Thursday, January 20, 2011

Homework #31: Comments

Me to Elizabeth

I really liked the research you did. It was very different from a lot of the things people did. My favorite line was "But the etymology of "die" shows that over time, humans have tried to make the idea of dying happier by "euphemistically" changing words.” Because it showed how humans in general try to soften the blow of harsh terms or events.



Me to Amanda:

Amanda, I really enjoyed reading your blog. The whole topic was really interesting and I think your take on it was fascinating. My favorite line was "hospitals won’t make money unless 'death is kept alive.'" Your grandmother's POV is really interesting and I completely agree.



Arden to me:

Sarah,
I enjoyed your elevator speech. I thought your choice of topic was interesting and unlike most other projects. I’m exploring your blog for those reasons. The reasons I found this most interesting was the personal experience you chose to incorporate. It was capturing how you compared the doctors’ relationships to patients with the midwives relationship. From your post it seems the mid wife was significantly closer with the patient, but I’m curious to know what their relationship is like after the fact of giving birth.
My favorite line was the last one when you wrote, "By using both allopathic/conventional care and homeopathic care, one is able to get the maximum treatment needed to make their illness least painful and/or time consuming." Most people's initial choices are treatments that entail pain killer medication. The methods of homeopathic care are often over looked and can be more beneficial in some cases.
Well done.

Sunday, January 16, 2011

Homework #30: Culminating Experimental Project

The dominant practice of medicine in our country today is the act of going to a hospital and being treated by doctors in lab coats with drugs and quick fixes. However, an alternative way of medicine is slowly becoming more and more popular: the practice of homeopathy or alternative healing. Some people think anti-biotic and drug use is the only way to heal while others believe herbs, rest, and/or exercise is healthier and more successful. In an article by ABC Homeopathy, it was stated that “While in many cases symptoms are relieved, cured, or prevented many allopathic medicines can do a lot of harm to your body.” This is the argument that a lot of homeopaths hold when the conversation is brought up. In hospitals, there are less personal interactions between a patient and their doctor. In some cases, this can comfort a patient: knowing there is a line between their physician and themselves. It’s as if they need to perceive their doctor as above normal or human in order to succumb to the physician’s orders. However, most people need a personal relationship with the person who holds their life in their hands. Over the past 50 years, the process of dying and giving birth has changed dramatically. Only two generations ago, most people gave birth and died at home. In an article on birthing centers and hospices by UC Berkeley, “Today in the United states, 95% of births take place in hospitals and over 70% of deaths take place in nursing homes and hospitals.” This just shows how much society relies on doctors and medicine.

Through an interview with a midwife, I learned about the main differences between doctoral care and preventive care. In her line of work, she is constantly with the mother and learning everything she can about the mother in order to determine the best approach to a healthy birth. I believe this is what a lot of hospice nurses and homeopaths mean when they say that it’s a lot more personal than hospital care. In order to prevent illness or problems, Maria (using a different name), discusses the background of each patient such as health, diet, social dangers (teenagers, abuse) and previous births. They also bring in modern technology like sonograms in order to get a clear picture of the baby’s organs. When I was discussing the necessity of a background check with Maria, she told me about a very interesting story. A pregnant woman came to her and as they were discussing the pregnancy, she admitted that this baby was a result of a rape. The mother was very tense about whether or not she would love the baby as her own. Maria was the only one who knew of this. When the baby came, the mother was extremely anxious so Maria took the baby out before the mother could see it in order to give her time to get ready. Meanwhile, the baby was gripping the shirt in a way that usually indicates a mental illness of some sort. So where most doctors would prescribe a drug or run multiple tests, Maria came to the conclusion that the baby was adapting the mother’s tension and the only treatment it needed was to be held and massaged. After that, the mother relaxed and so did the baby. Maria would not have been able to figure this out if she hadn’t discussed the background with the mother first.

When asked about her own personal encounters with homeopathic medicine, Maria said that when her kids were young, they had warts and no cream or medicine was working. So they turned to a homeopath who asked very unusual questions (in her opinion) such as “what time of day is he most hot?” or “when does he go to bed?” after answering these questions, they gave him a tiny little pill that when taken after two days, made all of the warts disappear. However, when Maria did the same thing again with her daughter, the pill didn’t work and they had to try something else. In conclusion, homeopathy doesn’t work for everyone and therefore is not always the best answer. To Maria, the best way of healing is mixing the two together. By using both allopathic/conventional care and homeopathic care, one is able to get the maximum treatment needed to make their illness least painful and/or time consuming.

