Open Heart (57 page)

after reproductive age, and natural selection,
254

chronic: increase in the U.S.,
171
–
73
,
272
,
289
; salaries for health-care workers,
290

“conquest” of,
26
,
90
–
91
,
96
–
98
,
268
–
69

germ theory,
26
,
249

global, ethics and policy,
286
–
88

Koch's postulates on,
249
–
50

preventable, mortality rates,
286

prevention: effects of activities for,
112
,
113
,
116
,
117
,
119
; need for medical school training,
163
,
173

as punishment from God,
116
–
17

reemergence of,
26
,
90
,
102
,
255

symptoms vs. causes,
87

use of technology prior to true understanding of,
44
–
45

vs. illness,
156

dizziness,
5

DNA.
See
genetic aspects

doctor-patient relationship.
See
physicians: relationship with the patient

drug industry

economic aspects of research,
286
–
87

marketing: the concept of choice,
287
,
290
; at conventions,
37
; direct-to-consumer,
26
,
96
–
97
,
260
,
261
–
62
,
290
; life extension claims,
96
–
98
,
99

physician conflict of interest,
37
,
261
,
290

drug-resistant pathogens,
26
,
102
,
255
,
288

drugs.
See
medications

Dupuytren's contracture,
137

ebola,
255

echocardiogram

of Aaron Neugeboren,
36

of the author,
5
,
8
,
31
,
68
–
69
,
70
,
82
,
131
,
247
–
48

false positives,
33

economic aspects

average health care spending annually,
286

care for chronic conditions,
172
,
225
,
289

cost of coronary bypass,
43

fee-for-service,
293

HIV/AIDS treatment and research,
282
,
291

low- vs. high-technology treatment,
165
–
66

managed care,
292
–
93

market values and choice,
287
,
290

medical industry and physician conflict of interest,
37
,
261
,
290

medical school,
166

neonatal intensive care,
295

psychotherapy,
208

ejection fraction,
3
,
70
,
82
,
130
,
131

electrocardiogram

author's,
8
,
31
,
59
,
66
–
68
,
69
–
70
,
81
,
247
–
48

false positives,
33

procedure,
66
–
67

Ellen,
50
,
52
,
53
,
58
,
74
,
80

endocarditis,
36

end-of-life care,
163
,
289

endorphins,
155

Erasmus High School (Brokklyn, N.Y.),
11
,
12
,
72
,
185
,
229
,
238
,
300

ethical issues

access to AIDS treatment,
41
,
282
,
286

physician conflicts of interest,
37
,
261
–
62
,
290

treatment of global disease,
286
–
88

evolutionary medicine,
252
–
57
,
259
,
271
,
272

Ewald, Paul W.,
252
–
57
,
259

exercise

by the author: first few weeks after surgery,
17
,
18
,
121
,
122
; in the hospital after surgery,
14
; prior to surgery,
5
,
6
,
24
,
47
,
49
,
53
,
69
; two years after surgery,
122
–
23

importance of,
6
,
131

as risk factor for heart disease,
24
,
106

as risk factor for type 2 diabetes,
106
,
107

exercise capacity test.
See
stress test

faintness,
5

faith,
157
,
204

Fallot's tetralogy,
280

false negatives,
133

false positives,
32
–
33
,
133

family

history, of the author,
5
,
9
,
24
,
45
,
241

as predictor of recovery,
40
,
41

as a support system,
42

family medical history.
See
patient medical history

Farber, Dr. Sidney,
76

fatalism,
25

father, author's

background,
62

closeness to, after death,
61
–
63
,
144
–
45

health conditions,
5
,
57
,
61
,
247

as a parent,
62

recipe for longevity,
75

visit to,
136

fatigue, unusual,
5
,
121

fear

of AIDS,
187

author's,
48
,
50
,
53
,
63
,
66
,
144

marketing based on,
96
–
98
,
133
-
34
.
See also
cholesterol-lowering medications

role in illness,
265

fetal environment,
30

fitness, evolutionary,
253
–
54

Fleming, Alexander,
270
,
271

Flexner Report,
168
,
169

Flynn, Dr.

