And with a magic wand, end the physical aches that flesh is heir to, ’tis a consummation devoutly to be wished.

Had the Bard of Staten Island, William Shakespeare, superstar at Notre Dame in the 1930s and hero of the so-called greatest game of the century in 1935, [against Ohio State] penned an account of the hundreds of poundings he took in search of glory on the battlefields of South Bend, Indiana, would he not have rewritten the original Bard’s line, “First thing we do is kill all the lawyers” and made that “kill all the doctors?” Has there ever been an industry more determined to proclaim itself as the savior of mankind than that of The Medicine Man? What are famous warriors, political geniuses, and men of science as compared to even the lowliest country doctor, twice put on probation for not having completed his yearly “continuing medical education” courses in a timely manner? [CME]

The ordinary understanding of “the medicine man” is of a shaman, a wheeler/dealer in divinations, a healer who succeeds (or doesn’t) in virtue of his spiritual gifts. Is that far from the “the man of science” who, when pressed to explain his failures, says that medicine is only an “art”? As for the criminal-mindedness of this “profession”, let us charitably turn our heads away from the painful sight. Is there a surgeon in America who participates in over 1000 surgeries per year who has not witnessed dozens of culpable errors on the part of some of his brethren? You know, I suppose, it is more than a breach of the medical code not to report the blunderer. It is a felony in most jurisdictions.

The pharmaceutical industry is the twin brother of the medical industry, often playing the payola game to get the Medicine Man to use certain products. Last January, the drug maker Eli Lilly pleaded guilty to a misdemeanor and paid $1.41 billion to settle criminal and civil charges that it improperly marketed an antipsychotic drug for elderly patients with dementia, potentially putting them at risk. In September, Pfizer paid $2.3 BILLION to settle criminal and civil charges that it had illegally marketed an anti-inflammatory drug and other products. One of its subsidiaires, the Pharmacia & Upjohn Company, pleaded guilty to a felony related to the anti-inflammatory drug.

In December, 2008, the Confederation of Medical Associations in Asia and Oceana presented a resolution to its 45th Congress.:
Resolution on Criminal Punishment for Medical Error

“That Council recommends to Congress, that Congress pass the resolution expressing grave concern at the law in some countries which that medical error as a felony and, in particular, treat medical error causing death as manslaughter (or equivalent). CMAAO believes that the criminal law should apply only in cases of gross or reckless negligency, or criminal intent, on the grounds that to do otherwise is not in the best interests of the patient or the public, as it will lead to the practice of defensive medicine which will limit the treatment opportunities for patients. While CMAAO believes that all doctors should be accountable for their actions, it also believes that erring doctors should answer to a professional tribunal or the civil courts rather than the criminal courts.”

So there. Not much different from police who practice a Code of Silence and insist they can handle their own problems without aid of outside agencies.

The Washington State Department of Health is canvassing hospitals to determine why so few have reported medical errors under a state law that says reporting is mandatory. Its report says:

“# The health department hasn’t made any annual reports to the legislature on medical errors, as required by the law, because of the failure to hire a contractor; # No Web site for reporting medical errors was created, as required by the law; # The state’s medical error reporting office is an under-funded one-person operation.”

Throughout the United States, only 52 percent of health care facilities have reported adverse events to the Department of Health,” said Linda Furkay, the health department’s patient safety-adverse event officer. Of course. That saves trillions of dollars.

An average of 195,000 people in the USA died due to preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company. Compare that to the total number of annual deaths of our soldiers and tack on deaths by auto accidents and murders. For fun, throw in suicides.

But what the hell, who’s counting? And, in addition to the fact that you are not counting, you have bought into the heavy barrage of propaganda that tells you the insurance industries are getting in the way of your intimate relationship with your doctor. Sure, you bet. Last week, I submitted to a physician who did the standard EMG on every patient dumb enough to enter his chambers. Charge for the 5 minutes of zapping me? $1800. My insurance company offered 100 bucks and he accepted. I got stuck with $10.

