Contagion

contagionWatch clip HERE before reading (this is a somewhat longer clip than most-less than 5 minutes)

Released in 2011, Contagion is considered a box-office success. This movie undoubtedly struck a chord with viewers that still remember the fear that surrounded the swine flu and avian flu. Movies like this are some of the scariest I have ever seen, yet they don’t really qualify as a horror film. I think what makes them so scary is the fact that this kind of thing could really happen. Throughout history, populations have been plagued with viruses; viruses that have no cures and some that wipe out entire communities of people before a vaccine is found. As can be seen with this film, the method in which information is either retained or communicated can vastly affect the publics fears and reactions.

As I sat and watched this movie, I was surprised to find how many scenes addressed this issue of crisis communication. I wanted to give you the most well-rounded example I could, hence the length of the clip. I inserted text to break up the scenes and to allow you the opportunity to ponder the questions I posed.

The very first clip you see shows physicians at the Centers for Disease Control (CDC) discussing the initial cases of infection. As Athena Du Pre (2010) reminds us, crisis communication is often used by public health officials, such as the CDC, as a way to distribute information to individuals during a crisis situation. Information is often released under significant time constraints and the information and choices made are far from perfect (p. 311). As you see in this clip, while much of the pertinent information surrounding this disease remains unfounded, the team must focus on the information that is correct and is able to be released to the public. In this instance, the public communication is identified as isolating the sick people and  the quarantine of potential persons with contact. Athena Du Pre (2010) reminds us again that news media pushing for ground-breaking coverage can sometimes raise levels of fear and increase an already stressed population so giving them something to work with can help alleviate this.

The next part of this clip shows a meeting with the Minnesota Department of Health. Again, the subject of what to tell the public is a main concern. There is concern over communicating a probable method of transfer; in this case, respiratory and surface contact. Should the public be told that a disease is probably an airborne pathogen or should the information be retained until more concrete findings are available? This is the battle that crisis communicators deal with; what information to give to the public and when. Information could save a person’s life but mis-information could cause unnecessary panic and fear. As shown in this seen, there are often extenuating concerns surrounding release of information.  A board of health representative raises awareness to the Thanksgiving holiday shopping weekend. A message to the public urging them to distance themselves from others could have severe implications on the economy. Athena Du Pre (2010) suggests that sometimes a sense of fear can be productive while at other times it can be disabling (p. 312). It is the belief that a certain level of fear can be a good catalyst for health. By telling people of the potential mode of transfer for this disease, people can start to take accountability for their health, perhaps by wearing a mask or limiting contact with other people.

The other part of this clip shows a physician from the CDC communicating with a loved one. He uses his position to communicate to his fiance that she should get out of Chicago while she can. He knows that there is going to be a mandatory quarantine soon and if she doesn’t leave soon that she will be stuck in Chicago. Putting myself in his shoes, I am not sure I would have the ethical consideration to withhold information from the people I care about. Think about it, how would you feel if you were put in a position where you had to hold back potentially life-saving information from the people you cared most about in the world? Would you communicate this information to a partner? How about to a child? Would you blame or convict a person that released information ahead of schedule? These are questions that I believe have changing answers. Nobody really knows how they would react in a crisis until they are placed in that position. Fear can make you do crazy things.

Athena Du Pre (2010) informs us that communicating with mass media is a vital part of the process for crisis communication. A dedication to being clear, honest and compassionate are key steps in delivering information. In this film, during a live broadcast, a physician from the CDC is presented with allegations that the public is being mis-informed and that information is being leaked to personal friends. This adds to the publics fear that something more substantial is happening. Conspiracy theories are often bred from a belief that information is being restricted from the public. A public forum, such as the one shown in this movie, is a vehicle that can carry this fear into the homes of people around the globe. Is it unethical to raise the public level of fear when it is not yet justified? Does that opinion change depending on the person (would you feel the same if it were a health official or a local conspiracy theorist spreading panic)?

