Kate Scannell, MD

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/07/2012

Is it OK for an anesthesiologist to play Angry Birds on his iPhone while administering anesthesia during a gallbladder surgery? During your gallbladder surgery?

What do you think about a surgeon voice-dialing her colleagues or chatting with family during the operation?

Although we've inhabited the Digital Age for many years, only recently have we begun to examine how it might affect us personally as patients and doctors, and whether overall patient safety and care have actually improved.

This inquiry is long overdue, and, as recent studies suggest, urgent.  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: November 27, 2011

Like many Americans this past week, my friends and I shared a turkey feast and gave thanks for all that was good in our lives and the world. But this annual ritual is always difficult for me, because I also think about things for which I am not grateful -- the economic and political turmoil in the world, people starving and homeless, my patients who have suffered and died, and ...

Still, I routinely manage to keep my sadness private, off the proverbial table. Pumpkin pie helps. So does a little wine.

While listening to my friends' expressions of gratitude, I am profoundly impressed with the role that happenstance has played in shaping everyone's fortunes (and hardships). Personal intention and deliberate actions have certainly played defining roles, but, to a large extent, our lot in life is the "real" estate of providence and serendipity. Through no free choice or conscious planning, we are born into poverty or wealth, in times and places associated with war or peace, to good or bad parents, and with variable genetic odds of living healthy lives. Our survival and opportunities to flourish in the world largely begin "as luck would have it." Read More 

By Dr. Kate Scannell, Syndicated columnist
First publised in print: 11/12/2011

I was checking out the broccoli at the local grocery store when an ex-patient tapped me on the shoulder and began a conversation. I was relieved that he found me in the fresh produce section rather than the wine or bakery aisles.

Naturally, he updated me about his chronic medical problems. I was sorry to hear that his diabetes had become difficult to control, all the while registering the high-calorie, processed foods in his shopping cart -- along with the discounted post-Halloween candy.

Nonetheless, he started complaining about his current doctor -- her "uncaring nature." He was annoyed by her slowness in responding to his recent request for a prescription. He was frustrated with her for "looking at the computer screen all the time" they were together in clinic. And after reciting a sad litany of further grievances, he paused dramatically for a moment before asking, "But you know what irks me the most about her?"

He stared intensely at me and waited, with an expectant smile on his face. Not knowing the answer, I began to wilt faster than the broccoli in my sweaty hands. The "doctor in me" wanted to answer his question correctly and assuredly, because he seemed to be suffering such estrangement from his current physician. He needed a healing dose of connection with an MD, I thought.

Luckily, a grocery clerk appeared and asked whether she could help us. My ex-patient instantly replied, "No. I'm just telling my old doctor here how my new doctor has never examined me."  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
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, Syndicated Columnist
First Published in Print: 05/15/2011

FOR WEEKS, we've been reading about air traffic controllers falling asleep on the job. In one case, an airborne ambulance transporting a sick patient had to circle a Nevada airport for 16 minutes while the controller snoozed. In March, two jetliners inbound for Reagan National Airport were forced to land without clearance while the air controller slept.

In response to such disturbing incidents, the office of fatigue risk management at the Federal Aviation Administration (FAA) has been collaborating with the National Air Traffic Controllers Association to identify and remedy conditions fostering controller fatigue. While not an expert at such matters, I have a (grounded) hunch these agencies will discover that 99.3 percent of human beings who sit alone within a tower, staring out for hours at a yawning night sky, working irregularly staggered shifts -- will tend to feel a little sleepy.

So far, the FAA has recommended a minimum nine-hour break between controller shifts, and at least one additional buddy present on overnight shifts at 27 airports that had previously maintained only one controller.

On the runway of public opinion about aviation safety, concerns about pilot fatigue immediately preceded our current focus on air traffic controllers. An ABC News investigative report in February claimed that "despite denials from the airline industry, large numbers of pilots report to duty every day after getting only a few hours of what fatigue experts call 'destructive sleep' in crowded crew lounges and so-called 'crash pads'." More than two dozen accidents and 250 fatalities in the U.S. had been linked to pilot fatigue in the past 20 years.

Public anxiety associated with air traffic controller or pilot fatigue is soaring high, partly fueled by post-9/11 insecurities regarding flying in general. But the reality is that fatigue-related safety hazards loom even larger on the ground. Whether referring to ourselves or to others within our daily lives, being sleepless IN Seattle might be riskier overall than being sleepless over it.  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