Heart failure has a long history in medicine. It began with the Greek physician Galen in 200 AD. In 1300, Ibn Nafis established the foundation upon which William Harvey made his revolutionary conclusion some 400 years later. Harvey noted that blood circulates continuously left to right through the lungs by the pumping or propelling action of the cardiac muscle, thus making the heart the center of the cardiovascular system. Today, heart failure remains a major public health problem and a leading cause of death affecting 26 million people worldwide. On this episode, Dr. Feinberg explores heart failure management with two specialists: Dr. Ugo Egalum, a cardiologist, and Dr. Kyle Thompson, a cardiothoracic surgeon.
In my 16 years of hosting a two-hour, call-in radio talk show, I’ve learned that as much as I enjoy my conversations with guests who share their unique medical backgrounds, information, and insights with the audience, I enjoy my conversations with the callers even more. Sometimes the conversations with a caller that meander without specific destination or purpose are the most compelling. One such conversation is the topic of today’s podcast.
Mother’s Day traces its roots back to ancient spring festivals honoring maternal goddesses of Greek mythology. The clearest modern precedent is the early Christian festival known as Mothering Sunday. Anna Jarvis campaigned tirelessly for a national holiday to honor mothers, culminating in President Woodrow Wilson signing a bill in 1914 designating the second Sunday in May as Mother’s Day. Interestingly, after the holiday was established, Anna Jarvis grew deeply disappointed by its extreme commercialization and spent the latter half of her life actively campaigning to rescind the holiday from the calendar. Dr. L. Joy Baker, an obstetrician, joined Dr. Feinberg in conversation this past Mother’s Day to discuss motherhood.
Managing a long-term illness is an ongoing process of adaptation, daily management, and resilience. It is a marathon, not a sprint; a journey, not a destination. It challenges the all-too-American notion of fixing the problem, and instead focuses on living well while managing the problem. It requires acknowledging that setbacks are part of the process and not personal failures. Chronic illness management involves adapting to new symptoms, changing treatments, and shifting limitations, making it an ever-winding road rather than a straight line to recovery. Instead of viewing medication or lifestyle changes as temporary measures, this approach treats them as long-term tools for maintaining functionality and quality of life. Viewing it as a journey allows for the psychological process of moving through phases like anger and denial toward a place of acceptance. But it is a journey with many inflection points that often invoke the refrain: now what?
In his farewell address as president on January 17, 1961, Eisenhower warned his countrymen of what he called "the military-industrial complex," a huge and permanent armaments industry that had acquired great political and economic power. He was concerned about the possible conflict between public and private interests in the crucial area of national defense. The past decade has seen the rise of another kind of federal/private "industrial complex" with an equally great potential for influence on public policy. What has been called the "medical-industrial complex" is a large and growing network of government agencies and huge corporations engaged in the business of supplying healthcare services to patients for a profit. The perception or reality of a medical-industrial complex weighs heavily on the way the average healthcare consumer thinks and interacts with the system.