Recent Newspaper & Online Columns by Kate Scannell MD

The unbearable otherness of illness and disease

June 23, 2013

Tags: Julia Pastrana, "ape woman", May van Oskan, Scannell, unbearable otherness of illness and disease, hirsutism

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 06/23/2013

By the time she was finally given a hometown burial near Sinaloa, Mexico last February, Julia Pastrana -- one of the most famous "human curiosities" of her time -- had been dead for 153 years.

Major news agencies covered the story about her corpse's transport home from a locked storage facility in a Norwegian research institute where it had been kept since 1996. But before that, her body had been embalmed, encased in glass, exhibited around the world, stolen from a warehouse, and subsequently recovered from a trash bin. (more…)

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'Tis the season of the 'Winter Flu Olympics' -- again

January 19, 2013

Tags: 2013, influenza, flu, California, flu vaccination, Scannell, flu Olympics, "The Sick Person's Etiquette Guide -- How to Contain Your Own Secretions with Style and Make the World a Healthier Place", Common Sense Medical Society, Benghazi flu

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/19/2013

Last week, while sitting in a doctor's crowded waiting room, I watched the new season of the Winter Flu Olympics.

A sneezing competition was in progress when I arrived. And within mere minutes of taking my seat, I thought I had witnessed the worst sneeze I might ever see in my entire life. It erupted without warning from a young man, slouched in his chair, tethered to an iPod, staring glassy-eyed at the ceiling. His Vesuvian sneeze rocked the room, spewed a misty cloud of viral detritus throughout our cramped quarters. It was an appallingly effortless performance -- entailing not even the slightest gesture toward covering his mouth.

I was ready to score him a perfect 10 in the category of "most obnoxious sneeze, greatest risk of public contagion." But then an older gentleman came out of nowhere and trumped him. He suddenly stood up, placed his hands on his hips, bent abruptly backward and inhaled deeply. Several of us tried to protect ourselves -- turning away or wrapping scarves across our faces. Alas, like a whipsaw, his body bent violently forward, flinging a wet and turbulent "ahhHHH-CHOooooo!" into the collective airspace.

In other events: Competitive coughing generated comparable infectious excitement within the room. And rivalry remained fierce, running nose-to-nose, for "greatest number of missed tissue-tosses into the wastebasket."

Still, as engrossing as these events may have been, I soon realized that every passing moment spent in the waiting room only increased my risk of getting sick. My hopes for leaving infection-free depleted faster than all the Purell dispensers stationed by the doors.

I derived meager consolation in considering how the experience might help inform the next revision of my best-selling book, "The Sick Person's Etiquette Guide -- How to Contain Your Own Secretions with Style and Make the World a Healthier Place." Published by the Common Sense Medical Association, it makes for a good read in front of the fireplace during a cold winter's night ... or, actually, just during a cold.

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Protecting children from unthinkable harm

January 6, 2013

Tags: child safety, unthinkable harm, rhetoric, guns, violence, drug shortage, Scannell, New England Journal of Medicine, mechlorethamine

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 01/06/2013

Last month, the country was shocked to learn that a gunman shot and killed 20 schoolchildren in Newtown, Conn. The tragedy sparked yet another so-called "national conversation" about gun control, igniting predictable passions on both sides of the heated debate. While National Rifle Association leadership recommended armed security guards in schools to enhance children's safety, gun-control advocates demanded stricter legislation to limit assault weapons and high-capacity magazines.

Locked in stark disagreement, still, both sides claimed to be aiming at the same objective: to keep children safe. How could that be?

"Keeping children safe" is always a great idea. But as an idea or abstraction, it can be easily shaped into a platitude, a moral imperative, or a political sound bite used to lure people toward wildly differing points of view. Want to keep children safe and healthy? Well, then -- do/do not have them vaccinated. Do/do not provide them with sex education. Do/do not allow contact sports. Do/do not pass legislation allowing confidential abortion counseling for teens. Do/do not tinker with school lunch menus.

