16 Eylül 2016 Cuma

Dr Oz"s missed opportunity: scolding Trump for all his bad habits | Celine Gounder

On the The Dr Oz Show Thursday, Donald Trump spent only a fraction of the hour discussing his health, on his own terms. There’s still a lot that he – and, for that matter, Hillary Clinton – still haven’t told us, but a superficial, televised chat did little to change that.


Dr Mehmet Oz started off his interview by asking Trump how he stayed healthy. Oz didn’t delve much into the candidate’s diet, though Trump has bragged that he loves fast food. With a body mass index of 29.5, Trump is overweight – practically obese.


As for exercise, Trump says he golfs, but hasn’t much lately, and poked fun at President Barack Obama’s time on the green. “He could play on the PGA tour,” Trump said.


During a commercial break, Dr Oz explained that lack of sleep has been linked to weight gain, heart disease and some cancers. He went on to say that sleep helps regulate your immune system and strengthens your memories. But when Trump told Oz he doesn’t need much sleep, Oz didn’t delve into it.


An occupational hazard of running for president is all the handshaking, which exposes candidates to innumerable viruses and bacteria at a time when they’re exhausted. Trump, a self-professed germaphobe, no doubt carries his own stash of alcohol-based hand sanitizer on the road, as Obama does on the advice of his predecessor, but Oz didn’t inquire about that either.


Dr Oz then moved on to the “Review of Systems,” a long checklist of symptoms that’s usually part of the form you fill out in your doctor’s waiting room. It’s a tool doctors use to jog patients’ memories and elicit additional symptoms of concern. It was cursory, at best.


Trump’s blood pressure and labs were all in the normal range, though his blood glucose, if fasting, was concerning for prediabetes. This would have been a great opportunity for Oz to educate his audience about the links between obesity, diabetes, heart attack, stroke, kidney and liver disease and various other medical conditions. Absent from Dr Harold Bornstein’s report on Trump’s health was a complete blood count and kidney function tests, labs most doctors would order before checking liver and thyroid function tests or a testosterone level. Absent signs or symptoms of disease, it’s unclear that Trump needed some of the tests he’s had, such as the EKG, chest x-ray and echocardiogram.


As for Clinton, her blood pressure was even lower than Trump’s and both have cholesterol levels in the normal range. Clinton’s calcium score – the higher the number, the higher the risk of heart attack – was zero in contrast to Trump’s 98. In other words, her risk of a heart attack is very low while he’s at moderate risk. Clinton has had a normal breast cancer screening, but there’s no mention of her having colonoscopies. Trump’s doctor reports he last had a normal colonoscopy in 2013.


Still, neither candidate has released anything close to their complete medical records. Releasing a letter or two from one’s personal doctor, as Trump had prior to his Dr Oz appearance, doesn’t come close to releasing complete medical records. Nowhere in Bornstein’s letter about Trump’s health did he mention anything about the bone spurs that supposedly sidelined him during the Vietnam Conflict. Trump, who described sex in the 1980s as his own “personal Vietnam,” must have taken tests for sexually transmitted diseases over the years. Trump reports having been hospitalized once for an appendectomy at age 11, but we haven’t seen those records.


As for Hillary Clinton – who wasn’t involved in the Dr Oz broadcast but whose health status became part of the news cycle when she was diagnosed with pneumonia – where are the records of her healthy child visits and childhood vaccinations? Of the prenatal care, including STD tests, she received when pregnant with Chelsea? In recent years, Clinton has suffered from falls, which could all be due to exhaustion or dehydration, but could also be a sign of an abnormal heart rhythm or other heart condition. And we don’t know why she takes coumadin, a blood thinner.


And does the public need full access to a candidate’s medical records to determine if candidate is healthy enough to serve as Commander in Chief? Or is this just to satisfy our own prurient interests?


What is relevant is whether either candidate has a chronic or life-threatening medical condition that would prevent them from doing their job or would lead to their untimely death while still in office.


We all get the occasional cough or cold. Sick with intestinal flu, Former President George HW Bush famously vomited and collapsed at a state dinner given in his honor at the home of Japanese Prime Minister. It was embarrassing, but he recovered. What I want to know is what Trump’s going to do to avoid developing full-blown diabetes or having a heart attack, and how Clinton’s going to take better care of herself so she doesn’t drive herself to the point of exhaustion.


The conspiracy theories about Clinton’s health are really a demand for transparency, but neither Trump nor Clinton is offering anything close to that. Both candidates have long relationships with their personal physicians. Doctors want to help their patients and may be biased, whether consciously or not, in reporting on their health when so much is at stake.


The best way to give voters the answers they need isn’t a data dump of thousands of pages of medical records. Even then, those records may not be complete and still need to be interpreted in the context of an up-to-date interview and physical exam. Early in the campaign, candidates should submit to examination by objective third party physicians – whether they be former Surgeon Generals or the attending physician for Congress – so that they are all held to the same standards.


We need a system that respects patient privacy, even when those patients are our presidential candidates, while answering voters’ reasonable questions about a candidate’s ability to serve.



Dr Oz"s missed opportunity: scolding Trump for all his bad habits | Celine Gounder

Hiç yorum yok:

Yorum Gönder