Kate Scannell, MD

By Dr. Kate Scannell, Syndicated Columnist
First published in print: 10/29/2011

You don't expect to read a Halloween story in the staid New England Journal of Medicine. But there it was this week -- a chilling tale about menacing hormones that kept taunting dieters to eat!

Dieters have long-suspected the presence of powerful adversarial forces laying "in weight" of any seemingly successful dieting effort. Lost pounds seem to return automatically, like cloying "boo!"-merangs.

Many dieters are dispirited by such frustrating experiences. They commonly convey a sense of feeling haunted by powerful internal messages that relentlessly coax them back to the snack table, scare them into believing they must -- and will -- return to their pre-diet weights.

Finally, Australian researchers have confirmed those dieters' suspicions.  Read More 

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.  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 10/01/2011

Vince Lombardi once famously declared that, in football, "The best defense is a good offense."

I thought about the coach's words while reading a new study about doctors ordering unnecessary medical tests and procedures -- whether practicing medicine on the defense or offense. The study was eye-opening in that it surveyed views about unnecessary medical care from the unique perspectives of 627 U.S. physicians on the front-line of medical practice -- internists and family practitioners who often call the plays that determine whether tests or subspecialty referrals are ordered.

In essence, this report in last week's Archives of Internal Medicine reveals that many doctors, by their own admission, believe that too many patients get too much care. And, after analyzing the explanations proposed by the doctors, the authors offer this striking conclusion: "Physicians believe they are paid to do more, and exposed to legal punishment if they do less."  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 09/18/2011

Sherlock Holmes famously partnered with his Doctor Watson to help solve the most baffling mysteries of his day. Soon, doctors in clinics will be partnering with another famous Watson, ostensibly to help solve diagnostic conundrums for patients.

Last week, IBM and health insurer WellPoint Inc. jointly announced that supercomputer Watson -- best known for trouncing human contestants on the TV game show "Jeopardy!" -- was being put to work as a doctor's aide. Or as an insurance agent. Maybe both. It's hard to compute just yet. Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 09/10/2011

Ten years ago, I wrote this column about doctoring throughout the week that followed the 9/11 terrorist attacks on the World Trade Center and the Pentagon. Most of the patients I saw had reported feeling anxious, distracted and troubled. Many were overwhelmed by anger, fear, sadness, or existential angst. Cognitive disturbances were epidemic -- trouble concentrating, thinking, and remembering.

I wrote then: "Depression's devitalizing fog cast across the lives of most patients and coworkers to varying degrees, and, on several occasions, the phrase 'Prozac nation' assumed new and prescient significance ... ."

Like many Americans, I was struggling a decade ago to find my way to "some kind of normal" through the communal haze, all the while the Twin Towers' ashes had not yet fully settled. It seemed that for days, the thick dust and debris kept falling, continually layering over what had been routine, obscuring the familiar. Everything became coated with dark surrealism.

Two days after the attack when I arrived at work, I stood hesitantly outside my office a while. I looked through the doorway at my old desk, my crammed bookshelves, my stacked medical journals, the photographs and cards from patients tacked to the walls -- and it all looked so very strange. The daily habit of my life and career felt suddenly foreign to me.

That same day, a patient told me that he felt thoroughly vindicated for not having followed my recommendation to schedule a screening colonoscopy. "After all," he said, "it could've been me in those Towers. And believe me, I would've been cursing you in my final moments knowing that I'd wasted my time having that test while an airplane took me out."
 Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 08/21/2011

You've got to be very careful if you don't know where you are going, because you might not get there. -- Yogi Berra

CONCEIVABLY, baseball legend Yogi Berra might have been referring to modern birthing trends. With new medical technologies constantly altering the conditions for human conception and birth, it's not always clear where we're going -- and if we're going to get there.

Last week, modern science threw another fastball when researchers claimed in the Journal of the American Medical Association that you could determine the sex of a fetus as early as seven weeks in its development in 95 percent of cases.

More remarkably, this determination could be made by sampling the mother's blood -- avoiding the risky and invasive methods we used to employ for fetal-DNA sex detection in the ancient days of ... well, yesterday.

Savvy readers may ask why this study is noteworthy. After all, since 1997 we've known that maternal blood carried free-floating fetal DNA, which could be analyzed for telltale evidence of either male (XY) or female (XX) chromosomes. Moreover, medical clinics in other countries have been offering maternal blood testing for fetal sex determination for years. And, not surprisingly, private companies have been marketing maternal blood and urine tests to consumers over the Internet, promising accuracy rates as great as 99 percent as early as 5-to-7 weeks' of gestation.

But the new study is radical because its researchers dared to test the test itself.  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in print: 08/06/2011

THINKING OFTEN about health care, I am increasingly disheartened about the direction it's taking in this country. We seem to be sailing further away from a clear understanding about the goals of medical care, on an expensive junket with politics and commerce commanding the helm.

It feels that we are sinking a little, our ship also bogged down with the weight of the federal deficit and hefty health care costs. We anxiously hang on because it's the only ship in sight, but all of us know there aren't enough lifeboats to go around.

So the last thing our health care system needed was last week's tribal tantrums in Congress rocking the boat for political show. The harrowing rollick not only nauseated most of us passengers -- it also demonstrated that our political officers were inept and unsafe navigators of the financial crisis on which health care drifts.  Read More 

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.  Read More 

By Dr. Kate Scannell
First Published in Print: 07/10/2011

A FEW weeks ago, I visited a hospitalized friend who was recuperating from hip-replacement surgery. While unpacking the deli items I promised to bring, he said, "Too bad! You just missed my orthopedic surgeon. He invented my hip replacement!"

"Really?" I said, almost spilling a carton of matzo ball soup.

"Yeah, he designed and patented it!" my friend bragged. "And he uses it in all of his hip surgeries!"

But I didn't feel as hip-hip-hooray about the news. An orthopedic surgeon inserting his patented, royalty-generating medical device into my friend's body as though it were an ATM card?

As a rheumatologist who'd cared for many arthritic patients needing joint replacements, I knew that the medical-device market was already steeped with tried-and-true hip replacement models. How could my friend have possibly evaluated the safety and efficacy of his surgeon's new -- and, undoubtedly, more expensive -- device? Was he aware that it had no known or knowable track record? What authentic choice did he truly have when consulting with his one-hip-wonder surgeon?  Read More 

By Dr. Kate Scannell
First Published in Print: 06/25/2011

TOBACCO MANUFACTURERS are fuming over the new warning labels that will be required on cigarette packages beginning next year. Cool camels and virile smokers pictured on current packs will have to make room for images of a stiff corpse. Or a not-so-virile smoker blowing smoke through a tracheostomy hole in his neck. Or a set of decaying teeth framed by cancer-eroded lips. In all, there will be nine possible graphic options associated with deadly serious text warnings about the life-threatening risks of tobacco consumption.

Last week, the Food and Drug Administration (FDA) revealed these new warning labels in advance of mandating their appearance on all cigarette packages and advertisements in the United States. By the fall of 2012, they are expected to occupy at least the upper half of the front and rear panels on cigarette packs, and at least the upper 20 percent of each ad.  Read More