Apologies: To all the pundits on ethics of confidentiality. This post might not be acceptable to the people that I have written about. Insistently, I write this. Consider the fact that no bad news is acceptable to the ones who make that news, be it rapists or racists. This story is real. Read it if you want to or chuck it if you don’t care. Stories that must to be told should be told.
Note: I respect confidentiality. I am a doctor, not a journalist or policeman. Therefore there is no need for me to tell the real names. The name I have used is fictitious. Also, the persons in the story are aware of my feelings towards their attitude. I hope to understand them and change their attitude for the better in my future interactions. I continue to treat this family.
Post: Being a Woman, Leper and a Brahmin
Her name is Madhusmitha Panda. She is about 50 years old. She is unmarried. Of course, who would marry her, for she had Leprosy. She had the stigmata of having had leprosy. She walked with a limp. Her toes were shrunk and her foot was deformed.
Her father retired from Government Service and receives a pension. He is about 80 years now. He is hard of hearing, but quite independent. Her mother was in her 70s and she had uncontrolled diabetes. She had no other siblings. She had few cousins, who were all married and well settled economically. The women who were married to her cousins do not take good care of them. So the three live independently in a small house. They have no other social supports.
She was an old patient of our institution. She had received MDT (multidrug therapy) and was cured of Leprosy few years ago. Our nurses have treated her of a foot ulcer a couple of months ago. She used to come on an out patient basis for dressing of the ulcer in her foot.It had healed well.
I saw her few weeks ago with a bad ulcer in her foot. Considering her situations, I felt that it would be difficult for her to come all the way from her home on a regular basis. Remember that travel costs money. I advised her to stay in Leprosy Home, a place where she could get free accommodation, food and ulcer care.Her father was not interested .He said that he would bring her regularly for dressings.
Madhusmitha came daily for dressings. Her father brought her everyday in an auto rickshaw. Over few days we realized that the ulcer is not getting better. At the same time she is developing changes in her sole indicating that there is possibility of new ulcer developing. This was because she was not giving adequate rest to her foot. Being the more able of the three, she had to do all the house hold work. Her dressings were not maintained as they had to be. We pressed them for an admission. It can be assumed that once a patient gets admitted, he/she could get some rest.
We also had asked her father to buy her MCR (Micro Cellular Rubber) footwear from the shoe maker in Leprosy Home. We told him of the costs etc.He wanted to find out, if it was available elsewhere. Even after a while, her foot did not improve. We realized he has not purchased the footwear for her. We felt irritated. He was not even willing to go to the Leprosy Home! We knew we could help her if she were admitted. When we insisted on admission, he blurted out, “How can I leave my daughter? What if someone does something?” . The nurses told me that he did not trust his own daughter. That is why he accompanied her everyday, even into the dressing room.
We had a word with her mother. We thought she could think more rationally. It made sense to admit her daughter to get treatment for free! She asked, “Do good people stay there?” I began to reason with her that most people living there are nice people. They too were suffering like her daughter. I also told her that there will be people to take care of her daughter. As I was explaining this, our nurse told me, “Sir, the meaning of her ‘good people’ is not nice people as you imagine. She refers to people of higher caste. She is a Brahmin. So, she does not want her daughter to live in a Home with lower caste people.”
I was shocked. I thought “What? Mother of a Leprosy patient was discriminating other oppressed people!!!”.Madhusmitha is not suffering with Leprosy problems alone. She was suffering for being a woman. She was suffering for being a Brahmin. Her parents think that they are being helpful and protective but they are the biggest stumbling blocks to her care. They being old cannot care for themselves. They want Madhusmitha to do all the household work. After all, she was born a woman. It is her responsibility to do the household chores. Adequate rest is therefore not possible. On the top of it, they deny her benefits of admission into a Home because of being Brahmins. Sadly again, because of associated stigma they do not want to go to the Home to buy MCR footwear.
I asked her mother, “Mousi, you said you have problems with wives of your nephews. Isn’t it?” She nodded with an expression anticipating sympathy. “Are they not Brahmins like you?” I asked. She agreed though her expression changed. I asked her, “Tell me who is better? The wives of your nephews, who being high caste Brahmins do not care for you or the tribal people and health workers in the Home, who would dress your daughter’s ulcers and take care of her, even in your absence?” There was a pause. She answered in a low tone, “Tribals”.I am glad that she could see the obvious truth.