This voodoo man, like all the others loaded with expensive gadgetry, is trying to pay off the bills he accumulated by acquiring all the tomfoolery in his menagerie. In ten years he will be out of the red and it will all be gravy. Meanwhile, I will be under the knife and soaked in red, having landed in the arms of another wunderkind who has his own assortment of Rube Goldberg inventions that he swears by. It may be a race against the clock. Will I live long enough to pay off his charges or will he kill me first? If he kills me first, it will be a consummation devoutly to be wished.

Throw that ball, Bill. TOUCHDOWN!

Voice: If this is a medical emergency, call 911 or go to your nearest hospital emergency room.
I persist and, eventually, reach a voice with a body attached.

SG: I would like an appointment.
Voice with Body: Are you a new patient?
SG: Why do you ask? V w/B: We have reasons. SG: Yes.
V w/B: We have next Tuesday at 9.30, 11, or 4 P.M. or on Thursday at 2 P.M. Also in three weeks, on Monday, Wednesday or Friday, anytime in the late afternoon.
SG: Monday, Wednesday or Friday? Hmmm. Sounds a bit like the Lone Ranger. Can I or should I bring a portable radio?
V w/B: Excuse me, sir? I don’t understand. SG: I’ll take next Tuesday at 9.30. Is that morning or evening?
V w/B: I don’t understand. Morning, of course. Your name, please?
SG: Sidney Gendin. V w/B: You’re all set, Sidney. Please arrive 15 minutes early to fill out some forms. Bring your insurance with you.

The following Tuesday, 9.15 A.M.
Body with a voice presents herself and hands me a questionnaire.
SG looks over the long list of questions and begins:
“History of diabetes in your family?” SG scribbles: “Your father’s mustache eats the square root of 3 for breakfast.”
Several puzzlers of that nature and SG puts down several more illuminating responses to each of them.
Finally, we get to a question about the level of pain I have been having. This one I know is important and I decide I must be very precise. “4.057739.”

I hand in my forms, sit down to read the doctor’s literature on the table. I can choose between People, Sports Illustrated, Glamour, Reader’s Digest, or Hunting and Fishing.

SG walks over to the B w/Voice, nicely ensconced in her seat behind a bullet-proof window, and asks, “Do you happen to have Annals of Family Medicine or the Journal of Electro-Physiology somewhere? They’re not on the table.” B w/V: I don’t think so. LaShawna? Do we have magazines besides those on the table?

SG: Forget it. I’ll just pick my nose, if that’s all right with you?
Voiceless Body: No response.

Sometime later – minutes, hours, decades? I’m too numb to have kept track – I am ushered into a cubby-hole room.
Return of the Body w/Voice: The doctor will be right with you. Take your clothes off.

SG: Did you read the form? I’m here to have my left forearm examined.
B w/V: Please, sir, explain all that to the doctor.

10 minutes or 20 minutes or 30 minutes later, I walk out and tell the Body, “It’s unpleasant in there. I’ll just wait in the waiting room until the doctor is ready to see me. B with V: Suit yourself but make sure you can undress quickly when the doctor arrives.

At last, the moment arrives and before you can say, PNEUMONO­ULTRA­MICRO­SCOPIC­SILICO­VOLCANO­CONIOSIS, the Great man arrives, complete with stethoscope around his neck.

Great Man speaks: What seems to be the problem?
SG: I am not sure. I think I may have PNEUMONO­ULTRA­MICRO­SCOPIC­SILICO­VOLCANO­CONIOSIS.
The GM is a bit startled. He looks down at the questionnaire he has brought in with him. “I doubt it. Take off your shoes and shirt. You may leave your socks on.

SG: Should I remove my trousers? GM: Please don’t.

He examines my feet. He announces: Ah, hah! You have Haglund’s Deformity.

