Gruesome video shows a doctor removing 15 YEARS worth of gunk from a woman’s ear

A gruesome video has revealed how it looks inside the ear of someone who hasn't cleaned the wax or dirt out for 15 years.

The four-minute clip shows a metal tool probing and scraping around inside a woman's ear canal and fishing out chunks and flakes of wax.

The doctor performing the procedure said the woman, who is not named, had not cleaned her ears for 15 years because she was afraid of getting water in them.  

But she was complaining she could no longer hear, which it became clear was because so much wax had built up inside her ear canal.  

The woman, who had not cleaned her ears in 15 years, visited a clinic in the Phu Tho Province in the north of Vietnam, where a doctor removed the build-up of wax and dirt in a matter of minutes

During the video the narrow ear tunnel is clogged full of crusty-looking chunks which, when pulled out and put onto a tissue on the doctor's table, appear to add up to the size of a grape.

The doctor, named only as Tuan, treated the patient at his clinic in the Phu Tho Province in the north of Vietnam.

The woman reportedly said the procedure, which Dr Tuan filmed with a tiny camera, was painful but it only took a few minutes for the dirt to be removed.

So much wax and dirt had built up she said she couldn't hear traffic outside the office when she met Dr Tuan. 

It appears as a black, brown and yellow rocky-looking substance when filmed on a television in the doctor's office.

After everything had been removed, Dr Tuan instructed the woman on how she should clean her ears properly in future.

Everybody has wax in their ears – the body produces it to protect the sensitive ear canal from dirt and foreign objects which could damage it.

It usually falls out of its own accord but, if it starts to build up, it can be removed using water or oils. The NHS recommends people don't use cotton buds to clean their ears.

If your ear is blocked you may find you get earache, itching, difficulty hearing, or dizziness.

When the wax is removed from the woman's ear and placed on the doctor's table it looks like a black and brown rocky substance adding up to a pile approximately the size of a grape

Earwax usually falls out on its own but, in some cases, it can become blocked.

It cannot be prevented as the wax is there to protect ears from water, dirt germs, infection and foreign bodies. 

Symptoms include earache, difficulty hearing, itchiness, dizziness, an ear infection and tinnitus.

You can try using over-the-counter wax softening drops or warm water to irrigate your ears.

If this doesn't work, seek professional medical help in case of infection.

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November 08, 2018

Sources: Daily Mail

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  • NHS England announces a ‘major overhaul’ of cancer screening programmes

    NHS England announces a ‘major overhaul’ of cancer screening programmes

    officials said today after an admin error meant thousands of women didn't get cervical screening invites.</p><p>A top-to-bottom review of screening programmes will be headed up by the Department of Health's former cancer director, Professor Sir Mike Richards.</p><p>Sir Mike will lead an investigation to advise NHS England and Public Health England on how they can improve cancer screening programmes and 'save more lives'.</p><p>The announcement came this morning after it was yesterday revealed that nearly 50,000 women did not receive their cervical cancer screening invites or test results.</p><p>Doctors warned 'lives are at risk' because of the blunder, pointing the finger at private firm Capita and calling for the NHS to cut ties with the company.</p><p>Capita, paid £330million to provide admin services for the NHS, has been called 'shambolic' and blamed human error for failing to send out thousands of letters.</p><p>And it was revealed today people in the company knew about the failure for two months before it told the NHS.</p><p>More than 4,500 of the letters were about women's screening results and around 180 of them had potential signs of cancer and had to be contacted by GPs. </p><p>Some 48,500 women in England did not receive letters inviting them or reminding them to attend cervical screening tests, which can pick up on early warnings of cancer (stock image)</p><p>Sir Mike, who is also the former chief inspector of hospitals for the Care Quality Commission, said: 'There is no doubt that the screening programmes in England save thousands of lives every year.</p><p>'However, as part of implementing the NHS's long-term plan, we want to make certain they are as effective as possible.</p><p>'This review provides the opportunity to look at recent advances in technology and innovative approaches to selecting people for screening, ensuring the NHS screening programme can go from strength to strength and save more lives.'</p><p>Sir Mike's review is expected to be complete by summer 2019 and may recommend 'changes to currently outsourced provision'.</p><p>This suggests the health service might be urged to take its work out of the hands of some private companies.</p><p>The review will look at the provision of cervical, breast and bowel screening, which are all given regularly in the UK.</p><p>After yesterday's bombshell the NHS revealed it had known for a month about the blunder which saw almost 50,000 women miss out on smear test invites and results.</p><p>NHS England said it kept quiet while contacting those affected by the error, which dates back to August and was made by private firm Capita. </p><p>The company has admitted it knew about the error since August but didn't tell the health service until October.</p><p>Capita won a seven-year contract worth £330million in 2015 to run back-office services for the NHS in England, such as sending out invitation letters to people eligible for screening programmes.</p><p>The firm, based in London, employees 70,000 people and specialises on administrative services for the private and public sector.</p><p>Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low.</p><p>The fall came after bosses blamed weak sales and said the company had spread itself too thinly.</p><p>Reports suggest the giant, listed on the London Stock Exchange, receives nearly half of its income from Government contracts.</p><p>Capita was considered responsible for 12 out of 18 serious NHS data blunders between July 2016 and July 2017.</p><p>Sacks of medical records were delivered to the wrong surgeries, emails sent to private firms and confidential details published on websites.</p><p>At the time the British Medical Association's Dr Richard Vautrey said: 'This is yet another serious failure of a service… run by Capita.’</p><p>Capita is also responsible for collecting the BBC licence fee from households and running the London Congestion Charge. </p><p>Last month, the Ministry of Defence acknowledged Capita, which has had the contract for Army recruiting since 2012, had 'underperformed'. </p><p>The disclosure drew an angry response from MPs on the committee who warned the service was 'withering on the vine' and called for the contractor to be sacked. </p><p>And the public only found out yesterday after the British Medical Association wrote to the head of NHS England calling for Capita to be stripped of its contract.</p><p>Doctors warned 'lives are at risk' because of the failure by the company, which has been branded 'shambolic' and 'incompetent'. </p><p>It blamed human error for the failure and said disciplinary measures would be taken.</p><p>Around 43,200 women did not receive either an invitation or a reminder letter to attend their screening appointment between January and June this year.</p><p>A further 4,500 were not sent the results of the smear tests they had attended between January and October. </p><p>It comes months after it emerged 450,000 women were not invited for breast cancer screening, with dozens believed to have died as a result.</p><p>The BMA, the GPs' trade union, wrote to NHS England about its 'extreme concern' that so many women did not get the letters because of the 'gross' error by Capita.</p><p>'This is an incredibly serious situation,' said the BMA's Dr Richard Vautrey. He added it was 'appalling that patients may now be at risk' of cervical cancer and said hundreds of women are likely to be 'extremely anxious' over the news.</p><p>Capita apologised for the blunder, saying the correct process 'was not properly followed' and implying it may sack the people responsible. </p><p>It is currently unclear how the administrative error occurred. The firm, based in London, has only said the correct process for uploading, organising and checking datafiles was not properly followed. </p><p>The firm added that the individuals responsible did not immediately escalate the issue to senior management upon discovery of the problem – details today emerged the problem was kept under wraps at the company for two months.   </p><p>The NHS sends women letters every three years after they turn 25 inviting them for a cervical screening test.</p><p>This falls to every five years for women aged 50 to 64. Those over 65 are only offered a test if they have recently had abnormal test results. </p><p>Around five million women in the UK are invited for smear tests every year. Around 850 die each year from cervical cancer in the UK. </p><p>Around one in 20 women who have a smear test have an abnormal result, but only one in 2,000 have cervical cancer, according to The British Society for Colposcopy and Cervical Pathology. </p><p>Kelly Swingler is one of the thousands of women who didn’t receive their NHS cervical screening results</p><p>Kelly Swingler is one of the thousands of women who didn’t receive their NHS cervical screening results.</p><p>The mother-of-two diligently attends cervical smears once every two years and regularly encourages her sister and friends to have them as well.</p><p>But when Miss Swingler, from Peterborough, did not receive her results after her most recent test in May, she became concerned.</p><p>She said: ‘The results normally come back in three to five days. It took me three weeks to get through to my doctor who said everything was okay.’</p><p>Mrs Swingler has had smear tests come back with abnormal results before, so she believes it is essential to keep up to date with screenings.</p><p>The 38-year-old businesswoman added: ‘I go every time I am reminded to.</p><p>‘Because the results are usually so quick to come back, I did start to get concerned. There are many women that are not going to their screenings. But the ones that do go don’t hear anything – that is something you just don’t need.’</p><p>Mrs Swingler said of Capita, the contract company responsible for the blunder: ‘They have a duty of care and responsibility. If that were any other company, if that were my company, we wouldn’t still be in business. They are being paid a lot of money.’ </p><p>The tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer.</p><p>Around 43,200 women who were due to receive invitation or reminder letters between January and June this year weren't sent them. And 4,508 women missed letters about the results of their screenings.</p><p>Around 180 of which are thought to have shown abnormal findings, meaning those women may have been at risk of cancer.</p><p>Of those women, 90 have already been contacted and the NHS is tracking down the rest over the next 10 days, NHS England says. </p><p>However, sources close to Capita deny the women faced any risk of cervical cancer because they would have been told the results by their GP. </p><p>Smear tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer (stock)</p><p>The BMA's Dr Vautrey added: 'This is an incredibly serious situation, and it is frankly appalling that patients may now be at risk because of this gross error on the part of Capita.</p><p>'Some women will now be left extremely anxious because they have not received important correspondence, particularly letters about abnormal smear test results that need urgent follow up. This has been caused solely by Capita's incompetence.'</p><p>The Royal College of General Practitioners (RCGP) has said women shouldn't panic but the NHS must answer for its failings.</p><p>The body has urged the health service to 'seriously review' its contract with Capita, suggesting pressure will grow on NHS bosses to cut ties with the company.</p><p>Professor Helen Stokes-Lampard, RCGP chair, said: 'This error has put patients at risk, and it will undoubtedly cause women more anxiety. </p><p>'It is vital everything is done as a matter of urgency to rectify the situation, and ensure all affected women are informed – particularly those who have not received their test results.</p><p>'We urge women not to panic and to await further information - we understand that NHS England are already working to contact anyone who has been affected.'</p><p>This is not the first time Capita has made an error while working for the NHS this year.</p><p>The company won a seven-year contract in 2015 to run a £330million back-office services contract for the NHS, in which it was required to crack down on 'ghost patients'.</p><p>These are patients who don't exist in reality but are registered at GP surgeries and, since Capita took over, the number of them has risen from three million to 3.6million.  </p><p>Health leaders are furious with the company's failure to meet the high standard expected.  </p><p>'Since it took responsibility for GP back room functions three years ago, Capita‘s running of these services has been nothing short of shambolic,' added Dr Vautrey.</p><p>'And after repeated warnings from the BMA and government, this is now clear evidence that its failings have put patient safety – and possibly lives – at risk.</p><p>Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low</p><p>The NHS breast cancer screening scandal that cost up to 270 lives may actually go back to 2005 - four years earlier than first thought, it was revealed in May.</p><p>Health Secretary Jeremy Hunt said around 450,000 women aged 68 to 71 had not been invited to their final routine screening due to a computer error dating back to 2009.</p><p>But Professor Peter Sasieni, a cancer screening and prevention researcher at King's College London, said the problems could have started as early as 2005.</p><p>Some 450,000 women have not been invited to crucial mammograms as a result of the IT glitches - and as many as 270 women are feared to have died.</p><p>If the scandal actually dates back 13 years instead of nine, then 500,000 people may have missed scans and some may have died as a result.</p><p>'It is ultimately NHS England that bears overall responsibility and it must now take this service back in-house. </p><p>'As the body which commissioned Capita to take on this work, despite clear warning signs that it was not up to the job, NHS England must shoulder the blame for this dreadful situation; you cannot outsource responsibility.' </p><p>Dr Stokes-Lampard added: 'This is the second blunder of its kind this year, and we all need answers about why this has happened and assurance that it will not happen again.</p><p>'We will be asking NHS England to urgently and seriously review its contract with Capita – this is the latest in a long line of serious errors made by the company, and it is clear to us that they have not properly understood the scope or complexity of the work they have bid to do to support primary care.'</p><p>An NHS England spokesperson said: 'Every woman’s case is being reviewed, but there is no current evidence that this incident has led to harm to the women involved, and our priority now is to ensure that anyone affected by this incident is contacted, and knows how to get checked if they are due a cervical screen.'</p><p>Capita has blamed human error for the failing and are taking 'disciplinary action' against the people responsible for covering it up, the company said.</p><p>It said an auditing team has been appointed to investigate the incident and more stringent checks put in place to try and stop it happening again.   </p><p>It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women denied life-saving breast cancer screening scans because of a 'colossal' IT failure</p><p>In a statement, Capita said: 'We have investigated the precise circumstances around this incident, and it is clear that the correct process for uploading, organising and checking datafiles was not properly followed.</p><p>'When the problem was discovered, it was not immediately escalated to senior leadership, or NHS England, by the individuals responsible. </p><p>'Capita is investigating the managerial handling of the matter and taking appropriate disciplinary action. </p><p>'Additionally, a senior executive responsible for this contract has already left Capita. </p><p>'The risk to women of this incident is low and there is no current evidence of harm, but Capita nevertheless apologises to both the NHS and to the women whose correspondence was delayed.' </p><p>It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women miss life-saving breast cancer screening scans because of a 'colossal' IT failure.</p><p>The women, aged between 68 and 71, were never sent letters offering them routine breast screening because of an IT error lasting from 2005 to 2018.</p><p>And then-Health Secretary, Jeremy Hunt, said up to 270 of them developed breast cancer which shortened their lives.</p><p>The chief of Breast Cancer Now, Baroness Delyth Morgan said at the time: 'It is beyond belief that this major mistake has been sustained for more than a decade.'</p><p>The glitch wasn't even discovered until Oxford University researchers were setting up breast screenings as part of a study and found some women's were automatically cancelled because of their age.</p><p>Mr Hunt first blamed a 'computer algorithm failure' but apologised, saying: 'For many years oversight of our screening programme has not been good enough.'</p><p>Women are invited for routine breast screening on the NHS every three years between the ages of 50 and 70.</p><p>Cervical cancer affects the lining of the lower part of womb.</p><p>The most common symptom is unusual bleeding, such as between periods, during sex or after the menopause, but other signs can include:</p><p>Being overweight or obese can double a woman's risk of cervical cancer, research suggests.</p><p>This is due to excessive fat leading to higher levels of the hormone oestrogen, which is associated with the disease.  </p><p>In the UK, the NHS invites women aged between 25 and 64 for cervical screening, known as smear tests, every three-to-four years.</p><p>This aims to pick up abnormal cells that could lead to cancer if left untreated and saves at least 2,000 cervical cancer deaths a year in the UK.</p><p>These abnormal cells can be destroyed by methods such as laser therapy or freezing treatment. </p><p>Since 2008, girls aged 12-to-13 have been offered an HPV vaccine, which protects against more than 70 per cent of cervical cancers. </p><p>If diagnosed, treatment depends on where the cancer is, if it has spread and the patient's general health.</p><p>Surgery may be required, which usually removes the womb and cervix. Enough can sometimes be left so a woman can still get pregnant. </p><p>In more advanced cases, a combination of chemo, radiotherapy and surgery may be required.</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 15, 2018
  • Living With Cancer: Tackling Cancer Anxiety

