Vermont Kicks The War On Drugs

“Addiction is, at its core, a chronic disease,” he said. “We must do for this disease what we do for cancer, diabetes, heart, and other chronic illness: first, aim for prevention, and then eradicate any disease that develops with aggressive treatment.”
In the months since then, Vermont has built a kinder, gentler blueprint for tackling the heroin epidemic. Bloomberg Businessweek announced last week, that Vermont had “quit the war on drugs to treat heroin abuse as a health issue.” Rather than locking up addicts, the state is attempting to provide them opiate replacement drugs like Methadone and Suboxone and place them in treatment. Even addicts who are currently incarcerated will have better access to prescription drugs to help kick the habit. Meanwhile, the state is pouring more money into opening and operating rehabilitation centers and increasing prevention efforts in medical offices and schools. Vermont, as the governor’s words promised, is treating heroin addiction like a disease, rather than a crime.

Kudos!

Vermont Kicks The War On Drugs

“Addiction is, at its core, a chronic disease,” he said. “We must do for this disease what we do for cancer, diabetes, heart, and other chronic illness: first, aim for prevention, and then eradicate any disease that develops with aggressive treatment.”

In the months since then, Vermont has built a kinder, gentler blueprint for tackling the heroin epidemic. Bloomberg Businessweek announced last week, that Vermont had “quit the war on drugs to treat heroin abuse as a health issue.” Rather than locking up addicts, the state is attempting to provide them opiate replacement drugs like Methadone and Suboxone and place them in treatment. Even addicts who are currently incarcerated will have better access to prescription drugs to help kick the habit. Meanwhile, the state is pouring more money into opening and operating rehabilitation centers and increasing prevention efforts in medical offices and schools. Vermont, as the governor’s words promised, is treating heroin addiction like a disease, rather than a crime.

Kudos!

Skinny Shaming Is Not The Same As Fat Discrimination 

In the medical field, the bias impacts both patients and professionals. Patients report that they don’t trust an overweight doctor; in the UK, 54% of doctors stated that they should be allowed to refuse treatment to the obese. Another Yale study surveyed 84 medical professionals and found that “physicians associated obese patients with poor hygiene, non-compliance, hostility, and even dishonesty,” while “nurses believe that obese persons are overindulgent, lazy, experience unresolved anger, and are less successful than their average-weight counterparts.”

Housing, adoption, welfare, education — all these areas reveal a persistent bias against fat people and a preference toward thin. Even Instagram keeps flagging fat women’s bikini photos as “inappropriate.” So, when thin people decry bullying and discrimination, they’re not always wrong, but they’re deliberately avoiding the bigger picture. 

One-off discrimination is different than systemic discrimination.  Sometimes, it may suck to be skinny, but being skinny is certainly a more privileged position than being fat in a skinny person’s world.

Skinny Shaming Is Not The Same As Fat Discrimination 

In the medical field, the bias impacts both patients and professionals. Patients report that they don’t trust an overweight doctor; in the UK, 54% of doctors stated that they should be allowed to refuse treatment to the obese. Another Yale study surveyed 84 medical professionals and found that “physicians associated obese patients with poor hygiene, non-compliance, hostility, and even dishonesty,” while “nurses believe that obese persons are overindulgent, lazy, experience unresolved anger, and are less successful than their average-weight counterparts.”

Housing, adoption, welfare, education — all these areas reveal a persistent bias against fat people and a preference toward thin. Even Instagram keeps flagging fat women’s bikini photos as “inappropriate.” So, when thin people decry bullying and discrimination, they’re not always wrong, but they’re deliberately avoiding the bigger picture. 

One-off discrimination is different than systemic discrimination.  Sometimes, it may suck to be skinny, but being skinny is certainly a more privileged position than being fat in a skinny person’s world.

When Doctors Discriminate

The first time it was an ear, nose and throat doctor. I had an emergency visit for an ear infection, which was causing a level of pain I hadn’t experienced since giving birth. He looked at the list of drugs I was taking for my bipolar disorder and closed my chart.
“I don’t feel comfortable prescribing anything,” he said. “Not with everything else you’re on.” He said it was probably safe to take Tylenol and politely but firmly indicated it was time for me to go. The next day my eardrum ruptured and I was left with minor but permanent hearing loss.
…If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.
I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”

This state of affairs is awful.  Our medical programs need to focus more on stigma reduction and inclusion of people living with mental health challenges.  Check out Columbia’s Narrative Medicine program.

