Wednesday, December 23, 2015
Are our plates too full? A nation confronts addiction
Thanks largely to the influence and convening power of Mehmet Oz, the nation was invited to talk about addiction. Among those weighing in to lend support, on air and via social media, was the nation's Surgeon General, Dr. Vivek Murthy.
The symbol chosen for the campaign was an empty plate, the image meant to convey that this night, the conversation and related food for thought mattered more than the food. Something additional suggests itself to me, however, especially as I try to get this column written (as I promised I would): catch up and then keep up with demands as furious and frenetic as a swarm of bees. Maybe our plates are generally way too full.
I really have no cause to complain on my own behalf. Yes, I am too busy, and yes, I do often feel like Sisyphus. But I have a loving family and plenty of support. Many are not so fortunate.
Many are on their own. Many are living hand to mouth. Many have plates that are figuratively too full, even if literally too empty. Or, if not empty, piled high with all the wrong things.
We are a nation of chronic insomnia, and a nation of chronic pain. Addiction takes many forms, of course, but often it begins with a prescription narcotic and no meaningful plan to follow. This, in turn, is symptomatic of a disease-care system that is often too pressed to be humanistic, too focused on productivity to be holistic. We are treating symptoms, rather than people.
We are a nation of some 300 million yet often manage to be lonely. We are a nation of phenomenal wealth yet appalling disparities. Even life expectancy gains, as we learned recently to our collective shock, have left an entire segment of the population behind.
We might talk about a particular substance and its perils. We might talk about pain, and the desperate reach for often elusive remedies. We might situate that pain below the neck, or above, and we might talk about granting comparable respect to both.
We might talk about bullying, the decline of empathy, the anonymities of cyberspace that invite diverse abuses in perpetual shadow. We might talk about the societal impulse to judge first and consider after, the demise of dialogue and civility.
We might talk about ever increasing demands on our time, and never increasing time to meet demands. We might talk about deep existential fears, as glaciers melt, and storms rage, and twisted ideologies claim innocent lives for inscrutable causes.
We are human. We are, as ever we were, subject to the thousand natural shocks that flesh is heir to; prone to the slings and arrows of outrageous fortune. The desperate question Hamlet posed to himself suggests itself to far too many, and all too many of them reach for a gun. Others reach for a bottle, or a vial, or a syringe.
We are human, and thus all part of an extended family. Now, as ever, there is no need to send to know for whom the alarm bell tolls. If it tolls at all, it tolls for us all.
We are part of the extended human family, and by extension, conjoined in an astonishing array of triumphs and disasters; a constant concert of sadness, and euphoria. It is all too much, so we must take it in smaller doses. One family, 1 conversation at a time.
We were invited to do just that yesterday evening.
The empty plate is an invitation to talk about the intimate side of epidemiology, the burdens and trials that may in turn make any of us vulnerable to the illusory relief and obnubilating solace of an intoxicating substance.
The empty plate is an invitation to acknowledge that all too often, our plates are too full, and left undiscussed, that is a very dangerous secret to keep.
David L. Katz, MD, FACP, MPH, FACPM, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care. He is a board certified specialist in both Internal Medicine, and Preventive Medicine/Public Health, and Associate Professor (adjunct) in Public Health Practice at the Yale University School of Medicine. He is the Director and founder (1998) of Yale University's Prevention Research Center; Director and founder of the Integrative Medicine Center at Griffin Hospital (2000) in Derby, Conn.; founder and president of the non-profit Turn the Tide Foundation; and formerly the Director of Medical Studies in Public Health at the Yale School of Medicine for eight years. This post originally appeared on his blog at The Huffington Post.
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Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).
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Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.
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Dr. Mintz' Blog
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David Katz, MD
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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