A major problem with "keeping children safe" is, well ... that it is such a great "idea." It brilliantly shines as a shared concept, but is dimly seen as a collective reality. Why should that be? (more…)

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The American eugenics movement -- In our living history

June 25, 2012

Tags: eugenics, Elaine Riddick, California, North Carolina, 2012, Scannell

By Dr. Kate Scannell, Syndicated columnist; First Published in Print: 06/23/2012

It's important to know about Elaine Riddick and what happened to her in North Carolina one godless day in 1967. Her disturbing personal story tells a troubling American tale that most of us would like to forget or deny.

But Riddick's story provides a living history of the American eugenics movement, experienced by tens of thousands of people who were forcibly sterilized by order of their state's governments. In fact, California was one of 32 states that supported and practiced eugenics, and about one-third of the 64,000 sterilizations that occurred nationwide between the dawn of the 20th century and the late 1970s were performed in California. (more…)

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Prescription--Take two clowns, call me in the morning

May 13, 2012

Tags: medical clowns, hospital clowns, therapeutic clowns, McGill, infertility, laughter in medicine, Scannell

Dr. Kate Scannell, Syndicated columnist; First published in print: 05/12/2012

It was a dark and stormy day. I sat in an overlit hallway of a sprawling urban hospital, anxiously waiting to be ushered into a conference room filled with doctors and administrators. Under considerable stress, I looked down at the notes in my hands, reviewing them one final time in preparation for my presentation. That's when three clowns approached me -- and, no, they were not members of the hospital staff.

I looked up and stared into their painted faces. One clown withdrew a squeaky rubber pen from her enormous pocket and, with dramatic flourish, made two giant check marks on a pink card. After her clown colleagues nodded approval, she handed the "ticket" to me and said: "We're citing you on two counts."

To be frank, I hesitated about engaging with these clowns. After all, I was a serious doctor on a serious mission, preparing for a tense interaction, and I didn't have time for, well, clowning around. Still, I was surrounded by three clowns, and the last thing I needed before my meeting was a lapel-flower squirt of water in my face.

So I smiled politely and read aloud the charges on my citation: "Feet are not big enough" and "Gathering too much dust." (more…)

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Sometimes, doctors can't see the forest for the statistics

April 30, 2012

Tags: doctors and statistics, innumeracy, numeracy, health literacy, cancer screening, Scannell

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 04/28/2012

One of my patients used to demand each year that he be screened for "any kind of cancer imaginable." He wanted blood tests and radiographic scans that scoured every reach of his body. He devoured handfuls of so-called "anti-cancer" supplements and wore copper bracelets to ward off malignancies. As healthy as he was, he suffered terribly with cancerphobia.

Ironically, his anxiety was his greatest risk for developing cancer. Every X-ray or CT scan he underwent to help "manage" his anxiety just increased his cumulative radiation exposure and, consequently, his chance of developing a malignancy. (more…)

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Remembering dementia, one world -- and family -- at a time

April 15, 2012

Tags: Dementia, Alzheimer, Alzheimer Services of the East Bay, ASEB, community, Scannell

By Dr. Kate Scannell, Syndicated columnist; First Published in Print 04/14/2012

A few days ago, my friend with severe dementia asked me at least a dozen times whether I'd heard about her granddaughter's scholarship award. We had been speaking by telephone during our weekly phone date, a tradition we've kept for many years.

Each time my friend asked the same question, she expressed continuously renewed joy -- no less infused with delight than any time she had asked before. She seemed to be living "in the moment" -- one that repeated independent of her memory. I was grateful that this moment of her reliving was a happy occasion. It is not always so. (more…)

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When doctors doctor the truth

February 23, 2012

Tags: doctors and truth telling, truth-telling, Oscar Wilde, uncertainty in medicine, Scannell

By Dr. Kate Scannell, Syndicated columnist; First published in print 02/18/2012

Last week, the journal Health Affairs published a study exploring physicians' attitudes about truth-telling that generated abundant media attention. Many public commentators deemed the results "shocking" -- although few seem to have read the fine print. You almost needed a tranquilizer to withstand headlines that "asked" whether YOUR DOCTOR IS LYING TO YOU!

