Port in the Storm: How to Make a Medical Decision & Live to Tell About It

Port in the Storm: How to Make a Medical Decision & Live to Tell About It

by Cole A. Giller

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Overview

Port in the Storm: How to Make a Medical Decision & Live to Tell About It by Cole A. Giller

"Dr. Giller has tamed the toughest problem facing anyone with important medical problems: deciding what to do. His plan is authoritative and yet warm, incorporating specific hard-to-find advice into an uplifting and insightful look at how good decisions can be made in times of crisis. This wonderful, compassionate guide will be essential reading for anyone facing a medical decision for years to come."

- Nancy Brinker, Founder of the Susan G. Komen Breast Cancer Foundation, Dallas

Product Details

ISBN-13: 9780895261328
Publisher: Regnery Publishing
Publication date: 12/15/2003
Pages: 320
Product dimensions: 6.00(w) x 9.00(h) x 0.80(d)

Table of Contents

Prefacexiii
Acknowledgmentsxvii
Why Read This Book?xix
Part IBasics
Chapter 1The Decision Crisis3
Changes, Changes4
Medical Decisions: Not What They Used to Be4
Information Is Not Enough6
Chapter 2The Basic Nature of Medical Decisions9
You Are Not Alone9
You Are Not Yourself10
What Is a Decision?11
Why Decisions Hurt12
Decisions Are Relative13
Chapter 3Some Philosophical Principles17
Realize That You Have Decisions17
Realize That You Must Decide18
Realize That Life Is Hard19
Realize That Everything Has Risks20
Who Is as Important as What21
You Need a Captain of Your Ship22
Don't Fight Yourself24
Take Some Breaks25
Part IIThe Six Steps of Medical Decision Making
Chapter 4An Introduction to the Six Steps of Medical Decision Making29
How We Decide: The Theory30
How We Decide: A Practical Six-Step Plan31
Step 1Identification of Your Options31
Step 2Identification of Tradeoffs32
Step 3Discovery of Data33
Step 4Interpretation of Numbers34
Step 5Gathering Your Beliefs35
Step 6Contemplation of Meaning38
Chapter 5Step 1: Identification of Your Options41
Use Your Sources42
Can I Really Talk to My Doctors?42
Keep an Open Mind42
Where to Go for Your Medical Care43
How to Find and Be Seen at Outside Medical Centers45
The Small-Town Syndrome46
Whom to Choose for Your Medical Care47
Be on the Lookout48
Chapter 6Step 2: Identification of Tradeoffs49
You've Been Framed!49
How to Shift Frames51
Search for Difficult Tradeoffs53
Chapter 7Step 3: Discovery of Data55
Preparing to Search55
It's Harder Than You Think55
Reasonable Expectations56
Do Your Homework57
Make Sure It's About You58
Seek Painful Information59
All Sources Have an Agenda60
Nobody Tells It Straight61
The Sources63
Books63
Medical Books63
How to Use a Medical Textbook65
Reference Books67
A Warning67
Suggested Medical Textbooks and Reference Books68
Articles72
Medical Articles72
How to Read a Medical Article74
Practice Guidelines77
Newsletters, Newspapers, Television, and Advertisements78
The Internet81
Beware the Internet83
Tips for Internet Use84
Before We Begin: One More Word86
Suggested Medical Web Sites87
How to Search the Web for Medical Web Sites96
How to Look at a Medical Web Site98
How to Use PubMed99
Final Words101
Friends and Family101
Individuals101
Groups103
How to Benefit from Friends and Family106
Your Doctors107
A Suggested Strategy for Finding Medical Information107
Chapter 8Step 4: Interpretation of Numbers109
Building Skepticism109
Trust No One, Believe Nothing110
... But You Must Trust Your Sources111
Go Beyond Words112
It's All in How You Say It112
It's All in How You Frame It113
How Much Information Is Enough?116
What if There Aren't Any Numbers?117
Timing Isn't Everything118
The Mathematics and Statistics of Decision Making119
How to Interpret Percentages120
Pitfalls and Special Circumstances of Percentages123
The Myth of Zero Risk126
Statistics Made Easy127
How to Evaluate a Medical Test128
More Tests: Backward and Forward131
What Happens for Two Events?132
When There Are Multiple Options133
Chapter 9Step 5: Gathering Your Beliefs137
Personal Beliefs138
What Do You Believe? And Why?138
We See What We Want to See139
Judging Books by Their Covers140
Beliefs in Wishes and Control141
Beliefs in Happy Endings143
Beliefs in Medicine144
Beliefs About Moral Questions145
Challenge Your Beliefs146
Hope versus Reality148
Beliefs about Data148
Beliefs Based on Coincidence: Why We Know What Isn't So149
Coincidence versus the Scientific Method151
Beliefs Based on Small Numbers153
Beliefs Based on Bad Choices: Selection Bias155
Beliefs Based on Single Reports156
The Need for a Guide157
Beliefs About Testimonials158
Chapter 10Step 6: Contemplation of Meaning163
Sleep On It!164
The Road to Meaning165
Use Your Imagination166
Repeat It Over and Over168
Keep Notes168
The Meaning of Risk169
The Meaning of Details170
The Meaning of Inconvenience172
The Meaning of the Past174
The Meaning of Style175
Thinking the Unthinkable176
The Meaning of Faith177
Part IIIHow to Use Your Doctors
Chapter 11Ambivalence, Anger, and Acceptance181
Ambivalence181
Anger182
Do We Really Want a Vote?183
Acceptance184
Chapter 12Managing Your Doctors187
Finding Doctors187
Do I Need a Doctor?187
Second Opinions188
Small Town versus Big Center188
Practical Tips for the Appointment189
The Use of Doctors192
Use Your Doctor as a Provider193
Don't Use Your Doctor as a Friend194
Don't Use Yourself as a Doctor195
Use Your Doctor as a Doctor196
The Use of Doctors-Recap197
How to Interpret Your Doctor197
Beware Pollyanna197
Facts, Opinions, and Value Judgments199
Expect a Spectrum200
Doctors with Hammers200
Multiple Doctors and Captains201
The Myth of Informed Consent201
Chapter 13When Doctors Disagree205
Know the Issues206
Know Your Doctors206
Seek Other Opinions207
Lump Them Together208
Rejecting the Doctor's Advice208
Part IVDeciding for Others
Chapter 14Deciding for Friends and Family213
The Thoughts of Others214
Relationship Dynamics215
Chapter 15Deciding for Children217
General Thoughts: Anxiety and Trust218
When Parents Disagree219
Does the Child Get a Vote?220
Part VSpecial Problems
Chapter 16Pitfalls223
Some Decision Don'ts223
Remembering It All225
Insurance and Financial Matters228
What If Your Can't Decide?230
Chapter 17Special Decisions233
Choosing to Do Nothing233
When There Isn't Time234
Deciding About Medical Testing236
Deciding to Participate in Experimental Trials237
Deciding About Alternative Treatments239
When There's No Hope240
Part VIYou've Made Your Decision; Now What?
Chapter 18How to Know When Your Medical Decision Is Good243
Two Criteria244
Changing Your Mind245
Chapter 19The Good and Bad of Afterward247
Afterward: When Things Go Wrong247
Afterward: When Things Go Right249
Part VIIHow to Begin
Chapter 20An Example: Cancer253
Step 1Identification of Your Options254
Step 2Identification of Tradeoffs254
Step 3Discovery of Data255
Step 4Interpretation of Numbers255
Step 5Gathering Your Beliefs255
Step 6Contemplation of Meaning256
Recommended Reading259
Index261

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