January 16, 2009, 11:58 am

Survival Lessons From a Sinking Plane

INSERT DESCRIPTIONThe rescue of passengers from US Airways Flight 1549. (Gary Hershorn/Reuters)

One of the more remarkable images from the Hudson River landing of the US Airways flight on Thursday is the photo of passengers standing calmly on the floating wings, waiting to be rescued.

But for people who study disasters, there is nothing surprising about the cool, collected demeanor of the passengers.

Amanda Ripley, author of the book “The Unthinkable: Who Survives When Disaster Strikes — and Why” (Crown, 2008), notes that in this plane crash, like other major disasters, people tend to stay calm, quiet and helpful to others.

“We’ve heard from people on the plane that once it crashed people were calm — the pervading sound was not screaming but silence, which is very typical,” said Ms. Ripley, who for years covered floods, plane crashes and other disasters for Time magazine. “The fear response is so evolved, it’s really going to take over in a situation like that. And it’s not in your interests to get hysterical. There’s some amount of reassurance in that I think.’’ Read more…

January 15, 2009, 3:54 pm

Why the Kidney Divorce Drama Matters

By now, you’ve probably heard the story of the Long Island surgeon who is suing his estranged wife for the kidney he donated to her. If it can’t be returned, he wants the $1.5 million dollars he believes it is worth.

For most of us, this is just tabloid fodder, but in her latest Doctor and Patient column, Dr. Pauline Chen says the case is representative of the “extent to which money has become enmeshed with medicine.” She writes, “Many of us reading, listening to and even writing about the story,­ myself included — accepted the premise long enough to wonder how (they) came up with that high a figure or if it was even physiologically possible for him to take back the kidney.”

Dr. Chen goes on to describe her first kidney transplant operation with a living donor, and how difficult it is to place a value on the transaction.

The experience was nothing short of extraordinary. And like the very act of donating an organ, the kidney itself was hardly glamorous, demanding nothing in return for its miraculous work. It was a sturdy organ –­ pink, firm as a small rubber ball, and shaped much like the kidney beans you’d find at a restaurant salad bar…. It was, I remember thinking that morning, a gift of life. But it’s a gift, according to some, that can be assessed for as much as $1.5 million or as little as $20,000 or less.

For more, read the full column, “Putting a Price on Compassion,” and then join the discussion below.

January 15, 2009, 12:05 pm

The Voices of Psoriasis

INSERT DESCRIPTIONThe faces and voices of psoriasis. (Photography credits: David Walter Banks, Meenu Bhardwaj, Ken Cedeno, Ryan Collerd, David Eulitt and Shana Sureck for The New York Times)

Many chronic diseases are invisible, taking a toll on the individual but not immediately apparent to outsiders. But the skin condition psoriasis causes obvious changes leading to itchy, scaly skin on the hands, legs, scalp and other body parts. Not only is it painful, but it can also be isolating, because sufferers are embarrassed by their appearance.

Today’s Patient Voices by Karen Barrow focuses on seven men, women and children with psoriasis, a chronic disease of the immune system that appears on the skin, usually as thick, red, scaly patches. Many people with psoriasis also develop psoriatic arthritis. According to the National Institutes of Health, as many as 7.5 million Americans have psoriasis. Read more…

January 14, 2009, 3:14 pm

A Father Struggles With His Daughter’s Cancer

For years, newspaper columnist Al Martinez has shared stories about his children with readers. In today’s Los Angeles Times, Mr. Martinez is asking his readers to share their own stories of hope.

Mr. Martinez reports that his eldest daughter, Cindy, has been diagnosed with cancer that has spread to her liver. The diagnosis has him reflecting on the day he first met his daughter in 1952, when she was nearly a year old. He had missed the birth because he was a marine stationed in Korea. A Red Cross worker had originally told him he was the father of a baby girl named Sarah. Weeks later he learned her name was actually Cinthia.

I still call her Sarah occasionally; it’s a joke we share, Sarah and I. I write about her today because she, and all of our family, is involved in a different kind of war; more insidious in a way. Cindy has cancer.