Frankly, I felt that if that old couple die then Madhusmitha might get a better deal. Till then she would remain a Brahmin woman, who would do all the household chores, limping with ulcerated feet. She should have been born into a Tribe. She would have had a better deal.
I still cannot understand how they could discriminate against persons from tribal background when they themselves get discriminated for having leprosy. I wonder how they try to hide the identity of having had leprosy, but flaunt the identity of high caste origin.
WASHINGTON (SR) – President Barack Obama struck back at the mounting criticism that his administration’s secrecy violates his promise on at least eight separate occasions to televise all important legislative hearings.
“I promised the American people that my administration would be absolutely transparent, and it has been,” the President told reporters Thursday. “Transparent means to see through or be invisible, and our extensive coverage of every House and Senate hearing dealing with health care reform has been just that: totally invisible,” he said.
When asked by reporters when and where the coverage had been broadcast, the President said that “literally thousands of hours of coverage” had been, and is still being, broadcast on “a special invisible network” operated by MSNBC.
A spokesperson for MSNBC confirmed the network had been broadcasting both the House and Senate hearings on healthcare reform, but that the unprecedented transparency rendered them invisible to all but space aliens.
My comments: I have to say, this restores my faith in Barry’s honesty. Let’s have a margarita and hope space aliens abduct us and fill us in on the high points of this healthcare thing…
Read More Satire and Humorous Comments at Scooter’s Report
Well, it’s the beginning of a new year – a time when we take a closer look at ourselves try to figure out what we can do to make this year better than the last. But it’s also a time when many people are hit with seasonal affective disorder as we begin the decent from our holiday high.
It’s no surprise that antidepressants are among the most prescribed drugs in the United States. In fact, as we reported back in August, the number of Americans taking antidepressants has doubled in only a decade. Many Americans feel we are over-medicated, and according to a new study published in the Journal of the American Medical Association, there may be some truth to that sentiment.
It was a small study – but an important one – because what it showed was that common antidepressants may not be as effective for mild to moderate depression, and that these patients could benefit from alternative treatments like psychotherapy, counseling, talk therapy, etc. without the risks associated with these medications.
Interestingly enough, another new study out of the Archives of General Psychiatry found that about 60 percent of the time, psychiatrists are prescribing more than one drug at a time to their patients. Many mental disorders go hand-in-hand, so often patients can be afflicted with two or more, and may need a combination of drugs to help them cope with their symptoms. So there is evidence that for some patients, a combination of psychotropic drugs can be very beneficial, but it brings us back to the fact that the way we monitor those patients is key.
Internists and primary care physicians often prescribe these medications for their patients, but it’s vital that the patient receive therapy from a professional to evaluate progress and observe any negative side effects, because many of these drugs have serious risks. This is especially important for the adolescent population, because children are being put on these medications more and more.
But patients are not the only ones who need to be monitored — we have to be careful that the agenda to treat mental illness does not become big business driven by the pharmaceutical companies so that we don’t become a society dependent on pills!
Speaking as someone who has done it, I can say with some degree of authority that quitting smoking completely sucks. You’re on edge all the time, you snack constantly, you have nothing to do in the morning before you use the bathroom, and perhaps most galling, you have to work through an entire day without a series of ten minute breaks. Like a Normal.
This is why no one ever quit smoking because they wanted to. Instead, the main reason people quit smoking is Fear of Chronic Disease. Which is a perfectly reasonable fear, mind you, and thus a perfectly rational reason to quit smoking.
Unless quitting smoking also makes you significantly more susceptible to a DIFFERENT chronic disease.
As it turns out, this is exactly the case. According to a Johns Hopkins study recently released in The Annals of Internal Medicine, breaking the habit can raise a person’s chances of developing Type II Diabetes by up to a staggering 70%. The heightened risk is tied to the aforementioned snacking and weight gain often associated with giving up smoking.
The researchers point out that this weight loss, and the diabetes risk tied to it, can be tempered by seeking help from a doctor while quitting. But at this point, we have to ask ourselves – do we really want to live in a world where everyone is short-tempered, on a diet and under the constant supervision of a doctor?
I think we call all agree that this is a scenario in which the living would envy the dead.
