My post this week is a random gathering of my observations on the “NAMI Basics” course I’m enrolled in and how my experience with US style medicine as a rush to medicate/operate is confirming what I’ve observed from abroad before moving here.
The NAMI Basics course is a bit of a surprise in that it questions the use of medication more than I would have thought. What is troubling is the emphasis on early intervention in the teen years, which sounds like a good idea, but really means bringing in a swat team of doctors, psychologists, etc. and elevating what could be a one-off situation into something more sinister and chronic. This is one version of the hammer approach to problem solving that I discuss in more detail in this post.
My more pressing concern these past few months has been my own health, not Chris’s. Without getting too specific about the details, I moved to Florida from Europe, proud of the fact that at my age I was on no prescription drugs and taking only baby aspirin to prevent blood clots. I’ve had atrial fibrillation on and off for many years, but I’ve lived with it and never consulted a doctor about it. It hasn’t impeded my life so far. Exercise doesn’t leave me breathless. I’m not saying that A-fib never requires some form of attention, but the devil’s in the details.
In November, I went for my first physical here in Florida and it was like setting off a five alarm fire judging from the response to the taking of my pulse. (This was the first time that my A-fib had been “caught” in real time.) The panicked look on the medical assistant’s face was the first tip-off that A-fib was not okay. (I had always heard that it might be scary, but not life threatening.) The doctor arrived. He pooh poohed the baby aspirin, gave me free samples for an expensive anti-coagulant and set me up for an appointment with a cardiologist. “But,” I protested, “I’ve always had A-fib to some extent or another. I’ve lived with it.”
Fast forward to today. The two heart drugs tried so far have not stopped my A-fib, and I’m no longer feeling quite as perky as before because of the side effects. Furthermore, the medical reaction to my condition had added stress. The cardiologist is sending me to an electrophysiologist and there is talk of surgical intervention (ablation). To gain some reassurance that my concerns about unnecessary intervention are well founded, I’m listening to a Youtube doctor from the UK who takes a much more laid back, non-surgical, non-drug view of atrial fibrillation. I am trying a variety of ways to normalize the heartbeat (heart rate is down already) and plan to discuss my preferred approach with the specialist. I’ll shut up and not question the need for the prescribed anti-coagulant if the specialist will backpedal on the need for the surgery.
I now find myself in the position that people under psychiatric care are in: being encouraged to accept stronger intervention that perhaps can be best managed by holistic means outside of a doctor’s office.
Magnesium, anyone?
One of the most important books I have edited in a very long career is about the sociology of medicine: Health, Illness, and Medicine in Canada by Juanne Nancarrow Clarke. Like you, Juanne has a child who developed a major health issue, cancer, and her book on that encounter with the health system in our country includes contributions by her daughter. On the cultural variations in medical approaches to illness (6th edition, page 225) she cites a study by Lynn Payer (1988) who visited doctors in the US, UK, West Germany, and France and “read morbidity and mortality tables and read medical journals and magazines” to determine cultural differences and diagnostic trends in those countries. “In general, Payer found that German doctors were far more likely to diagnose heart problems than doctors in other countries. English doctors, by contrast, are characterized as parsimonious. . . . They prescribe about half of the drugs that German and French doctors and perform about half of the surgery of American doctors. . . . The Americans are spendthrift and aggressive. They have a tendency to take action even in the face of uncertainty. They do not, however, focus on a particular organ. Among the French, most ills are ultimately attributable to the liver.” Payer connects these patterns in medical practice with other distinctive cultural attributes of those countries: “the German emphasis on the heart — on romance, in literature and music . . . the French focus on the pleasures of eating and drinking, the English preoccupation with rationalizing the national medical care system; and the American emphasis on getting things done and getting on with it.” More broadly, Clarke subjects the training of doctors and many aspects of the medical establishment to sociological analysis, showing clearly that these men and women constitute a subculture of societies that should be scrutinized carefully. As you are doing!
Hah! Brilliant! My mother once commented that the French were always complaining about their livers, so it makes sense that the doctors there focus on the liver. The Germans are true romantics, and highly excitable despite the popular image of them as unemotional.