It was discovered some weeks ago, a finding that took a part of her large intestine during subsequent surgery. The surgeon noticed that it had spread to her liver. Soon chemo will begin to shrink the tumor, and then it will be removed.

We discover in adversity what we are composed of. We suffer the shock of painful news, cry tears of self-pity and then, if there is steel in us, we march on. Cindy is going forward like a warrior into the fray with a toughness that I had expected from her. I know this girl….

I’m putting her name in print today so that you can tell me stories of your own fight against cancer; so you can help our family find the strength and courage to defeat the enemy within…. Cindy was handed to me a long time ago and occupies a special place in my life and in my heart, and I’m not about to hand her back.

To learn more, read “Looking For Strength to Fight Cancer.”

January 14, 2009, 10:52 am

Using Drugs for Longer Lashes

INSERT DESCRIPTIONLuscious, long lashes? (Alex Quesada for The New York Times)

A friend of mine with early glaucoma uses daily drops to prevent vision loss in one eye. The result: one eye has changed color and developed long thick lashes.

But it never occurred to me that people with healthy eyes might consider using these drugs to get a similar side effect. In “Love the Long Eyelashes. Who’s Your Doctor?” my colleague Natasha Singer today writes that Allergan, the company that brought us Botox, has repackaged a glaucoma treatment as the first federally approved prescription drug for growing longer, lusher lashes.

The product has the same formula as Allergan’s eye drops for glaucoma, called Lumigan. It is one of several drugs in a category known as prostaglandin analogs, which are meant to reduce dangerous pressure in the eyeball. But as a side effect, the treatment tends to make the eyelashes of many patients longer and fuller.

Unlike the version for glaucoma, Latisse isn’t used as a drop, but instead is applied once daily to the base of the upper eyelashes with a disposable applicator. One worry is that cosmetic users may experience some other side effects, including red, itchy eyes and changes in eyelid pigmentation. And longer lashes don’t come cheap. Latisse is expected to cost about $120 a month.

I regularly use mascara to lengthen my lashes, but I can’t imagine going to the trouble of daily eyedrops. But Cindy Ross, vice president for sales at Young Pharmaceuticals in Wethersfield, Conn., who participated in the Latisse clinical trial, loves the result so much that she had a doctor prescribe the glaucoma drug to use on her lashes until Latisse becomes commercially available.

“People would say to me ‘Are you wearing false eyelashes?’ — even my own mother asked,” Ms. Ross said. “I wouldn’t stop. I found a way to get it.”

What do you think? Are long lashes important to you? Would you take a daily drug to get them?

January 13, 2009, 11:39 am

Creating a Soundtrack for Health: The Contest

Music lifts our spirits during the best of times, so it’s no surprise that many people turn to music in times of poor health. For Dana Jennings, a Times editor who writes every week about coping with prostate cancer, music is an important part of his treatment.

“While the hormone shots and the radiation sessions are essential, they don’t tell the whole treatment tale,” he writes in his latest piece, “Notes to Soothe the Savage Cells.” “I’m a music-obsessive, and I can’t imagine having prostate cancer without listening to just the right music to complement my moods: joy and sadness, anger and gratitude, fear and doubt.”

Prostate Cancer Journal
One Man’s Story

Dana Jennings blogs about his experience with prostate cancer.

For Dana, listening to heavy metal music helps him manage the anger of cancer. This week, he offers his own personal playlist of “music to have cancer by.” Among his favorites, “Hallelujah” by Jeff Buckley, “Moanin’ at Midnight” by Howlin’ Wolf and “Hurt” by Johnny Cash.

Whether music has played an important role in your own cancer or other treatment, or if music is essential to your workout, we want to hear from you. Help us create a soundtrack for health, by sharing the most important song from your own personal health playlist. Tell us how the song helps you, and why it should be included on a soundtrack for health.

If we pick your submission, you’ll receive a signed copy of Dana’s latest book, “Sing Me Back Home: Love, Death and Country Music.

Share your songs and your stories below. We’ll pick our favorites and post the entire playlist with song links.

January 12, 2009, 9:37 pm

Will Drivers Ever Give Up Cellphones?

