Kate Scannell, MD

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 08/18/2012

Every doctor, it seems, has at least one story about a patient who, against all known odds, defied expectations and escaped -- "miraculously" -- from death's certain grasp.

One of mine involves a young man dying with multiple complications of AIDS during the early '80s. For days, his motionless body had been unresponsive to physical and verbal stimuli. He had ceased breathing and was ventilator-dependent. His blood pressure required chemical support to encourage blood flow. And one day, his heart just stopped beating. Honoring his previously expressed wishes, we disconnected the ventilator, the intravenous drips and the heart monitor, which had flat-lined. He didn't flinch when his breathing tube was extracted. After performing the ritual examination to determine death, I joined family members who comforted one another at his bedside, telling stories involving the patient, which made them laugh and cry.

About 10 minutes later, I informed the family that I needed to leave but would return within the hour. Before departing, I took the patient's cold hand in mine, while also checking for a pulse (none), and I placed my other hand over his heart (no beating and no response to the physical stimuli I covertly applied).

Approximately 30 minutes later, I returned to the patient's bedside. His cadaveric body had turned yet a deeper shade of gray, and his family was preparing to leave. We all said our final goodbyes and headed for the exit. And that's when, with our backs all turned, we heard him ask: "Where's everyone going?" Well, we were going into shock. And he proceeded to live several more months.

In general, we doctors don't like to speak publicly about such "cases." In fact, as someone who has written extensively about doctoring, I have not until now written about this patient. I didn't even include his story in the book I published -- "Death of the Good Doctor" -- that chronicles my experiences caring for AIDS patients within that same hospital during the early epidemic. Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 08/04/2012

I always learn a lot while watching the Olympics. During the parade of nations, I'm routinely educated about the existence of at least two countries that have, until then, escaped my awareness. I often discover that an otherwise ordinary capacity of the human body has been associated with some type of ball to create a new Olympic sport. And with each Olympics, I am freshly reminded that I am months or years behind in my personal fitness program.

But late last month, I was thoroughly stunned to learn from the 2012 Opening Ceremonies in London that real doctors can actually dance! The spectacle of British physicians and nurses kicking up their heels swept me off my feet. And it provided reassuring proof that medical office parties need not always be flat-footed events.

Watching an octogenarian Queen parachute into the stadium was unremarkable compared to witnessing happy doctors performing the Lindy Hop, keeping time and rhythm, having fun, receiving cheers from an appreciative public. In contrast, on this side of the pond, doctors are more likely to be doing the hobble, dancing as fast as they can, trying to work a somewhat cheerless crowd.

In the tradition of Olympics host countries, the Brits set out in the Opening Ceremony to showcase their unique history and culture. Homage was paid to the industrial revolution, the Beatles, the World Wide Web, multiculturalism, Mary Poppins, and, yes, the "NHS" -- the country's health care system.

The National Health Service is Britain's taxpayer funded, government-run health care system (akin to our country's Medicare program) Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 07/21/2012

Last Tuesday, I was eating lunch in a downtown Oakland diner when a 20-something man entered and politely asked the owner for work -- any work at all. The owner apologized profusely, regretting that he had no employment to offer.

Minutes later, a woman and her daughter sat down at a nearby table and carefully counted what coins they carried -- ostensibly assessing whether they could afford a lunch plate. After the daughter asked, "Do we have enough?" the mother replied, "no," and they left the restaurant, declining an offer of help.

On my way out, I told the owner that I had overheard his conversation with the job seeker. "Awfully hard times," I said.

The owner shook his head and said that he had never had so many people seeking work. And that he had never felt so helpless. "Business is down here, everywhere," he said. "We have no jobs to offer. Last week, a young man with an M.A. came in, begging to work in my kitchen."

As we talked, an elderly woman passed by, pushing a shopping cart stuffed with garbage bags. Echoing a commonly heard refrain, the diner's owner charged, "Washington politicians have no idea what it's really like for most of us. To survive -- find work, live in a safe place, get decent health care -- they just have no idea."

At home that evening, I kept thinking about people from the diner. It had been painfully obvious that they were struggling mightily -- for a $3.50 lunch special, a minimum-wage job, a small business establishment on a worn corner of Oakland. Were these people and their struggles really invisible to "Washington politicians?"

