I can’t believe it took more than two years to charge the physicians involved in the case of Anna Nicole Smith’s death. It really shocks me that it took so long for these investigators to connect the dots.

Even from the preliminary data, it is evident that prescription medication had clearly played an important role in the cause of her death.

In fact, according to an Associated Press report, investigators found 11 prescription medications in her hotel room the day she died. More than 600 pills — including about 450 muscle relaxers — were missing from prescriptions that were no more than five weeks old when she died, and most of the drugs were prescribed in the name of Howard K. Stern, her lawyer-turned-companion. And actually, none of them were prescribed in Smith’s name.

So it makes me wonder, how is it possible that it took almost two years for charges to be brought on these doctors?

If you look at the confidential fax that was sent in September of 2006 by Dr. Sandeep Kapoor, the list of medications is a “who’s who” of narcotics, sedatives and sleeping medications and there is no scientific or chemical way that all of these drugs can be tolerated by the human body. These drugs are highly addictive and mixing them is basically the equivalent of a loaded gun in the hands of a child.

There’s a whole list of drugs she was on including: Four bottles of 2 mg Dilaudid; 2 milliliter bottles of Lorazepam (Ativan); two bottles of 350 mg Soma, a total of 180 tablets; one bottle each of 30 mg Dalmane and 400 mg Prexige, the latter a British drug; and one bottle of methadone, 300 5mg tablets. All of them are classified as different types of painkillers. Click here to see the confidential fax from Dr Eroshevich to Dr. Kapoor.

And clearly evident in the story written by FOXNews.com’s Roger Freidman Friday, are statements from Smith’s psychiatrist, Dr. Khristine Eroshevich, where she pleads with Dr. Kapoor to give Smith something to knock her out.

If Dr. Eroshevich felt Anna Nicole needed to be sedated, the proper procedure would have been to put her in a hospital setting where she could be monitored and cared for in a healing environment.

At the end of the day, it comes down to the fact that all doctors take an oath to “do no harm.” So how, in keeping with that sacred oath, could any doctor prescribe these medications knowing that the outcome could be deadly?

Are we done paying for Bernie Madoff’s crimes? Not any time soon. Bernie may get at least 20 years in prison, but it seems we’re going to have to be paying for his lifestyle — although more modest behind bars — for quite some time.

According to some estimates, Bernie is going to cost taxpayers an average of $29,000 a year — and that’s not including any extra perks that his lawyers may negotiate in court.

Things may have changed since the days of Michael Milken spending a few years in “Club Fed” only to be released to his $500 million dollar fortune, but the Bernie Madoff tab is still open.

At a time when 45 million Americans are living without the benefits of health insurance, and reform is the hot topic on everyone’s lips, it’s quite disheartening to know that the only people with a constitutional right to government-funded health care are convicts. And isn’t it ironic that in the midst of an economic crisis, where many Americans are struggling to get by, that we taxpayers are once again footing the bill for those same greedy crooks who got us into this mess?

So the question is: Should Bernie Madoff have to pay for his own imprisonment? And I think the answer is yes. Now I know many of you smart lawyers out there might tell me this is a ridiculous notion, but I can’t help but think ― if I was planning my retirement, what would I want?

Well, I think I would want secluded place to spend my time, three hot meals a day, 24/7 health benefits ― including dental and vision ― and visitors that would come and see me once in a while, but would never stay long enough for me to have to kick them out. Sounds an awful lot like Bernie’s new retirement plan, doesn’t it?

So I guess I better start saving now for my retirement at the age of 70. But I wonder if all the people that he stole from, whose lives he destroyed, are going to be able to see some the benefits that American taxpayers will provide good ol’ Bernie for the rest of his miserable existence.

Today I want to comment on a news piece from the New York Post about Dr. Malcolm Lloyd, a physician who seems to be recommending daily alcohol consumption as a preventative for a variety of ailments from the common cold to Alzheimer’s and certain cancers. He also seems to be indicating that people who drink regularly in moderation seem to live longer than those who don’t. Give me a break!