Recently while driving from New York to Pennsylvania, I suddenly realized I had taken the wrong exit for the New Jersey Turnpike.

For me it was a startling mistake that had me going north instead of south, and added at least a half hour to my commute. It had happened while I was talking to a friend on the phone. Even though I had been using a headset and had both hands on the wheel, I still made an important driving error.

Beyond my driving mistake, there are plenty of data to show that cellphone conversations and driving don’t mix. My Well column in Tuesday’s Science Times explores the science of cellphones and driving, and helps explain why even hands-free cellphone use takes a toll on your driving ability. Now the National Safety Council has called for a total ban on cellphone use while driving.

Read the full story, “A Problem of the Brain, Not the Hands: Group Urges Phone Ban for Drivers,” and then join the discussion below. Are you willing to give up your hands-free cellphone calls during your driving time?

January 12, 2009, 7:32 pm

A Pediatrician’s View of Rude Children

Do good manners make a difference to a child’s health? Writing in Tuesday’s Science Times, pediatrician Dr. Perri Klass believes they do.

The conversations that every pediatrician has, over and over, about “limit setting” and “consistently praising good behavior” are conversations about manners. And when you are in the exam room with a child who seems to have none, you begin to wonder what is going on at home and at school, and questions of family dysfunction or neurodevelopmental problems begin to cross your mind.

Dr. Barbara Howard, an assistant professor of pediatrics at the Johns Hopkins School of Medicine and an expert on behavior and development, told me that a child’s manners were a perfectly appropriate topic to raise at a pediatric visit.

“It has a huge impact on people’s lives — why wouldn’t you bring it up?” she said. “Do they look you in the eye? If you stick your hand out do they shake it? How do they interact with the parents; do they interrupt, do they ask for things, do they open Mommy’s purse and take things out?”

Dr. Howard suggested that the whole “manners” concept might seem a little out of date — until you recast it as “social skills,” a very hot term these days. Social skills are necessary for school success, she pointed out; they affect how you do on the playground, in the classroom, in the workplace.

To read more about what a child’s manners mean to the pediatrician, read the full article, “Making Room for Miss Manners Is a Parenting Basic.” And then join the discussion below.

What do you think? Should a pediatrician comment on a child’s manners?

January 12, 2009, 3:23 pm

Declining Car Risk for Older Drivers

Drivers over 70 are keeping their licenses longer and driving more than earlier generations, a trend that has led to dire predictions about car accident risks for aging baby boomers.

But new research from the Insurance Institute for Highway Safety should ease those fears. It shows that fatal car accidents involving older drivers have actually declined markedly in the past decade.

“It’s not what people had expected to see,” said Anne T. McCartt, senior vice president for research at the insurance institute. “There were some studies, including our own research, that had predicted older driver crashes would become a bigger and bigger problem.”

Compared with middle-aged drivers (age 35 to 54), drivers 75 or older have far higher death rates per mile traveled. (So do drivers under 20.) Death rates jump markedly after age 80. But that does not necessarily mean that older people are worse drivers or that they are far more likely to crash.

Car fatalities involving young people are almost entirely explained by the fact that they have more accidents than experienced drivers. But while crash rates are slightly higher for older people, most of their increased risk for a fatal car accident is explained by the fact that they tend to be more frail. Older drivers are more likely to suffer a severe injury, particularly to the chest, or other medical complications.

But fatalities per capita among older people have decreased 35 percent since 1975 and are now at their lowest level. And while fatal crashes are declining over all, the rates for older driving deaths are falling the fastest. Between 1997 and 2006, the annual decline in fatal crash rates was 0.18 fewer fatal crashes per 100,000 middle-aged licensed drivers. By comparison, the annual decline for drivers age 70 to 74 was 0.55 fatal crashes per 100,000 licensed drivers, and for those over 80 it was 1.33.

Older drivers are also less likely to cause drunken driving accidents. In 2007, just 6 percent of drivers 70 and older who died in crashes had blood-alcohol levels above the legal limit. The figure for fatally injured drivers age 16 to 59 was 41 percent.

