Archives for posts with tag: health

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Dear Dr. Berger,

How can doctors and patients understand what is meant by “quality of life”?

Amy Allara, Maryland

Dear Ms. Allara,

It depends on the context, of course. The term “quality of life” is naturally unclear, so one has to ask some serious questions even to find out what is being referred to.

Read more in Medium.

Given that many attempts to improve the US health care system have failed, what should be done next, and how can real change be achieved?

Read my piece on Medium.

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Great first class yesterday at the Berman Institute in my new course, Ethics of Healthcare Decision Making. What is needed for a decision? What are the goals? More to come on these topics, and our fascinating discussions.

PechaKucha is a presentation format in which the speaker tells their story in “less is more” fashion, using only 20 images and speaking for only 20×20 seconds. Thanks to Hillel Glazer and some other high-energy organizers, an evening of such presentations recently took place in Baltimore. Check out mine below, featuring Dante, the caduceus, and communication.

If health means avoiding disease, we need to find the best evidence on prevention: how to keep the sickness we dread from creeping up on us.

If health means a broader well-being, we need to find the best way to live. We can live poorly while being free of disease, but we can be fully realized human beings even while terminally ill. 

As a doctor I am rarely asked how to achieve a state of broader well-being. This is probably as it should be. I have not been trained for such all-encompassing life counseling, nor am I comfortable in such a role.

But maybe tomorrow’s doctors should be expected to counsel in this way. There is so much we cannot control. We will all die; but we will not all die in the same way.

The people in Baltimore’s poorest ZIP codes die twenty years before those in the richest. I went to a meeting on Friday to try and help the health of the poorest, at least in the ZIP codes nearest to Johns Hopkins Hospital. Federal funding is behind this, as well as considerable clinical and research expertise.

It was a great meeting with important goals and inspiring ideas. At the same time, I felt like we were all blinding ourselves to a problem. We were talking about engaging patients in their care – vital to be sure, and there are a lot of patients who don’t see their doctors, do real damage to themselves, and don’t participate in what others try and do for them. On the other hand, there is a mountain of mistrust between Baltimore and Hopkins. I felt like we were all trying to look over it, and there it was in the middle of the polished table. 

How do we get over that mountain? Are good intentions and practical deeds enough? Is working with the community enough? Is there a way to apologize and make amends without shooting ourselves in the foot?