Kate Scannell, MD

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 10/04/10

"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? 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 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 

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