I am a family physician who loves to write about the HEART of HEALTH. On my blog, Watercress Words, I inform and inspire us in healthy living. My ideas come from my training, experiences, medical practice, personal life, and medicine in the media. There's always something new and interesting to explore in the world of health and medicine.
This post is not very “timely” as October is halfway through. My husband and I have been dealing with some health challenges of our own as well as getting ready for a wedding. However, the topic is no less timely.
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This photograph depicted a woman who was using a modern, battery-powered oral thermometer, in order to measure her body temperature. In order to return an accurate reading, this particular type of thermometer needed to be placed beneath the user’s tongue, for a set amount of time, beeping when the ambient, sublingual temperature was reached.
Photo credit-James Gathany, CDC, public domain
Influenza
In this part of the world the influenza season is starting, even though influenza can occur year round. Once again, the majority of physicians and other health professionals recommend vaccination as the most effective way to lower one’s risk of getting influenza. No matter how many people would like to believe otherwise, for most people the risk of influenza is greater than the risk of the influenza vaccine.
Most of the winter respiratory illnesses are not influenza, but can still make us feel miserable. Most of the time most of us recover uneventfully, but these diseases can cause more severe disease in certain people, like infants, elderly, and those with compromised immune systems. Here are some previous posts with info you need to know about keeping you and your family well and safe.
I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.
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Dear friends, I hope all is well with you and that you are as healthy in body as you are strong in spirit.
3 John 2
Stay well this winter, or what ever season you are enjoying now.
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Since my blog’s tag line is “exploring the HEART of health”, I couldn’t pass up the chance to read a book about exploring the heart. State of the Heart by cardiologist Dr. Haider Warraich explores the history, science, and future of cardiac disease.
Considering the current concern about heart disease and emphasis on heart health, it’s hard to believe that in ancient times people did not consider the heart a vital organ. The liver was revered as the driving force of the circulation responsible for maintaining life. Even now, the heart is sometimes thought of as just a pump, and not the complex organ that it is.
Dr. Warraich weaves the heart’s story with threads of medical history, explanations of basic cardiac anatomy and physiology, and stories about real patients he has treated for a variety of heart conditions.
The congestive heart failure patient who didn’t know he had heart failure
The woman who had a heart attack but whose coronary arteries were clear
The man who needed a heart transplant to stay alive but couldn’t afford the anti-rejection drugs
The man who couldn’t die until his mechanical heart (LVAD) was turned off
In this interview Dr. Warraich speaks with Nam Kiwanuka about advances and stumbles in the medical treatment of heart disease, a condition that kills more people annually than cancer.
Please review these previous posts from this blog that explain the heart, heart disease, and heart health.
Our brain controls the actions of the body’s other organs, but the heart supplies the power that keeps everything working smoothly, including the brain. Using the intricate “highway” system of arteries and veins, the heart pumps blood carrying oxygen, water, and nutrients to every cell in the body. Learn more in this post.
photo by Dr. Aletha, an exhibit at the Denver Museum of Nature and Science
Although we use the term HEART DISEASE , there are many diseases that involve the heart. HEART conditions affect people from birth to death. Find out more in this post.
Our modern lifestyles are particularly harsh on the heart-our diets, our lack of exercise, and the stress we expose ourselves to-
In this post I share 7 factors that make you at risk of heart disease , 7 symptoms you should not ignore, and 7 ways to keep your heart healthy. (Hint-Dr. Warraich mentions 3 in the quote above.)
Health is a lifelong expedition
Thanks for joining me to explore the heart, heart disease, and this new book by Dr. Warraich. Find it at your local public library or consider purchasing at one of these affiliate links which help me fund this blog.
I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.
To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.
In a previous post I told you about the students and residents in U.S. medical schools, the surprising new doctors caring for you. Here is an update.
Your doctor within the next 10-20 years is likely in medical school or a residency program in a United States medical center right now. Within 1-10 years, they will join the ranks of practicing physicians, while some doctors currently in practice will change to a non-clinical job, retire, or die.