When Doctors Discriminate

The first time it was an ear, nose and throat doctor. I had an emergency visit for an ear infection, which was causing a level of pain I hadn’t experienced since giving birth. He looked at the list of drugs I was taking for my bipolar disorder and closed my chart.

“I don’t feel comfortable prescribing anything,” he said. “Not with everything else you’re on.” He said it was probably safe to take Tylenol and politely but firmly indicated it was time for me to go. The next day my eardrum ruptured and I was left with minor but permanent hearing loss.

…If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.

I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”

This state of affairs is awful.  Our medical programs need to focus more on stigma reduction and inclusion of people living with mental health challenges.  Check out Columbia’s Narrative Medicine program.

"Dr. Cabbie" in Theaters September 19th

When new immigrant Dr. Deepak Chopra discovers his Indian medical degree isn’t recognized in Canada, he starts driving a cab. One night, he heroically delivers a passenger (Natalie’s) baby in his backseat. Footage of the delivery accidentally goes viral. Now famous, Deepak gets nicknamed ‘Dr. Cabbie’ as passengers flock to his cab for treatment.

It’s great to see this film taking on the issue of barriers faced by international medical graduates (IMGs) seeking accreditation in Canada.  Chose this trailer because trailer #2 has some seriously sexist cat-calling.  Looking forward to watching this film!  Would love to see more mobile taxi clinics or cabbies sharing health and wellness advice with clients (and fewer barriers for IMGs seeking accreditation)!

How Racism Creeps Into Medicine

In 1864, the year before the Civil War ended, a massive study was launched to quantify the bodies of Union soldiers. One key finding in what would become a 613-page report was that soldiers classified as “White” had a higher lung capacity than those labeled “Full Blacks” or “Mulattoes.” The study relied on the spirometer—a medical instrument that measures lung capacity. This device was previously used by plantation physicians to show that black slaves had weaker lungs than white citizens. The Civil War study seemed to validate this view. As early as Thomas Jefferson’s Notes on the State of Virginia, in which he remarked on the dysfunction of the “pulmonary apparatus” of blacks, lungs were used as a marker of difference, a sign that black bodies were fit for the field and little else. (Forced labor was seen as a way to “vitalize the blood” of flawed black physiology. By this logic, slavery is what kept black bodies alive.)  
The notion that people of color have a racially defined deficiency isn’t new. The 19th century practice of measuring skulls, and equating them with morality and intelligence, is perhaps the most infamous example. But race-based measurements still persist. Today, doctors examine our lungs using spirometers that are “race corrected.” Normal values for lung health are reduced for patients that doctors identify as black. Not only might this practice mask economic or environmental explanations for lower lung capacity, but the logic of innate, racial difference is built into things like disability estimates, pre-employment physicals, and clinical diagnoses that rely on the spirometer. Race has become a biologically distinct, scientifically valid category despite the unnatural and social process of its creation.
In her recent book Breathing Race into the Machine, Lundy Braun, a professor of Africana studies and medical science at Brown University, reveals the political and social influences that constantly shape science and technology. She traces the history of the spirometer and explains its role in establishing a hierarchy of human health, and the belief that race is a kind of genetic essence. I spoke with her about the science of racial difference, its history, and its resurgence.

Such a fascinating read - and all the more reason to incorporate more social sciences within medical education.  Scientists and physicians must fully understand the social production of health disparities - these disparities are not innate but a product of the interplay between genes, the physical environment, and our social world.

How Racism Creeps Into Medicine

In 1864, the year before the Civil War ended, a massive study was launched to quantify the bodies of Union soldiers. One key finding in what would become a 613-page report was that soldiers classified as “White” had a higher lung capacity than those labeled “Full Blacks” or “Mulattoes.” The study relied on the spirometer—a medical instrument that measures lung capacity. This device was previously used by plantation physicians to show that black slaves had weaker lungs than white citizens. The Civil War study seemed to validate this view. As early as Thomas Jefferson’s Notes on the State of Virginia, in which he remarked on the dysfunction of the “pulmonary apparatus” of blacks, lungs were used as a marker of difference, a sign that black bodies were fit for the field and little else. (Forced labor was seen as a way to “vitalize the blood” of flawed black physiology. By this logic, slavery is what kept black bodies alive.)  

