Puccini Was Dying Of Cancer—Hiding His Diagnosis Was A Grave Mistake

It would have been a difficult ending under the best of circumstances. Composing what would be his last opera, Giacomo Puccini was struggling to humanize Turandot, daughter of the Emperor and a woman of mesmerizing beauty. Early in the opera, she had cruelly disposed of a series of want-to-be suitors, beheading some and torturing others, with the casual cruelty of a sociopath. In the final act of the opera, Puccini was hoping to compose a compelling, yet plausible, aria that would thaw her icy cold heart without asking the audience to forget, or even forgive, her sadistic past.

Puccini’s struggle was made all the more difficult because he was suffering from persistent pain in his throat.

Pulling The Plug In Seriously Ill Patients—It’s Often A Matter Of Race

In the US, Black patients often receive significantly less medical care than similarly sick white patients. Black patients have less access to primary and subspecialty care; they’re less likely to receive flu and pneumonia vaccinations. When they do receive care, it is often of lower quality. Yet when Black patients experience a significant traumatic brain injury, they often receive more aggressive care than white patients.

That’s what my colleague, Theresa Williamson, showed in an article published in JAMA Surgery. Williamson is a neurosurgeon at the Mass General Hospital. When she trained at Duke, we collaborated on a study of patients who were admitted to hospitals with severe traumatic brain injuries—a fall, a car accident, or a violent assault created so much blunt force against the skull that the victims lost consciousness, with a risk of imminent death from bleeding or swelling of the brain.

Why do Black patients receive more aggressive care after traumatic brain injury? Williamson’s study can’t answer that question. But I would guess that many Black families are suspicious when, mere hours after their loved one is admitted to the hospital, a bunch of (largely non-Black) physicians start talking about whether it’s time to pull the plug.

A lifetime of healthcare deprivation and now doctors want to withdraw their loved ones ventilator?

Generations of healthcare disparities, and the surgeon doesn’t want to drain blood from a loved one’s skull?


To read the full article, please visit Forbes.

Time To Take Tax Breaks Away From Non-Profit Hospitals

Many nonprofit hospitals in the United States are not performing enough charitable care to justify the billions of dollars of tax breaks they receive.

Decades ago, the federal government created rules excepting non-profit hospitals from many taxes. At the time, most hospitals in the U.S. were charitable organizations, the majority of their patients unable to pay for the services they received. At that time, hospitals relied upon philanthropy—the support of religious organizations or the generosity of individual donors—to balance their budgets. They relied upon tax breaks, too.

Then after World War II, an increasing number of Americans gained health care coverage. Now, hospitals were receiving an increasing proportion of their income from paying customers. Nevertheless, neither local nor federal governments pulled back their tax breaks.

Fast forward to today: many wealthy nonprofit hospitals provide surprisingly little charitable care.


To read the full article, please visit Forbes.

Medicare Savings Might Be Costing Us: Here’s Why

In 2010, as part of the Affordable Care Act, Medicare invited healthcare providers to form accountable care organizations, aka ACOs. The idea was simple: shift away from fee for service by holding providers accountable for the cost and quality of medical care. Those providers that reduce healthcare utilization while maintaining high quality would be eligible for financial rewards.

In some parts of the country, lots of providers responded to this invitation. Sometimes, large provider organizations—ones that already included primary care and specialty clinicians, hospitals and skilled nursing facilities—leveraged their preexisting partnerships to form ACOs. Other times, provider organizations banded together—outpatient practices merging with hospitals. In theory, ACOs were supposed to save money by better coordinating patient care, and by achieving organizational efficiencies.

Could ACOs be costing us money?


To read the full article, please visit Forbes.

An Unbelievable Study Proves—College Students Make Rational Sex Decisions?!

Sex is risky. It can lead to emotional pain, privacy concerns, unwanted pregnancies, sexually transmitted infections (STIs), and even cancer. Many young adults engage in risky sexual behaviors, including college students, who too often, have sex with people they don’t know very well while, at times, under the influence of alcohol or other drugs.

Yet a study in Psychological Science, one of the field’s leading journals, concludes that “young adults make rational sexual decisions.” How could respected researchers come to this conclusion? And what does this study reveal about the way young adults make sexual decisions?

Let’s start with the way the research team studied sexual decision making.


To read full article, please visit Forbes.