Ring, ring. ” Hi, this is Kaiser Permanente, the largest managed care organization in the United States and we’re conducting a study. We were just wondering if those anti-depressant medications, antibiotics, and or cardiovascular medications you might have taken while you were pregnant gave your child birth defects or caused any perinatal problems?”
A new research program called the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) will fund research to study the effects of prescription medications used during pregnancy. The program is a collaboration among the U.S. Food and Drug Administration and researchers at the HMO Research Network Center for Education and Research in Therapeutics (CERT), Kaiser Permanente’s multiple research centers and Vanderbilt University.
Collectively, the 11 participating sites have health care information for about 1 million births over the past seven years (2001-2007). Many of the mothers associated with these births likely used medication during their pregnancies and now, with the program in place, the FDA and participating researchers have a systematic and timely way of retrieving information from this network. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm195934.htm
Did any pregnant mom systematically give permission to have their data used in this study? Was there “informed consent,” that prescription data could be used in future studies? We realize this is probably just an aggregate of data from various clinics, but everyone of those patients has a name and now are being used by a group of researchers to evaluate perscriptions drugs taken while pregnant. “In 2007, Kaiser it completed the four-year implementation of the Kaiser Permanenteprescriptions HealthConnect technology system, which standardizes technology across all locations.” http://www.wetfeet.com/Employers/Kaiser-Permanente.aspx What perfect timing!
Will the study look at race, age, and socio-economic factors as well? How much do you think they know about these women? About the children?
Smoking, drinking, and drug abuse are on the list as no no’s, but why is it the FDA now only taking action? Reading the small print on most medications, including the H1N1 Swine Flu vaccines patient inserts, “product may not be safe for use during pregnancy, benefits outweighing risks, etc.”
Why is it that the FDA is procuring this study as opposed to the pharmaceutical manufacturers themselves? Oh, that’s right- many are already released from any liability from injury -as is the case with the H1N1 vaccines. We have doubts that the outcome of this study will gain as much information as the government’s coordinated data effort which failed to reveal potential terrorists based on the events of 9-11, and as recently as on Christmas Day.
The stimulus package, officially the American Recovery and Reinvestment Act, includes $8.2 billion in “extramural” NIH funding to help stimulate the U.S. economy by supporting scientific research. Kaiser Permanente has won more than $54 million in federal stimulus funding to conduct research on many public and clinical health areas, including $25 million for genetic research in Northern California. http://sanfrancisco.bizjournals.com/sanfrancisco/stories/2009/10/12/daily1.html
Taking a conspiracy twist-
Financially influenced by Rockefeller’s leading petrochemical– pharmaceutical institutions, history shows these powerful “population planners” consistently working to manage global eugenics—the science of racial hygiene and “ethnic cleansing.” Desperately seeking ways to control “excess populations,” how do you suppose they might magically disappear half of us now targeted for elimination?
Before your imagination runs wild considering my view of “Vaccine Magic,” consider Kaiser’s history with the Rockefeller family cooperatively pioneering “managed care” in America along with the Kaiser Institute for Eugenics, Anthropology, and Human Heredity in pre-Nazi Germany. In essence, these contemporary powers spearheaded Hitler’s racial hygiene program, its genetic experiments for unnatural selection, and propaganda methods in advancing their “master race.” http://www.awakentothetruth.com/vaccine_magic_conspiracy.htm
“The Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics was founded in 1927. The Rockefeller Foundation supported both the Kaiser Wilhelm Institute of Psychiatry and the Kaiser Wilhelm Institute of Anthropology, Human Heredity and Eugenics. The Rockefeller Foundation partially funded the actual building of the Institute and helped keep the Institute afloat during the Depression. In its early years, and during the Nazi era, it was strongly associated with theories of Nazi eugenics and racial hygiene advocated by its leading theorists Fritz Lenz and Eugen Fischer, and by its director Otmar von Verschuer. Under Fischer, the sterilisation of so-called Rhineland Bastards was undertaken. During World War II, the Institute regularly received human body parts, including eyes and skulls, from Dr. Josef Mengele at Auschwitz to use in studies intended to prove Nazi racial theories and justify race-related social polices. http://en.wikipedia.org/wiki/Kaiser_Wilhelm_Institute_of_Anthropology,_Human_Heredity,_and_Eugenics
George Halvorson, the chief executive of one of the nation’s most respected health care systems, Kaiser Permanente, says he is hopeful that all the sausage-making in Washington will succeed in squeezing out a law….” lawmakers should support efforts to reward improvements in care for a handful of chronic conditions like asthma and heart failure, which affect millions of people and are some of the highest contributors to the nation’s health care bill. Tracking the care of those patients would be a good start, he said. “You don’t have to fix a lot of things.” http://prescriptions.blogs.nytimes.com/2009/09/22/kaiser-permanentes-chief-optimistic-about-health-overhaul-effort/
A handful of chronic conditions, eh? Is being pregnant considered chronic. Maybe for the Digger’s family! Oh wait, how do drug companies make money if a patient doesn’t take them? Could the underlying reason for this study really be linked back to The Kaiser Institute for Eugenics, Anthropology, and Human Heredity?
