Kate Scannell, MD

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/23/2011

IF THE ongoing ... ongoing ... and ongoing debates about repealing the Obama administration's new health care law causes you to feel weary or disoriented, a quick visit to "The Winchester Mystery House" could set you straight. This popular tourist attraction in San Jose is just the ticket for an invigorating education about the American health care system. It can make anyone feel more confident about surviving the deadening clamor of the current disputes.

The first thing to appreciate about the Winchester Mystery House is that it continues to stand despite its original owner's obsession with constant architectural renovations. Legend claims that Mrs. Winchester conducted nightly séances to divine home-remodeling tips that would allow her to elude and confuse "bad spirits." Her compulsive need for self-protection meant constant and unwieldy revisions to her home.

Consequently, at one point the Winchester home contained at least 500 separate rooms of varied shapes and sizes. Stairways that bluntly ended at ceilings. Chimneys that ascended short of the roof. Doors that opened to nowhere. As the home's official website describes: "The miles of twisting hallways are made even more intriguing by secret passageways in the walls. Mrs. Winchester traveled through her house in a roundabout fashion, supposedly to confuse any mischievous ghosts that might be following her."

We are kin to Mrs. Winchester as we continuously amass disconnected health care policies under one old roof and choose to think of our ramshackle construction as a unitary "system."

We never get the foundation right because we always listen to the loudest political spirits of the day and take their piecemeal advice. We pass innumerable health care laws and regulations that are so mind-boggling and labyrinthine to navigate, that we often give up the ghost trying. Meanwhile, as individuals and as a nation, we pay a hefty premium for the thrill of it all.

In other words, the Winchester Mystery House looks a lot like our American health care system.

But the Winchester house uniquely offers visitors the opportunity to experience chaos and structural anarchy without suffering apoplectic fits. In fact,  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 01/09/2011

LAST WEEK, the Obama administration removed a provision from the new health care law that would have encouraged opportunities for patients to consult with doctors about life and death concerns. Under the provision, Medicare would have reimbursed physicians for time spent with patients who wanted to discuss end-of-life treatment and voluntary advance care planning during their annual wellness visits.

Thank goodness -- and Sarah Palin -- that the Obama administration had the timidity to withdraw such a ridiculous provision. Really, why would any mortal being ever want to talk about ... being mortal? Why would anyone ever want to document their own preferences to guide their future medical care when they became unable to speak for themselves?

Besides, whoever heard of a dead person complaining about the insurers and medical personnel who took charge of their health care during their final hours or months within an ICU?

Clearly, it is better to allow our dying process to arrive as one big surprise party for all concerned. Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 12/26/2010

WHILE THE past year regaled us with a wealth of medical stories, the government's health care reform legislation took center stage. Meanwhile, the swine flu virus whimpered, but a killer bacterium left us with a whooping cough. Scientists created the world's first synthetic organism inside a Petri dish, while old-world bed bugs crawled into our mattresses. A baby was born from a fertilized human egg that had been frozen for two decades, and, following yet another Salmonella epidemic traced to tainted poultry, the FDA finally cracked down on the egg industry.

The swine flu whimpered
The swine flu hogged media attention, panicked millions of people and consumed considerable public health resources. Its causative virus -- H1N1 -- spread throughout the world like a hog on ice, ultimately proving to be much less formidable than experts had predicted. In the bitter end, critics claimed that the World Health Organization (WHO) had exaggerated the danger, fanning public fears about the scarcity of antiviral medications and life-saving medical interventions. An editorial in the British Medical Journal claimed that some experts advising the WHO about the pandemic had financial ties to drug companies that manufactured antivirals and vaccines. Still, the threat of a global pandemic forced governments and health care systems to plan collaboratively for a more coordinated and efficient emergency response to the next public health crisis.

The cough that whooped California
For six decades, whooping cough -- formally known as "pertussis" -- had been rather quiet on the Western front. But in July the CDC reported that six California infants had died from the infection.  Read More 

By Dr Kate Scannell, Syndicated columnist
First Published in Print: 12/12/2010

LAST WEEK, Lady Gaga, Jennifer Hudson, and Justin Timberlake threatened to "kill " themselves -- that is, on social media like Facebook and Twitter. They vowed to remain "digitally dead" and unavailable for contact until fans resurrected them through a collective million-dollar donation to Alicia Keys' campaign for AIDS relief in Africa and India.

Coming of age as a doctor during the early AIDS epidemic, I was happy to learn about this high-profile effort and its eventual success. But I was particularly gratified because the mainstream news media barely bothered to notice it.

Less than 30 years ago, during the dark pre-digital 1980s, there were no major stars to shine a public light on AIDS and its causative virus, HIV. Celebrities, fearing actual career deaths by association with AIDS, stayed behind the curtain even as the epidemic exacted a devastating human toll on the artistic community.

Most of the known early AIDS patients were young gay men who suffered the social stigma of homosexuality while facing death within months of their diagnoses. Many were contemptuously regarded as plague-bearers, as toxic creatures intent on spreading a frightening and lethal infection throughout decent society. It took 500 HIV deaths before "AIDS" landed on the front page of the New York Times, and 12,000 fatalities before President Ronald Reagan first mentioned "AIDS" in public.

When the epidemic began, we were light years away from compassionate public embrace of people suffering HIV/AIDS.
But now the stars align differently, and famous singers passionately voice support for people afflicted with a once-unspeakable disease. AIDS can command center stage before an attentive and caring public.

