The “Woke” Doctor’s Office

 

Whew! It looks like I retired from medicine just in time! Otherwise, I might have to go back to medical school to learn the latest “woke” thinking on the practice of medicine.

It seems that “wokeism” has now infected everything. For those of you uninformed, “wokeism” is the latest word concocted by our culture to describe political correctness. In a fascinating book called Woke, Inc., Vivek Ramaswamy tells us how this movement of political correctness is infecting the corporate world as business now pledges allegiance to their “stakeholders” instead of their shareholders. This movement threatens our democracy, as well as our economic future.

Now, it seems, the same movement is taking over the world of medical education. In a rush to fall in line with the progressive thinking that created “wokeism,” many in the field of medicine and medical education are pushing the same agenda. This movement threatens the future of the medical profession and the lives of millions of Americans.

Dr. Stanley Goldfarb is a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine. Writing in The Wall Street Journal, Dr. Goldfarb says healthcare is being infected by the radical ideology that has corrupted education and public safety. He says while critical race theory and crime waves have been in the news, the public is largely unaware of medicine’s turn toward division and discrimination. Americans deserve to know that their health and well-being are at risk.

The premise behind all this radical new thinking is that healthcare is systemically racist – that most physicians are biased and deliver worse care to minorities.

In my 47 years of formal medical education and practice, I have never encountered any evidence of that last statement. In fact, I would challenge anyone to prove that such a statement is backed by any facts. I can say without reservation that the practice of medicine in this country is probably freer from racial bias than any other profession.

Dr. Goldfarb says health disparities do exist among racial groups, but physician bias isn’t the cause. He says the psychological test at the root of this narrative, the 1998 Implicit Association Test, has been widely discredited, and he agrees with me that his long experience as a medical educator and practitioner has shown him that physicians address the needs of each patient, regardless of skin color.

It seems that the medical elites of the academic world are behind this movement.  Goldfarb says, “The National Library Medicine database shows more than 2,700 recent papers on “racism and medicine,” which generally purport to show physician bias leading to racial disparities in health outcomes. Yet the most commonly cited studies are shoddily designed, ignore such critical factors as pre-existing conditions, or reach predetermined and sensationalized conclusions that aren’t supported by reported results. These papers in turn are used to source even more shoddy research. This is a corruption of medical science in service to political ideology.”

“Prominent medical journals are complicit in the crusade against medical professionals. The New England Journal of Medicine touts its “commitment to understanding and combating racism as a public health and human rights crisis,” while Health Affairs is implementing a strategy to “dismantle racism and increase racial equity” in healthcare. They publish piece after piece calling, explicitly or implicitly, for a fundamental change in the medical profession. They’re also bringing race and other nonacademic factors into the peer-review process, threatening the scientific analysis on which physician practice and patient health depend.”

This really should come as no surprise when you consider it is the academic community at large that has moved our country to the political left. The academic elites at our most respected schools of higher education have been pushing a progressive agenda for many years. Now they have spread their influence even to the world of medical education. This will have a profound impact on our culture, but more importantly upon the training – and medical practices – of our future doctors. This can’t be good for our health as a country.

Pigs in Medicine

There is a national shortage of kidney donors. There are more than 90,000 Americans waiting for a kidney transplant. In 2021, fewer than 25,000 received one, and some 41,000 were added to the national waiting list. On the average day, around a dozen people on the list die.

These statistics are reported in an article published in The Wall Street Journal by Sally Satel, a senior fellow at The American Enterprise Institute and a visiting professor of psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons. Dr. Satel is a kidney transplant recipient. She says, “I had my first kidney transplant in 2004. It gave out after 10 years. The replacement, which I received in 2016, functions well but won’t last forever. ‘May your organ outlive you,’ older transplant patients tell each other. Otherwise, you may not survive the queue for a new one.”

This brings us to a new and exciting breakthrough in transplantation that may go a long way toward reducing the waiting time for kidney, and other organ, transplants. Xenotransplantation – the implantation of animal tissues and organs across species – have been exhilarating. In September, doctors at NYU Langone Medical Center attached a pig kidney to blood vessels in a dead woman’s leg (with permission of her family). The kidney produced urine and cleared waste products during the 54-hour observation period. The procedure was repeated in another patient two months later.

In the same month, a team of doctors at the University of Alabama – Birmingham implanted the first-ever genetically modified pig kidneys into the body of Jim Parsons, 57, of Huntsville, who had been brain-dead by a motorcycle accident. The new kidneys turned “beautiful and pink,” the lead surgeon said. The experiment lasted 77 hours.

On January 7, surgeons at the University of Maryland transplanted a heart from a genetically modified pig into David Bennett, Sr., who doctors said had exhausted all other treatment options. Mr. Bennett, 57, was still alive as of February 9, when Dr. Satel’s article was published.

