Confronting “Bad Faith” in Medicine


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This month’s reading focused on a sensitive topic – religion. When people mention religion and medicine, most people jump to abortion; however, there’s a frightening array of issues that involve religion in the setting of modern medicine. Bad Faith: When Religious Belief Undermines Modern Medicine covers these topics in depth. The preventable deaths caused by “faith healings” is the main focus of this book.

Several church groups and religious organizations shun the advancements of modern medicine on the basis of faith. Most notably, “Christian Scientists” refuse all medical treatments except those to set broken bones and a few other necessary treatments. Vaccinations, surgeries, antibiotics, and most medications are strictly forbidden by the Church. Instead, they seek “treatment” in the form of prayer.

Religious belief is a touchy subject. Many providers have difficulty understanding why people would refuse life-saving care in favor of prayer. There is little debate in how adults can choose to treat themselves. If a Jehovah’s Witness refuses a much-needed blood transfusion, that is their choice to make. This is the same for any patient, whether or not they choose this for religious reasons. Legal adults of sound mind are able to sign AMA (against medical advice) forms.

The greater problem lies in the children of these “faith-healers.” On the basis of their religious belief, parents deny their children medical care – which lawmakers refer to as “medical neglect. In the state of Arizona, there are multiple religious protections in place, including protections to avoid vaccinating school-age children. Although anti-vaxxers (religious or otherwise) have been refuted repeatedly due to overwhelming evidence in support of vaccinations, many continue to refuse to vaccinate their children against potentially deadly diseases.

It is my strong opinion that every adult person should be able to dictate their care. They have the right to refuse medical treatment and care. That belief, however, should not automatically apply to their children. An infant or a child cannot consent to medical care. In the medical community, we rely on the patient’s parents or guardians to provide that consent. The issue is that children cannot refuse medical care either, which unfortunately falls to the responsibility of the parents. The default practice should be, then, to provide care when children are sick and in emergencies, regardless of parental consent. The type of care provided may be subject to religious relief (such as avoiding blood transfusions), but parents should not be able to refuse care completely. Naturally that creates the issue of where the boundary lies. Providers and medical staff often end up court-ordering care for pediatric patients, which depends on the decision of a judge.

“Faith healers” can specifically refer to Christian Scientist “practitioners” who provide “care” in the form of prayers. The quotations are there because these people in no way provide actual medical care. Under Arizona law, these people are exempt from medical licensing. They can provide “care” yet they are not liable for the outcome of their “patients,” nor are they regulated in any way. This lack of accountability is something a physician would never dream of, a point made in Paul Offit’s book.

Doctors can be part of the problem as well. Per Arizona law, doctors and medical personnel can refuse to provide services based on their religious beliefs. This means refusing to prescribe birth control, perform abortions, collect umbilical cord blood (for stem cells), and end-of-life care. Notice that most of these cases are related to women’s health. (If you have the time, read Justice Ruth Bader Ginsburg’s scathing dissent of the Hobby Lobby ruling and the importance of reproductive rights). One pharmacist made headlines for refusing to provide a patient with abortion-inducing medication (even though the fetus had already died inside her.) Physicians and other healthcare providers should be required to perform and provide the services needed of them.

In the same way that providers would have to respect a patient’s religious belief, providers should respect their lack of religious belief.  Jehovah’s Witnesses do not believe in blood transfusions. I disagree with this, but I would respect that adult patient’s wishes. By the same logic, a patient requesting an abortion (for any reason) should be able to receive that procedure safely from a doctor, regardless of whether the doctor personally objects. A doctor’s personal conflicts, political leanings, or religious beliefs have no place in patient care. The physician is not a god, is not a judge of people’s moral actions. The physician’s duty is to provide the care needed.

I don’t have anything against religion in particular. In fact, Mr Offit’s book makes several points about the importance of faith. He even uses the New Testament and Jesus’ treatment of children to support medical care and protection for children. I would also like to note that some of the cases mentioned in the book involved religions and religious leaders who explicitly recommended medical care for the sick and dying, which individuals chose to ignore. The issue isn’t religion, but how religious belief becomes warped and causes harm in the realm of medicine.

