Kate Scannell, MD

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 Kate Scannell, Contributing columnist Bay Area News Group
PUBLISHED IN PRINT 07/11/2010

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. Read More 

By Kate Scannell MD, Contributing columnist Bay Area News Group
PUBLISHED IN PRINT 08/22/2010

SO MANY news reports about Alzheimer's dementia flooded the media within the last few weeks that it's hard to remember them all.

Where to begin? That question not only prompts topics for this column, it also presents a fundamental question about the most appropriate time to begin diagnosing someone with Alzheimer's. Can a diagnosis of dementia ever be made too soon in a person's life?

In this regard, we learned about two new tools that might diagnose people with Alzheimer's earlier than was previously possible. (Way earlier.)

Traditionally, physicians diagnose dementia only after a person develops three conditions: impaired memory; a deficiency in at least one other intellectual capacity (like recognizing familiar objects or performing familiar tasks); and, as a result of those impairments, the inability to continue functioning within the world of his own making -- at home, at work, among friends.

But our two new tools -- a certain type of brain scan (a PET scan) and a spinal fluid test -- aim to detect Alzheimer's before a person even demonstrates any evidence of memory or functional impairment.

Instead, these tests look for evidence of "amyloid" buildup in the brain -- what many scientists consider to be the cause or precursor of Alzheimer's. The new tests establish, in essence, a pathological condition of "pre-dementia Alzheimer's" in an otherwise healthy person.

Diagnosing "pre-diseases" -- like "pre-diabetes" or "pre-hypertension" -- has become an increasingly common practice in our medical culture. Ironically, this tendency continues to expand all the while that millions of Americans find it increasingly difficult to access and afford health care for established, de-facto illnesses.

And, it should be noted, this trend also enlarges the already sizable pool of people with "pre-existing conditions" -- or, I suppose, "pre-pre-existing conditions" -- who will surely do battle with insurance companies in hopes of securing health coverage.

The pre-disease bandwagon additionally offers pharmaceutical companies the promise of a great ride. As prospectors used to claim during the old Gold Rush era, "There's opportunity in them thar' ills." Speculating on pre-illnesses raises opportunities to encourage medication intake earlier in patients' (or pre-patients') lives, and to develop new and extended drug markets.

And on a cultural level, every time we diagnostically label millions of healthy people with a "pre-disease," we progressively pathologize the human condition. In the U.S., the so-called national character has come to resemble Woody Allen more than the Marlboro man (without his cigarette pack). If we are not ill, we should expect to be so and to suffer the attendant anxiety. We may have entered "Prozac Nation" a decade ago, but now we squarely reside within a pre-Prozac state.  Read More