19 February 2012

Blame the Dead

Anthony Shadid died the other day, apparently of an asthma attack.  Shadid was a New York Times correspondent, and was 43 years old -- supposedly in the prime of life.  A reporter who wrote about his death found three different doctors to blame him for it:
Dr. Harold Nelson, a professor of medicine at National Jewish Health in Denver,  said roughly 3,600 people die each year in the United States from asthma. ... “Individuals with asthma often underestimate the severity of their condition and often rely on ‘rescue medicine’ such as an albuterol inhaler to control their symptoms, he said. “These people are at increased risk of a severe and even fatal attack when they encounter ‘triggers’ for their asthma.”

“Being in a conflict zone, far from medical care, it is possible that Mr. Shadid focused on things other than his personal health,” said Dr. Sally Wenzel, director of the University of Pittsburgh Asthma Institute at UPMC, in an email to ABC News. “Often that may mean forgetting to take critical asthma medications that prevent severe asthma attacks, like inhaled corticosteroids.”
Doctors said that though Shadid’s circumstances may have made it difficult for him to ward off an asthma attack, most who live with asthma can take steps to protect themselves.
“Most deaths from asthma are preventable,” said Dr. Miles Weinberger, a professor of pediatrics at the University of Iowa. “A study on asthma deaths from the New England Journal of Medicine several years ago found that most were from what could be called ‘too little care too late’ — that is, there was sufficient time for intervention to have prevented the progression of an asthma exacerbation to a fatal conclusion.”
My mind is boggled, though it shouldn't be -- this fits right in with the blame-the-ill narratives that show up in the media on a regular basis.

Here's Pauline Chen, a doctor who narrates a couple of worst-case scenarios -- an overweight man with diabetes and heart disease, another person who keeps medicine with the cigarettes to help remember to take it -- with the implication that these are typical examples of patients who don't "comply" with medical advice. At least Chen acknowledges that doctors need to spend more time talking to patients about medications and lifestyle recommendations.

(That word "compliance" is big among doctors.  More on the problems with that, another day.)

And then there's Paula Deen, who has been much in the news lately, accused of causing her own diabetes with bad diet and then profiting off it by signing on to promote medication to help control blood sugar.