More women physicians are coming
For the academic year 2017-2018, 83,000 students, attended United States medical schools , slightly more males than female. However, in 2017, the entering class of medical students was slightly over 50% female, for the first time ever.
UPDATE
For the second year in a row, more women than men started their journey as physicians, 11,382, 328 more than last year. From 10,752, the number of men decreased to 10,634.
According to the Association of American Medical Colleges, since 2015 the number of women students has increased by 9% while the number of men has decreased by 2 %.
And already, the majority of young practicing physicians-under age 40 years old-are female.
So you are likely to be treated by a female physician eventually, if you haven’t already, especially if you go to a primary care doctor. Gynecology and pediatrics residency programs are now overwhelmingly comprised of female residents.
Ethnic diversity is still low but is improving
Entering classes at the nation’s medical schools continue to diversify.
Medical students and residents, both male and female, are still predominantly white. The ethnic percentages of most other students is far below their representation in the general population. Based on self-identification, race and ethnic origin of medical residents in 2017 was
White-60%
Black- 7%
Hispanic(any race)- 6%
Asian-26%
Multiracial- 3%
Unknown/other-7%
Native American/Alaskan/Pacific Island -less than 1%
UPDATE
In 2018, the numbers of black, Native American/Alaskan, Asian, Hispanic/Latino, and white women increased, while the number of white males decreased. 51% of students in medical schools are white.
70% of U.S. medical residents are native citizens, 8% are naturalized citizens and 6% are permanent residents. ( adds to less than 100% due to some status’ unknown.) These numbers remain the same as last year.
Credentials of today’s physicians
The average grade point of entering medical students was 3.56.
77% had done some type of volunteer medical service .
“Most students, including minority, disadvantaged, and marginalized students, enter medical school pursuing a lifelong dream of practicing medicine with little sense of projected incomes or what specialty they would like to pursue.
Most students do not make specialty choices solely on the basis of the high cost of medical school or the overall potential revenue based on specialty.
Most specialty choices are likely based on social, educational, and health care experiences; experiences in medical school; and the prospect of a 30-plus-year career in an area of medicine that provides a level of personal comfort, support, and fulfillment.”
Thomas B. Free Medical School Tuition: Will It Accomplish Its Goals? JAMA. 2019;321(2):143–144. doi:10.1001/jama.2018.19457
The specialization of medical care- the good and the bad
March 16 was Match Day. Not a match as in color choice for an outfit nor a match as in finding a spouse, but the concept is similar.
On Match Day, graduating medical students learn which residency program they will enter through the National Resident Matching Program , which “matches” them with available positions in residencies at medical centers all over the United States. A kind of medical “matchmaking” you could call it.
Why should you care? This matching process determines who will care for our medical needs in the next 30-40 years; our family physicians, internists, pediatricians, general surgeons, obstetricians, and the multitude of other medical specialties. Most doctors will continue in the same speciality their entire career, although some switch after a few or many years.
Ted Epperly, M.D., consults a patient at his practice in Boise, Idaho.photo compliments American Academy of Family Physicians
Some medical students know what speciality they want to pursue before they enter medical school, while others decide after trying the different types of medicine while students. We still have the traditional specialities that most students enter- (there are also many subspecialities under each of these categories.)
Primary care
Family medicine
Internal medicine -(adult medicine)
Pediatrics-children and adolescents
Obstetrics/Gynecology- care of women’s health and pregnancy
Surgical specialities
General Surgery- surgery on skin and internal organs
Orthopedics-bones and joints
Otorhinolaryngology- ear, nose, throat
Ophthalmology-eyes
Neurosurgery-the brain, spine, nerves
Plastic and Reconstructive surgery
Cardiac and vascular surgery
Others
Dermatology-skin
Psychiatry-mental health
Anesthesiology-surgical sedation and pain relief
Emergency medicine- emergencies and trauma
Radiology- xrays and other imaging-CT, MRI, US
Pathology-laboratory medicine
Allergy
Physical medicine and rehabilitation
Oncology-treatment of cancer
Integrative and complementary medicine
As medical care has become more complex and technological, so have the specialties of physicians. This has produced a plethora of new highly specialized fields of practice.
