Health Periodicals
S.Q. Lapius
handed me the list. “Here, Harry. Mail off checks
for the renewals to medical journals to which I subscribe.”
I perused the column of
names and suddenly stopped. Wedged into the list, which included Lancet, the
Archives of Internal Medicine, the New England Journal of Medicine, the
American Journal of Medicine, I encountered one that surely was misplaced.
“Simon, what’s the
Reader’s Digest doing here? A spoof, no doubt?”
“On the contrary, Harry,
I use that to find out what my patients are reading. For months I have
observed that patients would ask questions in clusters. One month it
would be about liver disease, another about pulmonary function and so
forth. Some of the questions were fairly sophisticated. It was all
a puzzle till I had a sore tooth.”
“You have lost me,” I
said.
“The tooth ached like
the dickens. I was forced to visit my dentist. There was a long
wait, which gave me a chance to catch up on six months worth of Reader’s Digest
issues, and there I solved the mystery.”
“I’m breathless,” I told
him.
“Well, you see they
usually have an article on some medical thing or other. One fellow,
what’s his name, Radcliffe or something keeps writing about the different
organs of the body. Has a gimmick – writes about the different organs in
the first person. I am Joe’s liver, I am Joe’s lung and so forth.”
“Has he done one on I am
Joe’s ovary yet?”
“As a
matter of fact, no.
But I think he’s running out of organs. Anyway this month the Digest had
a real winner. How to Survive a Heart Attack.
I was wondering what was going on. All my patients kept asking me about
EWS. I couldn’t imagine what they were talking about. But the
article clarified the matter.”
“So clarify it for
me. What is EWS?”
“EWS means Early Warning
Signs, and refers to early warning signs of an impending heart attack or one
that is actually in progress.”
“What happens.
Does a light go on?”
“You are droll tonight,
aren’t you Harry? No, but Dr. Glen O. Turner of Springfield, Ohio felt
that if patients could recognize the early signs of heart attack they would get
to the hospital in time to be protected against the arrhythmias that prove
fatal so often during the first hours of the attack. After all if
patients can be brought over the hump of the first few days, the outlook is
quite good. The heart will heal. But the danger is that the
electrical system of the heart is highly sensitized during the early hours of
the attack, and fatal in-coordinate heart rhythms can occur.”
“Simon,” I interrupted,
“You are lecturing me as if I was a high school student. I am a doctor,
remember?”
“Oh – sorry, Harry I got
carried away.”
“You should be carried
away,” I said to myself.
“Actually I have been
asked to address the high school students on this subject, and I guess I was
practicing a little. I’m pleased to know that I reached you, Harry.
But it wouldn’t hurt you to climb off your high horse once in a while and read
the lay periodicals. For instance, do you have any idea how many
Americans will die of heart attacks this year?”
“About
50,000 and one.” I
said looking at him malevolently.
“Wrong.” Lapius paid no attention to my deadly stare. “About 650,000. And about 50,000 or almost ten percent
of these deaths could be prevented by early hospital treatment and surveillance
in a Coronary Care Unit.”
I had to admit that they
were impressive statistics. I was a little abashed that my guess had been
so far off. But I knew I wasn’t going to go around reading the Reader’s
Digest. Lapius started foraging in the hall
closet for his
coat.
“Where
to now?” I asked.
“A
meeting of the
“Donating your heart to
some hapless individual?”
“No, Harry. They
haven’t asked me to do any such thing. But they did ask me to help plan
for the Voluntary Screening Examination that they will conduct at the Community
College, on 500 individuals chosen because their answers to a questionnaire
about health and heart disease suggest that they might fall into a high risk
group. The nurses at the hospital are putting a lot of time and effort
into this. It is a worthwhile cause. Sort of an
EEWS.”
“A
what?”
“An
Early-Early Warning System.”
“Nonsense. The whole effort is simply a drop in the
bucket.”
“Perhaps,” said Lapius. “But it does get people thinking about
community health and gets them used to working together voluntarily for
community causes. They develop an awareness of the facilities available
in the community, and hopefully its shortcomings too.”
“Well, Simon,” I told
him, “You can spend your time being a do-gooder and social-service buff, but
I’ve got some studying to do.”
Lapius left without another word. I gave him a ten minute
head start and shot out the door. He didn’t know it but I was chairman of
the meeting he was going to attend. They way he drives a car, I bet I get there before him.
COMMENT
This signaled
the introduction of Preventive Medicine into a nascent Health Care System that
asked doctors and patients alike to accept responsibility for personal health. Some
believe that government motivation was to reduce the immediate costs of Health
Care. At that time the subsequent prolonged costs of longevity had not yet been
calculated. A Health Care System is much less expensive when the average life
span is 65 rather than 85. As life span moves up the next generation will start
to rethink its priorities. Is grandma worth keeping alive at my expense?