The final part of this clip (I apologize for any spoilers) is in relation to the vaccine for the MEV-1 virus. After a vaccine was finally identified, the question of who gets the first suppliesis on nearly everyone’s mind. Limited quantities are available so rationing the vaccine is unavoidable. If there was already a fear that people in positions of power, such as the physician from the CDC, are releasing vital information to loved ones, one could assume there would also be a fear that vaccinations would go to those individuals before the general public as well. The decisions of the World Health Organization impact the distribution of vaccines throughout the world. As was done with the H5N1 vaccine, decisions regarding who to vaccinate first and how to pay for it are all weighed in on by representatives of this organization (Athena Du Pre, 2010, p, 323).

This movie served as more than just entertainment. It was an eye-opening look at the world of crisis communication as well as lesson in the epidemiology of viruses. In light of the film, I have developed a fear of touching my face as often as well as an even more dedicated appreciation for proper hand washing. I know a lot of what was depicted in this film is somewhat far-fetched but if you look back throughout history, there are many examples of diseases similar to the one depicted here. Do you think we are so advanced medically and technologically as to avoid another plague? I’m not so sure about that…

Until Next Time…

-N

Mad Men

Watch this clip before reading…

Mad Men is a show about an advertising agency in the 1960′s. The name Mad Men is a reference to the advertising executives that worked on Madison Avenue.  The show highlights the  sometimes devious ways different products were advertised in order to gain the most appeal in the public eye. Many of the advertising campaigns featured on the show blur the line between fact and fiction. Truth in advertising is often lying by omission, as seen with the smoking campaign featured in this episode.

This scene, which is actually quite long, I have edited down in order to showcase the most pertinent information. It features a conference between Lucky Strike Cigarette executives and advertising giants, Sterling Cooper. The scene takes place shortly after the FTC ban on cigarette advertising that claims any sort of health benefits. This is also in light of research at the time, that alerted the public to the dangers of smoking.

The beginning part of the scene shows the owner of Lucky Strike talking about how his cigarettes are completely healthy. As he lights up one of his cigarettes, he starts to cough. The advertising executives know better than to draw attention to the action so instead, all of the people in the meeting start to cough, giving the impression that it was ordinary. However, I find it amusing that this scene served dual-purpose.  It also allows the viewer to appreciate the irony of the situation; cigarettes are not good for your health. As Athena Du Pre (2010) informs us, according to the World Health Organization, more than 5 million people die from tobacco-related illnesses and a great majority are from second-hand smoke (p. 350). By showing everyone coughing as the smoke fills the room, it supports the research that second-hand smoke is a danger to your health. What you don’t see in this clip, but that is prevalent throughout the series, is that everyone in company smokes. As agents for Lucky Strikes, everyone in the office is expected to smoke their brand. As Athena Du Pre (2010) tells us, the theory of social norms explains why everyone in the office is so willing to take up smoking (p.376). During that time, smoking was considered an everyday part of life. In light of the research that revealed the health risks of smoking, the need for truthful advertising was at an all-time high.

This scene showcases a dispute between accuracy in advertising. On one hand, we have an agent that wishes to address the health issue head-on. He claims that the best way to handle the campaign is to admit that cigarettes are bad for your health and compare the health risks with the dangers of driving a car. As Athena Du Pre (2010) suggests, the concept of accuracy can be difficult to convey. One person may focus on ethical implications while another focuses on scientific findings. In this clip, one agent wants to focus on scientific research that suggests men like danger. His view on accuracy is to keep the public informed of the health risks but to persuade them that the health risks are part of being a man. The other agent, wanting to completely avoid the health risks, focuses on a menial fact about the way the cigarettes are made in order to detract from the recent bad publicity. In his opinion, the accuracy of “toasted tobacco” is a message that says ‘while all other cigarette brand are un-healthy, ours is simply toasted.’

It’s messages like these that cause such a huge problem when it comes to health communication.  As gatekeepers of information, the advertising agents have a responsibility to relay all accurate information to consumers. Sure, they are providing accurate information about Lucky Strikes,l. but they fail to inform the public of the dangers that are associated with smoking. Athena Du Pre (2010) says that both state and federal governments are targeting tobacco companies stating that it is unfair for them to sell a knowingly harmful product but not be responsible for the cost of treatment associated with tobacco-related illnesses. There is an estimated  cost of $167 billion dollar a year spent in medical expenses and lost productivity, according to the Centers for Disease Control; a figure that many feel tobacco companies should be held responsible for (p. 350).