    Living With Cancer: Tackling Cancer Anxiety

    minal CTs and mammograms, they always trigger a huge wave of ‘scanxiety.’</p><p>Last year, right before the winter holidays, the nurse practitioner palpating my breast paused and returned to a certain spot.</p><p>It was just below the port embedded in my chest that has been used for years of ovarian cancer treatment and above the scar from a previous lumpectomy. The terror that must overwhelm countless women engulfed me. “Maybe nothing,” she said, guiding my fingers to feel what she felt. “I’ll set up a mammogram.” I grimaced, knowing that anxiety always swamps me before scans.</p><p>Yet I knew from experience that this sort of frightful perseverating about potential — but not inevitable — decision-making squanders spirit and time. Without solid evidence, stressing over unknowns does not alter what the outcome will be; it only escalates angst. Yet scanxiety — by prompting us to stew about the future — eclipses the present. Even when no pending test looms on the horizon, the misuse of time and spirit depresses those of us who suffer from the condition patients call cancerchondria.</p><p>Like hypochondriacs, cancerchondriacs imagine every cough, twinge, bump or rash as a malignancy stealthily creeping back. Since cancer can recur with or without producing obvious symptoms, we may fritter away a remission of months in obsessive brooding. The dread of relapse hisses, snorts, whimpers, roars, drowning out all else. Checking our bodies for indications of disease, searching the internet for the causes of possible warning signs, we lay waste our powers. Healthy people can also suffer from cancerchondria, sometimes because a specific type of the disease is said to “run” in their family.</p><p>During my week of waiting, I had no choice but to cultivate a skill that seasoned cancer patients practice assiduously: The fine art of trying not to fret or fuss. Here are the techniques I used, though I am always on the lookout for more.</p><p>It helps to fixate on urgent problems about which something should and can be done. In a lucky break, a book manuscript of mine had just been copy-edited. There were zillions of nitpicky queries about style and grammar that had to be answered immediately. Work of any kind inevitably offers exasperating diversions.</p><p>Despite the self-absorption that unfortunately accompanies cancer scares, most older patients realize that there are others worse off than we are. While worrying about my own health, I saw a video about a mother grieving over a little boy dying of cancer. It reminded me that I had been given the gift of three-score-and-ten and should be relieved that my daughters were not facing my situation. Assisting someone worse off even more effectively derails compulsive introspection. Perusing the daily news can jolt us into an appreciation of the ghastly vulnerability of defenseless people and maybe motivate us to do something for those in our midst.</p><p>Walking, woodworking, weeding, video games, sporting events or playing an instrument succeed for some. What helped me was yoga and writing in my diary, where I could concentrate on crafting the best sentences to convey my emotions rather than the emotions themselves.</p><p>Some people want to vent about their qualms, but others need to button up. For the most part, I’m mum.</p><p>If administered responsibly, martinis, beer, wine, tranquilizers or a few CBD-infused gumdrops can provide succor, as can a soothing bath, a massage, a quiet session of meditation or prayer.</p><p>The day before the scan, not thinking about it became impossible. I did not want my aging husband schlepping from our home in Bloomington, Ind., to the Indianapolis hospital to which we would have to traipse if I needed surgery. I didn’t want to be lopsided or to wear what a friend calls a “foob” (a fake boob). But could my weakened body withstand a double mastectomy? By the time I arrived at the imaging center, I was a wreck.</p><p>Last December, the mammogram technician informed me that there would also be a sonogram, after which a doctor would explain the results. It took about two hours, at the end of which the radiologist cut to the chase: “You’re fine,” he said. “Just scar tissue.” I broke into tears as I thanked him for a gift at the start of Hanukkah. I was about to rush out into the waiting room to tell my husband the good news, when the technician gently guided me to the locker where I had left my clothing.</p><p>One and a half days between the scheduling and the scan had been wasted, but not all seven: a mini-miracle! And then there was the high that, alas, only some cancer patients experience: the reprieve of not having to undergo yet another medical intervention.</p><p>There should be a word for that rush of euphoria when there is no evidence of further disease.</p><p>If you readers have suggested coinages, please leave them in the comments. After all, even a rose by another name needs a moniker. The next time I face cancerchondria or scanxiety, I hope to use your inventions, for the words patients create illuminate our worlds.</p>