Tuesday, January 4, 2011

Homework #28: Comments

My dad: Sarah, I found the best part of your essay to be the penultimate paragraph about the gap between care provided to ICU patients as compared to those who are not in immediate danger. You could strengthen your case for better balance by pointing out how more attentive and thorough care for "normal" patients could avert crises and deterioration and reduce the need for intensive care in the first place.

------------------------

What I said:

Arden- "We are all in the same boat, faced with the scary idea of limited living time, talking about death, accepting it I think makes it easier." I really liked this line and how you presented it. I agree with what you're saying.You are a very good writer, my attention was grasped as soon as I started reading.

Homework #24: Reader Response 3

Albom, Mitch. Tuesdays with Morrie. New York: Doubleday, 1997. Print.

This section was mostly the process and final end of Morrie’s life.

“People are only mean when they’re threatened… and that’s what our culture does. That’s what our economy does. And when you get threatened, you start looking out only for yourself… It is all part of our culture” (P 154).  What Morrie is saying here is that we go on the defensive when we are attacked, which makes sense, but it comes out as aggressive or mean. I think that he’s absolutely in right that we as a society are constantly viewed as cruel or mean but only because we are always being threatened. This applies to the individual too. When people are threatened, other things seem to lose meaning and it becomes all about how we can threaten the other back. This results in aggressiveness and isolation – making it all about you. I agree with Morrie on this quote, but I don’t think that’s the only time when people are mean. Sometimes it can come from trying to hide their emotional feelings and trying to put up an emotionless front which can appear mean to most people.

“The big things – how we think, what we value – those you must choose yourself. You can’t let anyone – or any society – determine those for you” (P 155). I connected with this line a lot because I’ve often thought the same thing. What Morrie is saying is that we shouldn’t let the people or world around us determine what we should do, how we should act, or what we should love. They are our own decisions to make alone and they should be based on our own experiences.

“The problem, Mitch, is that we don’t believe we are as much alike as we are. Whites and blacks, Catholics and Protestants, men and women. If we saw each other as more alike, we might be very eager to join one big human family in this world, and to care about that family the way we care about our own” (P 156). What Morrie is saying here is that we all identify the differences between each other instead of just living with one another. We point out how we are all different and then make judgments based on those differences. If we pointed out how we were alike instead, then we might be able to care for one another the way we care for those we have most in common with. I agree with this statement because I’ve often thought that even if you are civil with people who are different from you, there is still a difference there, be it skin color, religion, or gender. If only we could overlook that difference, I think there would be much less hate in the world.

“Be compassionate and take responsibility for each other. If we only learned those lessons, this world would be so much better a place” (P 163). To me, this is how Morrie became so well loved by all in the first place. Even when he wasn’t dying, he still lived by this lesson with his students and with his family. I think that this is a lesson that is more instinctual than anything else because it’s hard to learn how to be compassionate towards someone if you haven’t been doing it your whole life, especially towards a stranger or acquaintance. To be able to sympathize with people who aren’t your closest friends and family is not something that most people can do easily. However, taking responsibility for each other is something that most people just don’t want to do because they are afraid of the consequences that might follow; or they just feel as if they don’t have to because it doesn’t apply to them. But it does in reality, because if that person can take responsibility for others, then they will get the same treatment. This is why Morrie said the world would be a better place if people lived by this lesson, because they would be more understanding of the problems around them and maybe then the problems could be solved. 

“If we know, in the end, that we can ultimately have that peace with dying, then we can finally do the really hard thing… Make peace with living” (P 173). This quote confused me a little which is why I wrote it down. I don’t understand how, if one is healthy, they can look ahead in life and say “I am eventually going to die and I accept that,” and then be able to live a better life. I also don’t understand what he means when he says: “make peace with living,” because to me, that means accept that you’re living which I think most people have done. If I were to paraphrase this I would say that it means, once you accept that you will eventually die and you can deal with it instead of fear it, then you can continue on with your life in a more meaningful way. In some ways I can agree with this – that we can live more thoroughly if we stop fearing death. But I also think that living more meaningful lives is not always the result of accepting death. 

“It’s natural to die. The fact that we make such a big hullabaloo over it is all because we don’t see ourselves as a part of nature. We think because we’re human we’re something above nature” (P 173). I personally love this quote. It points out all of the flaws that humans have and why we have them. I agree completely with this statement because I too think that we feel as if we are above nature and can avoid things that are supposed to happen naturally. I agree that we all fear death, but I also think it’s related to how we see death. There is unnatural death all around us – on TV, in movies. We can’t accept it when it’s real because we are used to telling ourselves it’s not when it’s on TV. It also connects back to our food. When we eat meat, we know that what we are eating used to be an animal that was killed. So when death comes for us, I think we subconsciously identify with those animals and it scares us that we have that in common with them.