A good question to ask is, should tobacco companies be held responsible for selling a product that is known to cause cancer? Should they be held accountable for the huge bills people receive for cancer treatments? In my opinion, they should. Knowingly selling someone a product that causes cancer and many other health problems is unethical, especially when they use advertising campaigns that manipulate facts in order to sell their product. Campaigns such as THIS are doing their part in keeping the public informed. As Athena Du Pre (2010) points out, the Truth campaign was successful in raising awareness of the adverse effects of smoking and influenced people to be less-likely to associate smoking with being ‘cool’. Media literacy campaigns are a great way for children to become aware of the manipulations of the mass media. The more aware they become, the more likely they are to look for the accuracy in all advertisements.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

Greys Anatomy

Watch this clip before reading…

There is no denying the fact that Greys Anatomy has become infamous for its flair for drama and unrealistic medical emergencies. With that being said, I still love to watch it, partly for those reasons alone. Sometimes I watch it and think to myself, ‘that is completely wrong’ or ‘did they seriously just do that’. Some of the things they depict in the show end up giving people the wrong impression of medicine. For those people who do not know much about the medical field, this can be a dangerous way to obtain information.

In this particular clip, Dr. Miranda Bailey interrupts a brain surgery on a suicidal patient. The background of this storyline is that this patient has repeatedly attempted suicide while in the hospital, asking everyone to just allow him to die. Dr. Bailey is working with another patient that will die without an organ transplant. This scene shows her plea for Dr. Sheppard to stop surgery in order to let the man die and therefore, have his organs available for donation. Dr. Bailey is reminded of her oath as a physician; do no harm. She is told that to stop surgery would be the equivalent of committing murder and still, Dr. Bailey pleas for the man to die.

As Athena Du Pre (2010) reminds us, nearly 19 people a day die while waiting on a transplant list. There are many reasons why people are fearful of becoming organ donors. Among those, is the fear that doctors will not work as hard to save the life of a donor. This fear is perpetuated in the scene from Greys Anatomy. This unrealistic depiction of a medical scenario supports the belief that doctors will not be an advocate for the health of a donor if  the life of a more suitable recipient is on the line. In reality, organ donation is handled by an outside team of medical professionals and doesn’t involve the physicians treating the patient at the time (Athena Du Pre, 2010, p. 178). Another common fear about organ donation, according to Athena Du Pre, is that organs will go to unworthy recipients. This scene is meant to make you sympathize with Dr. Bailey because her patient is a child and will die without a transplant.  I wonder however, if this scene would elicit the same kinds of emotions if the recipient were older or viewed as less worthy.

The evidence of sadness on Dr. Bailey’s face confirms that she is overwhelmed with emotion about her patient and his need for an organ donation. It is common tactic when discussing organ donation to play on a person’s emotions. It is also common to highlight the benefits of saving another persons life. A great example of both can be seen HERE. This is an advertising campaign from South Africa that is meant to sway non-donors into becoming registered donors. The advertisement uses the image of a dying child to evoke an emotional response as well as sending the message that dying without donation kills more that just yourself; the same message that Dr. Bailey is trying to communicate. By evoking an emotional response, they are hoping to make people feel guilty or sad, which Athena Du Pre (2010) suggests is a negative affect appeal. Perhaps a person watching this commercial would feel guilty about not allowing a loved one become a donor when they passed. Perhaps they are made to feel sad about potentially allowing a child to die without a transplant. The video also helps to make current registered donors feel good about their choice to save a life. In their words, their death will serve a greater purpose; saving the life of another person.

I understand the message behind the advertisement however, it is not sensitive to the population of people who believe, for religious reasons or otherwise, that organ donation is not an option. By playing on the emotions of viewers, the advertisement could potentially isolate people who have an adverse stance on organ donation; equating their decision to not donate with the death of an innocent child. As Athena Du Pre (2010) points out, patients become more resistant to organ donation if they feel that they are being pressured into it. An advertising campaign that uses a negative affect appeal, such as this one, will do little to help an already pressured group of people, become donors.

