I don't have much to say (what can you say?), but you're a beautiful writer.

Getting back to asthma, it seems to be a big thing amongst other people I know. I've never suffered it, but my oldest sister and her son have suffered through it, like our dad and his brother and our cousin.

Me, I have a smoker's cough. Understandable, I smoke.

My cousin Jackie did not smoke, and Jack gave it up a long time ago, and my nephew doesn't smoke either. First, why do some members of the family have weaker lungs, and second, why do certain drugs on the market lead to freak accidents?

I don't watch much TV except MSNBC and CNN or once in a blue moon HGTV or Bravo, but I've seen many commercials for drugs. And they all have happy, smiley people doing happy, smiley things, all the while with a man or woman speaking really fast in the background, saying, "You should not use XXXXXX if you do A or B or C and have not spoken with your doctor, and those who stand up really quickly and get light in the head should call their doctor immediately...."

Who is doing the drug-testing, and are they doing it long enough before they allow a new drug out on the market? Not that I want to scare anyone, but these thoughts do indeed occur to me everytime I see a new drug commercial. Sometimes, the cynic in me thinks "Soylent Green". Sometimes, I hope that these drugs do indeed provide the answer.

I'm just sayin'.

Wow, Lis, what a heartbreaker. The question of should they have sued? That's a toughie. In the throes of their grief, they probably just focused on that. But, then you think, what if the drug is dangerous? Or what if it was being administered properly? Shouldn't the public be protected? You don't want any more Jackies being lost.

Forgive that I steer this heartfelt post to the subject of crude politics, but you seem to express lack of confidence in our current drug-testing and approval system. Googling of the words "lobbyist revolving doors" yields some eye-opening results. Basically, when it comes to our government regulation agencies, including the FDA, the past few administrations, including the Clinton, have frequently appointed the foxes to guard the chicken coop, a situation which has resulted in lax, industry-friendly regulation. In the case of the FDA, it has allowed easy approval and toothless labeling of genetically modified produce, growth hormones in our meat, Vioxx, Nevirapine (for HIV treatment of pregnant women) and a whole panoply of horror stories.

Your family's tragedy is very personal, but even a modicum of research will clearly reveal to anyone that our system is broken and that this sort of thing happens more often than we believe. It is my hope that an administration untied to lobbyists will begin to make a difference.

You're right to be concerned. We are told the USA has the best medicine, and medicines on earth. Truth is, 51% of FDA approved drugs have to be pulled from the market or relabeled because of serious "post-approval side effects" (GAO). The revolving door is part of the problem, as are intensive lobbying of Congress, undue influence of industry in writing laws and regulations and outright drug company malfeasance. They cheat on research, bury negative studies, and use inappropriate populations for the studies. They lie about the results. By way of the massive advertising they do, they influence news stories too.

Anyone read Blink? Gladwell reports experiments on doctor/patient communications. Even with the words garbled and not understandable, experts can predict what doctors will get sued. Basically if patients like the doctor, they're unlikely to sue.

I've seen this personally. My dad had a stroke after doctors took him off anticoagulants to do a prostate biopsy. He never fully recovered, but though he could no longer speak clearly, he asked about the biopsy. Yep, it was cancer, but he was not deemed a viable candidate for chemo, radiation or surgery! So why risk clotting to do the biopsy? My mom and dad liked the doctor, and didn't sue.

Thanks Lis, I always love reading your posts. You always make me think, make me laugh, or make me cry. Or all three.

I just read an interesting piece on BBC online from a guy who's over here to cover the election. He was absolutely gobsmacked to see commercials (or adverts as they say) for prescription drugs on tv. Why are pharmacutical companies allowed to push drugs as just another consumer product like orange juice? Why indeed?

If I were Queen of the World, the first thing I'd do is kick those ads off the air. Then I'd ban violin solos.

After the long list of possible side effects, my husband and I always yell "and bleeding from the ass!"

LisB,

I'm working on a master's degree in environmental health and science. My current research is on ultrafine particles, under a professor fairly well-known for his work on indoor air pollution.

If I move on to a PhD, it will have to be in public health, since I'd have to follow my professor to his new department.

Asthma is one of the most important issues on our plate here in Southern California, for people in the environmental & public health fields. We focus so much on how it affects quality of life, especially for young people. One of the main projects of my professor's research group is working with foreign developing world governments on a local/provincial level to provide clean, efficient cooking stoves to families in poor communities to improve indoor air quality. We're also doing all sorts of other stuff on air pollution & particles here in SouCal, from studying wildfires to vehicle exhaust particles. I wanted you to know that the causes of asthma are being addressed vigorously, by a lot of great minds, and by at least 1 person who reads your posts. (When I have time to be on TPM..I'm not here every day, so I probably miss one here or there..)

You've brought home for me that asthma is not just a quality of life issue. It can really be life threatening, for the same reason that it's risky to have any disease - the treatment might kill you faster.

Allow me to compliment you. You've given us a very moving and personal story with the same dignity that I know your Aunt and Uncle had. Thank you.

And if you don't mind, I'll be thinking of your cousin for inspiration in the years to come. It will remind me that I'm really involved in a worthy cause.