    1 November 15, 2018
  • Scandals Catch Up to Private Chinese Hospitals, After Fortunes Are Made

    Scandals Catch Up to Private Chinese Hospitals, After Fortunes Are Made

    pidly with little government oversight, is facing national outrage and scrutiny over a death and fraud allegations.</p><p>PUTIAN, China — Chen Deliang, wearing an orange tunic, a gold watch and fluffy bedroom slippers decorated with snowflakes and the word “Love,” stood proudly in the 130,000-square-foot temple he had built. He had filled it with pagodas, Buddhas and a towering statue of a local goddess. There were several wings, with bedrooms and an office where he practiced calligraphy.</p><p>A chain smoker with a wispy beard, he initially hesitated talking about his path to unimagined wealth, but eventually relented with a matter-of-factness that betrayed no sense of smugness: “I was the first person to create everything.”</p><p>Nearby his family and friends owned mansions, many several stories tall, rising above the unpaved roads and sweet potato fields of the village of Dongzhuang in southern China. They exuded a gaudy opulence — elevators, minarets, gilded gates, fountains with Greek gods. Just days before the Lunar New Year, the most important festival in China, Ferraris and Lamborghinis lined their driveways.</p><p>Even in a country where multimillionaires are minted daily, Mr. Chen and his brethren are unlikely testaments to the Chinese dream. A middle school dropout turned martial arts performer turned itinerant salesman, Mr. Chen parlayed a remedy to treat scabies into a chain of clinics for sexually transmitted diseases and then into the country’s largest network of private hospitals. Along the way, his relatives and neighbors in Dongzhuang and the surrounding area of Putian got into the same business and also made lots of money.</p><p>“All of us were from Dongzhuang, and one by one, we started engaging in medicine,” Mr. Chen said. “It was your relatives, his relatives — all of us were relatives.”</p><p>The Putian system, a loosely affiliated network that traces back to Mr. Chen’s initial forays into medicine, accounts for eight of every 10 private hospitals in the country, some 8,000 facilities. Although they don’t all have the same owners, all were started by people with connections to the area of Putian and are members of the same trade group.</p><p>They offered a vision of the future of medicine, promising everything the old state hospitals lacked, like well-trained specialists, quick appointments at the click of a mouse and state-of-the-art equipment. Public officials praised the hospitals, while big Wall Street firms invested billions of dollars in them.</p><p>Then came the scandal. A university student died after a doctor at a Putian-linked hospital tried to treat his cancer with a discredited form of immunotherapy. The case prompted nationwide outrage and protests. Shares of Putian-linked hospitals plummeted. The government announced an investigation into Putian ads.</p><p>For the Chinese leadership, the death has exposed weaknesses in the country’s health care system. While public hospitals are subject to tighter scrutiny at the national level, private hospitals like those in the Putian network are largely overseen by local governments, many of which don’t have the resources and expertise to police the medical profession.</p><p>Some hospitals in the Putian group fabricated patients’ testimonies and doctors’ credentials. Others listed false certifications or used outdated treatments. The Global Times, a nationalist tabloid owned by the official newspaper of the ruling Communist Party, called them “harmful hospitals.”</p><p>Wu Xidong, executive president of the Putian health industry association, which oversees the group of private hospitals, defended its practices and operations. The public anger at Putian hospitals reflected dissatisfaction with poor regulation and the entire health care system, he said.</p><p>“The patients still give us recognition, isn’t that correct?” Mr. Wu said. “This proves that we have no problems. The state has also not taken any measures against us, right? Because our hospitals themselves are very good.”</p><p>Mr. Chen, 67, lives a quiet life in Dongzhuang after retiring in the 1990s from the health care empire he created. He drives his golf buggy around the temple complex, which has a statue devoted to Chen Jinggu, a woman who is revered in the area as the goddess of the land. None of the pilgrims seemed to recognize him.</p><p>Like other Putian tycoons, Mr. Chen has been keeping a low profile. He doesn’t want to talk about the scandal but rails against the “misinformation” out there.</p><p>“The reports were nonsense. They were a mess,” Mr. Chen said. “Now, when people go and see a doctor, they’ll ask: ‘Is this a private hospital? Should we go in?’ There’s a question mark. Will they be deceived? It’s making things difficult for us.”</p><p>During the turmoil of the Cultural Revolution, doctors were scarce and medicine was limited. Scabies, an itchy, highly infectious disease caused by mites, afflicted many Chinese. “It spread like wildfire,” Mr. Chen said.</p><p>Mr. Chen saw an opportunity, coming up with a homemade remedy — a combination of nitric acid, mercury and vinegar. Traveling throughout China, he sold it for 30 cents a bottle, 10 times the cost. Mr. Chen made about $2,200 a year, at a time when public servants earned about $5 a month.</p><p>“The country’s medical system was so backward,” Mr. Chen said. He attracted a core group of disciples, training them in his practice. “None of us had any medical background.”</p><p>For decades, the Communist Party provided the basics. In the countryside, legions of so-called barefoot doctors, medical professionals with limited training, treated farmers, with the government picking up most of the costs. In cities, most Chinese workers received coverage through their employers, state-owned companies.</p><p>When China’s paramount leader, Deng Xiaoping, started to open the economy in the late 1970s and introduce market reforms, he took away government subsidies for health care. “Barefoot doctors” lost their source of income, and hospitals were left to fend for themselves.</p><p>Mr. Chen and his apprentices started renting rooms in small hotels across from bus stations, where there was a lot of foot traffic. They posted ads on utility poles to target more customers.</p><p>In the decades that followed, Mr. Chen and his partners branched out, starting clinics to treat sexually transmitted diseases. Prostitution was on the rise, and people were embarrassed about going to public hospitals to be treated. The clinics allowed patients to register anonymously.</p><p>“S.T.D.s are embarrassing. You don’t want anyone else to know,” Mr. Chen said. “You could write down any name — we wouldn’t care.”</p><p>He and others in the Putian network soon developed a signature style, expanding widely with clinics in nonemergency fields like infertility, dermatology and cosmetic surgery. After clinics, they opened entire hospitals.</p><p>Mr. Chen bowed out of the business in the 1990s, after a car accident. The network continued to flourish.</p><p>The group got a major boost from the government in 2003, when China granted private hospitals tax-free status for three years. Severe acute respiratory syndrome had swept the country, forcing the authorities to scramble to get more hospital beds and build more quarantine facilities. And officials realized the public hospitals were insufficient to care for the rapidly swelling population.</p><p>A decade later, the government, at a meeting of the top party leadership, said it would further encourage the development of private hospitals. Chen Zhili, former vice chairwoman of the National People’s Congress, wrote a letter to the Putian network in 2014, thanking it for “making positive contributions to the development of private medical care in China.”</p><p>The government backing attracted interest from Wall Street. American financial firms like Sequoia Capital and Morgan Stanley have invested billions of dollars in health care companies in the Putian network. Several of the companies listed their shares on the stock exchanges of Shanghai and Hong Kong.</p><p>Steven Wang, founder of HighLight Capital, a private equity fund in Shanghai, said he had first heard about the Putian network from his parents, both doctors in public hospitals. When Mr. Wang visited the city of Putian in 2001, he found a place still mired in poverty, but he was impressed by the spirit of the locals.</p><p>Centuries earlier, the city had been invaded by Japanese pirates. A massacre followed, and people fled to the mountains. They were a people, Mr. Wang said, who could “eat bitterness,” referring to an expression used by Chinese to describe the ability to endure hardship.</p><p>Mr. Wang invested $150 million in the Putian-linked Angel Group (China) Holding Company, which runs a maternity hospital in the southwestern city of Chengdu. He said the second generation of entrepreneurs from Putian, who followed Mr. Chen and the initial founders, were mostly university educated. So their “knowledge, insights and vision” are different from those of their forebears, Mr. Wang said.