Which reminds me of a story my father used to tell. He was a radar technician attached to the RAF in Burma during WWII. When the equipment broke down in the jungle, he was expected to gerry-rig it himself. The Americans, on the other hand, didn’t bother with the parsimonious approach. They simply dropped in new equipment.
Rossa, I feel for you in your AFIB problem. I had the same problem – had been told since I was a child that the valve was leaky, and in 2010 a cardiologist said (at age 78) that “statistics showed” I likely had no more than a year to live. This scared me into considering surgery as recommended. Fortunately the cardie sent me to Dr Scott Ross of MUSC (Medical U of South Carolina, in Charleston SC). This genius dr replaced my atrial valve through a small (5 cm) incision in my right chest, instead of splitting me open at the breastbone for open heart surgery. He also put in a pacemaker to prevent heart irregularity. Total hospital time: 5 days. Now, 9 years later, I’m in good health, living independently and enjoying life. And eternally grateful to Dr Ross!
Just within the last few weeks Dr Ross did similar surgery for AFIB on a friend of mine (age 72) and she was in the hospital only 3 days, now at home, doing well, and like me very thankful for Dr Ross.
Don’t even consider surgery without knowing whether you can have the minimally invasive procedure my friend and I had! If you can’t find out there, then come to Charleston and see this wizard. I’d be happy to have you stay with me.
Best regards,
Mary (marysc11 “at” yahoo.com)
PS. When I had my surgery, Dr Ross said he was the only one in South Carolina trained to do it, so your average dr may claim it’s “not available.”
Hi, Mary,
I’ll take you up on your kind offer, should it come to that. The weird thing is I feel just fine, yet the drug hasn’t fixed the A-fib according to the cardiologist. According to the British cardiologist on Youtube, A-fib, while it can be scary, is not the cause of strokes or heart attacks. There are other factors at play. Glad to hear that you are doing so well!
…R
This thread is so important it should be trumpeted across the Internet. How does one do that?
It’s called Twitter, lol.
Hmmm…when I think ‘Germans’ I don’t think ‘romance’! It might have something to do with two world wars, genocide, and mass murder. Not a lot of ‘romance’ in Nazi (German) medical experiments of the Third Reich concentration camps. Romantic Dr. Mengele, indeed. But maybe it’s just me, hahaha!
The cultural issues involved in medicine are fascinating, but they’re the very worst sort of anecdotal storytelling and guesswork. The same culture that produced brilliant Traditional Chinese Medicine (TCM) evolved into a chilling, totalitarian police state. These culture/medicine connections are a fun game but nothing more.
The drive for bottom-line profits explain Americans’ rush to intervene. Medicine is a completely for-profit venture in the US. Doesn’t that explain it? European nations and Canada are social democracies and aren’t pressured to earn cash for each body entering the door.
But high-pressure capitalism notwithstanding, you’re in Florida, where it happens that some of THE MOST forward-thinking Integrative docs are; and the ones who critique the conventional system most strenuously. I wonder how they interpret your heart issue? I’m thinking of Mercola (MD) and Kelly Brogan (MD) off the top of my head, but I know there are more. Sayer Ji’s (Kelly Brogan’s new partner in love and work, as it happens) site Green Med Info links to all the Pub Med research. Have you done a Pub Med dive?
Hi, Liz, for all we know, Mengele might have been a romantic. One personal or cultural trait doesn’t preclude others and I’m sure Jordan Peterson would agree. The Youtube and internet doctors who take a much more relaxed view of A-fib rcommend liquid magnesium so I’m on to that in addition to listening to frequencies and practicing breath control. I discovered only a few days ago that I hold my breath, like when I change lanes while driving, reach to pick something up, bear down on the break pedal to stop the car, etc. This to me is the daytime equivalent of sleep apnea, but something I can control if I remind myself to breathe! I don’t want to up the ante by seeing more specialists unless I can’t fix it myself first. My heartbeat is now in the low normal range. Any lower and I’ll gain Buddhist monk status without having to do the hard work of meditating. This is after the cardiologist told me that the drugs weren’t working and to go straight to ablation! I’ll check out Dr. Brogan’s new partnership. Never heard of this guy. Thanks for commenting!
Wow.GreenMedinfo is great! Thanks so much for pointing it out. http://www.greenmedinfo.com