This thundering cultural transformation was once completely unimaginable for many socially outcast AIDS patients who were burdened with the hopelessness of the '80s throughout their dying. In my memoir about doctoring during that era, I conclude the book's introduction with the dying wish of a hopeful 22-year-old patient in 1986 -- to live another 10 years, mainly to witness the world arriving at a compassionate understanding of AIDS.

How thunderstruck he would be today to see Lady Gaga "killing herself" on behalf of people with AIDS.  Read More 

By Dr. Kate Scannell, Syndicated columnist, Bay Area News Group
First Published in Print: 11/28/10

THE 11TH season finale of "Dancing with the Stars" drew 24 million viewers last Monday night. I was one of them.

I watched the show, exhausted after a particularly grueling day at work. And though I had punched the proverbial clock, still, like many physicians, I continued to view the spectacle of the world through a doctor's lenses.

So I worried about Jennifer Grey's spine and cringed whenever her neck extended. I wished for Bristol Palin an experience of joy residing in the gift of an agile, healthy body -- resilient to the thorny body politic impinging upon it. And I was grateful for Kyle Massey's intrepid exuberance -- I've witnessed no better public health promotion for exercise and physical fitness.

The show was peppered with advertisements reminding us to stay tuned for the upcoming debut of its latest offshoot, "Skating with the Stars." And while I did not warm to that particular concept, I was inspired to think about a different spinoff with a medical twist.

Already, besides skating and dancing with experienced professionals, "the stars" are also singing with the pros. They are shaking and baking with celebrity chefs. Pitching business startups to Donald Trump. Everywhere, the stars are lined up -- literally and figuratively -- to illuminate how anything is possible, how any profession can be mastered within weeks of trying. So it seemed natural to wonder -- why not "Doctoring with the Stars!"?

There are so many good reasons to launch a show featuring pairs of stars and doctors who compete to provide the best quality medical care to patients in the current health care system. For example, "Doctoring with the Stars!" would provide a much-needed reality-check against the public's skewed view of doctors. Through documentary-type coverage of the stars during their monthlong training to become physicians, the public would see what genuine footwork was required of real doctors engaged in actual dances with life and death.

Even I am sometimes confused by media portrayals of doctors. After watching just a few episodes of "Private Practice" I once showed up at work in high-heels and a Chanel white coat, expecting to sit with colleagues all day around the break-room table until our one shared patient-of-the-day showed up and interrupted the fun. One day, I began shouting out inaccurate diagnoses and ordering every imaginable diagnostic test for patients simply because "House" had made that seem not only right, but also righteous. And after season four of "Grey's Anatomy" -- well, let's say I realized that not all doctors need to experience delusional psychotic breaks or personality transplants within the course of their careers.

Besides, if "Doctoring with the Stars!" succeeded in transforming waning stars into shining new careers as doctors, it could help alleviate our country's physician workforce shortage. Already, within the next 15 years, we expect to face at least a 125,000 physician shortfall.  Read More 

By Kate Scannell, Syndicated columnist, Bay Area News Group
First Published in Print: 11/14/2010

LAST WEEK'S news radiated hope that smokers' lung cancer mortality rates might be decreased through serial CT scanning -- as it also radiated concerns about the safety of CT scanning in general.

Last week, researchers from the National Cancer Institute proclaimed that the lung cancer death rate for smokers could be lowered by 20 percent if smokers underwent regular CT screening to detect early evidence of cancer.  Read More 

Crown Publishers, New York, NY, 2010, 369 pages, $26.00.
Pre-Print copy for the Journal of Legal Medicine
Reviewed by Kate Scannell, M.D., F.A.C.P.*
ENCOUNTERING HENRIETTA LACKS
Journalist Rebecca Skloot’s new book is a gripping read that embodies all abstractions about research ethics in a compelling tale about Henrietta Lacks – a woman whose microscopic cancerous cells shook the world’s medical establishment in 1951. Read More 

By Kate Scannell, MD, Contributing columnist Bay Area News Group
PUBLISHED IN PRINT 10/16/2010

ROBERT EDWARDS thought he was "doing God's work" when he began his research in the 1950s. But critics charged that he was actually trying to play the boss himself.

Still, this British biologist dreamed about helping infertile couples who dreamed about having children. If successful conception wasn't possible for those couples "in vivo," he would strive to make conception happen outside their bodies "in vitro" -- with the help of science to coax that process along.  Read More 

By Kate Scannell MD, Contributing columnist Bay Area News Group
PUBLISHED IN PRINT 09/18/2010

YOU RISK upsetting readers whenever you express strong opinions within medical columns. Writing about controversial health care issues predictably ruffles a few feathers. But "laying it all out" for public deliberation is a primary objective of op-ed writing, and this week's column shell make no eggs-ception.

So here goes. Simply put: I am opposed to the presence of disease-causing salmonella within eggs meant for human consumption.  Read More 

By Kate Scannell MD, Contributing columnist Bay Area News Group
PUBLISHED IN PRINT 08/08/2010

BELIEVE IT or not, parts of your own body might not always belong to you.

Tony Bennett may have famously -- and figuratively -- left his heart in San Francisco. But with much less fanfare -- and, quite literally -- people routinely leave behind parts of their organs and tissues in hundreds of cities across the country every single day.

They leave biopsies of skin, breast, liver, prostate, bone marrow -- you name it -- to doctors, hospitals, and diagnostic centers. Sections of their colons, lungs, and limbs are removed during surgeries, sent to labs for pathologic examination, and ... then what?  Read More