diagnosis,
70

echocardiogram by,
5
,
8
,
68
–
69

letter to Dr. Katz,
69

stress test appointment,
56
,
66
–
68

Friedland, Gail,
6
,
127
,
190
,
282
,
299

Friedland, Jerry

AIDS research and care: commitment to patients,
46
,
188
–
89
; future international work,
296
; in Nigeria,
179
–
84
; patients' trust in,
151
,
153
; research on adherence to medications,
41
; research on HIV transmission,
186
–
87
; in South Africa,
166
–
67
,
191
–
92
,
281
–
84
; at Yale-New Haven Hospital,
1
,
41

Black Panthers and,
189
–
90
,
192

childhood and adolescence,
11
,
12
,
185
,
196
–
97

as consultant,
42
,
79
,
80
,
84
,
136

education,
188
,
189
,
194
–
96

family,
188
,
192
–
93
,
196
–
97
,
282

friendship with the author: after author's surgery,
202
,
281
,
298
–
301
; during childhood and adolescence,
12
; like family,
124
,
126
; prior to author's surgery,
2
,
10
,
12

in Israel,
192

motivation to be an infectious disease physician,
46
,
179
–
85
,
191
,
196
,
267

personality,
46
,
187
–
88

teaching positions,
192
,
197
–
98

views: on AIDS research,
282
–
83
; on health care policy,
289
; on the human genome project,
114
–
15
; on importance of trust,
151
,
153
; on insurance companies,
88
; on medical school,
164
–
65
,
170
–
71

work hours,
2

Friedreich's ataxia,
234
,
297

friends.
See also
Friedland, Jerry; Helfant, Rich; Rudy, Arthur; Yarnell, Phil

effects of author's experience on,
25

importance of,
12
,
14
,
21
,
40
,
82
,
124
–
27
,
149
–
53
,
201
–
2
,
301

Gage, Phineas P.,
218

gastrointestinal disease,
91
,
109
,
156

“gatekeeping,”
35
,
292

genetic aspects

of aging,
98
,
117

alleles and genetic variability,
276

of cancer,
117

diseases with single causative abnormality,
250

ethical issues with testing positive,
295

of heart disease,
24
,
114
,
250
,
251
,
265

human genome,
113
–
15
,
212
,
276

of Huntington's disease,
295

of natural selection,
254

of neurological conditions,
234

paragenetics,
264
–
65

P53 system,
272
–
75

germ theory,
26
,
249

Gibbon, John,
277
–
80

Gilda's Club,
297
–
98

gingivitis,
259
,
260

Granberg, Ronald,
89

Granger, Beth,
223
–
25

HAART (highly active antiretroviral treatment),
40
–
41
,
255
,
282
–
83

Haight, Dr. Malcolm,
137
–
38
,
140
,
143
,
145
–
47
,
148

Hashim, Dr. Sabet

background,
9

postsurgery checkups with,
123
,
127

quintuple bypass surgery by,
13
,
83
–
85

trust in,
4
,
6
,
8
,
13
,
15

visit prior to surgery,
9
–
10

healing

body's ability to heal itself,
34
,
161
,
264

faith,
157

as a natural process,
149

placebo effect,
153
–
57
,
161
,
264

health care

access to,
41
,
282
,
285
–
87

policy-making,
287
–
91

universal,
175
,
289

in the U.S.
See
drug industry; managed care; medical industry

health-care workers,
166
,
290

heart

beats per minute after surgery,
127

ejection fraction,
3
,
70
,
82
,
130
,
131

pounding, prior to surgery,
60

slowing down for self-protection,
82
,
246

sound of common abnormalities,
35
–
36

heart attack

asymptomatic (silent),
25
,
28
–
29

author's possible,
67
,
68
,
70

depression following,
154

early research,
92
–
93

indication on an electrocardiogram,
67

with normal cholesterol levels,
29

risk with open-heart surgery,
44

role of arterial plaque and inflammation,
29
,
105
,
255
–
60

heart disease

asymptomatic,
24
–
25
,
28
–
29

coexistence with diabetes,
28

difficulty in diagnosis,
16
,
28

effects of prevention activities,
119

genetic aspects,
24
,
114
,
250
,
251
,
265