Cork Dork Takes Me on a Wine-Fueled Adventure

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I finally got around to reading a book that has been on my to-read list for a while- Cork Dork: A Wine-Fueled Adventure Among the Obsessive Sommeliers, Big Bottle Hunters, and Rogue Scientists Who Taught Me to Live for Taste. In this enrapturing true-story, the author Bianca Bosker quits her job as a journalist to pursue a single-minded journey of becoming a sommelier. For those of you who have never heard of a sommelier, they are the wine experts of high-end restaurants. Their role in the dining room is to help guests choose wine, then serve it to then. Part salesperson- part oenophile, they learn to distinguish wines based on smell and taste alone. They study the long process of making wines, the histories of certain wines, and the quality of certain producers.

Mrs. Bosker took her journey a step further, combining her new passion for wine with scientific study. She travels the world to meet experts in neuroscience, olfaction, and cognition. She attends conferences, watches human dissections, and even undergoes testing in an fMRI to analyze her brain activity during wine tasting.

To wholeheartedly commit your life to a passion is admirable. What makes the author’s journey so much more is that she spent the journey determining what she wanted out of being a sommelier. She questioned conventional practice, the tendencies of the Masters, and found her own place. Her greatest joy is in sharing the experience that great wine (like great food) changes a person, even if only for a moment. Our sensory experience of wine transports us to memories and moments.

If reading this book has done anything, it made wine a more approachable beverage. I like wine. I drink it, but I don’t know much about it. I considered my Malbecs to be pretty fancy (until the author called it “cougar crack”). So I decided I would go try to pick out some wines and learn a bit for myself.

I started with a book that is recommended reading for all sommelier’s – “The Wine Bible.” I also looked online. The best way to begin the journey toward being a oenophile seemed to be by expanding my horizons. This meant trying something other than my usual Riesling, Malbec, or Moscato.

While in Las Vegas, I tried two similar white wines. Chablis is a crisp, citrus-y wine. I described it as the “watered-down drunk girl in Vegas.” I could barely taste any alcohol, possibly due to the acidity. I followed this with a glass of Sancerre. Though there was a similar taste, the alcohol was more apparent. I was most intrigued by the color, as it appeared nearly clear in the glass.

I’ve purchased two bottles of wine since – a Cote du Rhone and a Paso Robles. Though I haven’t tried them yet, I’m looking forward to opening those bottles! Maybe in the meantime I’ll keep reading up on flavors. I’m really enjoying the journey of expanding my palate and exploring new flavors.

Reading List: In Shock

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Following on the trend of my last reading list book, In Shock is written by a physician who finds herself in the position of a patient. Unfortunately for Dr. Awdish, she is a critical patient who actually has an out-of-body experience as she codes during emergency surgery.

Following her surgery, the book covers her excruciating recovery from an unknown disease wreaking havoc on her body. This unknown disease cost her her unborn child. While her doctors and nurses struggled for answers, they took out their confusion and frustrations on her. Dr. Awdish became intimately aware of the manifestations of the wall many physicians put up to “be better doctors.”

My favorite habit that she points out is the power of words. Physicians are taught to empathize, but at the same time, cannot take a patient’s pain as their own. Emotionally compromised doctors are not good doctors. Unfortunately, this leads to bad habits. We make macabre jokes and say insensitive or flippant comments that ultimately harm our patients.

One of the phrases she pointed out as harmful was “You kept trying to die on us.” It seems harmless. The physician tries to seem lighthearted about a serious matter. Unfortunately, Dr. Awdish took these words to heart. She felt physicians blamed her for being sick and coding. I know I have said this phrase, maybe not to patients, but definitely when discussing patients with my providers.

The common theme throughout her book is the way that doctors speak to their patients. Now she has made a career of teaching healthcare professionals to watch their words, to think before they speak. I, for one, would love to attend one of her sessions.

Patients trust doctors they can connect with. It’s important to acknowledge their feelings and put them at ease, while acknowledging a patient’s goals and desires. This must be balanced with medical necessity and treatment. It’s difficult, but we’re not becoming doctors because it’s easy.

Have you said any of the phrases that Dr. Awdish condemns? Have you experienced burn-out that manifests itself in blaming patients or venting to them? Let me know how you feel about this book. Is Dr. Awdish right? What changes do you need to make in speaking to patients?

Reading List: When Breath Becomes Air

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It takes very little to make me cry. Ever since I was young I have been prone to cry. When I’m sad, when I’m angry, when I’m happy, I will cry. I cry at videos of wedding proposals, when soldiers surprise their families, at sad movies, or even when other people cry. I do not, however, usually cry when I read a sad book.

I probably chose the wrong time to read this book (during clinic) because I was crying at my desk as I finished this book.