Homework #23: Reader Response 2

Albom, Mitch. Tuesdays with Morrie. New York: Doubleday, 1997. Print.

My observations are on pages 80-128 where Morrie and Mitch discuss death, family, emotions and fear of aging. The main themes include Morrie’s point that without love we can’t survive, and sometimes we forget that. Another point is that once you learn how to die, you learn how to live more fully. Our culture is obsessed with youth and once we let go of the fears of aging and dying we can better enjoy living.

“Everyone knows they’re going to die, but nobody believes it.  If we did, we would do things differently… there’s a better approach. To know you’re going to die, and to be prepared for it at any time…That way you can actually be more involved in your life while you’re living” (P 81). In this quote, Morrie is basically saying that although we know death is inevitable, we are still shocked when it comes. However, if we did know exactly when we were going to die, the world would be different.  Morrie says that if we acted as if each day were our last day, and we could die any second, we would be more aware of our actions, and what really makes us satisfied.  In the movie, “The Last Holiday,” the character played by Queen Latifah learns she has only a short time to live.  She quits her awful job, cashes in all her savings, and heads to Europe to enjoy life.  In the process, she lives life to the fullest and meets people who are drawn to her wonderful outlook on life.  Even as she is facing life, she is helping others live more genuine lives.  She has nothing left to lose, so is very honest.  While that Hollywood tale had a happier ending than Morrie’s, the point is the same:  that facing death helps us to focus on what matters most in life. 

“The truth is, Mitch, ‘once you learn how to die, you learn how to live’” (P 82). When I read this line in the book, it seemed to me that this is the core of the message that Morrie was trying to make. I think that by saying this, Morrie wanted Mitch to understand what it meant to die or to see death so that he could inevitably live his own life the right way. What Morrie is saying is that when people go through life, they aren’t really living because they are constantly afraid of dying. They’re also focused on accumulating things and success and lots of trivial things.  However, if one ends up in a situation where they know they’re going to die, it makes them rethink all of the different actions they’ve made and they can really identify with how they should’ve acted or reacted. Only then can they really understand how to live.  Morrie’s effort, through this book, is to share this insight with others before they are facing death.

“Love each other or perish” (P 91). This is during the discussion of family. Morrie is describing to Mitch where he would be without his family. This line is saying that people need loved ones around them and people who are there for them because that’s what will make them happiest. Morrie says that if he didn’t have his family around, he probably wouldn’t be as able as he was at that stage of the disease. When he says “love each other or perish,” I think it means that you need to be able to rely on other people. If someone goes through life with no one else around, it can get lonely and miserable and should that person get sick, there would be no one to take care of them. With people in our lives who love us and want to care for us, we are more likely to try and deal with whatever sickness comes our way.

“You’re afraid of the pain, you’re afraid of the grief.  You’re afraid of the vulnerability that loving entails.   But by throwing yourself into these emotions, by allowing yourself to dive in, all the way, over your head, even, you experience them fully and completely” (P 103-104). To me, this line says a lot. As in, there is a deeper meaning to what Morrie is saying. What he is saying is that in our culture, people are so afraid of feeling heavy emotions because it makes us feel vulnerable. We don’t like to seem weak to other people, or possibly being hurt, so we try and hide our feelings. If we could just allow the feelings to take over instead of burying them, then maybe we could get a better sense of what they actually feel like and really experience them for the first time. Most people don’t do this because we are too obsessed with how other people see us, or too protective of ourselves.

Morrie’s process of dying from ALS is very unusual in our culture.  He was not focused on himself and his illness, but on other people.  He was eager to share insights from his life to help others.  Some of these insights include:

•    Being around people you love is always better
•    Be selfless even when at your weakest
•    Don’t hold in too long and don’t let go too soon

One insight from Morrie’s experience is that dying at home, surrounded by friends and family, is a more positive alternative to dying alone in a hospital, hooked up to machines.  Also, that drugs and medicines cannot take the place of love and caring.  An interesting example of creative alternatives to care at the end of life was featured in the New York Times this week.  [“Giving Alzheimer’s Patients Their Way, Even Doses of Chocolate,” Pam Belluck, January 1, 2011]  At the Beatitudes Nursing Home in Phoenix, AZ, they are caring for elderly with dementia and Alzheimers in new ways.  They allow them to eat and bathe when they want, they have stopped giving many medications used only to control them, and do not restrain them.  They have fake bus stops outside, so people can sit at the bus stops (until they forget where they were going.)  It has produced remarkable results. It seems that much of the medications and care is more about care givers now, and less about the patients. Similar to Morrie, the possibility of being heard and loved and cared for, and being allowed to give back, makes illness and dying more humane.

