Rush Physician on Gun Violence: ‘We Must Do Better’

By Beth Van Opstal, MD

On Monday, Nov. 19, my daughter’s eighth birthday, I was watching my children play at the school playground, when suddenly sirens began blaring all around. Staff ushered everyone into the school, stating there was a shooting nearby, and we were going on lockdown.

For a few chaotic minutes, I lost my son in the crowd. All of us at the school were safe, but we soon learned of the tragic shooting at Mercy Hospital just a few blocks away. On this day, the innocent lives of Dr. Tamara O’Neal, an emergency medicine physician, Dayna Less, a pharmacist, and Officer Samuel Jimenez were victims of gun violence. The shooter also died.

Chicago and the entire nation grieve these losses. My husband knew Officer Jimenez from his time working as a security guard at Skokie Hospital. He tells me what an honorable and good man he was. Many of our Rush family knew the other victims personally. And while these deaths are soul wrenching, they are all too familiar. As of Nov. 24, the Chicago Tribune reports there have been 518 homicides and at least 2,710 people shot in Chicago in 2018. According to the Centers for Disease Control and Prevention, over 14,000 of the 19,000 who died from homicides in 2017 were from firearm-related deaths. Study after study shows how dramatically higher our rate of death from gun violence is compared to other developed countries. Gun violence is undoubtedly a public health crisis.

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How Lung Cancer Advances Have Changed My Life

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Jill Feldman with radiation oncologist Gaurav Marwaha, MD, left, and medical oncologist Philip Bonomi, MD.

By Jill Feldman

I have been fighting lung cancer indirectly, and now directly, for 36 years, and most of it has been an uphill battle. I lost my dad and two grandparents to lung cancer when I was 13, and then my mom and aunt, Dede, died of lung cancer when I was in my 20s. I was shocked and upset that in the 14 years between my dad being diagnosed with lung cancer and my mom being diagnosed, there was not a single advancement in lung cancer treatment, despite it being the No. 1 cancer killer. My family and I felt helpless and hopeless, and while there wasn’t any research on hereditary lung cancer, I knew our familial lung cancer wasn’t just a coincidence.

I did what I could to get educated, be an advocate for myself and my family and to help advance a cause that many were not aware of and/or not interested in. While doing so, in 2009, I was diagnosed with lung cancer at 39 years old. My kids were 6, 8, 10 and 12 — and their only association with the disease was death. They were scared, and my greatest fear was becoming a reality. I was following in my family’s footsteps, and there wasn’t any promising research that convinced me the path would change.

For many years, the only distinction doctors could make was whether a person had small cell or non-small cell lung cancer, and patients had three treatment options: surgery, radiation and chemotherapy. It wasn’t even until the 1990s that combination chemotherapy regimens were  approved. Still, there was debate whether it was even worth treating lung cancer because in many cases, the toxicity was worse than the disease, and the benefits from chemotherapy were marginal.

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A Message of Hope for Lung Cancer

Immunotherapies have changed how we treat the disease

Philip Bonomi, MD

By Philip Bonomi, MD

One of the things I learned early on in medical school is never to forget that it’s a privilege when a patient puts his or her trust in you to take care of them. I have never taken that privilege lightly. My goal has always been to prolong meaningful life and relieve suffering for my patients. That’s been my personal mission statement throughout my career.

And those goals are not always easy when it comes to treating lung cancer. When I started out in medicine, some of the treatments we tried for lung cancer were simply not effective. There were not a lot of options for our patients and often the prognosis was poor.

But through my long career, I have seen that perseverance, believing in an idea and not giving up on it can pay off.

Enter immunotherapies. When I was in medical school in the late 1960s, we had high hopes for immunotherapy. We thought it was going to be very important for treating patients with cancer. But then, we saw one failed study after another over the next few decades.

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Nurse: Alternative Medicine Failed Her Mother

Beth_StewartBy Elizabeth Stewart

My mother died two years after being diagnosed with stage 4 ovarian cancer. She had for years believed strongly in naturopathy, so after a six-month period of remission, when her cancer returned after a round of integrating complementary medicine with chemotherapy, she chose to treat her cancer solely with alternative treatments.