I know that there have been numerous publications exploring the correlation between alcohol consumption and heart health. For example, we all know that a chemical compound found in wine called resvesterol, is a potent antioxidant that has been shown to complement the stability of a healthy heart.

However, there have been many other studies that have clearly demonstrated increased cancer rates ― especially breast cancer ― in women who consume moderate amounts of alcohol.

Now trust me, I am not, by a long shot, a person who doesn’t enjoy a good drink once in a while. And I do acknowledge that there are cultures in various parts of the world where alcohol is an integral part of the local cuisine. However, these are also the cultures where healthy servings of vital nutrients, vegetables and proteins play a key role in their daily eating habits. They tend to be more physically active, and place a lot of importance on maintaining healthy sleep patterns.

But here in the U.S., we are a “fast-food nation.” For the last 3-5 years, we’ve been hearing about how the obesity rate has reached epidemic proportions – affecting both adults and our children.

Obesity significantly raises the risk for many diseases and conditions like:
          o          Coronary heart disease

          o          Type 2 diabetes

          o          Cancers (endometrial, breast, and colon)

          o          Hypertension (high blood pressure)

          o          Dyslipidemia (high total cholesterol or high levels of triglycerides)

          o          Stroke

          o          Liver and Gallbladder disease

          o          Sleep apnea and respiratory problems

          o          Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)

          o          Gynecological problems

 
Americans also deal with high rates of depression — another disease that when coupled with the effects of alcohol can have disastrous results.

We also have to remember that alcohol has addictive properties that for some folks can completely ruin the chances of future health and longevity.

I know that everyone is looking for an excuse to justify their daily cocktail, but I find it irresponsible for one physician to give us a free pass to drink myself to “an everlasting life.”

Over the weekend, someone asked me if President Obama’s lift of the ban on federal funding for embryonic stem-cell research could lead to higher rates of abortion. At first, I was a little stunned by the question, but I began to think about all the potential problems, and ultimately my answer was “maybe.”

The reason my answer was “maybe,” is because in an unregulated world, the possibilities of science for profit become even larger. There is a gap between the expectations of many patients and the realities of what current science can offer us.

With the world entrenched in a global economic downturn, the business of science can easily take over, sometimes outweighing the medical implications. Already, years of research ― especially with umbilical cord stem cells ― have led to significant discoveries that, although seem very impressive in the laboratory, have failed to make their practical application in clinical medicine.

I hope that President Obama doesn’t rush into fully lifting the embryonic stem-cell research federal funding ban without the proper checks and balances that are necessary to keep the ethical and protective side of science always in the forefront.

I want to talk today about a recent story that caught my attention because of its tragic nature. It’s the story of a 9-year-old girl in Brazil who got pregnant with twins after she was allegedly raped by her stepfather.

When this story first came out, a lot of people asked me how it was possible for a 9-year-old girl to even get pregnant.  But the fact remains that once a female starts menstruating ― which can be as early as 8 years of age ― she is able to ovulate, and therefore, able to become pregnant.

The other question I was asked pertained the risks involved with having a pregnancy in such a young body. Now, there is very little data on pre-teen pregnancy, but there is a lot of data on teen pregnancy. And I can tell you from personal experience – these pregnancies can be quite risky.

Aside from the horrible psychological trauma that any young girl in this scenario would have to face, the physiologic changes that occur in a young person carrying a pregnancy could be quite dangerous to her body and to the unborn child.

Some of the risks that a pregnant 9-year-old could have include premature delivery, growth-restricted infants, uterine rupture and pelvic trauma.

Compounding the tragedy of this case, today we learned that the young girl aborted her twin pregnancy.

As I have said before in many of my blogs, children need to be protected. And adults that commit these kinds of crimes need to be severely punished.

Hey ladies! If you’re going for a dental cleaning with your friendly, neighborhood dentist, and he starts fondling your breasts, trust me, this is no medical therapy!