Saturday, January 1, 2011

Homework #27: Visiting an Unwell Person

This holiday, I was in Texas. Every day was planned out so there wasn’t really any time to visit someone who was sick. Instead, I interviewed my mother about her experience in visiting my good friend’s dad in the hospital. He’d had a long term illness that weakened him so about 4 months ago, he had a mild stroke. He was admitted into the hospital and it turned out that the stroke had damaged his ability to swallow. Through this new disability, mucus got backed up in his throat and he soon developed pneumonia. After a week or so, he was left over night, unattended, and went into a sudden crisis. My mom thinks it’s because he wasn’t being watched closely enough by the nurses and he didn’t have anyone around to comfort him. They took him to the ICU and did a tracheotomy which means putting a tube into his throat so he could get food. However, on IV, he still went a week without food.

When my mom went to visit him, he had been in the hospital for a month. She says that his whole situation was very scary. After his surgery, he was put in isolation. So when my mom went to visit him, she had to put on gloves, mask, and gown in order to see him. Because of the lack of food, he had lost tons of weight. He looked skinny and frail. On top of that, he couldn’t talk. So their whole conversation was through him writing on paper. Although he couldn’t speak, he still tried. However, he could barely make above a whisper so when he did, my mom had to ask him to write it down because she couldn’t understand. This embarrassed her a lot because she wanted him to be able to speak. At some points during this visit, he would ask her to pound on his back to loosen up what was in his throat. The same thing happened in Tuesdays With Morrie. Once he was well enough, they took him out of the ICU and put him in an isolation room. However, there were no isolation rooms at the standard treatment level, so they moved him to the luxury suites that celebrities and presidents stay in. The amazing part is that he didn’t have to pay extra for the room. When my mom went to visit him for a second time, he looked much better. He had put on weight and seemed more aware of his surroundings. In fact, he became frustrated that he couldn’t go anywhere or move around at all. My mom took this as a sign that he was getting better because it showed that he knew how to express his feelings and say what he wanted. The third and final visit happened at his house. He was mostly better and able to be discharged from the hospital. He’d had his trachea removed and could breathe on his own. My mom kept commenting on how much his wife had been through and how well she was doing with 2 kids in high school and college, bills, her job, and her husband who got very frustrating at times.

When my friend’s dad was in ICU, his wife raved about the amount of care and attention he got. However, once his case was less serious, his amount of care went down considerably. These were mostly physical realities. I think that hospitals base all of their care on the emergency patients and leave almost none for the long term patients. At some points, this is reasonable and makes sense. However, there should be some balance between helping a patient when they’re in crisis and following up with attention and care after they’ve stabilized.

In Tuesdays With Morrie, Morrie discusses how when we are sick, most people complain about their pain and it all about how they can get better fastest whereas he just gives to others and tries to do anything he can to help other people. According to Morrie, as long as you’re around people who you love and love you, it will be OK. My mom thinks that the reason my friend’s dad went into crisis that one night was because he was around people he loved and no one was there with him.

Homework #25: Sicko Response

Michael Moore’s provocative and controversial film, Sicko, takes on the disastrous US health care system. Moore looks at sick people in the US who are denied coverage despite having health insurance and compares it with countries that have universal and public health care coverage including Canada, France and the UK. He talks with former health insurance industry workers about how the system works to maximize profits by denying claims. He also describes how congress members are bought off for their silence. Moore also uses his typical, confrontational filmmaking style – taking 9-11 first responders and other sick US citizens to Cuba to receive free health care. One of his final proposals is that the US should change and bring in universal health care.

Moore has created a website to support facts that he sites in the movie, in response to numerous critics. [http://sickothemovie.com/checkup/]. As an example, the movie claims that “Canadian "wait times" are not nearly as long as some try to allege.” Moore’s site references the Canadian Institute for Health Information, [January 2007. http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=reports_wait_times_bulletins_e], which says that, “A recent study of emergency care in Ontario found that overall, "50% of patients were seen by a physician within 6 minutes and 86% were seen within 30 minutes of arriving at the [Emergency Department].50% of patients who were seen most quickly waited an hour or less; while 1 in 10 waited three hours or more.”  This is important to Moore’s thesis because many critics tend to attack any kind of government run health care system and cite Canada as an example of bad care. Moore gives evidence that this is not the case and Canada actually gives good care.