</p><p>“They are full of vitality, are keen to learn, are open-minded and want to improve,” he said.</p><p>Xing Jiaming was excited in 2015 to start his internship at a marketing firm for Putian hospitals in the cities of Nanjing and Jinan. As an economics student, he thought it would be useful to gain some other experience, especially at a fast-growing business. Over the previous decade, more than 9,000 private hospitals had opened in China, most connected to the Putian group.</p><p>During his first week at work, he got a plum assignment. A doctor had recently left one of the hospitals, and Mr. Xing was assigned to write up the credentials of the doctor’s replacement. The résumé of the replacement was identical to his predecessor’s. When the intern asked about the similarities, his boss told him to finish.</p><p>For the Nanjing Brain Hospital, Mr. Xing said, he was told to promote its treatment success rate as 100 percent. He also made up testimonials, including one of a woman in Nanjing who was cured of anxiety after going to a Putian-related hospital.</p><p>“Everything was fabricated by us,” he said. “None of them was a real case.”</p><p>Mr. Xing said he and his colleagues had been given templates. “We had to exaggerate the harm caused by the disease,” he said. “The more exaggerated, the better.” The company, he said, had a “professional art team” that would steal online photographs of other people and stick them onto testimonials.</p><p>“This phenomenon doesn’t only pertain to the Putian network, right?” Mr. Wu of the Putian health association said. “All over the internet, it’s likely that there are many other businesses who engage in that.”</p><p>Putian tapped the power of the internet to expand, plowing profits into marketing. Liang Jianyong, a former Communist Party secretary in Putian, said the network invested $1.8 billion in advertising on the Chinese search giant Baidu in 2013. It amounted to nearly half the search engine’s advertising revenue that year, according to the National Business Daily. Baidu declined to comment.</p><p>Many of the online marketing materials have a similar feel. They feature dozens of specialists, with lengthy résumés promoting “abundant clinical experience” and “praise from peers within the industry.” There are glowing testimonials from satisfied patients with emotional narratives.</p><p>One details the case of a father who “knelt down” pleading with the chief doctor at the Putian-linked Edward Hospital, in the far western region of Xinjiang, to treat his 5-year-old daughter. She received treatment that was “the most advanced technology in the world.”</p><p>Some Putian hospitals promoted credentials they didn’t have. Two of the nine doctors advertised on Shenyang Metropolis Hospital’s website are not accredited to work there, according to an analysis of a doctor database run by the National Health and Family Planning Commission, the government agency.</p><p>Others tried to make it seem they were affiliated with some of the country’s top hospitals.</p><p>Weining He Mu Jia, one of the 8,000 hospitals in the Putian network, had the patina of legitimacy. He Mu Jia was the Chinese name of Beijing United Family Hospital, China’s first foreign-owned hospital and one of its most respected.</p><p>President Barack Obama and Gary F. Locke, a former United States ambassador to China, graced the covers of Weining He Mu Jia’s magazines. A photo of Roberta Lipson, the founder of Beijing United Family Hospital, hung in the Weining hospital’s lobby. The photo, which was doctored, featured Ms. Lipson at the grand opening of the emergency room expansion of the “Weining United Family Hospital and Clinics.”</p><p>The connections were purely show. Despite no relation, more than 20 hospitals in the Putian network have used the Chinese name He Mu Jia or similar variations, according to Ms. Lipson. Her company, Chindex International, has sued six Putian hospitals for trademark infringement, including Weining He Mu Jia.</p><p>“Every single day in the news, there are people on the internet complaining about them, complaining about malpractice, and it’s our name,” Ms. Lipson said.</p><p>Beijing United won the trademark infringement lawsuit against the Weining hospital in 2014. But Weining still runs an account on Weibo, China’s version of Twitter, with the He Mu Jia name.</p><p>Wei Zexi, a 22-year-old university student, was lured by the promises of a Putian hospital.</p><p>With a diagnosis of synovial sarcoma, a rare form of cancer that attacks the tissue in the muscle joints, Mr. Wei had undergone three operations, four chemotherapy sessions and 25 radiation therapy sessions and had taken traditional Chinese medicines hundreds of times. With the help of donations, he bought Keytruda, an immunotherapy drug that is not available in most parts of the mainland, for $5,000 in Hong Kong.</p><p>When none of it worked, Mr. Wei desperately looked online for options. A Putian center at a military hospital in Beijing, appearing at the top of his search results on Baidu, offered what seemed like a miracle: an immunotherapy program called DC-CIK.</p><p>“As long as you have 1 percent of hope, it is worth using your life to take a gamble,” he wrote in a May 2015 reply to a post on Zhihu, a Chinese knowledge-sharing website.</p><p>A doctor, a specialist for the Putian treatment center, Shanghai Kangxin hospital management company, told him that the DC-CIK treatment had a success rate of 80 to 90 percent and could extend his life by 20 years. He touted a partnership with Stanford University.</p><p>His parents borrowed money from relatives and friends for the four treatments, which cost $30,000. Within a few months, the cancer had spread to his kidneys. In April 2016, 19 months after he first sought treatment in the Putian-linked hospital, Mr. Wei was dead.</p><p>The DC-CIK treatment had been phased out in the United States because it was largely ineffective. There was no partnership with Stanford.</p><p>Mr. Wei, according his best friend, Wang Xi, believed the treatment was legitimate because of Baidu’s search results. The influential state broadcaster China Central Television had also once interviewed the doctor who treated Mr. Wei.</p><p>“He felt he was already cautious enough,” his friend said.</p><p>A nationwide scandal erupted after his death. The Putian network became the emblem of unfettered corruption within the private health care system. Local authorities took particular aim at one of its more egregious violations, operating clinics within other hospitals. The practice had been outlawed years earlier, but many players in the Putian network continued to develop them.</p><p>In 2017, a court in Anhui Province said a hospital had violated local regulations by renting out several specialist departments in andrology and dermatology, among others, to a man from Putian, who was eventually forced to shut down. That same year, the local governments in the provinces of Liaoning and Henan announced crackdowns on the practice.</p><p>“China’s health care fraud is pretty rampant,” said Dr. Ma Jun, director of the Harbin Institute of Hematology and Oncology, a public hospital in China’s northeast. “With China’s private hospitals, there are a lot of traps.”</p><p>In October 2016, Chen Zhanghao paid $580 for nasal surgery in the eastern city of Ningbo at what he believed was a subsidiary of Tongren Hospital, a prestigious hospital in Beijing. He had found the Putian-affiliated hospital on Baidu.</p><p>According to Mr. Chen, the hospital at the time purported on its website to be a Tier 3 institution, the government’s top classification. Later, Mr. Chen learned, through a freedom of information request, that the hospital did not have the designation and was not allowed to conduct that type of surgery, according to a copy of the government’s response to his request, which was viewed by The Times. (The hospital has since removed the classification.)</p><p>Mr. Chen, 25, now has difficulty breathing sometimes because his nose either hurts or is congested, he said. He tried looking for the doctors who had treated him, but they have left the hospital, now known as the Ningbo Yinzhou Tongren Hospital.</p><p>Mr. Chen has nightmares thinking about his surgery. “I just don’t want to think about it anymore,” he said.</p><p>In March 2017, he joined five other patients with similar problems, protesting outside the offices of Baidu for compensation. They held banners that read: “We are the living Wei Zexis.”</p><p>Back at his temple, Chen Deliang defended the health care empire that he founded all those decades ago.</p><p>Mr. Chen said the hospital department that Mr. Wei had visited in Beijing had nothing to do with Putian but was owned by a company from Zhejiang Province. He did not elaborate, and corporate records showed otherwise.</p><p>When asked about the fake ads, Mr. Chen defended them, saying all ads need to have an element of “boastfulness,” but added that “it’s impossible that they are fake.”</p><p>He said many Putian hospitals had lost money, struggling to get loans and pay their workers. But when asked how many exactly, he said he could not tell for sure.</p><p>“We are not selling fake drugs, nor are we deceiving people,” Mr. Chen said. “The government has done nothing to us.”</p>

