Diet and Nutrition. Natural Health, and Healthy Living

In the winter 2009 issue of the Journal of Interdisciplinary History,a review essayappearsby Anne Hardy, one of the preeminent historians of medicine in the world, entitled "A New Chapter in Medical History." Here is the Abstract:

Once the domain of physicians intent on recording and memorializing professional achievements, the history of medicine has become fully interdisciplinary, encompassing myriad topics. Oddly, however, the problems that actually generate medicine, the diseases themselves, have—with such notable exceptions as plague, cholera, smallpox, tuberculosis, and hiv/aids—attracted relatively little attention until recently. Disease history now appears ready to enter a new phase.

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In last week’s NEJM, physician-author Abraham Verghese paints a disturbing picture of a medical world in which technology has morphed from tool to object, the patient relegated to a supporting role. To me, Abraham has nailed the diagnosis but not the treatment.

I had the distinct pleasure of getting to know Abraham when we both served on the board of the ABIM (actually I came to know his work 15 years earlier, when I reviewed his bestselling book, My Own Country, for the NEJM). Abraham is a romantic and a traditionalist, and in last week’s New England Journal piece he poignantly lays out a problem he has fretted about for years: namely, that information technology is dehumanizing the practice of medicine. Describing rounds with his ward team at Stanford, his new academic home (he was recently recruited there from the UT-San Antonio), he recalls:

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The disconnect between care and reimbursement for mental health services and other kinds of clinical services suggests just how deeply mind-body dualism pervades Western and American culture, despite the best efforts of many champions over many, many decades. The beast lives, as I put it in my dissertation. Thus, the news of a WHO Report on the need to integrate mental health care into primary care is welcome, though I admit it seems almost ridiculous to me that justification is needed for the notion that caring for those suffering from mental and emotional illnessesis crucial toimproving population health, let alone being important to lessening stigma,centering marginalized populations, and caring for persons with disabilities.

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Call for Papers, EAHMH Conference 2009

Theme:
"Global Developments and Local Specificities in the History of Medicine and Health"

The European Association for the History of Medicine and Health (EAHMH) invites submissions for its bi-annual meeting, to be held in Heidelberg (Germany), 3-6 September 2009. The association welcomes submissions on the general theme:

"Global Developments and Local Specificities in the History of Medicine and Health".

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Stuart Butler, Vice President of Domestic Policy at the conservative Heritage Foundation has an op-ed in Thursday’s Washington Times, “Four Steps Can Heal Health Care.”

He makes some very valuable points and proposes four steps toward reforming the health care system most people—liberals and conservatives —could agree on:

Making sure every working family has access to an affordable private health plan that could include state-based default plans with agreed upon minimum benefits and premiums subsidized through reinsurance pools that spread any adverse risk over the broad private market.Encouraging insurance exchanges not unlike those envisioned by Democrats but at the state level where Stuart sees these exchanges avoiding “endless Congressional micromanagement.”Reforming the existing federal tax preferences for health insurance by capping the value of these tax breaks as a means to encourage more efficient plans and raise revenue to help pay for premium subsidiesRedesigning the Medicaid and SCHIP programs by giving states the ability to streamline these programs and free-up funds to expand the help the low-income people get for health insurance—including vouchers to purchase private coverage.

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Despite my total lack of surprise, I am still outraged at some of the news coming out regarding thepractices of clinical research in India. Ed Silverman, at the indispensable Pharmalot, notes:

The race to test drugs in India, where costs are lower and patients are plentiful, is creating a vast cottage industry of doctors and contract research operators, but a dearth of oversight and ethical standards [. . . ]

Silverman references a series of articles on the subject written in the St. Petersburg Times. Some highlights from the main Times article:

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Ian Williams was kind enough to alert me to the existence of a new project he is working on, entitled "Graphic Medicine." I liked his description and rationale so much, I requested and received permission to post verbatim his discussion:

"It has long been known that comics are “not just for kids”. Over the past decade this underrated medium has begun to receive recognition and acclaim from literary critics, academics, and broadsheet reviewers. This renaissance is partly due to the rise in popularity of the graphic novel. In contrast to production line, genre based, mainstream comics, graphic novels are full length, square bound “serious” comic books, aimed at adults, usually written and illustrated by one person, thus encapsulating the style, narrative and subjective worldview of an individual. Often drawing on direct experience, the author builds a world into which the reader is drawn. Amongst the growing number of autobiographical works, titles dealing directly with the patient experience of illness or caring for others with an illness are to be found.

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Neurocultures Workshop
at Max Planck Institute for the History of Science, Berlin
20-22 February 2009.

From 20-22 February 2009, the workshop "Neurocultures," co-organized by the Max Planck Institute for the History of Science and the Brain, Self and Society project at the BIOS Centre of the London School of Economics, will take place in Berlin. It will focus on the emergence of "neurodisciplines" such as neuroethics, neuropsychoanalysis, neuroeconomics, and related practices in contemporary culture. For more information, please see http://www.brainhood.net/news/neurocultures.html.

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Translation is a hot-button word in public health and research policy these days. This is welcome, because one of the principal themes of this blog has been that even if we ceased all technical innovation in health, we have all the evidence and interventions we need to make our (U.S. and global)population substantially healthier than it is. This is not to endorse the cessation of innovation, but to note that the link between improved population health and translation of the evidence we already possess, in my opinion, rests on much firmer footing than does the link between population health and increased innovation.

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Hofstra University will host a two-day conference on Thursday and Friday, March 11-12, 2010: "New Directions in American Health Care: Innovations From Home and Abroad."

The goal of the conference is twofold: 1) to facilitate discussion from an interdisciplinary perspective, a year into the new presidential administration, around transferable, just solutions to America's health coverage crisis; and 2) to help set a research and policy agenda to broaden social justice by ameliorating critical dilemmas in coverage, cost and quality of health care.

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