The notion that people of color have a racially defined deficiency isn’t new. The 19th century practice of measuring skulls, and equating them with morality and intelligence, is perhaps the most infamous example. But race-based measurements still persist. Today, doctors examine our lungs using spirometers that are “race corrected.” Normal values for lung health are reduced for patients that doctors identify as black. Not only might this practice mask economic or environmental explanations for lower lung capacity, but the logic of innate, racial difference is built into things like disability estimates, pre-employment physicals, and clinical diagnoses that rely on the spirometer. Race has become a biologically distinct, scientifically valid category despite the unnatural and social process of its creation.

In her recent book Breathing Race into the Machine, Lundy Braun, a professor of Africana studies and medical science at Brown University, reveals the political and social influences that constantly shape science and technology. She traces the history of the spirometer and explains its role in establishing a hierarchy of human health, and the belief that race is a kind of genetic essence. I spoke with her about the science of racial difference, its history, and its resurgence.

Such a fascinating read - and all the more reason to incorporate more social sciences within medical education.  Scientists and physicians must fully understand the social production of health disparities - these disparities are not innate but a product of the interplay between genes, the physical environment, and our social world.

I’m going to bring this infographic EVERYWHERE with me.

I’m going to bring this infographic EVERYWHERE with me.

This is the recruitment letter for the infamous US Federal Tuskegee Syphilis Study (1932 - 1972), promising treatment for syphilis when in fact participants were withheld treatment and instead studied as syphilis took its “natural course” (aka causing their drawn-out and painful deaths due to untreated syphilis).  It should come as no surprise that racism influenced the recruitment of Black men as the study population.  This makes me sick.  Although, in 1997, President Clinton formally apologized for the study, the social ramifications of the study among marginalized groups, especially Black Americans, continue to breed distrust in medicine and health research - and rightfully so. In the wake of the Michael Brown shooting, this recruitment letter only reinforces how little we have moved forward in racial justice - this is still a climate where black people are treated as objects and not subjects.

This is the recruitment letter for the infamous US Federal Tuskegee Syphilis Study (1932 - 1972), promising treatment for syphilis when in fact participants were withheld treatment and instead studied as syphilis took its “natural course” (aka causing their drawn-out and painful deaths due to untreated syphilis).  It should come as no surprise that racism influenced the recruitment of Black men as the study population.  This makes me sick. 

Although, in 1997, President Clinton formally apologized for the study, the social ramifications of the study among marginalized groups, especially Black Americans, continue to breed distrust in medicine and health research - and rightfully so.

In the wake of the Michael Brown shooting, this recruitment letter only reinforces how little we have moved forward in racial justice - this is still a climate where black people are treated as objects and not subjects.

(Source: thesocietypages.org)

Where The Police Are Part Of Mental Health Care

To deal with the problem, San Antonio and Bexar County have completely overhauled their mental-health system into a program considered a model for the rest of the nation. Today, the jails are under capacity, and the city has saved $50 million over the past five years. The effort has focused on an idea called “smart justice”—basically, diverting people with serious mental illness out of jail and into treatment instead. It is possible because all the players in the system that deal with mental illness—the police, the county jail, mental-health department, criminal courts, hospitals and homeless programs—pooled their resources to take better care of people with mental illness.

A coordinated approach is the best approach - good on ya’, San Antonio and Bexar County!

Where The Police Are Part Of Mental Health Care

To deal with the problem, San Antonio and Bexar County have completely overhauled their mental-health system into a program considered a model for the rest of the nation. Today, the jails are under capacity, and the city has saved $50 million over the past five years.

The effort has focused on an idea called “smart justice”—basically, diverting people with serious mental illness out of jail and into treatment instead. It is possible because all the players in the system that deal with mental illness—the police, the county jail, mental-health department, criminal courts, hospitals and homeless programs—pooled their resources to take better care of people with mental illness.

A coordinated approach is the best approach - good on ya’, San Antonio and Bexar County!

nickdouglas:

My friend Thomas Leveritt is enjoying well-earned wild success for his video, “How the sun sees you,” which shows what your face looks like under UV light—and then with sunscreen.

A very visual reminder to wear sunscreen and sunglasses!

(via coketalk)

Mary Lambert - Secrets

Promoting social inclusion of those living with mental health challenges, being fat positive, unabashedly queer, and generally awesome - gotta love Mary Lambert!