    1 November 15, 2018
  • How a Low-Carb Diet Might Help You Maintain a Healthy Weight

    How a Low-Carb Diet Might Help You Maintain a Healthy Weight

    d them with fat sharply increased their metabolisms.</p><p>It has been a fundamental tenet of nutrition: When it comes to weight loss, all calories are created equal. Regardless of what you eat, the key is to track your calories and burn more than you consume.</p><p>The new research is unlikely to end the decades-long debate over the best diet for weight loss. But it provides strong new evidence that all calories are not metabolically alike to the body. And it suggests that the popular advice on weight loss promoted by health authorities — count calories, reduce portion sizes and lower your fat intake — might be outdated.</p><p>“This study confirms that, remarkably, diets higher in starch and sugar change the body’s burn rate after weight loss, lowering metabolism,” said Dr. Dariush Mozaffarian, the dean of the Friedman School of Nutrition Science and Policy at Tufts University, who was not involved in the research. “The observed metabolic difference was large, more than enough to explain the yo-yo effect so often experienced by people trying to lose weight.”</p><p>Dr. Mozaffarian called the findings “profound” and said they contradicted the conventional wisdom on calorie counting. “It’s time to shift guidelines, government policy and industry priorities away from calories and low-fat and toward better diet quality.”</p><p>While some experts praised the findings, others were more cautious. Dr. Kevin Hall, a scientist and obesity expert at the National Institute of Diabetes and Digestive and Kidney Diseases, said the new study was ambitious and very well run. But he said the researchers used methods that raise questions about the results. One method they used to track metabolism, called doubly labeled water, has not been shown to be reliable in people on low-carb diets and it may have exaggerated the amount of calories the subjects burned, he said.</p><p>Dr. David Ludwig, an endocrinologist at Harvard Medical School and Boston Children’s Hospital and one of the study authors, disagreed, saying: “We used a gold standard method that has been validated across a wide range of experimental conditions and universally adopted in the field.”</p><p>Dr. Hall added, “I would love it to be true that there was a diet combination of carbs and fats that led to large increases in energy expenditure — and I really hope it is true. But I think there are reasons to question whether or not it is.”</p><p>“A few days, or a couple weeks, is not enough time to make any meaningful conclusion about how diets affect metabolism over the long term,” he added.</p><p>To do the new study, Dr. Ludwig and his colleagues collaborated with Framingham State University, about 20 miles outside Boston, where they recruited overweight students, staff members and faculty members. Each participant went through two phases of the study. First, they were put on strict diets that lowered their body weight by about 12 percent, which was designed to stress their metabolisms.</p><p>“At that point their bodies are trying to regain the weight,” Dr. Ludwig said. “It pushes the body and predisposes to weight regain.”</p><p>In the second phase of the study, the subjects were assigned to one of three diets with 20 percent, 40 percent or 60 percent of their calories from carbohydrates. Protein was kept steady at 20 percent of calories in each diet. </p><p>Over the next five months, the researchers tracked the subjects meticulously and provided them with enough daily meals and snacks to keep them from losing or gaining any weight. This was so the researchers could determine precisely how the subjects’ metabolisms responded to the different diets while their body weight remained stable.</p><p>The researchers tracked biomarkers that helped them ensure that the participants stuck to their diets. They also worked with a large food service company, Sodexo, to prepare thousands of generally healthful meals that the subjects could eat in cafeterias or take home with them. A typical meal for the high-carb group might consist of a chicken burrito bowl with rice and vegetables, for example, or roasted turkey with green beans and mashed potatoes. The low-carb group would get a similar meal with fewer carbohydrates, like a chicken burrito lettuce wrap or roasted turkey with green beans and mashed cauliflower.</p><p>What the researchers found was striking. The roughly 250 extra calories that the subjects in the low-carb group burned each day could potentially produce a 20-pound weight loss after three years on the diet, Dr. Ludwig said. People who tended to secrete higher levels of insulin did the best on the low-carb diet, burning about 400 extra calories a day.</p><p>Dr. Ludwig emphasized that the results need to be replicated by other investigators and he stressed that the findings do not impugn whole fruits, beans and other unprocessed carbohydrates. Rather, he said, the study suggests that reducing foods with added sugar, flour and other refined carbohydrates could help people maintain weight loss by increasing their metabolisms at a lower body weight.</p><p>“These foods seem to undermine your metabolism,” he said. “They slow metabolism in a way that may work against long-term weight loss maintenance.”</p>

    1 November 15, 2018
  • Health threats of California wildfires: How smoke, dust and toxic fungus pose long-term risks

    Health threats of California wildfires: How smoke, dust and toxic fungus pose long-term risks

    d Human Services Secretary, to declare a public health emergency. </p><p>Tragically, his department warned, the threat is multi-faceted. </p><p>Smoke, pulverized dust, burned fuel, fungal spores and more could pose severe public health risks for people in the area.  </p><p>Rescuers work among debris after the wildfire in Paradise, California. The collapsed buildings and burning flames have disrupted all kinds of toxins now lingering in dust</p><p>For those who weren't close to collapsing buildings, the biggest concern is polluted, smoky air, which can also contain small dangerous particles. </p><p>Schools and public offices across California have been checking the air before re-opening. </p><p>As devastating photos have shown, the fires ravaging California have decimated buildings, creating clouds of dust for miles. </p><p>Those close to collapsed buildings may be exposed to pulverized concrete.</p><p>Our understanding of the health dangers of dust exposure primarily come from two sources: studies on workers at demolition sites and first responders to 9/11, who are at the center of the world's longest-running post-disaster study ever conducted.  </p><p>The toxic cocktail they inhaled has been directly linked to a number of illnesses, including a persistant cough, bronchitis, runny nose, gastroesophageal acid reflux disease (GERD) and cancer.  </p><p>In the last 20 years, these models have given us a greater understanding of how pulverized concrete - particularly the crystalline silica it contains - directly causes lung diseases and cancers.</p><p>They filter out small particles but still allow you to breath easily.</p><p>The toxin invades the human body in a very similar way to asbestos, which causes mesothelioma, an aggressive cancer of the chest. </p><p>With particles small enough to invade the lungs (fewer than five millionths of a meter), crystalline silica perforates cells, allowing them to mutate and divide - laying the foundations for cancer. This process also leads to respiratory diseases like pulmonary fibrosis, asthma and silicosis by weakening the cells and damaging the lungs' function.  </p><p>Sixteen years after 9/11, medics are seeing this process unfold in the men and women who mined Ground Zero for survivors.  </p><p>One of the most underestimated dangers to health after a natural disaster is fungus.</p><p>This was made plain after the January 1994 earthquake in Los Angeles.</p><p>Within days of the natural disaster, more than 170 people fell ill with Valley fever. Within months, dozens had died.</p><p>The deaths were traced back to a disease caused by a fungus called coccidioidomycosis, which is native to the soil of southern California.   </p><p>'If you understand your city map, and what's in the neighborhood, you will have a better idea of what you've been exposed to. What fungal organisms are in your region, and what kind of buildings were you near?'</p><p>The death toll has hit 50, prompting Alex Azar, Health and Human Services Secretary, to declare a public health emergency</p><p>Then, speak to your doctor. If they think there is cause for concern, get regular check-ups to screen for lung diseases and other dust-linked illnesses.</p><p>'What we found after 9/11 is that you can't x-ray everybody or CAT-scan everybody, so we had to work out those who were most likely to have a high risk and make sure they are getting monitored. </p><p>'We worked out regions of exposure - who was closest to the buildings? Then we monitor those people, and their symptoms. Are they developing a persistant cough? Do they have a runny nose? How is their lung function? If it's getting worse, and they're not a smoker, then that's cause for concern, so we do more tests. </p><p>'At the end of the day, the only way to protect yourself is to monitor your symptoms.'</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 15, 2018
  • NHS system error puts lives at risk as nearly 50,000 women are not sent screening letters

    NHS system error puts lives at risk as nearly 50,000 women are not sent screening letters

