Friday, December 21, 2007
Rescuing Youssif
Dr. Sanjay Gupta playing soccer with Youssif.
Every now and then, we as journalists get to report a story that makes a difference. It's a story where people see and then act. Such was the case with a little boy named Youssif. By now, you may know his story. He was four years old, playing outside in a Baghdad neighborhood when men with masks came and poured gasoline on his face. Then, in an unbelievable act of cruelty, they set him on fire and ran away. Four years old.

Cruelty like that really does exist in the world. You will see it if you watch the CNN Impact Your World Special "Rescuing Youssif." But, you will see something else. Something that is wonderful. Something that offers hope and optimism. You will see goodness that fights that cruelty with a vengeance. And wins. You see, when correspondent Arwa Damon and her producer Mohammed first started reporting the story on CNN, people all over the world reacted. You reacted. You gave letters of support, and money to help. Hundreds of thousands of dollars. It was enough to bring Youssif and his family to the United States and to house them for the entire time of his treatment. It was enough to start Youssif on the path to care for those horribly disfiguring burns. It was enough to make Youssif safe. It was enough to impact the world.

Through Youssif's eyes, you will see what happened on that awful day. You will be taken on a journey from the bombs in Baghdad to the beaches of Los Angeles. You will watch state-of-the-art burn surgery at work and learn about Dr. Peter Grossman, who stepped up to take care of Youssif and donated all of his services. You will see a remarkable transformation. As you watch, though, look not just at the physical healing, but notice the emotional healing as well. If you are like me, it will give you chills and make you feel good inside.

Maybe it's because I am a doctor, or maybe because I have children of my own, but I could not stop thinking about Youssif. Maybe it's that I have spent time in Iraq seeing things that I wish I could erase from my mind. For all those reasons and many more, I am so proud to be able to report this story, along with Arwa Damon, a woman I admire. Watch, and you will see why it just may be the best story to come out of this war. It is goodness overcoming cruelty.

Programming note: CNN's Impact Your World Special "Rescuing Youssif" premieres Monday at 10 p ET. It airs again at 4p ET Tuesday and Friday at 8p ET.
Tuning in to watch a 'miracle?'
With fiancée Wiande on his arm, last Friday was a walk in the park for Kevin Everett.
Buffalo Bills tight end Kevin Everett, who suffered a spinal cord injury during a tackle in a game on September 9, may show up at his team's home game against the New York Giants this weekend. It will no doubt be an inspirational moment for everyone. You will remember Kevin originally arrived at the hospital paralyzed from the neck down. He received very quick surgery by the Bills' doctors, orthopedic surgeon Dr. Andrew Cappuccino and neurosurgeon Dr. Kevin Gibbons.

The question many people may ask themselves is "Why did Mr. Everett recover when so many others don't?" Some will say his spinal cord injury wasn't as bad as originally thought. Others will say it had to do with a controversial therapy, known as hypothermia, where the body and spinal cord are chilled. Some will say it is a miracle.

No one could argue that Everett's recovery is on track, and that's a good thing. But as a neurosurgeon, I feel a wholesale endorsement of a highly controversial - and in medical literature, largely unproven -- treatment (one that's potentially quite dangerous - it's linked to everything from infection and cardiac arrhythmias to pneumonia and organ failure) does warrant a little more discussion, which is why I am blogging about it.

First off, the rehabilitation doctors at Memorial Hermann TIRR stated in a press release that Kevin Everett actually suffered from a central cord syndrome, as opposed to a complete spinal cord injury. This is very important because we know the vast majority of patients (97 percent) with central cord syndrome do actually improve to the point of walking again (click here for more information). So, Kevin already had the odds in his favor.

And here's what is incredibly striking. Kevin's improvement and recovery began before the hypothermia was ever started. Dr. Gibbons - who was right there, treating Kevin alongside Dr. Cappuccino, and who had largely stayed out of the limelight during Kevin's treatment -- had this to say in a yet unpublished letter to the Editor of Sports Illustrated: "Kevin's dramatic recovery of movement began before the placement of the catheter and before effective cooling."