I believe there is a sense of invincibility that comes with being a physician (or even a future physician). Doctors delay death, cure disease, conquer the natural processes of life and death. As a scribe and a pre-med, I witness the work of my providers every day. That may be why the death of our patients hits us so hard. The death of a physician seems that much more unimaginable.

Dr. Kalanithi was not only a physician, but a lover of the written word. He was so enraptured with the thin line between life and death. Stricken with cancer, he got to understand that border more intimately than most. Then he put pen to the page and wrote this moving book about the

I was struck by two parts of the book in particular. The first was Dr. Kalanithi’s oncologist. Her focus was only on her patient’s goals. The ultimate end was never the discussion until it was truly the end. She wanted her patient to focus on living, even if his time was limited. I admired the way she spoke with him, even if he was frustrated as a physician. Granted (in my experience), neurosurgeons have a tendency to be a bit more upfront with expectations. I believe it was his onocologist’s approach to discussing his condition that let him live his life to its fullest before the end.

The other was the timing of his illness. An extremely unexpected illness in a young man in the final year of his residency. After medical school, after nearly seven years of a grueling neurosurgery residency, he was cut off. It’s baffling. As pre-meds we always look toward the light at the end of the tunnel. We struggle through the pre-reqs, the MCAT, the applications. Then we fight through school and matching to get to residency. This is all in the hopes that one day we will obtain that final goal: the attending. After all of Dr. Kalanithi’s hard work, to be cut off from that last step seems completely unfair.

But death isn’t fair. It doesn’t always make sense. And Dr. Kalanitihi is sharing that with us. Read this to understand your patients’ perspectives. Read this to try and glean an understanding of life as well as death. Whatever you do, just read this book.





Reading List: Get Your Sh*t Together

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I don’t normally read self-help books. I tend to find their advice tedious and less-than-useful. A friend once loaned me a book on how to make myself more appealing to men. I disagreed with most of the advice and stopped reading halfway through.

This book, besides the cute title, drew me in because I really do need to get my sh*t together. I’m sure my fellow pre-meds would agree that achieving a work-school-life balance seems near impossible. It may happen differently for everyone, but I tend to go through “cycles.” I can keep myself together for a few weeks, then everything falls apart. I tell my boyfriend I’ll “reset” over the weekend, but the return to productivity and my goals can be slow and agonizing.

Here’s a list of the aspects in my life that I feel I have to balance:

  • Full-time Work
  • School (class, school)
  • Extracurriculars (research, volunteer work, lectures, etc.)
  • Keeping House (grocery shopping, cooking, cleaning, etc.)
  • Relationships (family, friends, Boyfriend)
  • Physical Health
  • Mental Health

When I’m overwhelmed, my mental health takes a hit. This means I’m more likely to put off housework to try and de-stress. I may also overeat or eat poorly (I’m a comfort eater). Then I stress out about my weight and how messy the house is. I put aside schoolwork and extracurriculars to deal with that and the cycle repeats itself.

So I picked up this book to try and help myself. Besides being hilarious, the simple solutions the author offers have made a great difference in my life already. I can make a million to-do lists, but I have a tendency to procrastinate by being productive in other areas. Instead of doing my homework, I’ll do the laundry. The laundry needs to get done, but it isn’t due tomorrow (like my homework). Or else I’ll indulge in my nasty habit of “procrasti-baking” – baking as a way to ignore all the things on my to-do list.

The book gave me the solutions I needed. I make a running to-do list and then a “must-do” list. It helps me prioritize tasks, including my self-care and hobbies. I remain productive. The best thing about the “must-do” list is that my priorities can adapt to my day. With new tasks and deadlines I can adapt. At the same time, I can add on extra tasks (or me-time) from the to-do list if my priority tasks get completed.

My larger tasks get broken down into bite-sized pieces. My laundry room is a hot mess. I dusted the linen closet one day. The next day I cleaned the linens. The day after that I folded and put them away. There’s still more to do, but many of the blankets and pillows cluttering my space have a place to be.

The content from the book also adds a challenge. I have to accept certain limitations. There will be days where not everything gets done. I cannot clean an entire house of four people by myself. Sometimes I will have to delegate. This will probably remain a challenge for my control-freak personality, but at least I’m making progress!

It may not be related to medicine, but I highly recommend this book for any pre-med struggling to achieve a balance between medicine, adulting, and self-care.

Have you read this book? Did the strategies work for you? Comment below!