SG: No wonder Haglund is feeling so much better. Imagine his shifting it to me. What about my pain level?
GM: As you quantified it, I would say your pain level is normal for Haglund.
SG: For poor Haglund, maybe. But my pains are nearly always under 3.878882. By the way, are you the doctor?
The Not-so-Great-Man, Any-Longer: I’m his physician’s assistant, here to do the work-up. I’m a cut above a nurse.
SG: Do you plan to be a doctor some day?
The N-S-G-M, A-L now getting into the swing of things and grinning: Which day do you have in mind?
SG: The first rainy Friday of next month.
The N-S-G-M, A-L: Actually, no, nor any other day. If and when I ever finish this gig, I plan to be a really hip tenor saxophonist. You like Coleman Hawkins?
SG: He’s okay. I prefer Lester Young.
The N-S-G-M, A-L: Hey, you’re okay man. Now, let’s take a look at that left forearm of yours. You say it is killing you to the jazzy tune of 4.057739?
SG: Hot diggedy, man. Let’s get it on. I think this is going to be the beginning of a great jam session.

In the second place, the man with a collection of abbreviations after his name, including the much vaunted “M.D.”, plunged a batch of needles into my right arm and wrist and zapped me with enough volts to make me scream repeatedly “Alessandro!” He pronounced me unwell. The Great Man has set up a series of traction appointments for me.

In the first place, he already knew I was a misfit from a visual examination and his questioning. To further convince himself, he asked me to spread my fingers apart and then he closed my hand with his. I have failed this test ever since the first 8 year old child tried it on me. I believe that even the great Isaac Berger of Brownsville could not pass this test even if administered by an 8 year old.

In the third place, I am a fan of Ike Newton and I accept on faith that there is an opposite and equal reaction for every action and therefore I am skeptical of the idea that my vertebra can be decompressed enough to allow the offending nerve freedom of movement. Moreover, having carried heavy suitcases, I know one’s ribcage does not stretch because one compensates by listing to the other side.

Fourthly, and most important, Torquemada abandoned the wheel in 1470 in favor of burning because he lost all faith in traction.

Conclusion: Like any child in the presence of an M.D., I will take my first traction exercise this coming Monday.

If you give me four random digits, say 3- 7 – 2 – 8, and ask me to spit them back at you, I haven’t got a prayer’s chance of getting them in the right order. If you call me and leave your phone number on my answering machine, it will take me 7 tries – one digit at a time – to get them all. It has been like this all my life – it is not creeping senility.

Now, I have a name for my condition: aural dyslexia. It doesn’t change a thing but it is nice to know. I am a bit like Tevye, in Fiddler on the Roof. You remember. He asks his wife of 25 years if she loves him and finally extracts the confession from her, “I suppose I do.” He also says that it doesn’t change a thing but it is nice to know.

Here’s Tevye, http://www.youtube.com/watch?v=h_y9F5St4j0

I think the chances are that you will die some day although statistics may be twisted to defy that idea. About 8 billion people are alive. By some counts, that is more than half the people ever born. That suggests to the wiseguys that you have a better than 50-50 chance of never dying. So, as the saying goes, “Statistics, damn statistics and lies.” But let’s get real.

You are male and 50 years old. Your life expectancy is 26.8 years. Female? Gone in 31.6 years.
Male and 60? Another 18.9 years for you. Female? 23.1 years left.
70 year old male? 12.4 years before you meet the chess-playing, Mr. Death.
Female? 15.5 years left. The longer life span may be attributed to the fact that women don’t like chess.
85 year old man? Get ready to hang it up in 5.5 years. Ladies, the gap is closing. You’ve got only 6.6 years left.

Back in 1900, measuring from the day they were born, men lived on average to be 47.9 but women hung tough until 50.7. But, already even in 1900, by age 65, men could count on 11.5 more years and women another 12.2. This shows (I am not making this up) that being young is a killer. Once you got over the hump, even back then, it was smooth sailing.

As for race, I used to try to persuade my black friends they ought not to fight but to switch. At birth, white men have a life expectancy that beats that of black men by six years. Again, being young is the killer as it was in 1900. By age 65, the difference is only 1.7 years and there is no statistically significant difference between 85 year old men of either race. [Not by my lights, at any rate, although officially, white men have an advantage of .2 of a year.]