    er as almost 50,000 women were not sent letters inviting them for a smear test.</p><p>Health leaders today warned 'lives are at risk' because of the 'appalling' error by the private firm Capita, which has been branded 'shambolic' and 'incompetent'. </p><p>The company - contracted to produce and send invitation letters to women eligible for the screening programme - blamed human error for the failure and said disciplinary measures would be taken. </p><p>The error meant 43,000 letters inviting female patients for a smear test or giving them a reminder were not sent between January and June. A further 4,500 were regarding their cervical cancer screening results.</p><p>The British Medical Association, the GPs' trade union, has written to NHS England about its 'extreme concern' that so many women did not get the letters because of the 'gross' error by Capita.</p><p>'This is an incredibly serious situation,' said the association's Dr Richard Vautrey. He added it was 'appalling that patients may now be at risk' of cervical cancer and said hundreds of women are likely to be 'extremely anxious' over the news. </p><p>It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women miss life-saving breast cancer screening scans because of a 'colossal' IT failure.  </p><p>Some 48,500 women in England did not receive letters inviting them or reminding them to attend cervical screening tests, which can pick up on early warnings of cancer (stock image)</p><p>The error has been traced back to the private company Capita and pressure is mounting on the NHS to cut ties with the firm.</p><p>Capita apologised for the blunder, saying the correct process 'was not properly followed' and implying it may sack the people responsible. </p><p>It is currently unclear how the administrative error occurred. The firm, based in London, has only said the correct process for uploading, organising and checking datafiles was not properly followed. </p><p>The firm added that the individuals responsible did not immediately escalate the issue to senior management upon discovery of the problem.  </p><p>The BMA accused the company of being 'shambolic' and said NHS England must take the blame for paying it to do the work.</p><p>The NHS sends women letters every three years after they turn 25 inviting them for a cervical screening test.</p><p>This falls to every five years for women aged 50 to 64. Those over 65 are only offered a test if they have recently had abnormal test results. </p><p>Around five million women in the UK are invited for smear tests every year. Around 850 die each year from cervical cancer in the UK. </p><p>Around one in 20 women who have a smear test have an abnormal result, but only one in 2,000 have cervical cancer, according to The British Society for Colposcopy and Cervical Pathology. </p><p>The tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer.</p><p>Around 43,200 women who were due to receive invitation or reminder letters between January and June this year weren't sent them. And 4,508 women missed letters about the results of their screenings.</p><p>Around 180 of which are thought to have shown abnormal findings, meaning those women may have been at risk of cancer.</p><p>Of those women, 90 have already been contacted and the NHS is tracking down the rest over the next 10 days, NHS England says. </p><p>However, sources close to Capita deny the women faced any risk of cervical cancer because they would have been told the results by their GP. </p><p>Kelly Swingler is one of the thousands of women who didn’t receive their NHS cervical screening results.</p><p>The mother-of-two diligently attends cervical smears once every two years and regularly encourages her sister and friends to have them as well.</p><p>But when Miss Swingler, from Peterborough, did not receive her results after her most recent test in May, she became concerned.</p><p>She said: ‘The results normally come back in three to five days. It took me three weeks to get through to my doctor who said everything was okay.’</p><p>Mrs Swingler has had smear tests come back with abnormal results before, so she believes it is essential to keep up to date with screenings.</p><p>The 38-year-old businesswoman added: ‘I go every time I am reminded to.</p><p>‘Because the results are usually so quick to come back, I did start to get concerned. There are many women that are not going to their screenings. But the ones that do go don’t hear anything – that is something you just don’t need.’</p><p>Mrs Swingler said of Capita, the contract company responsible for the blunder: ‘They have a duty of care and responsibility. If that were any other company, if that were my company, we wouldn’t still be in business. They are being paid a lot of money.’ </p><p>Smear tests pick up on abnormal cells on the cervix which, if caught early, can be removed in order to try and prevent cervical cancer (stock)</p><p>Capita won a seven-year contract worth £330million in 2015 to run back-office services for the NHS in England, such as sending out invitation letters to people eligible for screening programmes.</p><p>The firm, based in London, employees 70,000 people and specialises on administrative services for the private and public sector.</p><p>Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low.</p><p>The fall came after bosses blamed weak sales and said the company had spread itself too thinly.</p><p>Reports suggest the giant, listed on the London Stock Exchange, receives nearly half of its income from Government contracts.</p><p>Capita was considered responsible for 12 out of 18 serious NHS data blunders between July 2016 and July 2017.</p><p>Sacks of medical records were delivered to the wrong surgeries, emails sent to private firms and confidential details published on websites.</p><p>At the time the British Medical Association's Dr Richard Vautrey said: 'This is yet another serious failure of a service… run by Capita.’</p><p>Capita is also responsible for collecting the BBC licence fee from households and running the London Congestion Charge. </p><p>Last month, the Ministry of Defence acknowledged Capita, which has had the contract for Army recruiting since 2012, had 'underperformed'. </p><p>The disclosure drew an angry response from MPs on the committee who warned the service was 'withering on the vine' and called for the contractor to be sacked. </p><p>Dr Vautrey said: 'This is an incredibly serious situation, and it is frankly appalling that patients may now be at risk because of this gross error on the part of Capita.</p><p>'Some women will now be left extremely anxious because they have not received important correspondence, particularly letters about abnormal smear test results that need urgent follow up. This has been caused solely by Capita's incompetence.'</p><p>The Royal College of General Practitioners (RCGP) has said women shouldn't panic but the NHS must answer for its failings.</p><p>The body has urged the health service to 'seriously review' its contract with Capita, suggesting pressure will grow on NHS bosses to cut ties with the company.</p><p>Professor Helen Stokes-Lampard, RCGP chair, said: 'This error has put patients at risk, and it will undoubtedly cause women more anxiety. </p><p>'It is vital everything is done as a matter of urgency to rectify the situation, and ensure all affected women are informed – particularly those who have not received their test results.</p><p>'We urge women not to panic and to await further information - we understand that NHS England are already working to contact anyone who has been affected.'</p><p>This is not the first time Capita has made an error while working for the NHS this year.</p><p>The company won a seven-year contract in 2015 to run a £330million back-office services contract for the NHS, in which it was required to crack down on 'ghost patients'.</p><p>These are patients who don't exist in reality but are registered at GP surgeries and, since Capita took over, the number of them has risen from three million to 3.6million.  </p><p>Health leaders are furious with the company's failure to meet the high standard expected.  </p><p>'Since it took responsibility for GP back room functions three years ago, Capita‘s running of these services has been nothing short of shambolic,' added Dr Vautrey.</p><p>'And after repeated warnings from the BMA and government, this is now clear evidence that its failings have put patient safety – and possibly lives – at risk.</p><p>Capita, whose chairman is Sir Ian Powell, had nearly £1billion wiped off its value in January as shares plummeted to a 15-year low</p><p>The NHS breast cancer screening scandal that cost up to 270 lives may actually go back to 2005 - four years earlier than first thought, it was revealed in May.</p><p>Health Secretary Jeremy Hunt said around 450,000 women aged 68 to 71 had not been invited to their final routine screening due to a computer error dating back to 2009.</p><p>But Professor Peter Sasieni, a cancer screening and prevention researcher at King's College London, said the problems could have started as early as 2005.</p><p>Some 450,000 women have not been invited to crucial mammograms as a result of the IT glitches - and as many as 270 women are feared to have died.</p><p>If the scandal actually dates back 13 years instead of nine, then 500,000 people may have missed scans and some may have died as a result.</p><p>'It is ultimately NHS England that bears overall responsibility and it must now take this service back in-house. </p><p>'As the body which commissioned Capita to take on this work, despite clear warning signs that it was not up to the job, NHS England must shoulder the blame for this dreadful situation; you cannot outsource responsibility.' </p><p>Dr Stokes-Lampard added: 'This is the second blunder of its kind this year, and we all need answers about why this has happened and assurance that it will not happen again.</p><p>'We will be asking NHS England to urgently and seriously review its contract with Capita – this is the latest in a long line of serious errors made by the company, and it is clear to us that they have not properly understood the scope or complexity of the work they have bid to do to support primary care.'</p><p>An NHS England spokesperson said: 'Every woman’s case is being reviewed, but there is no current evidence that this incident has led to harm to the women involved, and our priority now is to ensure that anyone affected by this incident is contacted, and knows how to get checked if they are due a cervical screen.'</p><p>Capita has blamed human error for the failing and are taking 'disciplinary action' against the people responsible for covering it up, the company said.</p><p>It said an auditing team has been appointed to investigate the incident and more stringent checks put in place to try and stop it happening again.   </p><p>It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women denied life-saving breast cancer screening scans because of a 'colossal' IT failure</p><p>In a statement, Capita said: 'We have investigated the precise circumstances around this incident, and it is clear that the correct process for uploading, organising and checking datafiles was not properly followed.</p><p>'When the problem was discovered, it was not immediately escalated to senior leadership, or NHS England, by the individuals responsible. </p><p>'Capita is investigating the managerial handling of the matter and taking appropriate disciplinary action. </p><p>'Additionally, a senior executive responsible for this contract has already left Capita. </p><p>'The risk to women of this incident is low and there is no current evidence of harm, but Capita nevertheless apologises to both the NHS and to the women whose correspondence was delayed.' </p><p>It comes after the NHS was engulfed in a similar scandal in May, which saw 450,000 women miss life-saving breast cancer screening scans because of a 'colossal' IT failure.</p><p>The women, aged between 68 and 71, were never sent letters offering them routine breast screening because of an IT error lasting from 2005 to 2018.</p><p>And then-Health Secretary, Jeremy Hunt, said up to 270 of them developed breast cancer which shortened their lives.</p><p>The chief of Breast Cancer Now, Baroness Delyth Morgan said at the time: 'It is beyond belief that this major mistake has been sustained for more than a decade.'</p><p>The glitch wasn't even discovered until Oxford University researchers were setting up breast screenings as part of a study and found some women's were automatically cancelled because of their age.</p><p>Mr Hunt first blamed a 'computer algorithm failure' but apologised, saying: 'For many years oversight of our screening programme has not been good enough.'</p><p>Women are invited for routine breast screening on the NHS every three years between the ages of 50 and 70.</p><p>Cervical cancer affects the lining of the lower part of womb.</p><p>The most common symptom is unusual bleeding, such as between periods, during sex or after the menopause, but other signs can include:</p><p>Being overweight or obese can double a woman's risk of cervical cancer, research suggests.</p><p>This is due to excessive fat leading to higher levels of the hormone oestrogen, which is associated with the disease.  </p><p>In the UK, the NHS invites women aged between 25 and 64 for cervical screening, known as smear tests, every three-to-four years.</p><p>This aims to pick up abnormal cells that could lead to cancer if left untreated and saves at least 2,000 cervical cancer deaths a year in the UK.</p><p>These abnormal cells can be destroyed by methods such as laser therapy or freezing treatment. </p><p>Since 2008, girls aged 12-to-13 have been offered an HPV vaccine, which protects against more than 70 per cent of cervical cancers. </p><p>If diagnosed, treatment depends on where the cancer is, if it has spread and the patient's general health.</p><p>Surgery may be required, which usually removes the womb and cervix. Enough can sometimes be left so a woman can still get pregnant. </p><p>In more advanced cases, a combination of chemo, radiotherapy and surgery may be required.</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 15, 2018
  • California man, 26, who tried to kill himself receives face transplant in NYC 25-hour surgery

    California man, 26, who tried to kill himself receives face transplant in NYC 25-hour surgery

    rs after narrowly surviving an attempted suicide against the odds, a new report reveals.</p><p>Doctors managed to bring him back - and soon after, Cam's mother Bev Bailey-Potter contacted NYU Langone Medical Center's new face transplant unit.</p><p>He also expresses his gratitude to the family of his donor, 23-year-old Will Fisher, described by People as 'a budding New York City writer and filmmaker'. He became a donor after his 'sudden' death following a battle with mental illness on January 5, 2018.</p><p>Cam flew directly to New York from California and that night he underwent the 25-hour surgery that changed his life.</p><p>Transformation: Cam Underwood was 24 when he tried to take his own life with a shotgun while drunk in June 2016 - and he later could not believe he'd done such a thing. He lost everything below his eyes but surgeons managed to patch him up (left). On January 5, 2018, he was admitted for a face transplant (pictured, center, shortly after; pictured, right, recently)</p><p>Before: Cam had battled with depression for years and was self-medicating with alcohol</p><p>'I remember just a sigh of relief that I had a face again, I had a mouth and teeth again, I had a nose again—just such amazement and joy,' Cam told People.</p><p>'I couldn't be more thankful for all the hard work and the sacrifices that were made for me.'</p><p>He added: 'The biggest difference is just being able to go out without a mask and without people staring at me.'</p><p>According to the ABC report, screening tonight on 20/20, Cam was athletic, hard-working, and a thrifty saver.</p><p>As soon as he graduated high school, he got a job working for his stepfather, and by 19 he got a mortgage on a house.</p><p>He and his high school sweetheart separated after years together, and he lost touch with one of his closest friends, which seemed to hit hard. </p><p>Donor: Will Fisher, 23, was a writer, filmmaker, chess player who studied at Johns Hopkins University. He was described by family as wise beyond his years. He died suddenly in January 2018 after a battle with mental illness</p><p>(he is the youngest of four, with two brothers and a sister) moved away, and he was soon diagnosed with depression. </p><p>He started to drink a lot, and recoiled from any of his relatives' attempts to get him to ease off.</p><p>On June 26, 2016, he spent the day hitting the bottle - something that had become commonplace, he tells People and ABC. </p><p>But that night he entered a vortex that sucked him further than before, and he thought he should end his life. </p><p>He pointed a shotgun under his chin and pulled the trigger, obliterating his entire face. </p><p>It is not clear where Cam was or who found him, but help got to him quickly. He was airlifted to University of California Davis Medical Center, where doctors got to work. </p><p>After numerous surgeries he was stabilized, but his face was gone. At first he was in a medically-induced coma, then very heavily drugged for just over a month. </p><p>Finally, in August 2016, he was lucid enough to understand what had happened, and to see his face for the first time.</p><p>'When I woke up, I didn't know what was going on, where I was, what had happened to me,' he said - adding, painfully: 'I was shocked that I would actually do something like that, and that I had survived.'  </p><p>Cam stayed in the hospital until December 2016. Once he was discharged, he wore a mask all the time.  </p><p>For Will's mother Sally (right), Cam (left) is the one thing that helped her worked through her grief</p><p>She got in touch, and in March 2017 Dr Eduardo Rodriguez took him on, starting the lengthy procedure to get Cam enrolled, including physical screening, psychiatric screening and counseling, and getting him on the transplant list.</p><p>Finally, in January this year, he got the bitter-sweet call all transplant hopefuls yearn for: they had a candidate. </p><p>Will Fisher, 23, had died in New York City, and he was a registered organ donor. </p><p>His mother Sally was consulted as doctors found he would be able to transform multiple lives with his heart, liver, kidneys, eyes - and, of course, his face. </p><p>Will, described by his family as wise beyond his years, was just a bit younger than Cam when he died. He had the same skin tone, skull size, hair color, a full set of teeth and the same blood type.  </p><p>Cam says he knew it was a life-threatening procedure but he never saw it as a choice - it was his only option to reclaim his life. </p><p>For Will's mother Sally, Cam is the one thing that helped her worked through her grief. </p><p>She told People: 'I don't think I would have survived Will's death if it wasn't for Cameron. Cameron's got his whole life ahead of him — and I love the idea that Willie's helping him have a better life.'</p><p>Face transplants became possible in 2005, when French surgeons performed a partial one on Isabelle Dinoire, who had been attacked by a dog.</p><p>That same year, Cleveland Clinic proved it was possible, and got licensed to perform the procedure.</p><p>In December 2008, they did so, performing a near-total face transplant on Connie Culp who had been shot in the face by her husband years prior.</p><p>The operation took 22 hours. It was the first in the world that also involved bone and nerve reconstruction.</p><p>Now 54, Connie can smile, talk, a speak understandably.</p><p>James Maki was 59 when he received a partial face transplant, after being electrocuted by railway tracks when he fell in a Boston station in 2005.</p><p>Now 67, he can make facial expression and eat crunchy food thanks to new dentures.</p><p>Dallas Wiens lost most of his face to burns after his head hit a power line while he painted his church.</p><p>His full face transplant took 15 hours, restoring his eyes, nose and mouth.</p><p>Mitch Hunter lost most of his face to an electric shock in a car crash in 2001.</p><p>His partial face transplant operation took 14 hours.</p><p>He can now feel his entire face, and is speaking better and better.</p><p>Charla Nash lost her nose, eyelids, lips and hands in 2009 when she got attacked by a chimpanzee that belonged to a friend.</p><p>Richard Norris accidentally shot himself in the face at the age of 22 in 1997.</p><p>His operation lasted 36 hours, and was the most extensive to date.</p><p>Andy Sandness tried to take his own life with a rifle two days before Christmas in 2006. </p><p>He survived, and was put on the path to getting a transplant. </p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 15, 2018
  • Big babies are almost THREE TIMES more likely to be obese when they start school 

    Big babies are almost THREE TIMES more likely to be obese when they start school 

    as children, research suggests.</p><p>Newborns who weigh more than 8.8lbs (4kg) and whose mothers had diabetes while they were pregnant face the highest risk.</p><p>They are 2.79 times more likely to be obese or overweight by the time they start school than babies born weighing a normal amount.</p><p>Infants are more likely to be born heavy if their mothers are overweight or if they piled on the pounds during pregnancy.</p><p>Experts say this can lead to babies becoming obese in later life if they inherit their mothers' genes for the condition or if they pick up on her unhealthy eating habits.</p><p>Big babies are almost three times more likely to be obese as children (stock)</p><p>Researchers from the University of Alberta analysed 81,226 pre-school children born between January 2005 and August 2013 in the Canadian province.</p><p>The youngsters were put into groups according to their height, weight, size at birth and whether their mothers had diabetes while pregnant. </p><p>This was then linked back to their birth-registry data, as well as their mothers' hospitalisation records during pregnancy.  </p><p>By the time they started school, 21 per cent of those born a healthy weight and to mothers without diabetes were overweight or obese.</p><p>This is compared to 43 per cent of the newborns who were heavy at birth and whose mothers suffered from gestational diabetes. </p><p>Taking in too many calories during pregnancy means more go to the developing foetus, causing it to grow more than it should.</p><p>The researchers, led by Dr Padma Kaul, took into account both type 1 and type 2 diabetes, with the link to childhood obesity being stronger for mothers with type 2.</p><p>Being 'large for gestational age' (LGA) - born heavier than the 90th percentile - raises a baby's risk of childhood obesity by 39 per cent alone, the study found.</p><p>Percentiles compare youngsters to others their same age. For example, if a three-month-old is in the 40th percentile for weight, that means that 40 per cent of three-month-olds weigh the same or less than that baby.  </p><p>Even if a baby is born a normal size, the study found they are 16 per cent more likely to be obese if their mother had gestational diabetes and 15 per cent more at risk if she had diabetes before becoming pregnant.</p><p>But breastfeeding in the first five months of a newborn's life reduces a baby's risk of carrying too much weight as a child by around 25 per cent.</p><p>This benefit does not apply, however, to LGA babies born to mothers with diabetes.</p><p>The study was published in the journal Diabetologia. </p><p>The scientists stress being LGA may be modifiable by controlling a woman's weight gain and blood-glucose levels during pregnancy.</p><p>'We hope that these findings will reinforce public health campaigns advising women who are planning to get pregnant,' the authors wrote.</p><p>'Just like smoking, alcohol consumption and other lifestyle choices, their weight prior to getting pregnant, and weight gain and blood sugar control during pregnancy, may have a significant impact on the future health of their children.' </p><p>In the US, nearly one in five school-age children have obesity, while as many as one in five in the UK enter education with the condition.</p><p>Among children, research suggests that 70 per cent of obese youngsters have high blood pressure or raised cholesterol, which puts them at risk of heart disease.</p><p>Obese children are also significantly more likely to become obese adults. And if children are overweight, their obesity in adulthood is often more severe.  </p><p>This comes after research released earlier this month found obese children are less likely to 'flourish' at school.</p><p>Youngsters carrying dangerous amounts of weight fail to meet the five markers of flourishing compared to those who are a healthy size or overweight, according to a study by Brown University.</p><p>These markers include not finishing their homework, having a disinterest in how well they do in school and failing to complete tasks they have started. </p><p>Obesity is defined as an adult having a BMI of 30 or over.</p><p>A healthy person's BMI - calculated by dividing weight in kg by height in metres, and the answer by the height again - is between 18.5 and 24.9. </p><p>Among children, obesity is defined as being in the 95th percentile.</p><p>Percentiles compare youngsters to others their same age. </p><p>For example, if a three-month-old is in the 40th percentile for weight, that means that 40 per cent of three-month-olds weigh the same or less than that baby.</p><p>Around 58 per cent of women and 68 per cent of men in the UK are overweight or obese. </p><p>The condition costs the NHS around £6.1billion, out of its approximate £124.7 billion budget, every year.</p><p>This is due to obesity increasing a person's risk of a number of life-threatening conditions.</p><p>Such conditions include type 2 diabetes, which can cause kidney disease, blindness and even limb amputations.</p><p>Research suggests that at least one in six hospital beds in the UK are taken up by a diabetes patient.</p><p>Obesity also raises the risk of heart disease, which kills 315,000 people every year in the UK - making it the number one cause of death.</p><p>Carrying dangerous amounts of weight has also been linked to 12 different cancers. </p><p>This includes breast, which affects one in eight women at some point in their lives.</p><p>Among children, research suggests that 70 per cent of obese youngsters have high blood pressure or raised cholesterol, which puts them at risk of heart disease.</p><p>Obese children are also significantly more likely to become obese adults. </p><p>And if children are overweight, their obesity in adulthood is often more severe.  </p><p>As many as one in five children start school in the UK being overweight or obese, which rises to one in three by the time they turn 10.  </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 14, 2018
  • Gruesome footage shows cotton bud being removed from ear after becoming lodged 'for days'' 