This is a subject matter that is best handled with sensitivity and compassion.  As Athena Du Pre (2010) suggests, knowing a part of a loved one is ‘living on’ in some capacity is a good reason to donate.  Allowing people to see the benefits of donating while steering away from messages meant to evoke guilt or sadness is a good tactic. Please remember to watch shows like Greys Anatomy with an understanding that it is not representative of the medical field and the situations depicted are dramatized for entertainment purposes and are rarely medically accurate, as is the case with organ donation.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

ER

Please, view the YouTube clip prior to reading…

http://www.youtube.com/watch?v=aRsgen_JT0U&feature=youtu.be

The first show to ever capture my fascination with medicine was Doogie Howser M.D. Shortly after my ‘Doogie Days’, as I affectionately refer to them as, I became obsessed with a new show that revolved around medicine; ER. Unless you have been living under a rock I am sure you are, at the very least, aware of this shows existence. The show followed the lives and work of physicians working in the fictional Emergency Room of County General in Chicago. Perhaps the reason I loved this show so much was for its dedication to depicting scenes with medical accuracy. Granted, for entertainment sake, a lot was dramatized and blown out of proportion but looking back on it now as someone who has worked in an Emergency Room, there are a lot more similarities than differences.

The clip I have selected showcases the culture of the ER perfectly. There is a sense of family among the people who work there, as they depend on each other to save lives. The first portion of the scene shows a nurse leaving a patient’s room and alerting the new interns and medical students that a patient is coughing up “red snappers.” A new medical student, unfamiliar with the speech community of the ER, asks for clarification.  Red snappers, which are used in this instance to refer to a patient with Tuberculosis, are part of the language of infectious disease. As Ludwig A Lettau (2000) explains, terms like these incorporate color to explain the various spectrums that these terms represent. Various shades of red seem to be most common in describing infectious diseases.

In addition to a dedicated language, medical students and interns are presented with many ‘rites of passage’ on their journey to becoming a physician. This scene in particular shows the commonality of experiences between the medical students and interns by their telling of medical school stories. Everyone was told during medical school that it was highly competitive and that over half of the people enrolled would be gone within the year. It was this socialization process that ultimately shaped them into confident physicians. As Athena du Pre (2010) explains, students in medical school often feel belittled or punished. An example of this can also be seen in this clip when an intern talks about her days as a medical student when she referred to nurses by title rather than name. Punishment was doled out on the medical student in the shape of recurring requests for pain medication. However, this is all a part of the process in becoming socialized into the world of medicine.

The final portion of this scene shows a nurse referring to a patient by his diagnosis (naked, drunk and disorderly guy) rather than his name. As Athena du Pre (2010) points out, it becomes the norm to dehumanize patients. It starts in medical school where medical students are conditioned to treat the human body as inanimate. They work on cadavers in an effort to draw the line between emotion and medicine. Research suggests however, that communication is a vital component of patient satisfaction and many medical schools are now including communication studies as part of their core curriculum. The line between medicine and emotion is becoming more blurred than it was in the past. Patients are viewed as a person with feelings and emotions instead of just a body.

It is evident from this short clip that people who work in healthcare tend to have their own distinct way of communicating. Speaking from experience, its important to remember your audience. It is not always appropriate to speak with a patient the way you would a co-worker. I remember a patient I had a few years ago. We  referred to her as ‘the lady with the halo’, referring to the brace she wore for a spinal fracture she sustained. She overheard us talking in the hall one evening and when I entered her room later that night she voiced her concern over us referring to her by a diagnosis rather than by her name. I’ll never forget that patient for she was the one who taught me to remember that a patient is also a person, a fact I pushed aside over the years as I became assimilated into the medical community.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

Lettau, L.A. (2000). The language of infectious disease: A light-hearted review. Clinical Infectious Disease. 31(3), 734-738.

doi:10.1086/313994

‘You dont know Jack’

Watch this clip before reading on.

http://www.youtube.com/watch?v=wcwtT8qnSCc&feature=youtu.be

‘You don’t know Jack’ was released by HBO Films in April of 2010. The role of Jack Kevorkian led to a nomination and win for Al Pacino at the Emmy’s. The film gives viewers an insider perspective of the life and work of Jack Kevorkian, or as he is often called, Doctor Death. Regardless of your views on physician-assisted suicide, this movie evokes thoughts on death and dying, the role of God in our destiny and the standards set forth in the Hippocratic Oath.

