Robert J Lull, MD, Editor, San Francisco Medicine, in their issue on Women’s Health, outlines the challenges in women’s health since the dark ages and the increased polarization even in our modern era. To reduce the need for abortion clinics and meet the reproductive needs of women, he suggests that the high-dose hormone-based morning after pill as well as RU 486 should be made available to all women for use at home. He feels the solution to the abortion issue is more effective, practical, and safe contraception that avoids pregnancy in the first place.
“This is what’s wrong with medicine,” is the title of an editorial by Paul Raffer, MD, in a recent issue of the San Diego Physician. He was covering a practice in which a 94-year-old Alzheimer patient, bedridden with contractures, was admitted with sepsis. The patient was “no CPR,” was Medicare/MediCal, and so the family would never see or be concerned about a bill. Dr. Raffer was horrified as he counted neurology, nephrology, pulmonology, cardiology, general surgery, and infectious disease consultations the patient had undergone. He feels this abuse borders on assault on a defenseless patient and must stop. He feels our professional standards are lowered by these consultation feeding frenzies which are beneficial only to physicians.
Sonoma County Physician devotes its recent issue to “Love and Sex.” Fellow pulmonologist, James K. Gude, MD, in the leading editorial, refers to Ishimpo, the oldest medical book surviving in Japan, going back to the work of Yasuyori Tamba in the 10th century. Book 28, entitled “Within the Chamber,” consists of 30 chapters about the many aspects of sex. Chapter 1 introduces the topic of sexuality, “Is it not fundamental and far-reaching that Tao consists of one yin and one yang, and its working is found in the perpetuation of life through the interblending of sexual essences?” After giving other historical accounts, Gude feels we need to follow the advice of Su Nu, a plain-speaking woman, to the Yellow Emperor and treat with care the matters of sexual function and dysfunction, homosexuality, and love. The articles that his fellow members wrote are comments and prescriptions about sex and love. Gude feels they offer a new set of answers for the Emperor’s question.
Brien A Seeley, MD, ophthalmologist, chairman of the editorial board, leads off with “What is Love, Medically Speaking.” After an introduction from Shakespeare’s Romeo and Juliet, Seeley asks the questions and gives the answers: “Is love really just a genetically programmed mix of pheromones, neurohumors and autonomic discharges? Can medicine measure, understand and control love? If there is a dry, clinical side to love, it is likely that we can best understand it by studying an extreme example. Therefore, let me be clear that the kind of love referred to in this discussion is that profoundly affecting the strongest of emotions , the romantic love that can make two people content just to stare into each other’s eye. Eventually this voluntary insanity finds nearly everyone. It turns out that we are hardwired for it. . . . The predominance of marriage throughout the world and the fact that more than 90 percent of Americans marry are taken as evidence that monogamy comes naturally to humans. Even in cultures that practice polygamy, individuals generally prefer one partner toall others. Monogamy confers survival advantages distinct from those of sexual attraction. Though not essential to reproductive success, monogamy is thought to have provided a sense of security while reducing feelings of stress or anxiety, leading in turn to shared child rearing and better survival.”
After having a lot of fun discussing romantic love, love behavior, infatuation, sex, other psychiatric aspects, and the psychoneurobiologic process, Dr. Seeley concludes that “we physicians . . . must welcome our patients to unburden their troubled hearts and overcome the emptiness of isolation. Since love is good for you, let’s dispense more of it. There is, after all, enough for everyone.”
Other articles in this issue of Sonoma County Physician on are on sexual dysfunction, sexual discrepancies, and the health hazards of closets. The photography and multicolored cover are of the high caliber we’ve come to expect from Steve Osborn, the managing editor. To end on a more personal note, the humor in several of these articles caused me to reflect on my late uncle who was widowed in his late 60s He became serious about a woman he met at a senior citizens’ ball whom he eventually married. Because she smoked an occasional cigarette after meals, which he detested, he asked her if she ever smoked after sex? “Well, Otto,” she answered, “I’m not sure. I don’t think I’ve ever looked.”