The insurance institute is conducting further research to determine why the risks appear to be going down for older drivers. It may be that today’s older drivers are simply in better physical and mental shape than their counterparts a decade ago, so they are not only less likely to make a driving mistake, but also less frail and better able to survive injuries.

It may also be that driving patterns among older adults have changed, leading to more highway driving, which is safer than driving on local roads. Older drivers may be more likely than in the past to wear a seat belt or to drive a safer car.

Research suggests education campaigns have increased awareness about older driving risks.

Researchers from Johns Hopkins recently reported results of the Salisbury Eye Evaluation and Driving Study (Seeds for short), which looked at vision, cognition and health changes among 1,200 licensed drivers age 67 to 87. The study, published in the journal Investigative Ophthalmology & Visual Science, found that after a year 1.5 percent of the drivers had given up driving on their own, and 3.4 percent more had voluntarily restricted their driving because of declining vision.

“We’re intent on doing research to try to figure out why we’re seeing this,” Dr. McCartt said. “It’s certainly a possibility that older drivers compared to 10 or 20 years ago are in better condition in various ways.”

January 8, 2009, 1:33 pm

Doctors’ Favorite Medical Web Sites

INSERT DESCRIPTIONWhat sites are your doctor checking out?

Health writers often suggest Web sites and strategies for finding the best doctor. But what do doctors think about all this advice?

In today’s “Doctor and Patient” column, Dr. Pauline W. Chen talks to other doctors about the best way to find a doctor you trust, and the best places to research health information.

Many of the doctors I spoke to or exchanged e-mail with made commonsense suggestions that were not unexpected. They urged patients to find out which doctors their closest friends really like, to ask a prospective doctor questions like how much experience he or she has with a specific condition or operation, and to make sure that as a patient you feel part of a shared decision-making process and comfortable saying how you feel, or that you don’t understand or that you respectfully disagree.

But many of the physicians also shared links to valuable Web sites, several of which I was unfamiliar with. All the sites are free to the public and accessible to anyone with an Internet connection. When I looked at these sites while writing this column, I became really excited as a patient about the amount of information available.

For a complete lists of the various Web sites suggested by doctors, click here to read Dr. Chen’s full column, “In Search of a Good Doctor.” And then join the discussion below.

January 8, 2009, 11:45 am

Making Orange Sherbet With Your Kids

I overbought clementines during the holidays and am now dealing with a box of withering fruit. As I mulled juicing them, I remembered a charming story from The New York Times magazine last weekend that has inspired me to try a clementine sherbet.

Dining editor Pete Wells wrote about his son Dexter’s fascination with all things culinary — a father-son obsession that has included grinding coffee beans and baking cookies. The father-son chefs had made lots of sorbet during the summer, but Dexter wanted to make ice cream. A food allergy to eggs prevents him from eating real ice cream, but recently while making tangerine sorbet, Dexter insisted on adding cream.

When it was frozen, it reminded me of long-ago Creamsicles and Orange Juliuses at the mall, but it had a bright juiciness I don’t remember from my childhood. What we didn’t eat right away Dexter packed into tiny plastic bowls to freeze for later. He wanted to sell orange ice cream to our neighbors.

Read the story first, then grab your kid and juice some citrus. The Wells family recipe is here. (I plan to substitute a soy milk creamer, although Pete says half-and-half works fine too.) And don’t miss the video demonstration by food tester Jill Santopietro in her latest (and funny) Tiny Kitchen video, posted below.

January 7, 2009, 2:34 pm

Should a TV Doctor Be Surgeon General?

Sanjay Gupta is a doctor on TV, but should he be surgeon general?(Scott Gries/Getty Images)

The news that the television doctor and neurosurgeon Sanjay Gupta is being considered for the post of U.S. surgeon general has prompted a mixed reaction on health and science blogs and other sites. Here’s a sampling: The doctor blogger calls it a “bold pick” but asks whether “this a case of style over substance.”

THDblog: The Technology, Health and Development blog says, “Public health needs a rock star.”