Yet this is the excuse that Dr. Mark Anderson has given for his actions in the felony charges that he is facing in the state of California. He is charged with 19 felony charges for skin-to-skin contact and one misdemeanor for allegedly touching a patient’s breasts over her clothing. So far, fourteen women have come forward.

The attorney for the defendant told jurors that his client massaged women’s chests as part of a medical treatment. I wonder what kind of “treatment” calls for that?!

Let’s face it ― this is just another example of negligent behavior on the part of a medical professional. It is important for patients to understand that if they feel uncomfortable during a physical examination they should speak out and ask questions.

I also truly believe that a chaperone should always be present during a physical examination so that both the patient and the doctor are protected from unsubstantiated allegations.

I’m going to be following this trial because I can’t wait to see how the defending attorney is going to prove that his client’s actions were part of a medical treatment. But you know lawyers, they will give the jury “an act with lots of flash in it, and the reaction will be passionate.”

In some cultures, as soon as a baby is born, the father whispers a message into the child’s ears. I’ve seen it done with some of the babies I’ve delivered, and while I never ask what was said, I’m sure it’s a massage of hope and love.

I don’t know if my father did anything like that when I was born, but he did make sure to tell me early on in my life, that America was the land of hope and opportunity. And I believe that it was then, and it always will be.

I know that for many people right now this seems like a difficult concept to believe in, but for some of us, today’s troubles are the challenges that will continue to make our future great.

The stresses that most Americans are experiencing right now are overwhelming. I see it in my own practice — unfortunately these days it seems even the joy of a new baby is sometimes overshadowed by the financial strain of a growing family.  I tell some of my patients that are dealing with these feelings of anxiety to reflect on their past and see how America has always been there for them.

It’s human nature to survive, and throughout history, we have seen people survive through much worse conditions than we are in today. This isn’t the first time a nation has faced hardship, and history has shown us that even at the lowest points, through two world wars, depressions, the Holocaust, famine and terrorism, just to name a few, the human spirit has prevailed. And today, we as Americans will not surrender.

As a kid, I grew up in a communist dictatorship where our survival was predicated on dealing with a black market economy. My father came to America with just a coat and $150 in his pocket. America made him a new man and allowed him to work hard and build up his family. He stopped thinking about the worst-case scenario, and focused on making an honest living.

America will never fail — just look back in our history. The world has seen many terrible things. But rather than surrendering to your worries about the present, think of the past and remember the words of Winston Churchill, who in his most desperate moments, rallied those around him, by saying “We will fight in the hills, we will never surrender.”

These are interesting times we’re in ― to say the least. Over the past couple of weeks, we have all been concentrating on “Octomom” from California, and with new developments in the story everyday, it’s easy to see why she’s been the topic of conversation. I was following the story too, calling for an ethical investigation of the fertility clinic from day one, but with the state of our economy and the country experiencing what could be one of the most pivotal moments in American history, I want to move past that story.

I think it’s time the media starts concentrating on the changes that the Obama administration will be proposing in the future and some of the ideas that have already been approved.

Now, let’s look at the facts … The American health care system needs help! Why? Well, because it is filled with inefficiencies and overpriced operational costs.

How did it get like that? Well, it’s possible the American health care system has seen a lot of the same issues as our financial sector ― which we all know by now is quite a mess. Our financial experts have given us many explanations for the current economic crisis: Many blame the banks for recklessly handing out loans and credit, some blame the public for borrowing more money than they could ever repay, then there’s all the greedy Wall Street executives making profits off back of funds that don’t even exist, and who can forget those elaborate Ponzi schemes that went unnoticed by federal agencies for years.

Well, believe it or not, we have a lot of the same things happening in health care. We have some patients that demand every test in the book on the basis of what they’ve read or seen on television, hospitals that have been enamored with demands because of technological advances and profit margins, and doctors that have concentrated on sub-specialty service, rather than primary care and prevention.

So now, we are all looking to President Obama’s stimulus bill to see how he will resolve these problems. Some of his proposed ideas are very interesting. Electronic medical records, for instance, provide us with computerized data entry on patients, a way to track symptoms, disease processes, a way to dramatically decrease the overutilization of certain tests, minimize medical mistakes both by physicians and hospitals. And down the road, it might even decrease costs.

