ABCDE HEALTH SCIENCE tuesday, august 3, 2010 &
URBAN JUNGLE
Thriving ivy Modern conditions are great for this poisonous pest. E6
INSURING YOUR HEALTH
Most doctor-rating systems are rudimentary — and may not be reliable. E4
A DOCTOR’S SHAME
Admission of error A mistake may not be fatal, but it can torpedo a doctor’s sense of self. E4
100%
of food vendors at Verizon Center were cited for food-handling violations in 2009. The Checkup, E2
REPORTS
‘Each tooth has a story’
Free dental care draws thousands to outdoor clinic in rural Virginia
by Mary Otto in wise, va.
On a weekend in late July, at the free annual open-air health clinic held here in this Appalachian com- munity, a total of 2,643 teeth were ex- tracted. Each one bore mute and per- sonal testimony to the isolation of this rural place, and the defeats and losses of its people. “Each tooth has a story,” said den-
PHOTOS BY MICHAEL S. WILLIAMSON/THE WASHINGTON POST
As volunteers treat Terri Magee of Kingston, Tenn., her granddaughter Haley holds her hand and watches. Top, Brian Johnson came to the clinic hoping to get some of his teeth repaired, but he conceded that many of them might have to be pulled. In all, 2,643 teeth were extracted during the weekend.
tist Terry Dickinson quietly. He was standing just outside the huge tent at the county fairgrounds where more than 50 folding dental chairs were filled with patients and hundreds more people waited in the sweltering heat for care. The massive national health-care overhaul signed into law earlier this year included some gestures toward broadening access to dental care for children. But it contained scant men- tion of the broken dental care system for their poor elders. “You still have this big huge hole for adults,” said Dickinson, who runs the state dental association in Rich- mond and oversees the dental volun- teers. “You see it here.” This was the 11th year for the free Wise clinic, led by the Knoxville- based medical relief organization known as Remote Area Medical. RAM specializes in getting care to isolated, impoverished and ravaged places. But after parachuting into disaster zones around the world, RAM’s founder, adventurer Stan Brock, real- ized some of the deepest need lay in Knoxville’s own back yard. So each year an army of volunteer health-care providers from many medical special-
clinic continued on E5 E DM VA
Added risks CONSUMER
Americans love supplements, but here are 12 to avoid. E2
To get to the top, don’t worry, but don’t hurry
Guidelines suggest ways to minimize the risk of high-altitude sickness
by Rita Zeidner
Special to The Washington Post While planning my dream vacation
—a seven-day, 60-mile round-trip hike to the top of Mount Kilimanjaro — I couldn’t help but wonder how my body would hold up under African skies. It wasn’t the warnings about contam- inated water or disease-carrying mos- quitoes in Tanzania that concerned me most. It was the oxygen — or, more pre- cisely, the lack of it. I’m not usually a worrier. But my concerns about high-altitude illness — particularly its most severe forms, cer- ebral and pulmonary edema, poten- tially fatal conditions in which over- stressed organs fill with fluid — loomed large.
Kili is the highest freestanding mountain in the world, towering over Africa at nearly 20,000 feet above sea level. And my experience above 9,000
feet was dicey: There had been times when I’d been forced to spend far more time in my hotel room than I liked, gasping for every breath and sleeping off the annoying, hangover-like symp- toms of acute mountain sickness (AMS), including headache, nausea and debilitating exhaustion. I also worried about the safety of my companion, Harold. He is an experi- enced hiker who had never suffered more than a mild headache on moun- tain excursions, including two treks in the Himalayas. But those trips took place decades ago. Now he was push- ing 72; I wondered if his risk had climbed. Physician David Shlim, a travel med-
icine expert and one of the editors of the Centers for Disease Control and Prevention’s “Health Information for International Travel” books, wasn’t ex- actly reassuring when he mentioned offhandedly during a phone interview that research he had done in Nepal in the 1980s showed a higher death rate among trekkers on organized hikes than among independent hikers. This is probably due to real or perceived
altitude continued on E6 MICHAEL GLENWOOD FOR THE WASHINGTON POST
Shaking the hand of what’s bedeviling them
follow psychologist on trek to confront their fears
by Dana Scarton Special to The Washington Post Eleven-year-old Christian Low was
first in line for the bathroom exercise. Following a protocol demonstrated moments earlier, the Colorado youth pressed his bare hands against the rim of a urinal, licked each palm, then reached out to accept a Tic Tac. Before popping the mint into his mouth, Chris- tian added a move of his own: He dropped it onto the tile floor and stomped on it. The ad lib elicited gasps, congratulatory pats on the back, and ap- plause from onlookers crammed into the men’s room on a lower level of the Hyatt Regency Crystal City. As the others took their turn at the bi- zarre ritual, Christian leaned on a wall outside, seeming pleased if perhaps a bit queasy. “I wanted to challenge my- self,” he said. Christian later told his fa- ther, Kern Low, that he would no longer
XIAOMEI CHEN/THE WASHINGTON POST
A piece of gum plucked from a trash can was among the squirm-inducing finds on the “Virtual Camping” tour.
struggle with paralyzing fears of con- tamination associated with public rest- rooms, a problem that had interfered with family outings for the past three years. Facing fears was the evening’s objec- tive for Christian and about 150 other people dealing with obsessive-compul- sive disorder (OCD). Led by psychol- ogist Jonathan Grayson, they were go-
ocd continued on E4 Obsessive-compulsives
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