie. My friend was walking down the sidewalk in Soho one morning and heard someone whistling a Bowie tune. He turned around and saw David Bowie walking with his daughter on his shoulders whistling his own tune to her. I don’t know why, I just love that story.

Which New Yorker do you most admire?
Unfortunately I have to choose someone who recently died -- Jane Jacobs. The Death and Life of Great American Cities was a huge influence on the New York we know today and quite an influence on the design of my practice. New York can be such an isolating place because most of us just keep to ourselves on the sidewalks of New York. I think the modern forms of communication such as IM, email, and SMS are just as isolating. What if I could use these communication technologies to my advantage as a way to help people with their medical problems; make a meaningful change in a broken healthcare system; and get to know, in a very personal, real way, hundreds to thousands of New Yorkers.

Given the opportunity, how would you change New York?
I would make healthcare more affordable and accessible to young, uninsured or underinsured New Yorkers. I have that opportunity now and that’s what I plan to do. I saw a patient yesterday who was spending $63 a month on her monthly prescription from Walgreens. I knew of a place that was selling it for $42. I saved her over $250 per year because I’ve put the effort into doing the research. One person at a time, I will make sure they get affordable, high-quality healthcare.

Under what circumstance have you thought about leaving New York?
I only thought about leaving New York once. That was two years ago when I finished my residency at St. Vincent’s in the Village to do a residency at Johns Hopkins. Hopkins has a such a great name and is known as the best program in Preventive Medicine. My practice focuses on prevention in order to keep people as healthy as possible for as long as possible. I figured I could suck it up for two years in Baltimore and move back to New York the hour I finished my residency at Hopkins. I love this city. I don’t plan on leaving.

What's your current soundtrack to the city?
Ooooh. Good question. I know not everyone listed is from the city, but I figure that’s alright. They all have some sort of personal connection to NYC in my own mind.

Sonic Youth - Teenage Riot, Brian Eno - On Some Faraway Beach, Elliott Smith - Some Song, Gary Numan - M.E., The Hold Steady - Multitude of Casualties, Iggy Pop - The Passenger, Interpol - Untitled (from their only good record), John Phillips - Let it Bleed, Genevieve, Kiss - God Gave Rock-n-Roll to You, LCD Soundsystem - All My Friends, Liars - Grown Men Don’t Fall in the River Just Like That, Marah - Formula, Cola, Dollar Draft, The Modern Lovers - Dignified and Old, The National - All the Wine, Neutral Milk Hotel - Love You More than Life, The Stooges - I Wanna Be Your Dog, Super Furry Animals - Man Don’t Give a Fuck, TV on the Radio - Staring at the Sun, The Afghan Whigs - 1965, The Velvet Underground - Sunday Morning, Wilco - I Am Trying to Break Your Heart, !!! - Pardon My Freedom

What's the best subway line?
The L? It connects to everything.

Favorite headlines: NY Post or Daily News?
The Post is the shittiest newspaper in the entire nation.

Yankees or Mets?
Rangers

Best cheap eat in the city.
Cheap is so damn relative. Cheap (as in stuff your face for $3): Big Enchilada on 12th and University. Cheap (as in good eatin’ for a good price): Itzocan Cafe on 9th Street in the East Village.

Best venue to see music.
Bowery Ballroom. The only thing I hate about summer in NYC is having to see a band at some horrible outdoor venue.

Photo by Noah Kalina.

Smoothie Workshop tonight at 7:30 in the Broome Room. See you then.