Smoking and the Mentally Ill

The Washington Post had an interesting op-ed piece by Steven A. Schroeder this weekend on the prevalence of smoking among the mentally ill.

The most startling passage is this one:

The facts about smoking and mental illness are stark. Almost half of all cigarettes sold in the United States (44 percent) are consumed by people with mental illness. This is because so many people who have mental illnesses smoke (50 to 80 percent, compared with less than 20 percent of the general population) and because they smoke so many cigarettes a day — often three packs. Furthermore, smokers with mental illness are much more likely to smoke their cigarettes right down to the filters.

Shroeder says that because physicians and mental health advocates have looked the other way for years regarding smoking and their patients the problem has not gotten the attention it deserves. Sadly, tools such as counseling and nicotine replacement have been severely underutilized by the mentally ill.

– Lakshmi Gandhi

A Loss for Victory

Victory Memorial Hospital appears to be on its deathbed: the 107-year-old Bay Ridge institution announced sweeping layoffs last week and could be shuttered by Feb. 1. The only saving grace at this point would have to come in the form of a miracle.

The hospital, in the throes of bankruptcy for a year, revealed Nov. 10 that approximately 900 workers would be without jobs come the new year. Plans call for the rest of the medical staff to be phased out through January.

Hopes for a takeover by SUNY Downstate Medical Center were dashed Monday, bringing Victory Memorial’s demise a step closer. If the proposal had been approved, Downstate would have interjected around 38 million dollars to save the hospital’s Emergency Room and Acute Care beds.

“They’re going to have blood on their hands,” said Dr. Simon Saada, Director of Surgery and Urology at Victory Memorial since 1989.

Hospital supporters said 300,000 people in Bay Ridge, Dyker Heights and Bensonhurst – many of them senior citizens and immigrants ¬– would be left without proper medical care by Victory Memorial’s loss.

“I’m going to predict a healthcare crisis come February,” said Bill Guarinello, the acting chair of the not-for-profit hospital’s board of trustees, adding that creditors are urging Victory Memorial to close by Feb. 1.

The draconian layoff moves come in response to the demands of creditors, said Claudia Hutton, a spokeswoman for the state Health Department.

The 92nd Street medical center was among those recommended for closure by the Berger Commission, a state panel charged with helping reduce the number of empty hospital beds to save taxpayer money.

Victory Memorial owes creditors $90 million, said Assemblyman Peter Abbate, who is among those battling to save the hospital.

“Healthcare is going up and they’re looking at the bottom line – not lives,” said Abbate.

Area residents will now have to choose between two already understaffed and overburdened hospitals: Lutheran Medical Center in Sunset Park and Maimonides Medical Center in Borough Park.

But Victory Memorial supporters vowed to fight until the end. “I will not leave until they put the bolt on the door,” said Saada.

One Million Votes, One Million Dollars

BYLINE: Caitlin Drexler, Roisin O’Connor-McGinn, Rosaleen Ortiz

The New Diet

Imagine you are a teenage girl. A little overweight, you are happily surprised one day when you start to lose weight, pounds drop off by the week. People compliment you. You are thiner than you have ever been. Then, your doctor tells you this bout of what you thought was luck, is actually a disease–Type I diabetes. There is no cure. To stay healthy, the doctor orders you to inject yourself with a daily shot of insulin. You obey and gain twenty pounds in a few weeks.

What would you do?

One in three diabetic women under 30 opt to forgo their insulin shots, deciding to risk serious health problems like blindness and kidney failure in an attempt to stay slim. Diabulimia is becoming a growing problem in America as more young women find themselves caught making a choice between their present and their future.

A great article on Salon.com last week looked into the sad conundrum that seems indiosyncratically American.

Preparing For the New York City Marathon

Leading up to Sunday’s New York City Marathon the Wall Street Journal’s Health Blog had a nice interview with Lewis Maharam, the marathon’s medical director.

Dr. Maharam’s biggest worry is that one of the runners will have a heart attack. As he described it “running the race could be their stress test that they don’t pass.” Internationally, about 1 in 70,000 marathon runners dies during a race.

Marathon directors have been especially anxious since the Chicago marathon was halted last month due to sweltering heat. One runner died of cardiac arrest and roughly 50 others were hospitalized due to the extraordinarily high temperatures.

– Lakshmi Gandhi

Medical Trial Information to be Kept Confidential from Patients

Congress last month passed a bill requiring greater disclosure to patients who participate in medical trials for drugs that are brought to market, but those who participate in trials for drugs that are never marketed are not entitled to the same information, the New York Times reports.

Specifically, drug companies that test but do not market do not have to disclose the results of their studies to patients.

The next most important news of the article – which doesn’t appear for fifteen grafs – is that problems that arise during failed clinical trials do not have to be publicly reported.

Small device makers would supposedly face being put out of business by being forced to make such disclosures. The article seems to imply that small device makers that lobbied congress were influential in changing the bill.

But consider that Dr. Steven E. Nissen, quoted in the article as the chairman of the cardiology department at the Cleveland Clinic, said, “The problem is that if you don’t tell people about failed trials, you can make the same mistake again and again.”

-Clark Merrefield

Pharmacies Need Translators Too

Bensonhurst Brooklyn houses one of the largest immigrant communities in New York. A few weeks ago, The New York Timescame out with an article which highlighted this ethnic resurgence through one tiny pharmacy on 18th Avenue. According to the article, “A total of 16 languages are spoken in this single storefront.”

This transitions nicely into why certain immigrant advocacy groups are making noise to ensure that all pharmacies throughout the five boroughs provide interpreters and written translations of medication instructions. The Times piece yesterday addressed a complaint saying that 16 local pharmacies were failing to meet the federal civil rights law and state health regulations which “require pharmacies to provide linguistic help to guarantee that people who speak little or no English receive equal access to health care.”