And they didn't tell him he shouldn't go back to running. In James retired early to devote his life to improving patient safety. His mission: to teach people how to be empowered patients. He has created a patient bill of rights , which he's been pushing to become federal law. But for a young physician to come out and say what he did, that's pretty bold. Makary is a brave guy. James' site, Patient Safety America , lists the three levels in which patients can protect themselves.
These include being a wise consumer of health care by demanding quality, cost-effective care for yourself and those you love; by participating in patient-safety leadership through boards, panels and commissions that implement policy and laws; and by pushing for laws that favor safer care, transparency and accountability.
Ask questions. Gain as much insight as you can from your health-care provider. Ask about the benefits, side effects and disadvantages of a recommended medication or procedure. Use social media to learn more about the patient's own condition, as well as those medications and procedures for which they were prescribed. Seek a second opinion. If the situation warrants or if uncertainties exist, get a second opinion from another doctor: A good doctor will welcome confirmation of his diagnosis and resist any efforts to discourage the patient from learning more — or what Makary calls, "attempts to gag the patient.
Many doctors are reluctant to speculate, but some admit the answers range from simple ego to losing a patient to another doctor they trust more. Bring along an advocate. Sometimes it's hard to process all the information by yourself.
Bring a family member or a friend to your appointment — someone who can understand the information and suggestions given and ask questions. In some cases, she recommends a "designated medication manager" to be a safety check on the advice the care provider gives. Download an app. By having your medical information literally in the palm of your hand, you can work as a team with your doctor to cut your risk for medical errors.
Health-care apps can be simple or complex, and depending on your age and condition, you can manage your well-being, medications and more. More from Modern Medicine: Disturbing YouTube content reveals tech's dark side on young minds Scientific breakthrough may finally lead to an effective anti-obesity drug New treatment aims to prevent hair loss in cancer patients. Correction: The story has been updated to revise Dr.
personal baggage a tale of marriage medicine and murder Manual
Jennifer Lawrence is set to play Holmes. Disclosure: I was a consulting producer on the HBO project, which was partly based on an article I wrote about Theranos nearly three years ago.
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The fascination with Holmes often fixates on her extraordinary rise—her ability to convince Stanford scientists to believe her idea despite a lack of formal training; her aptitude for getting wisemen Henry Kissinger, James Mattis, George Schultz to sit on her board; and her skill for obtaining early funding from eminences such as Rupert Murdoch, the Walton family, and others. But the final days of Theranos were equally chilling. Holmes had always enjoyed a certain lifestyle. From the early days of the company, she had insisted on flying in a private jet.
They are no longer dating. Theranos paid all their legal bills, which totaled millions of dollars a month, according to both executives. By late , however, Holmes had begun to slightly rein in the spending. She agreed to give up her private-jet travel not a good look and instead downgraded to first class on commercial airlines. But given that she was flying all over the world trying to obtain more funding for Theranos, she was spending tens of thousands of dollars a month on travel. Theranos was also still paying for her mansion in Los Altos, and her team of personal assistants and drivers, who would become regular dog walkers for Balto.
The remaining employees were told they would be moving to the Theranos laboratory facility, across the bay in Newark, California.
Employees were set up on the second floor, where people would sit four to a table in the open-floor plan. Holmes took the corner office with Balto. The move may have been a last-gasp attempt to save the company, but morale at Theranos was already at an all-time low. The S. Remaining employees started to resign or were let go, almost on a daily basis, it seemed. Yet through all of this, former employees of the company have told me, Holmes had a bizarre way of acting like nothing was wrong.
Even more peculiarly, she appeared happy. She was so confident that the company would be fine, executives who worked with her said, that she enrolled Balto in a search-and-rescue program. Holmes spent weekends training him to find people in an emergency. Unfortunately, huskies are not bred for rescue; they are long-distance runners, and Balto failed out. For years, Holmes had relished in the ritual of giving speeches to the employees.
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When Balwani worked at Theranos, the speeches ended with chants. But such rhetoric was usually followed by excited cheers and roars. One day in late December , Holmes showed up at the Newark building and held an all-hands meeting. She appeared excited beyond restraint. One executive who was there told me the room was silent. Just a bristling silence.
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Months later, Holmes was charged with 11 criminal felony counts, including wire fraud and conspiracy. Theranos was essentially gutted by the spring of It shuttered in September , one year after Holmes adopted Balto. Recently, I posed a similar question to a former Theranos board member: how did the board of directors, composed of such accomplished people, not stop her. This person admitted that board members asked tough questions but were fed contrived answers. Notably, the board was stacked with dignitaries, not scientists. After the Journal broke the news that the company was being investigated, the board suggested that Holmes take the Theranos blood test and compare it with results from two other competing labs and one university lab, this person said.
Personal Baggage, A Tale of Marriage, Medicine, and Murder
If all the results were the same, Theranos could prove to regulators and the media, so went the logic, that their blood-testing products worked perfectly. Nine days after my initial diagnoses, I had a partial craniotomy and a partial resection of my temporal lobe. Both surgeries were an effort to stop the growth of my tumor. In April, I learned that not only had my tumor come back, but it was more aggressive.
Doctors gave me a prognosis of six months to live. Because my tumor is so large, doctors prescribed full brain radiation. I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone. After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.
I considered passing away in hospice care at my San Francisco Bay-area home.
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But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind. Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.
I did not want this nightmare scenario for my family, so I started researching death with dignity. It is an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live. It would enable me to use the medical practice of aid in dying: I could request and receive a prescription from a physician for medication that I could self-ingest to end my dying process if it becomes unbearable. I quickly decided that death with dignity was the best option for me and my family. We had to uproot from California to Oregon, because Oregon is one of only five states where death with dignity is authorized.
I met the criteria for death with dignity in Oregon, but establishing residency in the state to make use of the law required a monumental number of changes. I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver's license, change my voter registration and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job.
The vast majority of families do not have the flexibility, resources and time to make all these changes. I've had the medication for weeks. I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms.