As a life-long baseball fan, I have a deeply profound appreciation for all of the intricacies of America’s Pastime. As any true fan will tell you, baseball is a sport where the nuances and strategies mean as much as the skills and the physical prowess of the players.
Like all true fans, I am fascinated at the manager’s art, especially when it comes to how they dispute the calls of the umpires. Some managers take a low key approach, while others tend to get right up in the umpires face. Usually, the manager’s intervention has little effect on the umpire, and he returns to the bench without any further ado. However, sometimes the umpire will eject the manager from the game. The fascinating thing is that it’s not just the angry, overtly hostile managers who get ejected – sometimes the mild-mannered ones get tossed as well.
I learned long ago the reason why this happens. It seems that there is a certain ‘magic word’ that the manager (or a player) can use to address the umpire that will ensure his ejection from a game.
Now, being the genteel person that I am, I will not elaborate on the identity of this magic word, but the curious can view the following clip (from one of the greatest baseball movies of all time) in order to gain a clearer understanding of baseball’s magic word phenomena (just make sure that there are no small children, nuns, or prudes around before you play this clip):
http://video.sbrforum.com/video-2424-Bull+Durham+Arguing+with+the+Umpire.html
Baseball is so engrained in our national character that we use many baseball terms to describe everyday events in our daily lives. Phrases like “in the ballpark”, “bush league”, “touch base”, “throw a curveball” .. the list goes on and on. I hereby propose that we add the baseball phrase ‘magic word’ to our national lexicon, and use it to identify a certain phrase that will get you ejected from your doctor’s office.
Now, unless you are a physician, this is not a dirty word – it’s actually quite safe and mundane. You could use it in front of your Mon and she won’t wash out your mouth with soap. But, to physicians, this is the most foul and filthy word in the world.
Want t know what it is? (You know you do!)
It’s iatrogenic.
It’s a Latin word (like all good medical terms) and it means “physician induced” It’s used to describe conditions or diseases that are caused, inadvertently, by medical treatments or procedures.
Our first president, good ‘ol George Washington was a victim of an iatrogenic condition, and it cost him his life. His physicians, in trying to cure his sore throat, used bloodletting on poor George. So zealous were they in their efforts, they accidentally bled the founding father to death, stealing many years off of the end of his life.
Thankfully, modern physicians no longer use bloodletting as a medical procedure. However, they do cause more then their fair share of disease and destruction during the everyday practice od medicine. A disproportionate amount of iatrogenic conditions are the result of, directly or indirectly, prescription medicines.
We’ve all seen the T commercials. The last 10 seconds of almost any T commercial for a prescription drug almost always consists of an announcer calmly listing all the terrible things that can happen to you if you take this particular drug. Still, the consumer is advised to ‘ask your doctor’ about the drug du jour.
Now, the possibility of potentially harmful side effects may be well worth the risk if the drug is designed to save life or limb, but it’s incredible to me how people will risk their well being in taking a drug that promises to cure a inconsequential condition, like yellow toe nails or ‘Restless Leg Syndrome’.
It’s even more incredible how many physicians will support and recommend these drugs in spite of their high risks and low benefits. Physician, after all, are supposed to be guided by the Hippocratic Oath, whose classic translation includes the statement “I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect”
I guess that modern version of the oath (which does not include that statement) must have been re-written by Merck.
Even though most patients have never heard of iatrogenic, it is a dirty little secret amongst the medical community. A 2000 presidential report called iatrogenic illness "a national problem of epidemic proportions". The report estimated that iatrgenic disease causes tens of thousands of annual deaths every year, and costs the health care consumer some $29 billion a year. This report is over ten years old, and the figures have not improved with age. Finally, report concludes that half of iatrogenic events are preventable.
Yet, in spite of these staggering and sobering figures, most of us medical muggles have never even heard of iatrogenic disease.
Maybe this is a good thing. Asking your Doctor about iatrogenic disease and iatrogenic drug interactions might just get you kicked out of their office even faster then calling them that other ‘magic’ word.
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