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Friday, Sep 1 2017

Full Issue

Viewpoints: What About That War On Drugs? Updates And Adaptations For Medical Education

A selection of opinions on public health issues from around the country.

Afghanistan isn鈥檛 the only one of America鈥檚 longest wars headed for a surge. A century into the war on drugs, the United States is awash in narcotics 鈥 a problem the president intends to solve with a wall, and Attorney General Jeff Session intends to solve without mercy.聽Just this week, Sessions urged a zero-tolerance approach to the drug war, contending that 鈥淲e must not capitulate, intellectually or morally, to drug use.鈥 (Matthew R. Pembleton, 8/31)

Today, Amy Kalber is a leader. She鈥檚 an active mother who is the glue who keeps her large family together. She is working on her master鈥檚 degree in social work. She works as a case manager for a nonprofit. Amy sets an example for how to balance work and home and still give back to her community. Not long ago, virtually nobody 鈥 including Amy 鈥 would have believed this future was possible. (Jennifer Hancock, 8/31)

鈥淭his might have been the most important thing I did in medical school,鈥 the fourth-year student said. 鈥淚t felt like we had an impact.鈥 The student was reflecting on a program during his final semester of medical school in which he collaborated with a team of students from nursing, pharmacy, social work, and anthropology. The team worked with three patients who were identified by their primary care physician as having uncontrolled health problems. The students sought to identify underlying barriers to improving the patients鈥 health by visiting them in their homes and accompanying them to health care visits. Then they leveraged the expertise of each of their disciplines to develop solutions to overcome those barriers. (Alan Dow and George Thibault, 8/31)

The curriculum overhaul at the University of Vermont鈥檚 Larner College of Medicine plans to completely replace lectures with so-called active learning approaches that let students learn material in a more hands-on way, as in simulation labs and group case studies. At the new Hofstra North Shore-LIJ School of Medicine, students are required to train and practice in the field as certified emergency medical technicians rather than sit through lectures during their first eight weeks. Other programs give students more time for hands-on electives in later years by concentrating academic courses in early semesters. Still others supplement the traditional four-year system with classes targeting newer technologies and databases. (Kendall Sarson, 8/31)

After the funeral, she calls me to obtain a letter for work. I have one chance to ask the question that has been pricking my conscience, though I can鈥檛 bring myself to use the nurse鈥檚 terminology. 鈥淪ome people feel abandoned in hospice. Do you think your mother ever felt that?鈥 鈥淎bandoned? Oh god, no!鈥 My heart soars with relief. I told you so, I quietly and gleefully retort to the nurse. I could have told you that the peripheral involvement of an oncologist is no match for the comforts and consolations of hospice, that advocacy can stretch only so far, that abandonment by the oncologist is a myth, that patients get over the fact that their oncologist can鈥檛 be everywhere. From here it鈥檚 short work to convince myself that perhaps my job can end when patients enter hospice, that things will work out even without my exertions. 鈥淏ut doctor, you know why, don鈥檛 you?鈥 the daughter continues, with renewed emphasis. I hold my breath for the denunciation. You passed off her care, I expect her to say, but we got better doctors in the end. But no. Instead, I hear, 鈥淲e felt safe because we knew you had our back. Mum knew you鈥檇 take care of her no matter what. You were always going to be her oncologist.鈥 (Ranjana Srivastava, 8/31)

When health officials learned that the 2015 measles outbreak was caused by clusters of unvaccinated children, Americans once more wanted to understand why some parents do not vaccinate their children. In our highly polarized culture, media commentators and even academics began to connect opposition to vaccination to either the left or right of politics. So a question arises: Who is more likely to be opposed to vaccination, liberals or conservatives? As a sociologist who studies infectious disease, I took a look at this. The answer seems to depend on what question you ask. (Charles McCoy, 8/31)

The explosion that wounded me during a Taliban ambush in Afghanistan in 2010 left me with a traumatic brain injury and post-traumatic stress. In 2012 I was medically retired from the Marine Corps because of debilitating migraines, vertigo and crippling depression. After a nine-year career, I sought care from the Department of Veterans Affairs. At first, I didn鈥檛 object to the pills that arrived by mail: antidepressants, sedatives, amphetamines and mood stabilizers. Stuff to wake me up. Stuff to put me down. Stuff to keep me calm. Stuff to rile me up. Stuff to numb me from the effects of my wars as an infantryman in Iraq and Afghanistan. Stuff to numb me from the world all around. (Thomas James Brennan, 9/1)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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