Where should we take you?

Years ago, when I started working with homeless cancer survivors in Birmingham, Rachael Martin, then-associate pastor at Church of the Reconciler, shared something with me that I’ll never forget. She said that when a homeless person needed immediate medical attention and an ambulance driver asked her where to take the individual, she always aimed high.

“They’re more likely to get better care at a place like UAB,” she told me, than at one of the less funded hospitals with fewer well-trained medical personnel on staff in the city. Rachael’s thinking was that even if a person lacking the necessary health benefits couldn’t stay at a more selective facility and had to be moved eventually, the initial triage care would be better and therefore boost the patient’s chances of getting the right diagnosis and initial care–and ultimately, of survival.

Today, a New York Times article reports on a study in PLoS that adds support to Rachael’s logic.  According to the researchers, patients at less credible institutions were “three times more likely to die” and a whopping “13 times more likely to [suffer from] medical complications” than those who were taken to the best facilities. The full article and link to the published study can be found here: http://www.nytimes.com/2016/12/14/business/hospitals-death-rates-quality-vary-widely.html?emc=edit_th_20161216&nl=todaysheadlines&nlid=44005038&_r=0

Maybe those in need of medical attention need to replace “Take me to the hospital” with “Take me to that hospital.” Unfortunately, for many of the least advantaged in our society, the question “Where should we take you?” is never asked.

Addiction, up close

My friend and colleague, Kerry Madden, just published a piece on addiction (and the upcoming vote over legalizing marijuana in California) in the LA Times: http://www.latimes.com/opinion/op-ed/la-oe-madden-addiction-marijuana-legalization-20160603-snap-story.html

Kerry’s essay is powerful, regardless of the snarky comments from readers–many of whom are pro-legalization. I’d love to introduce them to my brother who, no doubt about it, used pot as a gateway drug to a host of substances and continues to deal with addiction at 56 years old.

To the moon, via the White House

My friend, Jerry Lee, is going to the White House.

I’ve known Jerry for some time through his involvement in the Scientist Survivor Program (SSP) at the American Association for Cancer Research. In 2015, I served as an Advocate Mentor for a group of SSP participants, and Jerry was our Scientific Mentor.

Jerry’s full-time position is at the National Cancer Institute in Bethesda, Maryland, where he is Deputy Director of NCI’s Center for Strategic Scientific Initiatives. The role he’ll be stepping into through January 2017 (when a new administration will take the reins) is Deputy Director for Cancer Research and Technologies for the White House Moonshot Task Force under the Executive Office of the Vice President.

During his 2016 State of the Union Address, President Obama called on VP Joe Biden, who lost his son Beau to brain cancer in 2015, to lead a “Moonshot” initiative to eliminate cancer. The White House issued a press release to outline the specifics of this national endeavor: https://www.whitehouse.gov/the-press-office/2016/02/01/fact-sheet-investing-national-cancer-moonshot

Scientists, cancer survivors and advocates initially responded harshly to the call, since the metaphor of a “moonshot”–the implication that a single, well-targeted discovery could end all cancer–is naïve and outdated given the knowledge we now have that cancer is a multitude of diseases which continually mutate and evolve. In response to the criticism, VP Biden hit the road to learn more from people who have been studying cancer throughout their careers. His first stop was the NCI.

I can’t imagine a better choice than Jerry to join this Task Force. In addition to being a brilliant scientist, Jerry is passionate about eliminating the pain and suffering of individuals who experience cancer in one form or another.

Go, Jerry!

The plight of farmers in Romania

One of the best things about traveling to Amsterdam was the opportunity to work with two very bright, energetic women from Sustainable Amsterdam: Cornelia Dinca and Anna Hajdu. Both are from Romania, and they have discovered a home in the Netherlands and an outlet for their passions:  http://sustainableamsterdam.com/

Anna works as a Research Assistant, and shared with me some of the research that she is currently conducting back in her home country. While I’ll avoid going into the details of Anna’s research–since the work is, after all, hers to tell–she did offer an interesting perspective on farming in Romania when we sat down to dinner at Cornelia’s home Sunday evening.

Like small farmers in the Midwest, where I lived the first 17 years of my life and my dad continues to live on the land as a fourth generation farmer, farm families in Romania are steadily losing their ground to corporations. Commercial stakeholders interested in acquiring land and turning over a quick investment–by working the soil aggressively until it can no longer produce anything of value–are strategically tricking older farmers into selling their property cheaply while corporate profits remain high.

Anna told me that corporations set up shop in an area and post signs indicating that farmers should show up on a certain day and time to find out what their land is worth. To a generation raised on Communist dictates, these notifications, Anna said, appear mandatory. Farmers come to the meetings, and before you know it, their property has been sold to a corporate representative for far less than the land is worth.