This is exciting news! As noted above, the number of human kidneys and hearts available for transplantation is far less than the demand. Dialysis, an hourslong process of having your blood cleansed, extends life, though not nearly as much as a transplant. It is a several-times-a-week ordeal. More than half a million Americans have end-stage kidney disease and depend on dialysis, according to the National Institute of diabetes and Digestive and Kidney Diseases. Medicare’s End State Renal Disease program spent $51 billion on dialysis in 2019, 6% of the total Medicare budget.

Dr. Satel says, “Xenotransplantation is the future. Jayme Locke, the surgeon who headed the University of Alabama team, said she hopes to be able to offer pig-kidney transplants within five years. Godspeed to Dr. Locke, her colleagues and the noble pig. Make the donor shortage – its heartbreak, its unfairness and its expense – a thing of the past.”

We can all agree with that sentiment.

Failing Memory Not Just for Seniors

We’re all getting older and worrying about loss of memory comes with age. But what if you’re experiencing memory loss even when you’re young?

Elizabeth Bernstein, writing in The Wall Street Journal, says we all may be having difficulty with our memories regardless of age. For example, Grant Shields was teaching a college seminar to 24 students last week when his mind went blank. He’d forgotten the name of his teaching assistant. “I was embarrassed,” says Dr. Shields, who though he heard students laugh when he said the wrong name, then struggled to recover. “I wish my memory was as good as it used to be.”

You might think Dr. Shields is getting up in years – but he’s just 32 years old. He’s actually a memory researcher, an assistant professor in the Department of Psychological Science at the University of Arkansas. What’s more, he was teaching a class on how stress affects cognition.

Short, temporary instances of forgetfulness are happening to more of us more often these days, memory experts say. We’re finding it difficult to recall simple things: names of friends and co-workers we haven’t seen in a while, words that should come easily, even how to perform routine acts that once seemed like second nature. Apparently, we can blame even some of our memory loss on the pandemic.

Bernstein says we’re living in yet another moment of big change as we return to something approaching normalcy after two years of the pandemic. Add to that the stress of inflation and a war in Europe that could have world-wide consequences and you have plenty of reasons for being distracted and forgetting things. All this change consumes cognitive energy, often much more than we think, neuroscientists say. It’s no wonder we can’t remember what we had for breakfast.

“Our brains are like computers with so many tabs open right now,” says Sara C. Mednick, a neuroscientist and professor of cognitive science at the University of California, Irvine. “This slows down our processing power, and memory is one of the areas that falters.”

The chronic and cumulative stress of the past two years has taken its toll, too. Research led by Dr. Shields shows that people who have experienced recent life stressors have impaired memory. Stress negatively affects our attention span and sleep, which also impact memory. And chronic stress can damage the brain, causing further memory problems, says Dr. Shields.

Another factor may be the deluge of information coming at us on a daily basis, cluttering our brains. We’re terrible at paying attention, constantly distracted by scrolling our phones and trying to multi-task. This makes it hard to encode memories in the first place. Then there’s the sameness of our lives, especially during the pandemic. When each day seems just like the next, it’s hard for the brain to recall what just happened. “Memory benefits from novelty,” says Zachariah Reagh, a cognitive neuroscientist and assistant professor of psychological and brain sciences at Washington University in St. Louis. “When all of our experiences blend together, it’s hard to remember any of them as distinct.” 

Memory does decline with age, but medical science isn’t clear exactly when. People age cognitively at different rates. Some studies show that memory ability peaks in people’s 20s and gradually declines from there; others suggest the sharpest decline starts around age 60, Dr. Reagh says. If you think your memory is declining faster than most, you should see your doctor.

What can we do to improve our memories?

Here are some suggestions for boosting your memory:

  • Don’t force it – Forcing yourself to try to remember something is counterproductive – and frustrating. That frustration will only make matters worse. Take some deep breaths to calm your brain and try again later.
  • Stop multitasking – If you’re trying to do two things at once, your brain will have a harder time remembering what you’ve done. Pay attention to small tasks you typically do on autopilot, such as brushing your teeth. “When you practice paying attention in those moments when it doesn’t matter, it will become easier in those moments when it does,” says Dr. Jennifer Kilkus of Yale School of Medicine.
  • Help your brain calm – To strengthen your frontal lobe, which is involved in both memory encoding and retrieval, says Dr. Mednick, author of the coming book, The Power of the Downstate. Mednick recommends daily meditation, yoga, or simply slow deep breathing for at least 10 minutes a day. Take a walk, connect with a loved one, have a long chat, give a hug, have sex. Intimacy reduces stress by making you feel safe and cared for. And get some sleep! This clears out toxins in your brain that can clog your memory processing, she says.
  • Be socially present – Give your full attention to people when you talk to them. Doing so will help you better recall what you want to say in the conversation and remember what was said. We need to approach each conversation intentionally, says Dr. Jeanine Turner, professor of communication at Georgetown University.

 

Sounds like good advice – and not one mention of taking Prevagen! Let’s summarize: Relax, take things one at a time, take a walk, sleep more, have more intimacy, and pay attention to people you’re talking to. Sounds like a plan!