The New York Times Sunday Review: Conversations Between Doctor And Patient

The Letter To the Editor:

The old days of medical paternalism are gone. Today we have shared decision-making, in which doctors describe treatment options and patients choose the one they prefer.

It sounds simple, but it’s not. I learned this when I had to decide whether to have a feeding tube during cancer treatment. Doctors explained the tube’s benefits and risks, then left it to me to decide. I said no. I had my reasons — I didn’t want a foreign object in my body or an overnight stay in the hospital. I wanted to prove that I was tough enough to get through treatment without extra help.

But this was a bad decision. As time passed, I became too weak to continue daily radiation sessions. People kept trying to get me to change my mind, and finally a nurse succeeded. Consenting to the tube was the right thing to do, but it took a lot of persuasion for me to accept that.

Argument is a legitimate part of shared decision-making, but not everyone understands this. Some clinicians think that respect for autonomy means they should never disagree with a patient. Some think that it would be cruel to question what a seriously ill person says she wants. Some don’t want to devote time to the hard conversations that produce good decisions.

Patients avoid arguments, too. Many are too intimidated to take issue with anything a doctor says. But doctors aren’t always right, and patients who are afraid to argue can pay the price. A friend had his cancer properly diagnosed only after he challenged his doctors’ opinions about what was wrong.

In everyday life, arguments with family and friends help us think through the consequences of our choices and sometimes change our minds. Patients and doctors should do the same for one another.

REBECCA DRESSER
St. Louis, Aug. 21, 2012

The writer is a professor of law and medical humanities at Washington University and the editor of “Malignant: Medical Ethicists Confront Cancer.”

Read More: http://www.nytimes.com/2012/08/26/opinion/sunday/sunday-dialogue-conversations-between-doctor-and-patient.html?smid=pl-share

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Alice Peterson: Fifty Shades Of Grey Booted Off Kindle Top Spot By Romantic Novel About Dog Walkers

Move over EL James, there’s a new top dog in town.

But she’s only from down the road.

The third installment of James’ saucy ‘mummy porn’ trilogy Fifty Shades Of Grey has lost its vice-like grip on the Kindle best-selling ebook chart, having being ousted by a sweet literary romance about a group of dog walkers – and both writers are from west London.

Monday To Friday Man is the fourth novel and seventh book from Hammersmith-based dog lover Alice Peterson, 38, a former professional tennis player who turned to writing after her promising athletic career was prematurely curtailed at the age of 18 when she was left wheelchair-bound by rheumatoid arthritis.

Read More: http://www.dailymail.co.uk/femail/article-2190882/EL-James-Fifty-Shades-Grey-drops-Kindle-list-Alice-Petersons-Monday-Friday-Man-hits-top.html

Alice Peterson is the author of Another Alice.

Love, lust boys and shopping – the main worries of a teenage girl? Not for eighteen-year-old Alice Peterson, who, at the height of her youth and extremely promising tennis career, was diagnosed with rheumatoid arthritis.

In the midst of shock and denial, and the enduring question, ‘Isn’t it old people who get arthritis?’ Alice had to learn to live with what quickly turned from the odd ache and pain to an aggressive form of the illness, and rediscover a new path in life.

Another Alice is at times utterly heartbreaking, and at others laugh-out-loud. Here is a story of how, armed with humour and courage, she left behind a world she loved to overcome the pain of a degenerative disease.

Told with wit, charm and frankness, Another Alice is also a story of friendship, family, growing up and the desire to be normal. Above all it celebrates the power of the human spirit.

More Info: http://www.alicepeterson.co.uk/another-alice.htm

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New York Times: How To Pursue An Active Live With Arthritis

Arthritis is the leading cause of disability in the United States. But with a few simple adjustments, life can be easier and less painful for the millions of people who now permit this common condition to limit what they are able to do and enjoy.

The changes can be as simple as playing with grandchildren on the couch or at a table, instead of on the floor, said one knowledgeable grandfather, Dr. Kenneth Brandt, who is also an orthopedic surgeon and clinical professor of medicine at the University of Kansas Medical Center in Kansas City.

The trick is to decide what activities are important to you and then modify them in ways that ease symptoms like pain, stiffness and fatigue. Arthritis may be a mechanical disability, but it need not turn people into couch potatoes.

Read More: http://well.blogs.nytimes.com/2012/07/16/jane-brody-on-arthritis/

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The New York Times: The ‘Busy’ Trap

Idleness is not just a vacation, an indulgence or a vice; it is as indispensable to the brain as vitamin D is to the body, and deprived of it we suffer a mental affliction as disfiguring as rickets. The space and quiet that idleness provides is a necessary condition for standing back from life and seeing it whole, for making unexpected connections and waiting for the wild summer lightning strikes of inspiration — it is, paradoxically, necessary to getting any work done. “Idle dreaming is often of the essence of what we do,” wrote Thomas Pynchon in his essay on sloth. Archimedes’ “Eureka” in the bath, Newton’s apple, Jekyll & Hyde and the benzene ring: history is full of stories of inspirations that come in idle moments and dreams. It almost makes you wonder whether loafers, goldbricks and no-accounts aren’t responsible for more of the world’s great ideas, inventions and masterpieces than the hardworking.

Read More: http://opinionator.blogs.nytimes.com/2012/06/30/the-busy-trap/

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Journal Sentinel: When The Choice Is Health Or Hearth

For Michelle Grosskreuz, the choice came down to her home or her health.

The moving van comes next week.

She has lost her condominium in St. Francis to mortgage foreclosure, in part because of the rising cost of the medications she takes for rheumatoid arthritis that has ravaged multiple joints in her body since she was 2 years old. She is 38 now.

Paradoxically, what she wants you to know is that she’s among the lucky ones. She has insurance that helps cover the cost of the drugs.

“There are so many others out there who have higher deductibles and out-of-pocket costs where these biologic medications, whether it’s for arthritis, multiple sclerosis, epilepsy, organ transplant, etc., take allof their extra money,” she said.

Or patients decide they cannot afford the specialty prescriptions and they go without, often leading to more health problems and costs down the road.

Read More: http://www.jsonline.com/news/milwaukee/when-the-choice-is-health-or-hearth-k45k7oo-156039825.html

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