HAWAII MEDICAL JOURNAL I
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HAWAII MEDICAL JOURNAL April 1999 Volume 58, No. 4 ISSN: 0017-8594 1 P i I \ti call titat What would it cost to have Hawaii’s leading business executives, community leaders, labor representatives, doctors and clergy run your business? Ask HMSA. For more than 60 years, Hawaii’s leading health plan has been led by a volunteer board of directors made up of some of the most distin guished people in our community. That’s right—volunteer. Our direc tors are committed to improving the health and well-being of Hawaii’s people and they accept no compensation for their hard work. ITMSA, Now that’s a health plan. HMSA rid HAWAII Contents MEDICAL Editorial JOURNAL Norman Goldstein MD 76 (USPS 237-640) Special Contribution A.A. Smyser 76 Published monthly by the Hawaii Medical Association Incorporated in 1856 under the Monarchy Special Contribution 1360 South Beretania, Second Floor 77 Honolulu, Hawaii 96814 John A. Sheedy MD Phone (808) 536-7702; Fax (808) 528-2376 Letter to the Editor Editors HeritaA. YuIoMD 79 Editor: Norman Goldstein MD News Editor: Henry N. Yokoyama MD Contributing Editor: Russell T. Stodd MD Medical School Hotline Andrew W. Nichols MD 81 Editorial Board Vincent S. Aoki MD. Benjamin W. Berg MD, A Novel Treatment of Patients with Chronic Hepatitis C John Breinich MLS. Satoru Izutsu PhD. Naolcv CS. Tsai MD, Neil Shimoda MD, Linda Wong MD, Stanley Shimoda MD, James Lumeng MD, Douglas G. Massey MD, Kimberly Goad RN, Herbert Yee, Miles Chen 85 Myron E. Shirasu MD. Frank L. Tabrab MD, Alfred D. Morris MD Liver Transplantation h Hawaii: The initial five years Journal Staff Linda L. Wong MD, Alan H.S. cheung MD, Whitney M. Limm MD, Naoky Tsai MD, Managing Editor: Becky Kendro Neal Shimoda MD, Kinzberlv Goad RN 90 Editorial Assistant: Drake Chinen Use of Complementary and Alternative Medicine in Hawaii Cancer Patients Officers (Reprinted from March 1999 issue. Hawaii Medical Journal pg.49-51 & 54-55) President: Patricia L. Chinn MD carolyn c. Gotay PhD, Wendy tiara BA, Brian Isseli MD, Lumeng MD President-Elect: James Gertrared Masarinec MD, PhD 94 Secretary: Philip Hellreich MD Treasurer: Charles R. Kelley MD Past President: Leonard R. Howard MD Doctor’s Day 100 County Presidents Hawaii: Timothy Oldfather MD Honolulu: Cedric K. Akau MD News and Notes Maui: Michael Savona MD Henry N. YokoyamaMD 102 West Hawaii: Ali Bairos MD Kauai: Patrick Am MD Classified Notices 104 Advertising Representative Roth Communications Drive 2040 Alewa Weathervane Honolulu, Hawaii 96817 106 Phone (808) 595-4124 Russell T. Stodd MD Fax (808) 595-5087 1- The Journal cannot be held responsible for opinions expressed in papers, discussion, communications or advertisements. The ad vertising policy of the Hawaii Medical Journal is governed by the Cover art and descriptive text by Dietrich Varez, Volcano, the American Medical Associa rules of the Council on Drugs of artist. tion. The right is reserved to reject material submitted foreditorial Hawaii. All rights reserved by the or advertising columns. The Hawaii Medical Journal (USPS 237640) is published monthlyby the Hawaii Medical Association (ISSN 0017-8594), 1360 South Beretania Street, Second Floor, Honolulu, Hawaii 96814. Coronation Pavilion Postmaster: Send address changes to the Hasvaii Medical Journal. 1360 South Beretania Street, Second Floor. Honolulu. Hawaii 968)4. Periodical postage paid at Honolulu. Hawaii. Also used as a bandstand, the Coronation Pavilion was where King Kalakaua Nonmember subscriptions are 825. Copyright 1998 by the was crowned. Hawaii Medical Association. Printed in the US. HAWAW MEDICAL JOURNAL, VOL 55. APRIL 1999 75 reported in our Special Issue on Organ Transplantation five years ago by Dr. Wong and 2They Editorial associates. herein report on a total of 21 transplants, 20 currently alive.3 Mahalo to Hawaii’s pioneers in medicine and surgery, Naoky, Linda and their associates. Norman Goldstein MD Editor References 1. Tsai, NCS. et al ‘A Novel Treatment of Patients with Chronic Hepatitis C’ WORDS, WORDS, WORDS 2. Wong, LL. et al “Liver Transplantation in Hawaii” Hawaii Medical Journal 1994; 53(3):86.89 3. Wong, LL. et al “Liver Transplantation in Hawaii: The Initial Five Years” At the time Hamlet was written, Shakespeare had 20,000 words available to express all through the English language. When Presi dent Lincoln made his famous, concise Gettysburg address, there were 114,000 English words from which to choose. Today we can find 600,000 words defined in Webster’s Dictionary. When we add medical terminology and accepted words from other languages, our Special Contribution options have expanded forty fold since Shakespeare’s time. D The late Dr. Harry