So, why is this so important? Well, because many people around the country who have suffered a tragic injury to the spinal cord may point to hypothermia as the key to recovery. That may offer false hope. As with most things, it is not that easy. Of course, none of this really matters to Kevin, and I will tune in to see him walk at the game. It will be a great moment.
Thursday, December 20, 2007
Pre-existing conditions preclude you from insurance
There is more evidence than ever that not having health care insurance can cost you your life. I was pretty struck by a report this morning showing that cancer patients were 1.6 times more likely to die in five years if they did not have insurance. (Watch Video)

And, here is something even more striking: A patient with grade 2 cancer has a 90 percent survival rate at five years if the patient is insured. A patient with grade 1 cancer (a better stage to have) has an 80 percent survival rate if the patient is not insured. Yes, you read that right. According to new data from the American Cancer Society, being uninsured makes you less likely to survive, even if you start with a lower-grade cancer.

There are more insurance issues raised in the study, and many of them have to do with lack of access to care. For instance, 86 percent of insured women get pap smears, compared to only 68 percent of uninsured women. And, to make matters worse, if you do develop cancer, it is often difficult to get insurance because you now have a pre-existing condition. In fact, health care proposals released by presidential candidates Rudy Giuliani, John McCain and Fred Thompson have few provisions for people to obtain insurance if they already have a medical condition. That is all the more ironic, given Mayor Giuliani's history of prostate cancer, Sen. McCain's history of melanoma and Sen. Thompson's history of lymphoma.

The insurance industry is taking steps to try to create plans for people with pre-existing conditions that are not prohibitively expensive, but for many people that relief may not come fast enough. Have you had a hard time getting insurance, even when you wanted to buy it? What did you do about it?
Monday, December 17, 2007
Rating your doctor
I hate going to see the doctor. I probably shouldn't admit this, but it's been almost three years since my last general checkup. In my case, it's not about the high cost of insurance (my co-pay is a reasonable $15) and not about being lectured on taking better care of myself (even though the doctor does harass me about exercising more). For me, avoiding the doctor's office is about not actually liking my doctor's personality. I don't particularly find her pleasant to be around.

You see, I've tried to find a doctor I like, but as many of you know, it's not easy. If you do manage to make an appointment with a doctor who actually accepts your insurance, you wait months to see him or her. Even after you get into the examination room, good luck spending more than five minutes with the doctor. I can't even remember the last doctor who actually remembered me from my last visit.

That's why I was so intrigued by a new service run by the restaurant review service Zagat's Survey and health insurance company WellPoint. I've been using Zagat's little burgundy books to choose my dining experiences for years. My wife and I never try a new restaurant without consulting Zagat's first. Before I sound too much like a commercial, let me tell you what I like about it. More than 300,000 people chime in on restaurants all around the world, and the establishments are rated on a 30-point scale on food, decor, service and cost. There is also a "straightforward" and "helpful" comment section that puts "well-meaning" reviewer comments in quotes (as I just did). Now, imagine the same idea of "quick and easy" reviews applied to your doctor's visit.

In the Zagat/WellPoint survey, the doctors will be rated online on trust, communication, availability and environment on a 30-point scale. There will also be a comment section after the numerical ratings. A doctor's review won't be published until he/she has 10 reviews by patients. The survey is free and for now is available only to WellPoint insurance members.

"It's not necessarily a bad idea," says Dr. James King, president of the American Academy of Family Physicians. "It's a little different choosing a doctor over the best restaurant in town. Whether you like the doctor is not indicative of whether you're not getting the best care. A patient needs to understand what's being measured and not being measured." King says communication and friendliness don't always come hand in hand with the best skill. Critics say that a potential pitfall may be any influence WellPoint may have in the survey. Other rating services by insurers may factor the cost of a patient's care into the ratings.

What do you think about rating your doctor? What would you say needs improvement at your doctor's office?
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