Athena du Pre (2010) introduces us to the Hippocratic Oath that has been a major influential code for physicians for many years.There have been many changes to the oath over the years; as medicine and time changed the need for a modern oath arose. The current version of the oath contains statements such as:

“If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God (Tyson, 2001).”

This statement is meant to draw the line between physician and God. What gives a person the right to take a life? Should this even be an option? There are a lot of things that are open to debate but as this clip shows, great respect, compassion and sympathy must be given when speaking with patients about this subject. As the scene shows, Jack Kevorkian (Al Pacino) communicates with the patient in a calm and reassuring manner.  He speaks directly to the patient and acknowledges their presence instead of speaking to other people on his behalf, a skill that Athena du Pre (2010) suggests caregivers follow when communicating with people with disabilities (p. 147). There are times when Dr. Kevorkian lacks compassion, for example when he talks about sensitive subject matter such as the organ donation. His goal in communicating this to the patient may have been just to make him aware of his options and the benefits of organ donation but his delivery of this information could have been perceived as disrespectful, as was illustrated on the faces of the people in the room. However, when it comes to explaining the medical information behind his invention, Jack does a wonderful job at maintaining direct eye contact with the patient, making the process understandable and thorough.

Patients like the one seen here, are often talked down to or are not able to provide input regarding their care because of their disability. You can tell that Jack understands this delicate situation and has compassion for this patient. It is evident that Jack has a patient-centered focus on care. As Athena du Pre (2010) suggests, “patient-centered care has been linked to favorable patient outcomes” (p. 57).  All of Jack’s patients were very thankful for his compassion and empathy for the pain and suffering they experienced. He was favored because of his approach to medicine; putting the patient first.

The Hippocratic Oath still has great value in modern medicine. It sets a standard of care for physicians to adhere to. This film is a great agent for ongoing discussion of physician-assisted suicide. There is no denying that this film is meant to sway viewers towards feeling compassion for terminal patients who wish to end their suffering as well as feeling compassion for the work of Dr. Jack Kevorkian. This film makes me question how one can be considered ‘acting as if they were God’ if they side with a patient who wishes to end their suffering but not ‘acting as if they were God’ when they prescribe medications to alleviate symptoms or cure illnesses; is this not a method of intervention or is this not also going against God’s plan? Also, when we have a pet that is sick it is considered inhumane to make them suffer through illnesses yet it is considered an act of kindness to put them down and end that suffering. Is it that we hold animals to a higher standard of care or a lower standard and what does that say about our society? Personally, this film really registered with me and reminded me that some things, like medicine, are best served without religion. I have always been a firm believer in the freedom of choice for an individual and I believe that has to include the way a person chooses to live their life and how they choose to die.

I propose you watch this film with an open mind. If you agree or if you do not agree, I am certain you will take something away from film.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

Tyson, P. (2001, March 27). The Hippocratic Oath today. Retrieved from

http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html

‘Puncture’

PLEASE WATCH THE CLIP I HAVE EDITED AND POSTED TO YOUTUBE BEFORE READING!

http://www.youtube.com/watch?v=tKzpCLQXxSc

Ideally, I would have liked to upload this video I made directly to WordPress but apparently I am given a limited amount of space for a free account so I uploaded to the next best thing, YouTube.

