Senator Ted Kennedy (1932 - 2009)

TuftScope acknowledges and remembers the service of Senator Edward 'Ted' M. Kennedy (1932 - 2009) who passed away today from the lingering consequences of malignant brain cancer. As a representative of our state of Massachusetts for nearly 46 years, he defended progressive change and legislation. He was a stalwart defender of healthcare as a right, rather than as privilege, and of multiple other critical issues. Despite his flaws he brought about such seminal legislation as HIPAA, the Americans with Disabilities Act, and the State Children's Health Insurance Program (S-CHIP). Today's NY Times carries a biographical article about him, we urge you to read the article to learn more about the complex and full life of the Senator. The article had this to say:

Born to one of the wealthiest American families, Mr. Kennedy spoke for the downtrodden in his public life while living the heedless private life of a playboy and a rake for many of his years. Dismissed early in his career as a lightweight and an unworthy successor to his revered brothers, he grew in stature over time by sheer longevity and by hewing to liberal principles while often crossing the partisan aisle to enact legislation. A man of unbridled appetites at times, he nevertheless brought a discipline to his public work that resulted in an impressive catalog of legislative achievement across a broad landscape of social policy.

We hope that his legacy on healthcare will be reflected in the bills being considered before Congress in the coming months.

Update: From a Newsweek article, the Senator's own words on healthcare (emphasis added; July 18, 2009):

But quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to.

This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver—to support Barack Obama, but also to make sure, as I said, "that we will break the old gridlock and guarantee that every American…will have decent, quality health care as a fundamental right and not just a privilege." For four decades I have carried this cause—from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society. Now the issue has more meaning for me—and more urgency—than ever before. But it's always been deeply personal, because the importance of health care has been a recurrent lesson throughout most of my 77 years.

Update #2: Senator Ted Kennedy spoke during the Nixon Administration on universal healthcare:

Overexposure During Surgery: Too Much Media?

The modern attraction for live presentations and entertainment may have transferred itself into the surgical field. The use of new laparoscopic techniques now allows for the introduction of cameras into the surgical field to observe procedures. Dr. Adam Wolfberg (Tufts Medical Center), reports for Slate (August 18, 2009) about the advent of live-surgery for surgical conference attendees:

Combining education with entertainment and patient care with promotion, live telesurgery is a fixture at surgical conferences and marketing campaigns by hospitals and medical device manufacturers. It's natural that conference attendees want to see the best surgeons performing the most advanced procedures with the newest equipment. There's no inherent reason why they need to watch it happen live—a narrated DVD would provide the same or better educational experience, with mundane sections eliminated and critical points in the surgery highlighted. But try telling that to conference organizers who know that live telesurgery is, rationally or not, a high point of many conferences.

A case of advertising, the human desire for entertainment, the surgeons need to prove themselves, and the spectators need to believe that others make the same mistakes that they do have fed into this developing trend. What remains unclear is whether the interests of the patient are best served by a distracted surgeon and an eager audience. Certainly the use of expert surgeons to teach others is invaluable, especially when the alternative might be to travel hundreds of miles to scrub in for a procedure. But the level of multitasking and distraction apparent in media oriented surgery can be disconcerting. Whether telesurgery will replace physical observation as the 21st century equivalent remains to be seen.

Michael Shusterman is the Editor in Chief of TuftScope (2009 - 2010).

Why Do We Need Evidence Based Medicine?

Harriet Hall, who writes for Science-Based Medicine, discusses the importance of evidence based practice in medicine. Often the inherent psychological flaws of human reasoning lead individuals to assume that treatments are efficacious when really a successful outcome is independent from the treatment. The article is available here (Science Based Medicine, August 18,2009). A short excerpt below:

Sometimes We Get It Wrong

How can you know whether a medical treatment really works? If everybody says it works, and it worked for your Aunt Sally, and you try it and your symptoms go away, you can pretty well assume it really works. Right?

No, you can’t make that assumption, because sometimes we get it wrong. For many centuries doctors used leeches and lancets to relieve patients of their blood. They KNEW bloodletting worked. Everybody said it did. When you had a fever and the doctor bled you, you got better. Everyone knew of a friend or relative who had been at death’s door until bloodletting cured him. Doctors could recount thousands of successful cases.

All those people got it wrong. When George Washington got a bad throat infection, his doctors removed so much of his blood that his weakened body couldn’t recover, and he died. We finally got around to testing bloodletting and found out it did much more harm than good. Patients who got well had been getting well IN SPITE of bloodletting, not because of it. And some patients had died unnecessarily, like George Washington.