The Anesthesiologist Said What?; Designing for Behavioral Health; Superbug Crisis

“After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit.” Believe it or not, that was one of the less offensive things an anesthesiologist told a sedated patient about to undergo a colonoscopy in a Virginia medical clinic, Tom Peters reported in the Washington Post on Tuesday. The anesthesiologist also scoffed when told the patient had felt queasy earlier at seeing a needle placed in his arm. “Well, why are you looking then, retard?” she said, assuming the guy was now too out of it to understand. Unfortunately for her, the patient had already activated his smartphone so he wouldn’t forget to record the physician’s instructions after the procedure; the phone captured everything she had to say — and there were a bunch of even nastier comments. On his way home, the patient heard it all and then sued for defamation and medical malpractice. Last week, a jury ordered the anesthesiologist and her practice to pay the patient $500,000.

“A building’s not going to heal anybody,” acknowledges one architect who specializes in creating facilities for behavioral health care. “But you can put [these patients] in a space that makes them worse … that makes them feel like they’re being punished for being ill.” On the other hand, as Health Facilities Management reports in its June cover story, well-considered environments can truly enhance the healing experience for behavioral health patients. The article points to a raft of nifty design advances: layouts that are more open and inviting to encourage patients to participate in activities outside their rooms; nurses’ work stations that are decentralized so the staff are always visible to patients who are prone to anxiety; and the generous use of natural light, among many other things. There’s certainly a lot more interest in mental health care these days — historically, a secondary concern for most medical providers — at least judging from the number of clicks H&HN’s May cover story, “Four Ways Hospitals are Improving Behavioral Health,” continues to receive on the Web.

Urgency over the frightening proliferation of drug-resistant bacteria is growing, and, boy, does it need to. “Decades of inaction to curb the overuse of life-saving antibiotics by physicians, dentists, patients and farmers has created hard-to-treat ‘superbugs’ that are spreading and growing stronger, with dire consequences,” warns Consumer Reports, which kicks off a three-part investigative series on the issue in its August magazine. The first installment notes that “resistant bacteria like MRSA, were once confined to hospitals, but have now spread to otherwise healthy people in the community.” The CDC estimates that 2.25 million Americans are sickened by antibiotic-resistant infections every year, and they kill another 37,000 people. It’s absolutely a crisis, and it's compounded, Consumer Reports states, “because the pipeline for new antibiotics has slowed to a trickle.”

Gotta love this headline on a blog about the need to get kids more physically active: No Child Left on His Behind. In his Edible Rx blog in last Friday’s MedPage Today, Keith Ayoob challenges the argument by some experts that we can’t exercise our way out of America’s childhood obesity crisis, but instead should focus on more healthful diets. “The benefit of physical activity comes not just from the absolute calories that activity burns up,” writes Ayoob, a registered dietitian and associate professor of pediatrics at Albert Einstein College of Medicine in New York City. “It’s also that the more vigorous the activity, the less compatible it is with eating. Whether shooting hoops, playing volleyball, dancing, running around a playground or backyard, or even gardening or washing the car, it’s unlikely that somebody is eating while doing them.”

As noted in an H&HN Daily blog on Monday, the American Hospital Association was holding a regional policy board meeting in Charleston, S.C., when nine people were shot to death June 17 at Emanuel A.M.E. Church six blocks away. The AHA’s Rick Pollack and past board chair Jim Hinton summed up what many of us back home thought as we watched the news reports in the days following. “In the midst of this tragedy, we have also seen the strength and bonds within a community that have provided us with a teachable moment for our country, if not the world,” they wrote. “They came not to lay blame, but to support and heal.” Let’s hope that kind of grace is contagious and spreads quickly to every corner of our sometimes polarized land.