I first saw this film last year shortly after it came out. As an independent film, it was only screened in select theaters. It really is a shame that it wasnt selected for wide-release because it carries such a strong message. This movie is a real-life story of two lawyers that take on a case regarding needlesticks and safety needles. For those that are not familiar with needlesticks, the CDC estimates around 385,000 sharps-related injuries happen every year (Cunningham & Burnett, 2011). That is a frightening statistic considering the implications that can come from a needlestick (HIV, hepatitis B, hepatitis C). During the time that this film was set, needlesticks accounted for over 800,000 sharps-related injuries a year. New laws have been put in place to ensure safety when dealing with needles and many healthcare facilities have started to purchase safety needles, like the ones described in this clip. All of these advances have helped lower the number of needlesticks but more must be done in order to eradicate them completely.

This clip does a great job at illustrating the animosity that some nurses and medical professionals feel when it comes to these statistics. Speaking from experience, there are often situations that occur within a hospital environment that for some reason or another, tend to get overlooked. Either it is cheaper for the purchasing companies to go with one product over another, as was the case with this film, or not enough attention is given to the complaints of the people who are most familiar with the processes that could use improvement. Most decisions are made by medical boards that have little to know idea how things really are on the frontlines of healthcare. Medical staff are aware of the issues and in an effort to cope with their mismanagement, some people take on a humorous or sarcastic approach when it comes to talking about them. The nurse in this clip for example, uses sarcasm to deflect the questioning coming from the lawyer. It alludes to the sense that this nurse is very familiar with needlestick data and is also aware that not much was being done to prevent them.

Medical mistakes happen and when they do they often bring a lot of cost to the medical facility and the physicians responsible. My question is this, who should be held responsible in the event of a ‘medical mistake’ where the victim is an employee? Shouldn’t it be considered a medical mistake for a hospital purchasing department to knowingly refuse to purchase and provide materials that ensure employee safety? If the same regard were not given to patients it would qualify as a case for malpractice. ‘First, do no harm’ is often one of the first oath’s a physician takes, why then would we subject people to something potentially harmful in lieu of something that can save lives and prevent illness? Essentially, it is a lack of communication between the powers that be and employee’s lower on the proverbial totem pole that are responsible.

As Athena du Pre (2010) suggests in her textbook, communication is interdependent. We communicate with others in order to come to a common understanding; working together is the way we accomplish our goals. I bring this up because it plays a direct role throughout this film. The lawyers have to work with medical professionals to ascertain accurate data to support their case (as can be seen when he approaches the nurse for information on needlesticks) while also working with healthcare administration to incorporate the purchase of safety needles (which can be seen when he is directed to speak with purchasing). In this particular clip, the nursing staff is working directly with the lawyer to reach an ultimate common goal of decreasing the occurrence of needlesticks. Once it is communicated by the lawyer that he desires the same outcome as the nurse (the implementation of safety needles) the nurse is more forthcoming with information to help the lawyer build his case.

By continuing to work together, we can continue to push for more safety laws and procedures in an effort to make medicine a safe place for both patients and their caregivers.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

T. Cunningham, G. Burnett. (2011, November 15). Puncture: Exposure for bloodborne pathogen exposure. [web log comment]. Retrieved from

http://blogs.cdc.gov/niosh-science-blog/2011/11/puncture/

Introduction

Welcome!!!

This is a live blog for a class I am taking this semester at Carlow University. Given that this will be available to the general public as well as my professor, I thought it would be appropriate to give a general overview of the class and the assignment. The class is titled “Communication and Healthcare’ and it covers a very broad spectrum of the healthcare industry and focuses on the ways communication impact the way we view and experience healthcare. The text for this class is Communicating About Health 3rd edition, by Athena du Pre. As I post blog content, I will tie in key concepts from the text and shall refer to the book as a reference for further study.  I will do my best to make sure I explain the content for those who are not familiar with the text or healthcare in general. For the assignment portion of the class, I will be focusing on various aspects of healthcare as depicted in mass media, either through T.V. shows or movies. I plan to review many films and television shows in an effort to make this a well-balanced blog. If you have any suggestions for films or shows, please leave them in the comments!

I hope that you enjoy watching the clips as well as reading my commentary. Most of all, I hope that something sparks an interest with you and that you are pushed to start asking questions about your own experiences with healthcare.

Until next time…

-N