In comparison, the study's actual title reads less sensationally: "Survey shows that at least some physicians are not always open or honest with patients." Although not much of an attention grabber, it concisely summarizes the researchers' main conclusion based upon a survey of 1,891 practicing physicians in the United States.

The actual media reports about the content of the new survey also tended to be off-key and misleading. (more…)

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Picture this: Kids eating their vegetables willingly

February 5, 2012

Tags: children and nutrition, food security and social justice, children eating vegetables, Scannell, healthy children

By Dr. Kate Scannell, Syndicated Columnist
First published in print: February 5, 2012

It's often said that "a picture is worth a thousand words." Now, according to new research, we also know that a picture might be worth "the price of a meal ticket" to healthier eating habits for young children.

This week in the Journal of the American Medical Association, University of Minnesota researchers reported that elementary-school children ate more vegetables when the compartments in their lunch trays were lined with photographs of vegetables. Pictures of carrots served as . . . well, carrots, and led three times as many children to that veggie in the cafeteria line. Images of green beans inspired twice as many children to give beans a chance.

That's the good news. (more…)

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Dying of a Broken Heart

January 22, 2012

Tags: broken heart, broken heart syndrome, Circulation, takotsubo, stress cardiomyopathy, Jimmy Ruffin, Scannell

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/22/12

In the early 1970s, my friend's father died on stage while receiving a golden watch from his boss to mark his retirement. Grasping the watch in one hand, he reportedly clutched his chest with the other and collapsed. He could not be revived. His sudden death had been completely unexpected, and his family was devastated. His death was officially attributed to a heart attack.

Afterward, my grieving friend speculated that her father's death had been triggered by the stress and heightened emotions he'd been experiencing over the unwelcome prospect of retirement. He'd been a dedicated "company man" his entire adult life, someone who had found meaning and personal fulfillment through his job at the auto plant. He couldn't imagine living without the satisfying daily routine of his work and the companionship of co-workers.

I knew nothing at the time about cardiology, the heart's autonomic neural regulation or the body's powerful, smoldering brew of stress hormones. However, I was convinced by what had happened to my friend's father that a heart could be broken by grief and loss. That it could shatter under the unbearable weight of despair.

Years later, after becoming a physician, I often was reminded of my friend's father. (more…)

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Health and safety of patients must not get lost in e-Doctoring

January 8, 2012

Tags: eDoctoring, iPatient, iDoctor, distracted doctors, patient safety, Scannell, Angry Birds, iPad, medical devices

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/07/2012

Is it OK for an anesthesiologist to play Angry Birds on his iPhone while administering anesthesia during a gallbladder surgery? During your gallbladder surgery?

What do you think about a surgeon voice-dialing her colleagues or chatting with family during the operation?

Although we've inhabited the Digital Age for many years, only recently have we begun to examine how it might affect us personally as patients and doctors, and whether overall patient safety and care have actually improved.

This inquiry is long overdue, and, as recent studies suggest, urgent. (more…)

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In healthy acknowledgment of life's uncertainty

November 28, 2011

Tags: uncertainty in medicine, medical uncertainty, grace, Thanksgiving, serendipity, Scannell, fortuitous discovery

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: November 27, 2011

Like many Americans this past week, my friends and I shared a turkey feast and gave thanks for all that was good in our lives and the world. But this annual ritual is always difficult for me, because I also think about things for which I am not grateful -- the economic and political turmoil in the world, people starving and homeless, my patients who have suffered and died, and ...

Still, I routinely manage to keep my sadness private, off the proverbial table. Pumpkin pie helps. So does a little wine.

While listening to my friends' expressions of gratitude, I am profoundly impressed with the role that happenstance has played in shaping everyone's fortunes (and hardships). Personal intention and deliberate actions have certainly played defining roles, but, to a large extent, our lot in life is the "real" estate of providence and serendipity. Through no free choice or conscious planning, we are born into poverty or wealth, in times and places associated with war or peace, to good or bad parents, and with variable genetic odds of living healthy lives. Our survival and opportunities to flourish in the world largely begin "as luck would have it." (more…)

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Can you be a doctor without ever touching a patient?