In addition to the backdrop of Communism influencing how Romanian farmers perceive their right to refuse to sell, or at the very least, to negotiate a fair price for their land, Anna noted that most of these farmers lack a sense of pride in what they have accomplished as caretakers of the soil.

“In Romania,” Anna said, “the young people are leaving to get an education and to find other kinds of work. Once they leave the farm. they are no longer interested in it.”

There is a sense that what these younger generations are leaving for is a step up to a better life.

While my cousins and I have all gone to college and entered careers away from the farm, I wouldn’t say that any of us think of these choices as necessarily “better.” In some ways, leaving the farming life is a necessity, as land prices and equipment costs continue to soar making the continuation of another generation of family farmers increasingly difficult.

But we all maintain a sense of pride in what our parents have accomplished on the land and intend to remain involved in the workings of our family farms wherever our lives may lead us–Chicago, Kansas City, Birmingham.

It made me sad to think of an older generation of Romanian farmers being forced from their land, at the same time they doubt the worth of their labor.

Paths through Amsterdam

Since arriving in Amsterdam four days ago, I’ve done more walking and bike riding than I have in a long time.

The city of Amsterdam is breathtakingly beautiful. Just like in the movies, Amsterdam’s canals and cobblestone streets make for a picturesque backdrop to a curious culture.

As we strolled through the city last night after a delicious dinner in an Indonesian restaurant (one of the culinary specialties in this city of many cultures), we passed through the Red Light District, by quaint high-end boutiques and cafes, and alongside an old canal house-turned-museum called Our Lord in the Attic.

During the Protestant Reformation, Catholicism was banned in the city. So, a wealthy local Catholic merchant invited fellow parishioners into the upper room of his home to celebrate mass.

Our guide, Cornelia, shared an anecdote about Our Lord in the Attic that speaks to the tolerance for which the Dutch are best known. During the Reformation, when numerous Catholics flocked to the wealthy merchant’s home for mass on Sundays, a Protestant man standing outside the home complained to a local constable.

“Why don’t you arrest them? Can’t you see the Catholics are breaking the law?”

To which the constable replied, “Sir, like you, I am a good Protestant and don’t work on Sundays. I’ll come back tomorrow, though, and if they’re still there, I’ll arrest them.”

Dutch tolerance at its finest.

The Kushner’s

After my op-ed on survivor stories in the media lacking sufficient science came out in the LA Times, Lesley Kushner contacted me. Lesley is the daughter of Rose and Harvey Kushner, both of whom are well known in the breast cancer community for first bringing Rose’s story, and passion, to the conversation about breast cancer in the 1970s through writing and advocacy.

It was Rose who ushered in the two-stage surgical procedure for breast biopsy and mastectomy. Before Rose, women went into the operating room not knowing whether the lump in their breast was malignant or whether they would awake without a breast.

Lesley offered to talk to me further about her mom’s work, and said that her dad would be happy to share his memories as well. I took them up on their invitation last week.

I immediately connected with Harvey and Lesley’s passion for cancer advocacy and their belief that Rose, if alive today, would have her head in the research literature and the laboratory to uncover the most recent findings about what causes breast cancer and the myriad of approaches to treating it. She wouldn’t, they assured me, be caught up in the pink, running races and putting a happy face on the disease.

Our conversation was rich and provided me with plenty of directions for further writing. While I wish I could have met Rose, who sadly passed away before I was diagnosed with breast cancer in 1993, her example gives me faith in the power of words to make a difference.

Bad luck

A story out this morning reports on a study attributing many cases of cancer to plain old bad luck: http://www.msn.com/en-us/health/medical/biological-bad-luck-blamed-in-two-thirds-of-cancer-cases/ar-BBhqxBi?ocid=DELLDHP

According to researchers at Johns Hopkins in Baltimore, oftentimes there’s not a definitive, preventable cause of cancer. Our attention in much cancer research has been on isolating specific lifestyle factors like smoking or weight gain, and then educating the public on how to avoid these triggers. But it’s nearly impossible to predict and address random mutations that affect people and predispose them to certain kinds of cancer.

When I read this report, I immediately thought about Robert Crawford’s article from the 1970s on “healthism,” an ideology that privileges the healthy and blames those who fall ill for neglecting to care for themselves and becoming a burden on society. Crawford denounces this particular “ism,” arguing that such attitudes focus too narrowly on the individual body while ignoring the whole of society. It’s convenient to point the finger at smokers, for instance, without considering the lack of regulation or cultural influences that led these smokers to pick up the habit in the first place.

I wonder what Crawford would say about the random stroke of luck, good or bad, suggested in this recent study.