What’s killing older people? Up until 1985, it was heart disease. The mortality rate was twice that of all cancers combined. The Big C has practically caught up. And that is not because of cigarettes given that it is illegal nowadays to smoke in your own bathroom if a neighbor is in an elevator approaching the floor on which you live. All the other causes of death are bush league: stroke, diabetes, chronic obstructive pulmonary disease, pneumonia, Saturday night specials, suicides, auto accidents. These data are strictly for Americans. In Africa, malaria, AIDS and a few others of that ilk are prominent.

Over in Japan, inscrutable Japanese women with oriental guile are piling up big years. If it is not too late for you, make the switch. So what if you have to shorten your leg stride.

In the bad old days in ancient Greece, chess-playing death came early. You had no doors to keep him at bay. Average life expectancy at birth was 20 years. But that is, I think, a fraudulent statistic because of high infant mortality and lots of slaves who, if they lived that long, were unlucky. Philosophers and other good guys tended to live about as long as we do today. For long life, nothing beats semi-reclining on a soft rug while a slave drops ambrosia and grapes on your tongue.

Married couples live longer than single people, which is odd. You think you know the reason but you don’t. I could tell you why, but I won’t.

Old people live in Florida, West Virginia, Pennsylvania, Iowa and North Dakota. No wonder W.C Fields chose death.

Fat people don’t live as long as most people but they outlive very skinny people.

Immigrants to our shores outlive us by a wide margin. Are you going to put up with that? Get thee to Arizona and build a wall. Anyway, it is a mystery why people come here. If people want to live, they can do better in 41 other countries. Andorra, a tiny country in the Pyrenees, is where the really long-livers live.

There is a deep moral to all this: Life is like a 5-legged table, brown on one side, green on the other, with a copy of Tom Brown’s Schooldays lying on it, open at page 245.

The Dutch are nobody’s fools. When they say that high blood pressure is good for diabetics, you better believe it. Over at a slew of world-class medical and research centers, Kornelis J. J. van Hateren, Gijs W. D. Landman, Nanne Kleefstra, Klaas H. Groenier, Adriaan M. Kamper, Sebastiaan T. Houweling and Henk J. G. Bilo are doing significant things….and stuff, too. Why, theirs are more impressive sounding names than Fanny Blankers-Koen had. So, if you think she was great (and I certainly do), then you have to think these people are great, too.

In any case, they discovered that diabetic people over age 75 should stick to their high blood pressure. A decrease of 10 mm Hg in systolic blood pressure, diastolic blood pressure or pulse pressure led to a mortality increase of 22%. If you are a diabetic between the ages of 65 and 75, there is no connection between your blood pressure and your dropping dead prematurely. If you do die young, it is because your bicycle gets hit by a car. You deserve it. People over 60 should not be riding bicycles. Stick to roller blades.

It is false that people who live in the Netherworld die from gangrene poisoning as a consequence of sticking their fingers into dike holes. As for your mistakenly supposing I refer to those who stick their fingers into dyke holes, please forgive me for reminding you of such obscenities.

Cutting-edge Scandinavian researchers Ingrid Wikstrand, Jarl Torgerson, & Kristina Bengtsson Boström published a peer-reviewed article in the
Scandinavian Journal of Primary Health Care
June 2010, Vol. 28, No. 2, Pages 89-94 , DOI 10.3109/02813431003778540.

Yes, for once, they discovered something that even Mammy did not know. It seems that people who are put on VLCD [Scandinavian code word for "very low calorie diet"] lose weight. It was an extremely scientific study and all the usual precautions
to test for reliability and validity were taken. Plenty of statistical analysis that would have befuddled Mammy is included.

Ingrid and her companions in wisdom and truth also wanted to know if wearing corsets for a year would be helpful in keeping weight off. Unfortunately, too many subjects dropped out of their corsets for Ingrid to come to any conclusion. [This writer cannot help wondering how Ingrid looks in a corset.]

