How to save a friend from the brink.

I’ve been thinking a lot about how we can prevent our friends and loved ones from taking their own lives (due to the number of celebrity suicides lately), and CNN publishes this:

For five days, Alexis Moore carefully planned how she would take her own life. She’s not a violent person, so she knew handguns were out. She settled on vodka instead, to be followed by a bottle of Xanax. She did it methodically. First, she says she drank the vodka for two hours. Then she lined up the 20 pills on the kitchen counter, taking a few at a time, going to her bedroom to cry and then coming back for more Xanax. After about six pills, just when she was beginning to feel woozy and lethargic, Moore heard a knock on the door and someone calling her name. She ignored him, even though she recognized the voice as someone she’d meet three days before at a business event. Then the man came around and banged on her bedroom window. She got up off the bed where she’d been sobbing and let him in. They sat down in her living room. She talked. He listened. By the end of the evening, she decided not to take her life. In the five years since, she’s never tried to commit suicide again.

What to say and do:

Tell her you don’t want her to die.

Send a card.

Say “I’m here.”

Bring a meal.

Don’t leave her alone.

Don’t say “I know how you feel.”

Don’t say “Just snap out of it.”

Don’t say “There was an earthquake in Haiti. Your situation isn’t that bad.”

Don’t ignore it. Don’t keep secrets.

Long-term use of osteoporosis drugs linked to hip breaks

I believe one day we’ll look back on chronic disease medications we’re supposed to take every day for decades and finally realize that reductionist medicine via a simple pill never really worked.

A Pharmacist’s Jail Cell Interview – What Good Does Blame Do?

via Mark Graban:

Here’s one to ponder and comment on – does putting a pharmacist in jail for six months and ruining his career and life do anything to bring back a two year-old girl? Does it do anything to make future patients any safer? Watch this video from CNN about Eric Cropp, an Ohio pharmacist who was convicted and put in jail for six months after a fatal process error…

In 2006, Eric Cropp was a pharmacist at a Cleveland hospital when 2-year-old cancer patient Emily Jerry was killed by the medical error of a pharmacy technician. She was given a chemotherapy drug mixed with a salt solution 23 times more concentrated than the normal dose. But because Eric Cropp was the supervising pharmacist and should have caught the mistake, he was sent to jail. And that’s where I found him, confused, and struggling with regret.

My sense of outrage is overwhelmed by my sense of sadness over this whole case, between the tragic death of the little girl, Emily Jerry (more about the case and the girl), and about how the reaction does nothing to make other patients safer.

It *feels* good, maybe, to put a guy in jail… to hold him accountable, possibly to make an example of him. Cropp claims he was overworked and the pharmacy was chronically understaffed. Has a CEO or other hospital leader ever been convicted for systemic problems in a hospital? Whose fault is it if the pharmacy is overworked? Who goes to jail for that?

Health care costs: How Maryland keeps its costs down | The Economist

In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients. For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charge $1,555…Since the program started, the Wall Street Journal reports that Maryland hospitals have enjoyed a steady profit margin, unlike hospitals in other states that often make more money during boom years and less during a recession…

I love this picture. Me. Barbara Bush.

Making health simple:

Living in such a complicated world can seem so complex. But we’re creatures of habit. Ninety-three percent of our behavior is predictable.

And everyday the media reports on new research that suggests certain things are good or bad for you. It’s all quite confusing. We get so lost and so paralyzed by complicated details, we lose sight of making health simple. Don’t worry about whether or not coffee is good or bad for you. If the “science” of analyzing one substance and its effect on health hasn’t figured it out by now, the implications of that substance is mostly unknown for you as an individual. In fact, even the number one selling drug in America, Lipitor, designed to reduce your cholesterol has very little evidence to suggest it prolongs your life. In reality, our longevity is limited by our genes and our everyday behaviors.

All I ask is that you stop and think about your life today.

We’re all expected to live 82 years or so in the developed world. What do we want out of those years? Do you want to prolong your life at the end? Do you want to live to be 92 instead of 82? Or do you want to feel your best prior to getting old and limited by age? What do you think will give you the most happiness out of life? Living your life optimally as a young person? Or stretching your life out at the end for another decade of life as a slow-moving senior citizen?

Now, think about your everyday. Spend a few minutes and write down how you spend your day. What are you doing? What are you doing that’s probably good for you? What are you doing that’s probably not that great for you? What are you doing too much of? Not enough of? Make a list. It’s actually pretty simple. For everything you identify that’s not so great for you, write a simple way you can change that behavior.

Think about just three things– sleep, food, activity. Changes should be very, very simple. It’s things like taking the stairs instead of the elevator. It could be eating less meat. It could be sleeping 7 hours instead of six. It could be drinking with friends 3 nights a week instead of four. It could be one less hour of sitting in front of your computer.

Life really isn’t about your health. It’s about happiness. Health is just one component of happiness. So take a break every once in a while and sit down and think about a few small everyday things that have huge impact on your happiness.

video portrait of Drew Anderson by me.

The Farm Bill, a massive piece of federal legislation making its way through Congress, governs what children are fed in schools and what food assistance programs can distribute to recipients. The bill provides billions of dollars in subsidies, much of which goes to huge agribusinesses producing feed crops, such as corn and soy, which are then fed to animals. By funding these crops, the government supports the production of meat and dairy products—the same products that contribute to our growing rates of obesity and chronic disease. Fruit and vegetable farmers, on the other hand, receive less than 1 percent of government subsidies. The government also purchases surplus foods like cheese, milk, pork, and beef for distribution to food assistance programs—including school lunches. The government is not required to purchase nutritious foods. (via PCRM)

The Free Wheelchair Mission:

Free Wheelchair Mission is an international non-profit organization dedicated to providing wheelchairs for the impoverished disabled in developing nations.

I met Stefan Bucher at Design Indaba last week. He was there speaking about his Daily Monsters. He introduced me to this organization and we think it’s ingenious. We’re big fans of using off the shelf parts to solve the simple problems first. Health doesn’t need to be as complex as it is. It’s mostly about unique thinking for simple solutions that solve 90% of problems for 90% of people.

Each wheelchair costs $59.20! Donate a wheelchair here.

A little perspective on healthcare in other countries.

People always use other countries as examples of healthcare systems that are “better” than the United States. Here are the populations of those countries:

Norway = 4,861,100
Switzerland = 7,779,200
Sweden = 9,340,682
Cuba = 11,204,000
Australia = 22,174,000
Canada = 34,021,000
UK = 62,041,708
Vatican City! = 800 

Number of Kaiser Permanente members in California = 8.6 million