Tuesday, June 24, 2008


There's an interesting article in the New York Times today that discusses questions that have arisen out of Tim Russert's death. His sudden heart attack has led many people with similar conditions to want to look for the thing that Mr. Russert did wrong—which medication should he have been on, which test did Mr. Russert's doctors miss, etc. But in reality, while there are things that could have been done differently, Mr. Russert and his medical team didn't do anything wrong. He had some high risk factors for a heart attack—large waist circumference, low HDL (protective cholesterol)—but he also had some good factors on his side—no family history of heart attack, low LDL (negative cholesterol), his high blood pressure was being managed by medication. (All of this is laid out in the article.)

What is noteworthy in this situation, the article points out, is that cardiologist can find people who are at risk for heart attacks, but they cannot distinguish those who are at very high risk of having massive heart attacks in the near future, say in the next year or two. And for anyone who has been identified as a heart-attack risk at all, that's got to be a scary uncertainty to sit with. The easier reaction would be to want to blame Russert or his medical team, wanting to think they did something wrong that led to his death. But the reality is, we just don't have the technology to know exactly who is at the greatest risk.


jackie lynn said...

You have hit upon one of the things that bothers me most about the medical field today . The truth is that most of what determines our demise is heredity. we can control very little, and yet we blame patients for causing their own illness.
I think it makes us feel more in control
.That couldn't happen to me because I work out or I drink soy milk etc.

Jessica Knapp said...

Exactly. It reminds me of the book I read about Susan Sontag's death. She was so determined that she could stop her death if she just found the right doctor and the right treatment. And really, these things are just out of our control. That's a hard fact to sit with ... harder for some people than others. But you're absolutely right; it's a real shame the medical field isn't better set up to help people come to terms with our lack of control over or mortality.