A central point of the movie is Moore’s claim that “The government initially refused to pay for the health care of 9/11 volunteers, because they were not on the government payroll. It remains difficult for the volunteers to access the $50 million fund that has been appropriated for their care.” In response, Moore’s website refers us to Robert E. Robertson’s statement to the US Government Accountability Office. The US “provided a total of $175 million for workers compensation programs - $125 million to NYS Workers Compensation Review Board, and an additional $50 million to reimburse the NYS Uninsured Employers Fund, including for benefits paid to volunteers. However, there have been major delays in getting money to volunteers.” This was central to Moore’s aregument because it’s playing on people’s sympathy that even the heroes that stepped in at a time of great crisis can’t get the right health care that they need.


Moore’s film was challenged by the media and politicians. For example, Dr. Sanjay Gupta of CNN said that not all of Moore’s arguments are correct. [http://newsbusters.org/node/13866] This was picked up by websites who wanted to attack Moore’s thesis. Gupta noted that Cuba is ranked below the US in overall health care as one false claim in the movie. These people would like to discredit Moore on small points to undermine his larger thesis, which I believe is correct, that the US healthcare system is flawed and needs fixing.

 As a result of this controversy, I have sought to check one piece of evidence that Moore cites. Moore’s website, http://sickothemovie.com/checkup/, gives evidence that insurance companies were willing to spend millions to block Hilary Clinton’s health care reform proposals in the 90’s. I found two independent sources that back this up.

·         "In 1993-94, the Health Insurance Association of America, a trade group, spent about $15 million on advertising to defeat Clinton's proposed overhaul of the nation's health care system." John MacDonald, "Proponents, Opponents Join Battle Over Drug Price Limits," Hartford Courant, June 21, 2000.
·         Harvard professor, Theta Skocpol, cites the Center for Public Integrity in saying 100 million dollars were spent to bring down Hilary Clinton’s health care plan. “Well-endowed and vitally threatened groups (such as the Health Insurance Association of America [HIAA], the association of smaller insurers that the Clinton plan might have put out of business) also could fund public relations campaigns designed to influence public opinion against the Clinton overhaul.  In the end, according to a study by the Center for Public Integrity, health care reform would become “the most heavily lobbied legislative initiative in recent US. history.” During 1993 and 1994 “hundreds of special interests cumulatively . . . [spent] in excess of $100 million to influence the outcome of this public policy issue.” [T Skocpol. The rise and resounding fall of the Clinton plan. Health Affairs, 14 no. 1 (1995); 66-85]

Moore claims there are four times as many health care lobbyists as there are members of Congress. According to the Center for Responsive Politics (www.opensecrets.org),“in 2005 there were 2,084 health care lobbyists registered with the federal government. With 535 members of Congress, that's 3.895 lobbyists per member.” This is independent support for his claim.

As I watched the movie, Sicko, some of the more important parts to me were the scene where Moore went to other countries see how much better their health care was in comparison to ours. I watched this movie with my whole family during the break and every time Moore went to a different country, we all made comments like, “Ok, pack your things. We are moving there.” This showed that because health care is so good in other places, we wanted to move there and out of this country. My older cousin is a 29 year old single mom of two. She kept staring in awe at the things Moore said because she has to pay medical bills for her 5 year old son with asthma. She kept saying how grateful she was that her epileptic daughter of 11 is covered by Medicaid, so all of her bills are covered. Otherwise she would have to pay a whole lot more than she could afford.

Throughout the movie, the main feeling I felt was shock. I was in awe that our insurance companies could be so dense and actually keep people from surviving at certain points. One part that made me laugh at the insanity was the part where a woman was in a car accident and was driven to the hospital in an ambulance. Later, she got a bill for the ambulance saying that she needed to pay for it because she didn’t pre-approve it. My question is, ‘At what point was she supposed to pre-approve an ambulance after a car accident that rendered her unconscious?’ Another part that was less funny and way more shocking was the scene where a hospital in LA left a disoriented woman on the street because she couldn’t pay. She didn’t know where she was or how she got there and they didn’t care. This came as a surprising to me, that hospitals and insurance companies can be so hell-bent on making money that they don’t even care long enough to get a patient to safety.

My perspective on the dominant social practices has changed because of this movie. I am now more aware of how poorly the people in this country are treated due to the money-driven insurance companies.