The study was sponsored by the Department of Health Care, Regional Secretariat and Department of Molecular and Clinical Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg and conducted in better dining rooms everywhere.

Buried somewhere in the body of the paper, our authors make the intriguing claim that obesity is a worldwide problem and associated with risk of cardiovascular disease. They also make the usual, linguistically incompetent observation that obesity is associated with “increased cardiovascular risk.” You do not know what that means and you should not try to understand it, presuming, as I do, that this is something independent of the risk of developing cardiovascular disease.

God bless the Swedes and we should all thank them for their devotion to Telegaleria, the best of corset companies. Here is a splendid link I found for corset wear. CLICK HERE.

1. Consumer Lab reports Echinacea has health benefits of some sort. Last I remember about her, she was Don Quixote’s inspiration.

2. ConsumerLab also glows over goldenseal. As you recall, it was first introduced by I.P. Daily as a way to bind books. Now it cures the (un)common cold.

3. Sloan-Kettering tells us to choose from 2 minutes per day of exposure to the sun or 400 IU of vitamin D. Is this an order or suggestion? What if I refuse both?

4. JAMA determined that high serum levels of vitamin B-6 provides protection against lung cancer but also takes note of the fact that increasing your intake of B-6 won’t do you a damn bit of good. Now, I call this mean-spirited news a clever version of the genetic fallacy with a twist.

5. New studies have appeared that indicate second-hand smoke from second-hand mouths soon produces second-hand lungs. Mammy told me this 25 years ago.

6. New studies have proved that running long distances is bad for the heart – causes bad inflammation of heart vessels. Robert Benchley has been vindicated.

7. Both ConsumerLab and Consumers’Report warn readers to read labels. Otherwise, as Fats Waller so well put it, “One never know, do one.”

8. My pills always state on their vial labels, “Take by mouth.” I say to them, “Up yours.”

From medicinenet.com

June 18, 2010 — People who drink a lot of tea or drink coffee in moderation are less likely to die of heart disease than coffee and tea abstainers, new research suggests.

The finding adds to the growing body of evidence suggesting that coffee and tea help protect against heart disease, but not stroke.

Researchers followed more than 37,000 people in The Netherlands for 13 years in one of the largest and longest studies ever to examine the impact of coffee and tea drinking on heart health.

They found that:

People who drank three to six cups of tea per day had a 45% lower risk of death from heart disease than people who drank less than one cup of tea a day.
Drinking more than six cups of tea a day was associated with a 36% lower risk of heart disease, compared to drinking less than one cup.
People who drank more than two, but no more than four, cups of coffee a day had about a 20% lower risk of heart disease than people who drank more or less coffee or no coffee at all.
Moderate coffee consumption was associated with a slight, but not statistically significant, reduction in death from heart disease, but neither coffee nor tea affected stroke risk. The association was seen even though the researchers considered other lifestyle factors associated with heart disease, including smoking and exercise level.

Several earlier studies have also found that drinking coffee or tea lowers the risk for heart disease. In one, reported in 2008, women who drank four to five cups of coffee a day had a 34% lower risk of dying from heart disease while men who drank more than five cups had a 44% lower risk.

[SG: Informal study by one regular reader of this Journal indicates that coffee is almost as healthful a brew as vodka.]

The study appears in the latest issue of the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.