Sleep medicine
Medical genetics and genomics
Pain management
Geriatrics- care of the elderly
Palliative care-managing diseases that cannot be cured and are likely terminal
Hospital medicine-care of patients admitted to a hospital
Critical care medicine-care of patients in an ICU (intensive care unit)
Aerospace medicine
Wound management
Medical informatics – use of computers and medical software in medicine
Bariatrics- treatment of obesity with or without surgery
Sports medicine-treatment of athletic injuries and fitness training
Transplant medicine- surgery to transplant organs and after care
Addiction medicine
A recent viewpoint in JAMA suggested that we need a new specialty, virtual medicine, to describe physicians who treat patients through a virtual medium, telemedicine or web based, on a computer or a mobile app.
Consider that in the early 1970s, there were only 20 medical specialties !
“the progress of biomedical science is a major factor in the emergence of new subspecialities. There are some patients who benefit from highly focused knowledge and skills.”
All of these specialities mean more medical knowledge and experience will be available to both treat and prevent a diverse and growing variety of disorders.
Today’s new specialist will have a high degree of expertise in their field, making them better able to treat your problem in the most efficient, effective, safest way.
You may find your doctor recommends more testing which may lead to more treatment than might otherwise have happened; some of which may not necessarily improve outcomes. More specialized testing and treatments may increase the cost of medical care.
Dr. Sandeep Jauhar addresses this issue in this article from Time.
With a more narrow focus of experience, that doctor may be less familiar with other aspects of your medical status.
So, to close this gap, primary care physicians have become increasingly important to oversee and coordinate care, especially for complex patients.
So there was good news in the Match this year. The upward trend in students matching into family medicine continued for the ninth consecutive year . In 2018 more students matched into family medicine than in any previous year, 3,535 compared to 3,237 in 2017.
3,848medical students and graduates matched to family medicine residency programs in 2019, the most in family medicine’s history as a specialty, and 313 more than 2018. The results marked a decade of growth in overall positions offered and filled for family medicine in the Match.
“The number and proportion of U.S. medical graduates going into family medicine is the strongest indicator of the future of the primary care workforce because family medicine is the only specialty completely devoted to primary care,”
said Michael Munger, MD, president of the American Academy of Family Physicians.
graphic provided by the American Academy of Family Physicians
My specialty-Family Medicine
I’ve often been asked ,”Why didn’t you specialize?” My answer, “I did. I specialize in Family Medicine.”
Once called “general practice”, Family Medicine is now a recognized specialty, requiring a residency and certification by the American Board of Family Medicine.
“In Jauhar’s wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, he takes readers to the heart of every young physician’s hardest test: to become a doctor yet remain a human being.”― Time
Unless otherwise stated, the doctor photos in the post are from the Lightstock.com collection . Get a free 30 day trial at this affiliate link. (This blog can earn a commission if you buy photos which helps support the mission of Watercress Words.)
Thank you for joining me to explore the surprising new doctors caring for you. I hope you’ve learned something. Please contact me about topics you want to read about.
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This scripture from the Bible book Matthew reminds me of the famous poem by Robert Frost. The late poet Robert Frost won four Pulitzer Prizes for poetry; his work is among the most widely read and often quoted poetry to this day. Listen to it here if you don’t remember it.
“The Road Not Taken” was originally published in The Atlantic in 1915 along with two other poems from Frost. It is now widely considered to be one of the most popular works of American literature.
“Its signature phrases have become so ubiquitous, so much a part of everything from coffee mugs to refrigerator magnets to graduation speeches, that it’s almost possible to forget the poem is actually a poem. “The Road Not Taken” has been used in advertisements for Mentos, Nicorette, the multibillion-dollar insurance company AIG, and the job-search Web site Monster.com, which deployed the poem during Super Bowl XXXIV to great success.”
