Patient Safety--Your Lifestyle

“Jaded Julie, I have some good news and some bad news.”

“(Oh, no! Here we go again.) Proceed, Professor. I’ll be hanging on every word.”

“The bad news is that the likelihood of our emerging from this game called ‘life’ unscathed is zilch, i.e., the ultimate mortality rate is 100%. The good news is that most of us will have a chance of influencing the ‘how’ and maybe even the ‘when.’”

“Okay, Curmudge. First you said that we are doomed, and then you sounded as if you had found the Fountain of Youth. Which is it?”

“I doubt that there’s much we can do to extend our life, but there are lots of ways to avoid shortening it. If you believe your life is to follow some sort of grand design, you should avoid a lifestyle that might circumvent the plan.”

“I’ve got it, Curmudge. I read Dr. G’s book (1), and she comes down pretty hard in favor of a healthy lifestyle. As a medical examiner, she is able to describe in intimate anatomic detail what your insides look like when things go wrong. I wouldn’t want to be caught dead looking like that.”

“Nobody would, Julie. However, most of us simply ignore what we know about healthy living. What we need is a good jolt of reality to bring us to our senses. Dr. G does that. Here are some quoted or paraphrased examples:

‘Where healthy lungs are pinkish, a smoker’s lungs are gray and ribboned with black pigment.’

‘The tumor (from advanced lung cancer) …pushed through the wall of his lung into his pulmonary artery. Like a bursting dam, blood began to flow through the hole, filling his lungs.’

‘In the mouth of the corpse was some dark brown material that looked like coffee grounds that we doctors call coffee-ground vomitus. It’s often a sign of gastrointestinal bleeding. In the retroperitoneum there was a pus-filled abscess (from MRSA).’

‘Diverticulitis is a potentially lethal condition often associated with a low-fiber diet and lack of exercise. This condition begins as diverticulosis, the presence of pockets or protrusions in the wall of the colon. Diverticulitis can sometimes lead to perforation of the bowel and an infection in the abdominal cavity.’

‘One who is 100 pounds overweight is characterized as morbidly obese. Diagnosis using an ultrasonogram is more difficult when it is taken through layers of fat. People who are obese run a higher risk of coronary heart disease, stroke, high blood pressure, some cancers, diabetes, gout, arthritis, gallstones, infertility, injuries due to falls, sleep apnea, fatty liver disease, and post-surgical blood clots.’

‘Methamphetamine has a decomposing effect on the body while you are still living. Many addicts have black, rotting teeth, worn down to stumps. They tend to scratch nervously (because of a sensation of imaginary bugs crawling under their skin), causing sores and lesions on their bodies.’”

“Enough, Curmudge! You have my attention. Aren’t there some lifestyle lessons that are less graphic?”

“Of course. Here’s one: ‘Chewing tobacco contains 28 carcinogens.’”

“You know, Curmudge, chewing tobacco was pretty popular during the Civil War. Maybe that’s why all of the Civil War veterans are dead.”

“I can’t fault your data, Julie, but I do question your conclusion.”

“A final question, Curmudge. What does lifestyle have to do with patient safety?”

“The best way to be a safe patient is not to be a patient at all. We hope to achieve that by living a healthy lifestyle and, as we’ll discuss next week, minimizing accidents and trauma. It’s as we said in our discussion on January 29, ‘To avoid a hospital-acquired infection, stay out of the hospital.’”

Affinity’s Kaizen Curmudgeon

(1) Garavaglia, Jan. How Not to Die: Surprising Lessons on Living Longer, Safer, and Healthier. (Crown Pub., 2008)