It was a U.S. Army motto in the years in which I served that when a company of men were “At Ease” they smoked. In fact, the company commander would bark out the words, “Smoke, if you’ve got ‘em.” During basic training (about 6 weeks), we were also required to have a pack of Lucky Strikes prominently displayed in the upper right hand corner of our foot lockers. Camel smokers and non-smokers alike had to keep Luckies on display. I smoked. Probably, I averaged over half a pack per day for the 6 months I was at Ft. Dix, New Jersey. The day I got out of the Army, I completely forgot I was a smoker. Six months may have passed before it occurred to me I wanted a cigarette. My smoking habit has been very queer ever since. Often, I go months without a cigarette and then I bomb away at close to half a pack per day for many weeks. My consumption is so erratic that I have no good idea how much I smoke annually. It is sheer guess on my part but I would say that during the last 50 years I have averaged about 2-4 cigarettes each day. People have warned me more times than I can recall that once you start you become habituated and that the habit grows worse almost by the week. That hasn’t been the case for me. If I am in a heavy smoking period, say about 5-7 cigarettes daily, all it takes for me to stop – and I do it without any effort – is for my wife to go away for several days or longer. While she is gone, I don’t just quit, I forget. Again, it is sheer guess on my part but I would say that I have bought 3-5 packs of cigarettes in my life. Somewhat like the good Blanche Dubois, I have always depended on the cigarettes of others.

I never trust the studies of epidemiologists because they all have anti-smoking biases. The two most important cancer-studying epidemiologists, Richard Doll and Richard Peto have patiently studied the link between smoking, lung cancer and vascular disease for more than 50 years but I don’t like their studies and am not persuaded by them. Just as well-known and almost as important as the studies of Doll and Peto is the Framingham Heart Study that also concluded there was an undeniable and very powerful link between heart disease, stroke, mortality and smoking. Take a look at the Framingham study by CLICKING HERE. Thousands of data points, hundreds of columns but not one word about what I’d like to know: what are the differences between very light smokers (whom I define as 3-4 cigarettes per day with 5 week breaks per year) and heavy smokers who top one pack per day every day of the year. Let’s break that down a little further. Compare light smokers who smoke extra light cigarettes such as Carlton with smokers who still prefer the heavy-duty non-filter cigarettes such as Camels. If you go out and create your own study, you will do something that Doll and Peto never did – nor did the Framingham investigators. Moreover, it is standard propaganda among the anti-cigarette cops that because Carlton is so low in nicotine and tars (and the dozens of carcinogens that it may contain) that those who smoke them smoke very heavily to get their daily fix. The trouble with this idea is that there is not a scintilla of evidence to support it. Since I probably know more than any epidemiologist about the smoking habits of Carlton smokers, because once upon a time I took the trouble of asking dozens of them how much they smoked, I say with utmost confidence that Carlton smokers and other smokers of the extreme low nicotine and tars ilk smoke about as many cigarettes per day as other smokers do – with the exception of those old timers who still hang tough with their non-filtered brands. People in the latter category typically smoke over two packs per day or, at any rate, they did in the good old days when I did my informal study. Today, prices being what they are, everybody is trying to cut down.

But finally we are getting somewhere. A lung cancer prevention study called the Carotene and Retinol Efficacy Trial (CARET) conducted by investigators at the Fred Hutchinson Cancer Center came up with some results sure to depress the anti-smoking researchers. They found a definite correlation between cancer rates and the amount people smoked. CARET studied 18.172 subjects (more than Framingham but fewer than Doll and Peto). The investigators, stationed at Memorial Sloan-Kettering Cancer Center also did the obvious: they stratified the subjects according to gender. Surprise, surprise – women who don’t smoke much are at much less risk of developing cancer than men who smoke heavily.

You are what you eat. So goes the old saying and CARET looked at the effect of beta-carotene and Vitamin A supplements on lung cancer prevention in 18,314 people. Yup, there is a good effect. Sensible research is also being conducted elsewhere. The Roswell Park Cancer Institute produced a report just a few months ago: “Cruciferous vegetable intake is inversely associated with lung cancer risk among smokers: a case-control study.” Roswell did not go far enough for me because it neglected to address the matter whether there is an association among the different smoking status subgroups and veggie habits. I am betting that when an honest study is finally conducted, we will find a powerful negative association between lung cancer on the one hand and people who eat right AND smoke lightly on the other. This will shake the anti-smokers down to their boots. It’s okay, guys and girls. I have soothing advice for you: SMOKE, IF YOU’VE GOT ‘EM.