    Gruesome footage shows cotton bud being removed from ear after becoming lodged 'for days'' 

    a patient’s ear after becoming lodged for several days.</p><p>Neel Raithatha, who runs a private audiology clinic in Leicestershire, captured the revolting moment he removed the object.</p><p>The unnamed patient was struggling to hear properly and was suffering from an earache before seeking medical help. </p><p>Grim: Anonymous patient presented themselves suffering hearing loss and earache - after the the tip of a cotton bud became stuck and compromised the eardrum  </p><p>Mr Raithatha discovered the wool had detached from the stick upon removing it from their ear, thought to be behind their symptoms. </p><p>Commenting on the bizarre case, Mr Raithatha said: 'The client attempted to self-clean their ear using a cotton bud. </p><p>'They felt they were not hearing too well and believed the cause to be impacted earwax.</p><p>'This is not recommended as the cotton bud, itself, can further push in and impact any earwax present.</p><p>'The cotton wool was quite deep in the external auditory canal (ear canal) by using crocodile forceps, I gently prized it out.</p><p>'It took about a minute, but it was a delicate procedure given the cotton bud was deep in the ear canal.'</p><p>The audiologist has previously removed a pen cap, earrings, twenty-two wax filters and an unidentified plastic object from an ear canal.</p><p>In November last year, the National Institute for Health and Care Excellence (Nice) stressed that cotton buds should not be used to clean ears. </p><p>Obstruction: The foreign mass can be seen blocking the canal prior to its careful extraction  </p><p>Did you know? In November 2017, the National Institute for Health and Care Excellence (Nice) stressed that cotton buds should not be used to clean ears</p><p>Clear: The patient's hearing was fully-restored after the product was removed in full  </p><p>It admitted there is a ‘lack of evidence’ on the risks associated with using cotton buds but that they present a ‘potential hazard’ when used by patients to remove wax themselves.</p><p>Katherine Harrop-Griffiths, consultant in audiovestibular medicine and chairman of the guideline committee, said: ‘The general advice given is not to insert anything into the ear canal as it is self-cleaning.</p><p>'The only cleaning needed is to gently wipe the conch of the external ear with a damp flannel over a finger.</p><p>‘Ear irrigation is an effective method of removing earwax.' </p><p>Earwax usually falls out on its own but, in some cases, it can become blocked.</p><p>It cannot be prevented as the wax is there to protect ears from water, dirt germs, infection and foreign bodies. </p><p>Symptoms include earache, difficulty hearing, itchiness, dizziness, an ear infection and tinnitus.</p><p>You can try using over-the-counter wax softening drops or warm water to irrigate your ears.</p><p>If this doesn't work, seek professional medical help in case of infection.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday &amp; Metro Media Group</p>

    1 November 14, 2018
  • Doctors: Grief as My Guide: How My Sister Made Me a Better Doctor

    Doctors: Grief as My Guide: How My Sister Made Me a Better Doctor

    tting before me and in the way I was newly able to comfort and reassure her.</p><p>The razor had a familiar thrum. Only this time, I wasn’t the one doing the shaving. I was watching as my sister’s remaining hair fell away.</p><p>She was putting on a brave face, joking with the hairdresser. Her defiant look said: “Leukemia’s not going to get me.” But in her eyes, I also saw terror. I wanted to rescue her, but there was nothing I could do.</p><p>Eighteen months younger than me, Victoria had always been there, someone I took for granted. When we played as children, she tried to keep up, to convince me she was cool and worthy of attention. We had weathered much together: a move to London, our parents’ divorce, a health crisis of my own. She always had my back. But with college, marriages, moves across the country, kids of our own, we grew apart. She became an actress; I became a neurosurgeon.</p><p>Was our relationship still relevant? Victoria had pushed many visitors away, but invited me to fly out from North Carolina to spend a week at her bedside at City of Hope, the cancer hospital outside Los Angeles where she was being treated. As I entered her hospital room for the first time, I was afraid I would disappoint her.</p><p>I was in a strange city, in an unknown place, asking for directions and permission to enter restricted areas. I had to scrub my hands, glove and gown to enter her room, a ritual I perform many times in the course of a busy workday but one that felt foreign and awkward in this new context.</p><p>But Victoria and I grinned at each other through our masks, and her eyes twinkled with the pleasure of a long-anticipated reunion. The years of distance vanished. She gave me courage, which was strange, because I thought I was there to give her courage. While we spoke about the medical facts of her illness during that glorious first week, mostly we chatted, sharing memories of our childhood, played Yahtzee and Scrabble, watched movies contending for Oscars and laughed.</p><p>I stayed each day by her bedside, leaving only to eat and take walks around the hospital’s gardens while she rested, then spent the afternoon and evenings with her as well. I came back for another week after her bone marrow transplant to be with her while she recovered, fighting through fevers, chills, vomiting and diarrhea, seemingly endless tests and intravenous treatments. She was fearless as she prepared for the transplant, enduring full-body radiation and powerful chemotherapy given to kill off her marrow in preparation for an infusion of stem cells (from her son, Nick, who became her donor). </p><p>Each day they weighed her and, despite eating nothing at all, she was gaining, rather than losing, weight. She was furious: She had hoped at least she would be thinner after all she was going through.</p><p>I felt my sister’s frustration and anguish as we waited hours for doctors and consultants to come by and answer our questions. Stripped of my physician status, I was aware of the consuming and unrelenting fear that patients carry with them and cannot shake. I was no longer the doctor dropping in on rounds, calling the shots.</p><p>While Victoria wouldn’t discuss her mortality with anyone (that was off the table), she resolved herself to conquer whatever the medical team asked of her. Each day she walked further, sat in a chair longer, tried to eat when she could keep things down. The housekeepers stopped by to talk with Victoria every morning. She knew their names, and the names of their children. José spoke of his son’s difficulties with school. Victoria listened and made suggestions. She knew the nurses’ names and concerns as well; how long their commutes were, how they tried to balance the personal and professional demands in their lives.</p><p>Over time, Victoria became increasingly grateful for the kindness and compassion of others, whether it came from her husband, Pat, who stayed with her each day (my visits provided necessary respite for him); or from her sons, Nick and Will, whose faces beamed at her from large poster-size photos they had placed in her room; or from the friends who looked after her family, feeding them every day for the eight-plus months of her continuous hospitalization.</p><p>Sitting with Victoria allowed me to reconnect with a part of myself I had been suppressing for years. Her courage rubbed off on me. Blood test results set the expectations for each new day. A higher white blood count would allow Victoria the freedom to step from her room into the hallway to take a few steps around her unit, albeit with a thick filtration mask covering her mouth and nose. If her counts were low, she would sit confined to her room, often for days on end, gazing longingly through a sealed window at people six stories below walking the garden paths and at the trees swaying in the breeze.</p><p>I went to City of Hope to support my sister, and what I found there was gratitude: appreciation for others; reveling in small pleasures we usually take for granted, like a hot shower, sunlight, a walk outdoors.</p><p>Victoria’s gift was a tangible lesson, something I have been able to carry with me. Now I approach patients differently than I did before her illness. </p><p>Recently, I met Meghan White, a 34-year-old woman with breast cancer that had metastasized to her brain. I was initially hesitant and fearful as I entered the examining room to see her one afternoon after a long day in clinic. She was going to need me to surgically place a reservoir into her brain to deliver chemotherapy. My colleagues and I also planned to perform focused radiation treatments to two tumors in her brain that were growing quickly. Meghan sat bald and proudly beautiful in my examining room, her mother there to support her. </p><p>Previously, I would have thought nothing of her shaved head, but now I understood Meghan had a story to tell. As they were with Victoria, the odds were long against her.</p><p>Meghan was a fourth-grade teacher and wanted to put off her surgery until her students completed their year-end assessments late the following week. I agreed that it was a milestone she shouldn’t miss and said we could work around her schedule. I held her hand. Her mother, eyes brimming with tears, asked me to take care of her baby. I assured her I would.</p><p>As I left the room, Meghan thanked me and said this was the first doctor’s appointment she had had in a long time where she didn’t cry. I never used to cry when speaking with patients. I would gird myself, push forward, distract myself with new and pressing problems to fix; I focused on technical, rather than human, matters. Now, I told Meghan that I would cry for us both. My sister was present in that room, in the patient sitting before me and in the way I was newly able to comfort and reassure her.</p><p>With Victoria, as with Meghan, my immediate reaction to her diagnosis had been fear and a desire to run (or at least to hide from the depths of my feelings while still being physically present). But in witnessing Victoria’s fearlessness, and later her gratitude, I found courage. My sister showed me how to become a better brother and, at the same time, a better doctor.</p>

    1 November 14, 2018

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