A paradigm shift possible in 'constructing the Medical Humanities gaze'?

I'm pleased to be able to present the formal abstract, which is in the public domain, for an important philosophically-rooted study in CROH, an important medical journal for cancer studies.  I don't want to exaggerate, but the study (yes, it has forerunners) holds promise of a new paradigm functioning in and for medicine.  First off, it doesn't dismiss the patient's story (see item iii in the abstract below).  In conjunction with this item and the other of the authors' four, we encounter the authors' call for an approach they name Medical Humanities.  Since I articulated my own cri de coeur that led to establishing this blog, Christian Medical Observations & Ruminations, I began narrativizing my own medical experience from the midst of controversy and keen disappointment, in the form of a a Complaint against the two chief medicos administering a medicine to me of a very different sort from Medical Humanities.  Rather than cancer and genetic testing, my presently focal malady is one involving diabetes.  Of course, now I have a different medico, a nurse practioner of considerable experience and largeness of heart.

I want to thank the medical researchers who have written the article (to which I don't have access), Dr Marco Annoni, Dr Giuseppe Schiavone, Dr Luca Chiapperino, and Dr Giovanni Ronilo.  But even a tidbit, a brief abstract in a medical journal can prove extremely valuable.  Such is the present contribution of the four doctors who authored the research.

-- Albert Gedraitis


Critical Reviews in Oncology Hematology (Feb2,2k13)

Constructing the Medical Humanities gaze

• Marco Annoni
, 
• Giuseppe Schiavone
, 
• Luca Chiapperino
, 
• Giovanni Boniolo

SEMM (European School of Molecular Medicine) & 

IEO (European Institute of Oncology), Via Adamello 16, 20139 Milan, Italy 

& Faculty of Medicine, University of Milan, Milan, Italy

Critical Reviews in Oncology / Hematology
Volume 84, Supplement 2 , Pages S5-S10, 31 December 2012

Abstract 

In the last few decades genomics has completely reshaped the way in which patients and physicians experience and make sense of illness. In this paper we build upon a real case – namely that of breast cancer genetic testing – in order to point to the shortcomings of the paradigm currently driving healthcare delivery. In particular, we put forward a viable analytical model for the construction of a proper decisional process broadening the scope of medical gaze onto human experience of illness. This model revolves around four main conceptual axes: 

(i) communicating information; 

(ii) informing decisions; 

(iii) respecting narratives; 

(iv) empowering decision-making. 

These four kernels, we argue, map precisely onto the main pitfalls of the model presently dealing with genetic testing provision. Medical Humanities, we conclude, ought to play a pivotal role in constructing the environment for competent decision-making, autonomous self-determination and respectful narrativization of one's own life.

Keywords:  Medical Humanities , Decision-making , Autonomy , Narrative medicine , Information provision , Empowerment , Breast cancer , Genetic susceptibility

 

PII: S1040-8428(13)70003-9

doi:10.1016/S1040-8428(13)70003-9

© 2012 Elsevier Ireland Ltd. All rights reserved.

Health: Sitting can ill you: read the pattern that has become multi-national and worldwide

Think about how much of your daily time is spent sitting ... scary, huh?  Now give Kate Linau's analytic article some meditative time and journey with her into what she's learned about our major (in)activity, on our rear ends, sitting ...

-- Albert Gedraitis


Maclean's.ca (Jan20,2k13)

Sitting can ill you

It’s tied to obesity, diabetes and cancer–and exercise won’t make up for it

by Kate Lunau on Tuesday, January 8, 2013 1:36pm - 5 Comments

On Sept. 24, 2007, a Monday evening, Cathleen Renner sat down in her home office to tackle a project. Renner, 47, was a manager at AT&T, where she’d been for 25 years. It isn’t clear how many hours she spent at the computer that night, making a plan for a possible employee strike, but she did send an email to a colleague at 12:26 a.m. When her son got up at 7 a.m., she was at her desk. Renner took him to the bus a little later, and as she walked out the door, she clutched her leg and let out a cry of pain. Still, she returned to work. At 11:34, she called an ambulance. Renner was dead by the time she reached the hospital.

Like most of us, Renner spent long hours on the job seated at her computer; in a workers’ compensation claim filed after her death, her husband argued that sitting was what killed her. (Renner died of a pulmonary embolism after a blood clot formed in her leg.) The case was not exactly straightforward; AT&T called an expert who pointed out Renner was morbidly obese, weighing 304 lb., and had recently started taking new medication, birth control pills. But in 2011 a New Jersey judge ruled in James Renner’s favour, noting his wife’s job required her to “spend unusually long hours at her computer” and awarding him workers’ compensation benefits as a result. The decision was extremely unusual, the first of its kind legal observers could recall. But if a growing number of health experts are right about the dangers of sitting, it could be a harbinger of things to come.