Could there be a link to other well known institutions? In 1904, the Carnegie Institution established a laboratory complex at Cold Spring Harbor on Long Island that stockpiled millions of index cards on ordinary Americans, as researchers carefully plotted the removal of families, bloodlines and whole peoples. Read more: http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/11/09/ING9C2QSKB1.DTL#ixzz0bfTKdKOR
Elluminati’s blog takes the conspiracy farther in thinking that Kaiser has a connection to the three pillars of masonic ritual. Pointing out the 3 pillars (sizes) of the Doctors, and the 3 dots of the Kaiser Permanente logo. http://elluminati.blogspot.com/2009/01/kaiser-permanente-and-3-pillars-of.html
Heck, you can fold a $20 dollar bill to show the world trade center towers too, so you never know what symbology can get you if you try.
https://www.kaiserpermanente.org/ is Kaiser’s homepage.
http://www.certs.hhs.gov/ is the HMO Research Network Center for Education and Research in Therapeutics (CERT) and offers it’s data base of patients for sale. via http://info.ahrq.gov/cgi-bin/ahrq.cfg/php/enduser/std_adp.php?p_faqid=90&p_created=1151339260&p_sid=GsErx9Rj&p_accessibility=0&p_redirect=&p_srch=1&p_lva=&p_sp=cF9zcmNoPTEmcF9zb3J0X2J5PSZwX2dyaWRzb3J0PSZwX3Jvd19jbnQ9MSwxJnBfcHJvZHM9JnBfY2F0cz0wJnBfcHY9JnBfY3Y9JnBfcGFnZT0xJnBfc2VhcmNoX3RleHQ9ZmluYW5jaW5n&p_li=&p_topview=1
HCUPnet is part of the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ). HCUPnet generates statistics using data from HCUP’s Nationwide Inpatient Sample (NIS), the Kids’ Inpatient Database (KID), and the State Inpatient Databases (SID). These databases and HCUPnet would not be possible without the statewide data collection projects that provide data to HCUP. You can purchase many HCUP databases to do more detailed analysis not possible through HCUPnet. For more information on purchasing HCUP data go to the HCUP Central Distributor Web site at http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp
From Vanderbilt, VUMC is known for its highly-acclaimed teaching hospital and its groundbreaking efforts in electronic medical records. Its 1,800 physicians see more than 1.2 million patients each year and its hospitals admit more than 65,000 patients via wiki http://en.wikipedia.org/wiki/Vanderbilt_University_Medical_Center, VUMC’s home page can be found at http://www.mc.vanderbilt.edu/
You didn’t think your or your children’s patient data was really confidential did you? Have a baby, pay the bills, they collect the money and the data, get tax dollars to subsidize the data, and they can still sell your data.
Might as well just get an RFID chip now and get it over with.
Open wide, say ahhh and check out these posts on the A/H1N1 Swine Flu from Ahrcanum, where the conspiracy spreads as fast as the virus itself. Subscribe for free in the top right margin.
I have finished the web re-design! In fact I re-designed it so thoroughly that I am posting this from there RIGHT NOW. (If you are reading this from kristinmh.com that will make *no* sense, but don’t worry, it doesn’t really matter.)
Anyway, here is the latest episode of Complaining with Kay:
Complaining with Kay, Episode 40
In this episode, I tell you more than you ever wanted to know about my weird neck scar, and talk about how much I would pay for healthcare if I lived in the US. (WAAAYYYY more than I pay in taxes to the Canadian government.)