November 15, 2011

Tags: doctors and patients, physical exams, physical examinations, lost art of medicine, touching, technology, Scannell

By Dr. Kate Scannell, Syndicated columnist
First publised in print: 11/12/2011

I was checking out the broccoli at the local grocery store when an ex-patient tapped me on the shoulder and began a conversation. I was relieved that he found me in the fresh produce section rather than the wine or bakery aisles.

Naturally, he updated me about his chronic medical problems. I was sorry to hear that his diabetes had become difficult to control, all the while registering the high-calorie, processed foods in his shopping cart -- along with the discounted post-Halloween candy.

Nonetheless, he started complaining about his current doctor -- her "uncaring nature." He was annoyed by her slowness in responding to his recent request for a prescription. He was frustrated with her for "looking at the computer screen all the time" they were together in clinic. And after reciting a sad litany of further grievances, he paused dramatically for a moment before asking, "But you know what irks me the most about her?"

He stared intensely at me and waited, with an expectant smile on his face. Not knowing the answer, I began to wilt faster than the broccoli in my sweaty hands. The "doctor in me" wanted to answer his question correctly and assuredly, because he seemed to be suffering such estrangement from his current physician. He needed a healing dose of connection with an MD, I thought.

Luckily, a grocery clerk appeared and asked whether she could help us. My ex-patient instantly replied, "No. I'm just telling my old doctor here how my new doctor has never examined me." (more…)

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Physicians under the influence--An anatomy of addiction and the health of a nation

October 23, 2011

Tags: addicted physicians, Halsted, Freud, book review, An anatomy of Addiction, Howard Markel, Physicians under the influence, cocaine, addicted Fathers of Medicine, Scannell

By Dr. Kate Scannell, Syndicated Columnist
First published in print: 10/23/2011

After injecting himself with cocaine, the acclaimed New York surgeon -- who would come to be known as the "Father of Modern Surgery" -- proceeded to the trauma room where he'd been summoned by hospital staff. Awaiting his arrival was a construction worker with life-threatening bone fractures who was "writhing in agony." But, rather than picking up a scalpel and treating the laborer, the surgeon, Dr William Halsted, "turned on his heels, walked out of the hospital, and hailed a cab to gallop him to his home. ... Once there, he sank into a cocaine oblivion that lasted more than seven months."

Meanwhile, across the Atlantic and 12 days after Halsted fled the hospital, the Viennese physician who would become the "Father of Psychoanalysis" began composing love letters -- about cocaine -- to his fiancée, Martha. In those letters, Sigmund Freud wrote about his self-experimentation with "this magical substance" -- the way it lifted him "to the heights in a wonderful fashion." Two months later, he would publish his legendary monograph, "Über Coca" -- a "song of praise" to cocaine.

Through compellingly told stories of these two physicians, author and medical historian Howard Markel takes us on a sometimes-cringing tour of the medical establishment during the late-19th and early-20th centuries -- and, as we discover, much of what we encounter seems hauntingly familiar today. In his new book, "An Anatomy of Addiction -- Sigmund Freud, William Halsted, and the Miracle Drug Cocaine," Markel also tells a timeless and over-arching tale about medical practice "under the influence" of commerce and happenstance. (more…)

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Betty Ford changed much of how we think about medicine

July 24, 2011

Tags: Betty Ford, addiction, eulogy, cancer, Scannell, Betty Ford Center, rehab, Winehouse

By Dr. Kate Scannell
First published in print: 07/24/11

BETTY FORD never actually set foot in my medical clinic. But it sometimes felt that she was there, accompanying patients who were motivated to seek care because of her.