What does the poem mean?
The poem’s meaning has been extensively dissected, discussed, and debated; most assign a deep meaning about life, choices, regrets, what-ifs, etc.
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So I was surprised to read that Frost himself didn’t take the poem nearly as seriously as everyone else has. He claimed that he wrote it as a joke for a friend.
“Soon after writing the poem in 1915, Frost griped to Edward Thomas that he had read the poem to an audience of college students and that it had been “taken pretty seriously … despite doing my best to make it obvious by my manner that I was fooling. … Mea culpa.” However, Frost liked to quip, “I’m never more serious than when joking.”
As his joke unfolds, Frost creates a multiplicity of meanings, never quite allowing one to supplant the other. When Frost sent the poem to Thomas, Thomas initially failed to realize that the poem was (mockingly) about him. Instead, he believed it was a serious reflection on the need for decisive action. (He would not be alone in that assessment.) “
What did Jesus mean in Matthew 7?
This scripture is part of the Sermon on the Mount attributed to Jesus (I’ve written other posts about these verses from Matthew chapters 5-7.) It also is widely known and quoted, as well as other verses like the Golden Rule, the Lord’s Prayer, and the Beatitudes.
In a devotional titled “All Noble Things are Difficult” for July 7th, he wrote
“The Christian life is gloriously difficult, but the difficulty of it does not make us faint and cave in, it rouses us up to overcome.
God’s grace turns out men and women with a strong family likeness to Jesus Christ, not milksops.”
It is always necessary to make an effort to be noble.”
Oswald Chambers
Milksops. That’s not a word we hear often; I looked it up and it means exactly what it sounds like. What happens when you dip bread into milk? It gets soggy and falls apart. So a milksop is ” a person who is indecisive and lacks courage.“
Choices, choices, choices
Despite Frost’s assertion that his poem was a joke, multiple commentaries dissect it extensively and assign all kinds of meaning to it, suggesting that we do believe that our choices matter in life, whether relationships, finances, education, or health.
Doctors and other health professionals now believe that lifestyle is one of the chief determinants of health and emphasize preventing and even treating illness with nutrition, exercise, mindfulness, sleep, healthy habits, and stress management.
Consider the Foundation
Whether you’re building a house, a career, a family, or your health, what you build on matters too. Jesus concluded his sermon with a building lesson.
Everyone then who hears these words of mine and does them will be like a wise man who built his house on the rock.
And the rain fell, and the floods came, and the winds blew and beat on that house, but it did not fall, because it had been founded on the rock.
And everyone who hears these words of mine and does not do them will be like a foolish man who built his house on the sand.
And the rain fell, and the floods came, and the winds blew and beat against that house, and it fell, and great was the fall of it.”
Matthew 7:24-27, ESV
Reading these verses reminds me of the rain storms we endured in Oklahoma this past spring leading to extensive flooding causing loss of homes and businesses; other parts of the country suffered the same, and now we’re watching coastal areas deal with devastating hurricanes. We’re pretty helpless to defend our property against the ravages of nature. That doesn’t have to be the case with our health if we build well. To paraphrase Oswald Chambers, “It is necessary to make an effort to be healthy.”
Here’s the story of Oswald Chambers and his wife Biddy. After his death, she collected writings from his lectures and talks into books and the well known devotional mentioned above. In the introduction she wrote,
it is sent out with the prayer that day by day the messages may continue to bring the life and inspiration of the Holy Spirit.
Biddy Chambers
exploring faith, hope, and love
Thanks for joining me to explore poetry and scripture; my hope is that this prompts you to further explore on your own. Here are some other posts from this series
You can find many books about Oswald Chambers’ writing and teaching at this affiliate link (meaning it will pay a commission to this blog if you purchase anything through it.)
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“Lifestyle medicine (LM) involves the use of evidence-based therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, and avoidance of risky substance use, to prevent, treat, and, oftentimes, reverse the chronic disease that’s all too prevalent,”
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