LisB: I am so sorry about your cousin, who deserved a full life.
Medical and pharmaceutical negligence seems to be rampant. Or is it just that it shocks us when it occurs, because we assume doctors and hospital workers can be relied on to know what they're doing? (Of course, why do we think that when nurses work such long shifts, interns, etc. are subjected to 36 hour on-call, and surgeons have no time for aftercare communication?)
For what it's worth, both of my parents died relatively young, five years apart, as a result of serial procedural and drug mistakes.
My father (a sports fanatic at 69 who had just had an A+ physical, and had been cross-country skiing a few days before) came down with a bad cold/lung infection. A local GP (God help me -- my college sweetheart) gave him antibiotics (which one, unknown) which did nothing for the infection but to which he had a severe allergic reaction. Breathless, he was rushed to the ER where, given the family connection and guilt, no holds were barred; within hours, after multiple blood tests, X-rays and sonograms revealed nothing obviously wrong, Dr. Heartthrob ordered a lung biopsy, which triggered the massive clot that killed him. Convinced that Dr. Heartthrob has misdiagnosed him in the beginning, I was wanted answers -- residual torch carrying notwithstanding -- but it was unthinkable to my grieving mother, at the time, to pursue the whys and wherefores.
Five years later, my mother (an active type at 71) fell on wet grass during an early morning croquet tournament, and broke her shoulder. Two weeks later she was dead. Why? Rail thin, with a delicate digestive system, and with a history of reverse drug responses, Dr. Heartthrob, playing it safe, sent her to a specialist who apparently paid no attention to her history. He gave her three days worth of 3x a day, 1600 milligrams of Ibubrofen for pain, which promptly blew a hole in her stomach, causing life-threatening peritinitus. Because she had a heart valve issue, it was judged prudent to put in a pacemaker before her emergency abdominal surgery. The pacemaker malfunctioned, one of her IVs lines was septic which caused an infection and, a day later, the extra strain on her post-surgical system caused a heart attack. Immediate heart surgery was recommended. But she was allergic to Heparin, and to Cumadin (sp?). So the surgeon petitioned the FDA to use one from Europe they thought she could tolerate. The FDA said no.
At this point my sister and I were beside ourselves. Our mother was on a respirator and could not talk. What to do??? (Certainly not consult with Dr. Heartthrob again, but who?)
Her cardiac surgeon informed us that, with surgery out of the question, although she might recover enough to go home, nevertheless, without surgery, she was at risk for a second, and likely fatal heart attack at any time. Hearing that, our mother looked at us, her clear blue/gray eyes intent, and motioned for a piece of paper and pen. She wrote: "See living will. Turn everything off; ask for morphine. And do not sue." Discussion ensued. Questions were repeated. Finally, she motioned for us to be quiet, and for another piece of paper and pen. She wrote: "Do as I say. Now." Then she blew each of us a kiss, closed her eyes, and literally tuned out.
Meetings were held, papers were signed, equipment was turned off. Two days and two nights later, she died. Because the grass was wet, and because a string of idiots, including ourselves, were in charge.

LisB - as always, your prose gets to me. When I'm not laughing at the 'hats off' I am usually tearing up at something you write.

count me [b/c I have not figured out 'avatars' -yes! I am stupid!] among your anonymous fans. A former orchestra musician who tears up at Brahms and Faure, who - like you - has broken home stories. Who - with the beloved hubby, now raises and proudly but with a broken heart passes back one after another seeing eye puppy for the Morristown NJ Seeing Eye to train and send to partner with someone. There. That's what you may envision when you see my blank profile.

Aside from others' well-though out comments I can only add that those we love live in our memories.

All best.

God, that was hard to read, Lis. But thanks for sharing.

The only thing that frightens me more than the prospect of losing my sanity is the loss of a child. I truly don't think I could go on.

Yes, she was. A "keep it light and bright" southern belle on the surface who was, underneath, a consummate realist. Thank you for noticing.

O LisB, what terribly sad story.

Most people are unaware that doctors kill approximately 60,000 patients a year in the US. The AMA knows it, but won't do anything about it. They get away with it because: people don't sue or question a death and doctors sign off on death certificates for other doctors under suspicious circumstances. It's gotten to be an "accepted" factor in American medical practice and it stinks. And I know this because 1. I've read the statistics on doctor caused deaths and 2. I have a very close friend who is a retired surgeon and he's told me that doctors raise this issue at AMA conventions all the time and it is never addressed. He also supported the statistics I'd read and thought the number was low.

I no longer trust anyone in this health care system. A health care system for profit is stupid. It invites abuse.

Laura, I lost my son (my only child) and yes, you do actually go on.

Someone I heard on the radio once said it best: "You never get over it, but you do get used to it."

LisB, you are a gift to all of us. Thank you for your beautiful writing and your beautiful heart.

I have a friend who I believe is an unusual MD who carries authority because she has a lot of background in and knowledge of chemistry. She actually studies and grows pharmaceutical herbs on her family farm as per her wish that folks will one day become wiser about finding alternatives to ingesting harsh chemical drugs. Not long ago, she related to me that many drugs on the market are statistically barely more effective than placebos, but that most colleagues in the medical field ignore those statistics.

She also stays fairly current in her field with continuing education workshops. One workshop she attended really did fit her personal assertion that we should use common sense before we succumb to pressures to use the many drugs on the market. That workshop for MDs was focused upon 'wilderness doctoring' and what that doctoring would entail in the absence of modern medical testing and facilities and available drugs.

There are so many bad professionals, it's scary. Our bodies are so fragile and idiosyncratic. Thank you very much for writing your piece, Lis.