I was a medical student in 1978 when it was widely reported that Betty Ford had a problem with "addiction" to a variety of prescribed pills and alcohol. The news was shocking in that pre-Amy-Winehouse era when nobody spoke -- let alone sang -- about addiction and "rehab." In fact, had you told someone back then that you were "going to rehab," they may well have assumed you were planning to renovate your kitchen. (more…)

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Sleep deprivation is a wake-up call in the air and on the ground

May 15, 2011

Tags: sleep deprivation, medical error, pilot error, patient safety, fatigue, Scannell

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 05/15/2011

FOR WEEKS, we've been reading about air traffic controllers falling asleep on the job. In one case, an airborne ambulance transporting a sick patient had to circle a Nevada airport for 16 minutes while the controller snoozed. In March, two jetliners inbound for Reagan National Airport were forced to land without clearance while the air controller slept.

In response to such disturbing incidents, the office of fatigue risk management at the Federal Aviation Administration (FAA) has been collaborating with the National Air Traffic Controllers Association to identify and remedy conditions fostering controller fatigue. While not an expert at such matters, I have a (grounded) hunch these agencies will discover that 99.3 percent of human beings who sit alone within a tower, staring out for hours at a yawning night sky, working irregularly staggered shifts -- will tend to feel a little sleepy.

So far, the FAA has recommended a minimum nine-hour break between controller shifts, and at least one additional buddy present on overnight shifts at 27 airports that had previously maintained only one controller.

On the runway of public opinion about aviation safety, concerns about pilot fatigue immediately preceded our current focus on air traffic controllers. An ABC News investigative report in February claimed that "despite denials from the airline industry, large numbers of pilots report to duty every day after getting only a few hours of what fatigue experts call 'destructive sleep' in crowded crew lounges and so-called 'crash pads'." More than two dozen accidents and 250 fatalities in the U.S. had been linked to pilot fatigue in the past 20 years.

Public anxiety associated with air traffic controller or pilot fatigue is soaring high, partly fueled by post-9/11 insecurities regarding flying in general. But the reality is that fatigue-related safety hazards loom even larger on the ground. Whether referring to ourselves or to others within our daily lives, being sleepless IN Seattle might be riskier overall than being sleepless over it. (more…)

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The Big 'C'-- the cost of health care

October 8, 2010

Tags: Big C, cost of health care, rationining, insurance coverage decisions, Scannell, health insurance

By Kate Scannell MD, Contributing columnist Bay Area News Group

"THE BIG C." It's always been difficult for doctors, hospital administrators and health care executives to "spell it out." It terrifies American politicians. Patients tend to confront it only when it afflicts them or their loved ones. Everyone is so afraid of discussing the Big C, that we prefer to remain silent all the while it eats like a cancer through our national economy and health care infrastructure.

I am referring to health care "Cost." Today I'm writing about a new study that raises the specter of the Big C in a manner we can ill-afford to ignore. It also forces this question: When we pay for health care, just what are we buying -- with our pocketbooks, our downward salary adjustments for increasingly expensive insurance benefits, and our taxes funding government-sponsored health programs like Medicare? When does a costly new drug or medical device become worthy of its expense to us? (more…)

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California's whooping cough epidemic -- a (really) scary story

October 4, 2010

Tags: whooping cough, pertussis, epidemic, California, Scannell, medical school, public health

By Kate Scannell, Contributing columnist Bay Area News Group

MY NEPHEW is a self-proclaimed connoisseur of scary movies. Over time, he has refined his tastes, and he is no longer interested in the "boring" films that lamely depend upon rivers of blood, high-octave screaming, high-octane lethal pursuits, and passe props like hatchets, knives, and guns. For him, a "quality" horror film now requires potent doses of supernatural and psychological thrills and a smattering of aliens or interspecies creatures. Multicolored slime, however, has maintained its perpetual allure.

After delivering his critique of yet another gruesome film during a recent dinner together, he asked whether I had seen any good horror stories.

Well, yes, I thought. I had been watching the nightly news, following the wars, monitoring the Gulf Coast oil spill, reading the financial pages, and ... to top it all off, I was also a doctor.

Being a doctor can bring you up-close and personal to a variety of frightening circumstances that can make your toes curl permanently. (more…)

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