But many critics worry about privacy issues. I totally agree that patient confidentiality should always be protected. I remember when the new HIPPA laws came into effect under President Clinton, I could not even discuss a patient’s medical condition or get a second opinion from a colleague without getting a written consent from the patient.

But I think that before we start throwing good money in to solve the problems bad money got us into, the way previous financial stimulus plans have, we need to really understand how our current health care system is working, and address the issues that got us here in the first place.

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It’s a good thing I never became a judge, because if I had, Stewart Parnell, president of Peanut Corp. of America would have been in jail by now.

The public evidence is overwhelming: He showed blatant disregard for the safety of millions of Americans, including children. He allowed contaminated peanut products to end up in our food supply.

People have died here! Where is the outrage??!! Stop the hearings, and send this guy and people like him to jail! Just this afternoon, medical examiners confirmed another salmonella-related death in Ohio, which brings the death toll up to nine people that have fallen victim to this profit-mongering filth.

Earlier today, e-mails were released as evidence where Parnell was quoted as saying he wanted to “turn the raw peanuts on our floor into money.” And this man had the audacity to respectfully decline to answer questions at his hearing on the advice of his counsel.

I believe in due process, but I also believe that there are certain circumstances that call for more immediate action.

I have three beautiful children, all school-aged, and one of them had to come home from school today because he was nauseous. Yes, this is probably your run-of-the-mill flu virus, but for a fleeting moment, I actually thought to myself, “I hope he didn’t contract salmonella.”

When anyone or anything threatens the welfare of our children, due process must change and you should be guilty until proven innocent.

CLICK HERE FOR THE LIST OF RECALLED PEANUT PRODUCTS. (You can also find the list on our Health home page next to the most up-to-date salmonella story in headlines)

Health Officials Report Salmonella-Linked Death | RECALL

Today I read a story about a woman at the center of a controversial legal battle in Italy.

Eluana Englaro had been in a vegetative state since she was in a car accident 17 years ago. The media was calling Englaro “the Terri Schiavo of Italy,” because her case was similar to woman here in the United States. (Schiavo’s husband as legal guardian, wanted his wife’s feeding tube removed, but Schiavo’s parents fought their son-in-law for years to keep the tube in place).

Englaro’s father fought the Italian courts to remove his daughter’s feeding tube, which kept his daughter alive, saying it was not his daughter’s wish to be kept alive “artificially.”

This case sparked heated debate between parts of the Italian government and the Catholic Church, who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

This case sparked heated debate between parts of the Italian government and the Catholic Church who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

Unfortunately, the woman died before any of these legal issues were resolved, and I’m sure this is a controversial debate that will rage on among contending parties for years to come.

But one of the most interesting aspects of this story has nothing to do with lawmakers and government officials at the center of the debate. Rather, it’s the way the people in the region have taken matters into their own hands, and the ever-expanding role technology is beginning to play in the public’s interpretation of the law.

Over the weekend, some Italian citizens began creating living wills on YouTube, documenting their personal wishes with regard to “do not resuscitate” (DNR) orders, designation of health care proxies and any other modifications they feel are important, in the event they are rendered incapacitated. But the irony lies in the fact that in Italy, there is no legislation on end-of-life issues and no recognition of living wills as legal documentation of a person’s wishes.

Here in the U.S., it’s quite the opposite. As physicians, a standard question that we must ask all patients upon admission to the hospital is whether or not they have a living will. If they do, we request to see a copy of it so that it can described in detail in the patient’s chart.

But I have to tell you, in the last few years since this law was mandated, I can literally count on one hand, the number of patients that have answered yes to that question. For many of us, it’s human nature to try not to think about what could go wrong, so we often don’t take the time to plan for it.

So when I look at these people taking matters into their own hands, making a short video clip detailing what they would want done in a worst-case scenario, I’m curious about how these videos will be interpreted by the law in future ethical debates, and at the end of the day, if their wishes will be honored.

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