Terra Sigillata: Science blogger Abel notes that “literally millions of Americans already trust him for health care information,” adding that “Gupta has also been on-site for several of the most challenging medical emergencies the U.S. has faced in recent years, most significantly the aftermath of Hurricane Katrina in New Orleans.” But fellow blogger Jake at Pure Pedantry says Dr. Gupta has waffled on issues like vaccines and autism under the guise of journalistic fairness — something he can’t do as surgeon general.

Center for Science in the Public Interest: Director Michael Jacobson says: “It has been a long time since we’ve had a surgeon general who had a major national impact, such as Dr. C. Everett Koop, who took on the tobacco industry. Certainly no one could accuse any surgeon general in the last eight years of tackling tough health problems.” Dr. Val says, “I don’t think he has the gravitas or appropriate experience for the role of Surgeon General of the United States.” She cites an unidentified source close to the nomination proceedings who says, “It will be difficult for Gupta to be taken seriously by peers at the Pentagon and State Department.” The gossip site points out that Dr. Gupta was voted one of People Magazine’s Sexiest Men Alive in 2003. “Obviously Dr. Quinn, Medicine Woman, is the big loser here,” says Gawker.

According to Dr. Gupta’s bio provided by CNN, he regularly performs surgery at Emory University Hospital and Grady Memorial Hospital, where he serves as associate chief of neurosurgery. Before joining CNN, Gupta was a fellow in neurosurgery at the University of Tennessee’s Semmes-Murphy clinic, and before that, the University of Michigan Medical Center. In 1997, he was chosen as a White House Fellow — one of only 15 fellows appointed.

What do you think of Dr. Gupta’s credentials to become surgeon general?

January 7, 2009, 11:08 am

Teens Exposing Themselves in Cyberspace

Today’s highlights a recent study that found one in five teens are using cell phones and online technology to send sexually explicit pictures of themselves to others. The research is from the National Campaign to Prevent Teen and Unwanted Pregnancy and (Click here to read the original report.)

PsychCentral founder John Grohol, an expert in online psychology issues, says that the “online disinhibition effect,” the phenomenon that prompts people to say and do things in cyberspace that they wouldn’t ordinarily say or do in the real world, is strongly at work here. He notes that nearly one quarter of teens say that technology makes them personally more forward and aggressive. According to Dr. Grohol: Read more…

January 6, 2009, 10:30 am

A Private Song of Prostate Cancer

Every week, Times editor Dana Jennings writes about his experiences coping with an aggressive form of prostate cancer.

By Dana Jennings

Long before I started writing publicly about my prostate cancer, I wrote about it for myself.

Dana JenningsDana Jennings. (Lonnie Schlein/The New York Times)

Since the mid-’90s, I’ve kept a journal, mainly to take my mental temperature, and as a hedge against forgetting. I’m one of those people who needs to explain himself to himself. I never truly know what I’m thinking until I’m hunched over a notebook, razor-point pen poised above a blank page.

I wrote my first journal entry about prostate cancer last March, when I learned I had a 50-50 chance of having the disease.

March 19: It makes no sense to freak out right now. And, to be honest, it makes no sense to freak out if I do have cancer.

Since then, my journal has been a record of my highs, lows and everything in between on the cancer road. I never imagined at the time that these very private thoughts would be made public. At first, I was still trying to figure out how to have cancer. I was stunned but trying to be a good stoic, as I’d been taught as a kid back home in New Hampshire.

April 9: I found out two days ago that I have prostate cancer. I’m not angry. I’m not sad. I’m not depressed — it is what it is. … I wouldn’t choose to have cancer, but it does represent the opportunity to engage in an unexpected and serious spiritual adventure.

Prostate Cancer Journal
One Man’s Story

Dana Jennings blogs about his experience with prostate cancer.

Keeping a written record of having cancer isn’t rare, and studies suggest that such writing can help patients cope better with their illnesses and even improve the quality of their lives. For me, keeping a prostate cancer journal lets me slow down, take a deep breath and potentially shrug off the hurry-up-and-wait hysteria that arrives with the disease.