I am a nurse who believes in evidence-based practice and also in innovation. I accepted my mother’s decision not to use chemo when her cancer came back because I knew from researching the disease that when ovarian cancer comes back, life expectancy is similar with or without chemo.

So, despite my reluctance to trust treatments that have not been tested for safety or efficacy, I reasoned that little harm could come from alternative treatment methods at this point.

I watched as my 73-year-old mother spent the last year of her life replacing the foods she loved with concoctions of cottage cheese mixed with flaxseed oil. I listened as she justified spending thousands of dollars and hours of her precious remaining time traveling many miles to receive vitamin C infusions.

Hope for ‘miracles’

As she grew more ill, I gently questioned the supplements she was taking — often so many that there was no room left in her shrinking stomach for any food. And at times, when I could find evidence that a treatment had been scientifically tested — and proved not to be effective — I shared a strong opinion.

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Defining ‘Safe’ Alcohol Consumption

Nancy Reau, MD

Nancy Reau, MD

By Nancy Reau, MD

Statistics often feel unrelated to everyday life, however the recent BMJ report on the increasing incidence of alcohol-related liver disease in our younger population mirrors my real life experiences in clinical practice. In the last few months alone, I have seen an increase in young adults being admitted for alcohol-related liver injury.

Many of these young people struggle with depression or addiction and often use alcohol as a coping mechanism. While most recognize they’re drinking, they don’t realize how dangerous their habit has become until they present with jaundice, malnutrition and multi-organ failure. Unfortunately, what is often accompanied with the progression of liver disease, several of these young patients have died.

As both a parent and a physician, it is a challenge to care for these young patients who should have a long life ahead of them. But instead, I find myself speaking with their families about hospice and end-of-life arrangements. From my point of view, this means there is an urgent need for physicians to speak with their patients, especially those who are younger, about alcohol consumption. Alcohol is ever-present in our society, from advertising to social events, it’s around every turn. Meaning it is our responsibility to discuss what safe alcohol consumption really looks like with our patients and discuss it often.

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Rush Nurse Helps Save Girl’s Life at Lakefront

Joselyne Nicolalde1Being called a “hero” by her colleagues seems a bit strange to Joselyne Nicolalde, BSN, RN, a nurse in Rush University Medical Center’s cardiac intensive care unit.

After all, Nicolalde says she did what any one of them would have done when a teenage girl was pulled from Lake Michigan unresponsive and not breathing after a near-drowning incident. She sprang into action.

She was enjoying an afternoon at Montrose Beach with her 10-year-old son and a friend on Aug. 14 when they heard people yelling for help.

“I looked up and saw a man holding what seemed to be a lifeless girl on the shore,” she recalled. “I couldn’t believe my eyes. I had to do something.”

‘She lacked a pulse’

Nicolalde and a lifeguard were the first to reach the girl. “She lacked a pulse and was unresponsive at the time, so we immediately administered CPR. There was a return of circulation shortly thereafter. It wasn’t long before the paramedics arrived and took over.”

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Life-Saving Poison Control Centers Have Origins at Rush

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Pharmacist Louis Gdalman, 1966

By Nathalie Wheaton

When Brenna Farrell’s 18 month-old son Marty swallowed medicated diaper ointment early one morning, her husband Nick heeded the instructions on the ointment’s label and called the Brooklyn couple’s local poison control center — which assured them Marty would be fine.

Here in the Chicago area, if you or someone you know has consumed or been exposed to a toxic substance, or have questions about how to avoid such an exposure, you can get help from the Illinois Poison Control Center, one of 55 poison control centers nationwide.

Chicago is home to the oldest poison control center in the United States, because these centers have their origin in what now is Rush University Medical Center. Those origins recently were included as part of the “Poison Control” episode of Radiolab, a public radio show based in New York that airs locally on WBEZ (91.5 FM). As the archivist of Rush University Medical Center, I assisted Farrell — a Radiolab contributor —  with the episode, as I do for a wide range of patrons from both inside and outside of Rush.

Growing need

The Radiolab episode is a great occasion to look back at the role Rush, and pharmacist Louis Gdalman, played in the development of poison control centers, and to take a look at some of the records in the Rush Archives that drew Radiolab’s attention.

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