All the Things Working


“Everything’s amazing and nobody’s happy.” – Louis CK

We speak so often about all the things that need to be “disrupted” in the healthcare system in order for it to work more efficiently. It’s true, there are vast and critical areas that need improvement. EMRs, insurance, billing, communication, design, transparency, research methodologies, patient-clinician collaboration, pharmaceuticals, patient adherence and engagement, big data: higher quality care for more people at lower cost.

Less appreciated, or at least less noted, are the advancements in medical science and research that propel everything forward. I’m certainly guilty of narrowing my focus on the things wrong with the system. And sure, despite the amazingness of it all there still exist problems, mistakes, and there is room for improvement.

Yes, yes. But let’s look at it from a different angle, just for a moment, to appreciate how far we’ve come.

Personal story: my father-in-law, Phil, is a retired Physicians Assistant of 30 years at New York State Correctional System and was diagnosed with idiopathic pulmonary fibrosis (IPF), a chronic and ultimately fatal disease characterized by a progressive decline in lung function. A typical prognosis is two to five years. Phil, however, has lived with IPF for over twelve years, experiencing some years without any decline at all, other years with rapid reduction in lung capacity. Heart complications and drastically declined lung function landed him at the Cleveland Clinic, where high-risk surgeries are pretty common. They approved him for a single lung transplant.

His heart, also a mess, with clogged arteries and blood pooling, needed to be worked on, too. Awaiting his donor, resting in the immaculate Cleveland Clinic’s ICU, Phil was put on a life-supporting ventilator. He lost weight, was put on and taken off the donor list because of recurring infection and fever. Family flew out to say their goodbyes.

But a matching lung arrived. Surgery lasted four hours, during which he was affixed with his new lung and a coronary double bypass and maze procedure for atrial fibrillation.

There were no complications, and he was wheeled back into the ICU for recovery. Over the next few days, he was gradually brought out of sedation, tubes were removed, and he’s now breathing on his own, with his new lung.

That this surgery can even be performed, let alone on an individual in such a poor physical state, is nothing less than jaw dropping in my mind. Payment issues and long road to recovery aside, not to mention the still unknowns inherent in donor organ rejection, the intense understanding and use of technology to perform such a feat is absolutely incredible.

If we are to criticize the system that supports such success, it’s equally as important to marvel at the accomplishments we have made because of the system. We hear about success stories all the time – how a patient pulled through, how she beat her cancer, how he got a new heart, how she can walk again after nearly severing a leg in an accident, how an infant survives without complications after being born at 25 weeks. But less publicly noted is the science, the technology, and the people that enable those successes.

I’m reminded of Louis CK’s famous skit and a paraphrased favorite line about airplanes and flying:

Complaining passenger: “I had to sit on the runway for forty minutes and there are always delays…”

Louis CK: “But oh, wait. Did you fly through the air like birds? Take flight? Soar amongst the clouds? You’re flying!!”

Look at what we’ve done, and let that – not just the negative and the lack – also drive the passion to innovate.

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Susan E. Williams (@estherswilliams) explores experiments at the intersection of health care and technology, particularly around how mobile apps, games and sensory apparatus change the way we pay attention, understand, and make decisions about our bodies, emotions, and behavior. Susan received her BA in cultural anthropology from Columbia University and her MA in East Asian Culture, with an emphasis on Japan, from New York University. She is on the board of Health 2.0 Seattle, and works (and believes) in social media communications for health care and science.


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