L. Arnold, HMJ Editor for 41 years, was expert at using proper vocabulary. Some of my fondest controversial Demanding Compliance with Living Wills medical discussions appeared in print between Harry and the late From the Honolulu Star-Bulletin, February 23, 1999 NYU Professor of Dermatology, Dr. Morris Leider. It was Morris who called me the Semitic Semanticist (considered an honor, A.A. Smyser coming from him). Contributing Editor, Honolulu Star-Bulletin To communicate effectively, we often simplify our spoken lan guage through idioms and contractions. So, instead of saying, “It is not efficacious to indoctrinate a superannuated canine with innova Bill Perry’s wife Pat, aged 88, as he is, looked up from a gurney tive maneuvers”, we remark, “You can’t teach an old dog new at Queen s Hospital Emergency Room and told him, “I’m in horrible tricks.” American shorthand speech reduces the phrase, “we need to pain. Let me die.” dimensionalize this management initiative” to “Let’s make a plan”. In the dark of the morning soon after 5 a.m. on Dec. 31 she had Simply put, let’s make a plan to: been hit by a car while going to get the morning newspaper out of 1. Keep sentences short their mailbox in the Kahaluu area. He is a late sleeper and didn’t 2. Pick simple words over complex ones know about it until a neighbor woke him with the news. 3. Choose familiar words instead of obscure ones She was still on the street being tended by paramedics who came 4. Avoid unnecessary words promptly. Perry followed the ambulance in his car. On the subject of 5. Put action in our verbs death, Pat and Bill understood each other. They had plans for killing 6. Write the way we talk themselves when it seemed appropriate. 7. Use terminology that our patients can picture Bill knew his wife meant it when she asked to be allowed to die. 8. Tie in with our patients’ experience He was able to get her living will faxed to the emergency room from 9. Make full use of a variety of words Kaiser Koolau Clinic. A final paragraph gave him power of attorney 10. Write and speak to express, not impress’ to act for her. 1 Trout, J and Rivkin, S. The Power of Simplicity, Mcgraw.Hill Inc. and Audiotech Business Book Summaries 1999. He said he told the emergency personnel to get her out of pain or let her die. They said she wasn’t terminal and that pain medication had to be withheld until they learned whether there was internal Hepatitis C - Molecular Treatments and bleeding. Liver Transplantation Then he did what he says he wouldn’t do now - signed a form allowing surgery on her broken leg with bones protruding through The well designed study by Naoky C.S. Tsai, MD and Associates, the skin in order to get her pain relief. “A Novel Treatment of Patients with Chronic Hepatitis C” is an Next time he saw her was in intensive care - unconscious and example of the future of medicine. Recombinant human Granulo hooked up to an array of tubes and piping intended for life-saving cyte Macrophage Colony-Stimulating-Factor will undoubtedly be efforts neither he nor she wanted. used for other infections and conditions in the near future. As was When he asked to have the tubes disconnected he was told by a evidenced at the recent “Genetics and Molecular Biology - From physician that would be euthanasia or murder. Discovery to Practice” seminar sponsored by the Queen’s Medical The physician said it wasn’t possible. even though Perry had his Center and the Ohio State University (Feb. 22-24, 1999). the age of wife’s living will and power of attorney and requested it. Even Molecular Biology is here now, and physicians must keep up with though friends at a hospital family conference, including their this exciting new field of medicine. minister, supported his request. Even though their son, newly Hepatitis C was the main reason for the liver transplantations in arrived from the mainland, supported it. Linda L. Wong MD ci’ al review. Hawaii’s first liver transplant was Finally after a second family conference following the arrival of HAWAII MEDICAL JOURNAL. VOL 58, APRIL 1999 76 their daughter from the East Coast, the physician assented to see if Hawaii Revised Statutes (Section 291.54). Similar provisions have Patricia Perry could breathe on her own without a respirator. This also been enacted throughout the United States and reciprocity was Jan. 6, and she could. But the next day she died. exists between states. Bill, who had been willing to let her bleed to death a week earlier, Handicapped is defined as having a medical condition that limits got a bill for 18 pints of blood instead. mobility to 200 feet without stopping to rest due to an arthritic, Bill now is on a crusade. He is outraged. He told his story at a state neurological, or orthopedic disorder.