Even when faced with life-changing situations, we tend toward forgetting. My journal lets me recall all the phases and stages of my prostate cancer. Sometimes, I don’t write full entries but just a couple words — kind of like Post-It notes to myself. Even so, they’re enough to remind me of the deep April dusk when my wife, Deb, told me that I had cancer (she had picked up the call from my urologist and I wasn’t home yet), or the post-op pleasure of shuffling around the neighborhood in my bathrobe — when you have cancer, you really don’t care what anyone else thinks.

And while I have worked hard to keep a good attitude, my journal has been a safe place to confess my deepest fears and sadness.

May 1: I am angry and raw, tired and hungry — feeling a bit feral, a bit mangy.

May 5: For a month now, I’ve been at loose ends, trying to be worthy of my situation, trying to be an example to my sons.

May 16: Ah, God, the Depression arrived this morning the way the heavy rain arrived — I couldn’t resist it. … I’m not persuaded at all that a complete recovery is assured. … The fact of my cancer is inescapable. As inescapable as your shadow on a sunny day.

An essential part of my journaling experience is handled by my wife — whom we lovingly call the Mistress of Minutiae. She has put together a comprehensive medical binder that details every blood test, every scan, every conversation with a doctor. Sometimes I flip through it, fascinated by the arcane details of my disease — like how it took 25 staples to close me up after my surgeon removed my prostate. It has also proved to be an invaluable resource as my wife and I have negotiated the health care system.

While there are many practical reasons to keep a prostate cancer journal, for me it’s also an act of defiance.

I grew up in a rural family whose members prided themselves on nursing bitter secrets — hoarded them like silver dollars — including their cancers: my maternal great-grandmother, my mother’s parents and a couple uncles and aunts were all killed by cancer. And most of them, until they were betrayed by seeping blood and withering flesh, said nothing about being sick.

In many ways, their silence and shame helped kill them. I keep my journal to defy that epidemic of silence. A journal lets each one of us sing a private song that shatters the silence that too often surrounds this cancer or any cancer.

May 22: The stress of cancer can be overwhelming. There’s the disease itself — burrowing and devouring, even as you outwardly look healthy as you rot from the inside. There’s the uncertainty of the health care bureaucracy — finding the right pair of hands, finding the payment. And there’s simply uncertainty.

Most days, I try not to think too much about having cancer — I rejoice in those times when I am just myself and not a “cancer patient” — but I am grateful for these in-the-moment dispatches and wonder what truths the coming year will unveil. Ultimately, I hope that these entries won’t just tell a tale of disease, but one, too, of healing.

July 1: Am I afraid? I don’t think so. I love this sweet ol’ world, and I want more of it. I’m not ready to leave, and it doesn’t feel as if it’s time to go. But, I suppose, that it’s possible. … This is what it still comes down to for me: a quiet corner, a piece of paper and a pen.

January 5, 2009, 11:19 pm

Exercise Machines Gathering Dust

A year ago on this blog, I wrote about my desire to purchase a new home exercise machine. In Tuesday’s Science Times column, I wrote about the fact that it mostly gathers dust in my house.

Last year, Consumer Reports found that nearly 40 percent of people surveyed said they used their home exercise machines far less than they had planned. The phenomenon is a source of fascination for behavioral scientists. The hope is that by better understanding the behavior, they can help people make better buying decisions — and help them start exercising and stick with it. To read more about the issue, check out With the Right Motivation, That Home Gym Makes Sense.

In hindsight, I realize my gym-quality elliptical machine is far too big and bulky for my space — sometimes I even hit my head on the sloping ceiling when I use it. I’ve also realized that despite my best intentions to work out at home, I hate indoor exercise, at least in my house. I’d much rather jog on my local trails, take a yoga class or work out with a live personal trainer than spend solitary time on an elliptical machine. Even on the day of my purchase, I didn’t sound confident that I would use it.

“I made my purchase today,” I told readers last Jan. 12. “It is big and ugly. Now I have a great machine, but will I use it? That’s always the big question.”

What about you? Is your home exercise machine gathering dust? Why do you think you haven’t used it as much as you had hoped? If you do use your machine regularly, what’s your secret?

About Well

Tara Parker-Pope on HealthHealthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at

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