You almost want to believe that's true because the alternative -- politicians seeing but doing little to help -- is even more dispiriting. Still, on street corners across America, joblessness and economic insecurity are on hard to ignore.

Perhaps the seeming invisibility of careworn Americans is a byproduct of cognitive dissonance. That is, while our eyes might detect a family rummaging through garbage bins along Main Street, our brain rejects that as possible; it simply couldn't -- and shouldn't -- be happening in the world's wealthiest nation.

Regardless -- whether unseen, or seen but disbelieved -- impoverished Americans exist, and their ranks are growing. Recent U.S. census data reveal that in 2010 our country's poverty rate jumped to 15 percent -- representing more than 48 million Americans.

Of course, it is not only politicians who may have blind spots on this issue. But it is to them that we look for moral leadership and problem-solving when so many millions of us urgently need a helping hand. Serving as our governmental representatives, they are supposed to be of us, for us, and by us. All of us.

That's why it's so disturbing to hear that several states are threatening to boycott Medicaid expansion as proposed by the Affordable Care Act (ACA) -- our nation's new health care reform law.  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 07/06/2012

Cora Sledge soberly recalled all the useless prayers she had offered up throughout her 80 years of hardscrabble living. Without a hint of self-pity, she recounted: "I used to pray to keep my ma and daddy safe, but that was no use. I prayed for gifts at Christmas and to win the school prize. I prayed to be slim, so no one would make fun of me. That didn't happen, either. I asked Jesus to protect my kids. Look what happened."

Yet somehow, despite all the tragedy that had seeped into her long life through small holes in her big prayers, Cora remained hopeful about her uncertain future. But her hopes now focused more internally, and her prayers reshaped around her longing to escape the assisted-living facility in which her children had abandoned her. She asked for her heart to be healed, all the while it stayed open and "ready to love." She explained, "I pray now like I did when I was a little girl -- not needing to understand. I ask for simple things. Let me not hurt. Let me not be hungry, or cold. Please keep my loneliness at bay."

I finished reading about Cora Sledge in Berkeley novelist Leslie Larson's moving (and comical) novel "Breaking Out of Bedlam" the same day that UC San Francisco researchers reported finding statistical associations between loneliness and an increased risk of dying among elderly people.  Read More 

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. Read More 

By Dr. Kate Scannell, Syndicated columnist; First Published in Print: 06/09/2012

Can physical exercise be unhealthy for you?

Throughout my career as a doctor, this question certainly ranks amongst "the top 10" questions ever raised by my patients. Typically, it was asked by patients who, like Mark Twain, had "never taken any exercise except sleeping and resting" and intended to argue against my recommendation for a healthy dose of physical activity.

Everyone, it seemed, could recount a cautionary tale about a friend or family member who had suffered some ungodly accident or illness in the course of exercising.  Read More 

By Dr. Kate Scannell, Syndicated Columnist; First published in print: 05/27/2012

When I was a young girl, I watched my mother use a small amount of carbonated cola to successfully remove a rusty stain from our kitchen sink. I was amazed -- and a bit worried -- that a beverage I regularly consumed could also serve as a powerful stain remover.

Inspired by my mother's wizardry, I wondered what else the cola might do. Let's just say that experimentation allowed me to discover that the cola could not remove freckles from my little sister's face. And it failed as fuel for my father's cigarette lighter.

Obviously, the cola manufacturer made no marketing claims about its beverage other than encouraging its use as a tasty thirst quencher. My mother and I had freely chosen to use the cola for wholly unapproved uses -- notably, with both success and failure.

After becoming a physician, I discovered that we doctors often prescribed medications for unproven and unapproved uses. We would speculate how a drug proven useful by research to treat a specific illness might work for other diseases as well. That ostensible leap of faith into "the art of medicine" usually entailed a dollop of scientific hypothesis and a dash of hope, and it was generally taken only when a known cure for a patient's disease did not exist. Notably, both remarkable successes and lamentable failures ensued.

There is much talk today about "evidence-based medicine" providing the great corrective to drug-prescribing and medical practice guided by hunch and hope. In theory, evidence-based medicine operates on the assumption that judicious analysis of all the published evidence concerning a particular treatment will lead to an accurate assessment of that treatment's true effects.  Read More 

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."  Read More 

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.  Read More 

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. Read More