MCMS Physician Summer 2017 - 6

mon t m e d s o c .c om

Editor's Comments
Editor's Comments

Politics Blur Lines
Between Fact and Fiction

Thewas
world
is upside-down.
driving
down the ramp
As towards
I sit here,
the
theSunday,
Pennsylvania
19th ofTurnpike
February,
it's 69
when
mydegrees
phone
outside.
Two
of
my
kids
rang. It was an old friend,are
one I
running around the front yard in
talked to frequently but hadn't
long pants and short sleeves. Our
seen in a while. Her knee hurt,
newest addition, Maxwell Jacob,
and she wanted my advice. How
is napping in the stroller wearing
bad? I asked.
Horrible,
late-spring
clothes.
Just she
shysaid.
of A
healthy,
young
woman,
she
five
weeksactive
old, he
knows
nothing
had
developed
debilitating
pain
that
about the outside world, and that's
waswith
now me.
so severe
wassoon
unable
fine
He'llshe
learn
to walk. There was no swellingenough.
or rash, but the joint was tender
When
I stare
down
into his
eyes,
all over.
"What
do you
think?"
sheliquid-brown
said. Her voice
waswatching
steady,
the
up-and-down
rapidly-growing
but binky
I couldbounce
hear her
concern. Notbetween
wanting two
to speculate
without
cheeks,
I
can't
help
but
wonder
what
kind
of
America
heTwo
will
an exam, I counseled her to seek out her family physician.
come
of
age
in.
We
are
at
a
crossroads,
this
nation
of
ours,
and
aspirations and several cultures later, the answer came back: Lyme
ever
since
he
arrived,
I've
found
myself
pondering
what
role,
arthritis. After thirty days of doxycycline and a taper of steroids,if
any, physicians will play in America's future.
she's finally feeling whole again. That, and determined to keep a
I don't mean professionally, of course. We all know what
closer eye on what her cat is up to this summer - especially in the
doctors do, and my comment wasn't meant to imply that there
woods behind her home.
would no longer be a use for us. Rather, I'm thinking about
social responsibility, and the special bond between physician
Lyme
Arthritis:
The about
Culprit
and
patient.
I've written
this theme many times, but like
a moth drawn to a flame, I keep coming back to it. Especially
If her story surprises you, it shouldn't. Cases of Lyme are on
now.
the rise
all along
the East
coast. "patient
In fact, Pennsylvania
has "shared
not only
We've
all heard
the terms
autonomy" and
decision-making,"
but at what
doesfor
ourthree
dutystraight
to the truth
led the nation in confirmed
casespoint
of Lyme
years,
outweigh
another
human
being's
thoughts
and
feelings?
Some
but the deer ticks which carry the disease have now been found in
lines,
the long-debunked
link2013
between
vaccines
and
all 67 such
of theasstate's
counties. Between
and 2014,
cases
in the
autism,
are
clear.
Others,
like
opinions
based
on
the
dreaded
Commonwealth increased by 25%, with even higher projections
'Google
seemtoless
It's easy
to point out
for 2017.search',
According
the so.
CDC,
Pennsylvania
nowinformation
accounts for a
which is blatantly false - the idea that antibiotics are an
quarter of all cases of Lyme in the United States.
effective treatment for viruses comes to mind - but what
Despite this, funding for research and prevention lags other
does one do when confronted with a worldview that holds any
viewpoint grounded in science with suspicion, or even disdain?

With all
Due Respect:
Science
Trumps
Opinion
diseases.
Pennsylvania
spends $2
million dollars
a year
tracking
West Nile virus and spraying for the mosquitos that carry it. On
I'm talking
about
politics.
the federal
level, the
CDC
and NIH spend about $35 million per
Now,
before
I
proceed
any further,
I'mthink.
goingBut
to make
it
year on Lyme research. Not bad,
you might
consider
clear
that
I
believe
conversations
about
a
patient's
political
this - since 2000, our state has had only 60 or more confirmed
views, voting habits, and positions on hot-button issues
cases of West Nile over a two-year period, while thousands of
are clearly off-limits and have no place in the exam room.
Pennsylvanians are, according to current projections, living with
However, in our current adversarial and disruptive era, how a
chronic Lyme. Given that up to 40% of those infected may
patient views politics may have a direct impact on how they
develop
problems,
our best current
perceivelong-term
educated health
professionals,
andand
potentially
disrupttest
the
protocols
for
Lyme
involve
antibody
and
serologic
assays
that can
patient-physician relationship. And in our current
political
take
4-6 weeks
to turn
positive,
early recognition
prevention
climate,
nowhere
is this
more pronounced
than and
women's
are
paramount.
health.
Charges that physicians routinely perform elective lateterm abortions (and are illegally compensated with taxpayer
funds) or
the erroneous
idea Boys
that birth
control
Prime
Target
for Lyme:
Under
thepills
Agepromote
of 19
promiscuity have become a rallying cry for those whom this
particular
social
issue
near and
dear. As
a physician
and
As we head
into
the issummer
months,
it's both
also worth
mentioning
a person,
thatcases
pointoccur
of view
as a personal
belief, but
that
a thirdI respect
of reported
in children,
particularly
boys
not
as
the
foundation
of
public
policy.
And
recently,
under the age of 19. While progress has been made, theI've
lackfound
of
myself questioning even that respect. (Full disclosure - I
specific funding for Lyme in Governor Wolf 's $66 million 2017would personally support legislation banning elective abortions
2018 health research budget shows much work remains to be
at 20 weeks or earlier, but only if they contain exceptions for
done. In Washington, the 21st Century Cures Act granted a voice
the life and health of the mother, and granted final decisionto
citizensauthority
serving in
working
group
tick-borne diseases.
making
toathe
patient
and studying
her physician).
WithThe
influence
over howSenate
federalhas
research
dollarsintroduced
are spent, it's a
Pennsylvania
once again
step
in
the
right
direction,
but
still
only
a
small
one.
legislation to prohibit the termination of pregnancy beyond
the home
front,
the question
remains:
howAmerican
do we fight
20On
weeks.
Despite
unified
opposition
from the
back
against
has been
"the infectious
disease
equivalent
Congress
ofwhat
Obstetrics
andcalled
Gynecology
- both
nationally
and
the
Pennsylvania
chapter
-
the
legislation
passed
of cancer?" The answer is to be found in this issue's featurethe
article,
Senatewill
andaddress
now itnot
moves
the
House.
will a
which
onlytothe
points
I'veWhile
raised Gov.
above,Wolf
but take
certainly
veto
the
legislation
should
it
make
it
to
his
desk,
closer look at the prevention and treatment of this serious disease,
thewell
factasthat
it is even being
begs
is the
as
the grassroots
effortsdebated
underway
in the
our question:
state to help
raise
outcome
preordained?
Can
we
simply
guess
what
type
of
bills
awareness of this growing threat. As both physicians and citizens of
legislators will introduce based on whether they have a 'D' or
our Commonwealth, it is important that we not only educate our
'R' next to their name? Despite overwhelming evidence that
a) the majority of abortions performed in the United States
happen in the first trimester and b) later-term procedures are

MCMS PHYSICIAN 6 SUMMER 2017

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