Like obesity or smoking before it, sitting is the new plague, and not just because it can lead to deadly blood clots. Alarmingly, the latest research links it to obesity, diabetes and the major killers, heart disease and cancer. And exercising the recommended half-hour a day, while beneficial, isn’t enough to stave off the ill effects of sitting. “Thirty minutes is two per cent of your day,” says Mark Tremblay, director of the Healthy Active Living and Obesity Research Group (HALO) at the CHEO Research Institute in Ottawa. “What about the other 98 per cent?”

Read more ...

Mayo Clinic: Proton beam therapy: Alternative to radiation therapy in some types of cancer with high recurrence

This article interests me from the contruction and tech viewpoints, but also and even more importantly from the viewpoint of building and technology aimed to reduce the cases of recurrent cancer treatments that two of my friends have been undergoing for years.  We have no such facility in Canada, so were my friends interested in such an advanced-tech treatment they woud have to travel south to the USA, I understand.  Machinery for just one of the proton beam treatment rooms requires two-floors of space to obtain "the proper treatment direction," I presume, in order to pinpoint the precise position of the cancerous cells in the patient's body.   In the long-run this medical-technological building is expected to reduce financial costs as well, in comparison to expenses of recurrent treatments for stricken patients.

— Albert Gedraitis

PostBulletin.com (Rochester, Minnesota USA) Nov13,2k12

$185 million Mayo Clinic proton beam therapy center marks construction milestone

Posted: Nov 13, 2012, 8:37 am

by Jeff Kiger The Post-Bulletin, Rochester MN Mayo Clinic's proton center by the numbers  • 2.9 million pounds of steel in the building. • 6,000 truckloads of dirt and rock excavated/removed. That's equal to 74,000 cubic yards. • 19,419 cubic yards of concrete. • 2.34 million pounds of rebar. • 500 construction jobs. By putting the final steel beam in place, Mayo Clinic in Rochester marked another milestone in its journey toward offering proton beam therapy on Monday. Despite the cold temperatures with a dusting of snow, many Mayo Clinic doctors and executives came out to sign the beam, which was painted white with a Christmas tree attached to it. John Black, the co-chairman of Mayo Clinic's proton beam center project, described the construction of the $185 million proton therapy treatment center as "online, on time and within budget." He said "the physics project with a beautiful appearance on the outside" should be able to start treating patients by mid-2015. The Rochester building will be named in honor of Richard O. Jacobson, in recognition of his $100 million gift to Mayo Clinic's Proton Beam Therapy Program. Jacobson founded the Jacobson Companies, a Des Moines corporation that operates public warehouses and trucking and packaging businesses. Mayo Clinic studies have predicted that about 1,240 patients per year will come to Rochester for treatment at the facility. The clinic also is building a second $185 million proton center on its Arizona campus. Black told the crowd huddled against the cold wind at the beam raising that the center is expected to "lower health care costs in the long term." Dr. Robert Foote, Mayo Clinic's chairman of Radiation Oncology, later elaborated on that. "The costs that will be lowered will be the costs associated with treating the acute side effects and long-term complications typically associated with conventional radiation therapy and the costs associated with treating recurrent cancer," Foote said. "The initial treatment costs will be lowered for some specific types of cancer in which the number of treatments can be substantially reduce." There are 10 such facilities in operation in the U.S. There are seven, including the two being built by Mayo Clinic, under construction. However, Mayo Clinic says the growing number of such facilities does not affect the drive to open the Rochester center. "There's no competitive pressure. The only pressure and urgency is for our patients with cancer," says Foote. The Rochester facility will feature four pencil-beam cancer treatment rooms. Each will be equipped with machinery that requires two floors of space to rotate to the proper treatment direction. When Mayo Clinic broke ground for the project, it was mentioned that a possible Phase II had been sketched out to add as many as 17 floors on top of the proton facility. Mayo Clinic officials say they have nothing to publicly report on a possible 17-floor addition.

Anecdotal confirmation of the thesis of "Complaint against Dr Alpha and Dr Beta"

Hi Albert, Jerry wrote: "Reynold Price's memoir, A Whole New Life, tells of his Job-like battle with cancer. Although the point of the book is certainly not to complain about doctors, it offers a very insightful look at medical treatment from the point of the patient. In his case, the doctors failed to mention what was for him the solution, which came from a nurse." Go to comments Can anyone send me this title?  I have zero dollars for books in my very tite budget (8-) Update Nov23,2k12 — A few days ago, I received a package in the mail from Amazon.com.  Inside, there were 2 books — A Whole New Life by Reynolds Price (Scribner: New York, 1982 1st edition) and The End of Your Life Book Club by Will Schwalbe (Alfred A. Knopf: New York, 2012). Many thanks to my anonymous gift-giver, whom I shall try to identify after making a few inquiries. (8-) Look for more updates to this blog-entry!