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Spring 2009 Issue

UCLA-SANTA MONICA CARE EXTENDER INTERNSHIP PROGRAM

The Beat

Health Care 2-4

Gender Identity Issues 5-6

Swine Flu 7-10

CEs of the Rotation 11

Special Thanks 12

Inside this issue:

Editorial

To all of you amazing Care Extenders,

In this newsletter you will be able to read about one Care Ex-

tender’s opinion on how to fix our healthcare system, what

another Care Extender thinks about permitting teenagers

with gender identity issues to postpone puberty, and also

some updates on the swine flu outbreak.

Finally, I want to thank you all for your continued dedication

to this program. You all are what make this program one of

the best! Second, as this is my final newsletter I would like to

thank the Care Extenders who have contributed to the news-

letters in the past and to all those who take the time to read

it! It has been a pleasure writing for all of you and I wish all of

you the best in your future endeavors.

Best,

Tracy Fong

Extension forms C-ICARE Card

Deadline: Wednesday of 2nd week Your DC will assign individual deadlines

Every CE must fill out one each rotation

Leave of Absence forms Competency Checklist

Deadline: At least one week in advance of anticipated leave. Deadline: Sunday of 4th week

Don’t forget to sign up for preferences and finish your hours. Preferences

Contact LOA Coordinator at ce_ad@hotmail.com Deadline: Sunday of 6th week

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A Care Extender’s Take on How to Fix the Longtime

Controversial Issue of Health Care...

Healthcare in the United States is a controversial issue and while many solu-

tions have been proposed, no single one has been implemented. Is there a so-

lution that has the potential to bring accessible and affordable health care to

all? Read on to find out what your fellow Care Extender, Jamie Yao, has to say

about our country’s healthcare situation and how she thinks it should be

solved.

Health care is a right, not a privilege. As the last industrialized nation without

universal health care, it’s about time we implemented one that guarantees

health care to all without regards to how rich or poor someone is. The federal

government as of now provides insurance to children, the elderly, the poor, and

veterans, yet 45 million Americans are uninsured. Several studies have proven

that whether or not someone is insured does make a difference: one-third of

the uninsured reported not being able to fill a prescription, more than half said

they postponed necessary care, and more than one-third could not follow

through on a physician’s recommendation for a test or treatment, all because of

cost (American Medical Student Association). Further, uninsured non-elderly

people are 50% less likely to receive mammograms, pap smears, cholesterol

screening, and other forms of preventative treatment. From a pragmatic stand-

point, this is a large waste of money. For example, breast tumors detected early

through mammograms are easier and less expensive to treat than if the cancer

were in its late stages. From a moral standpoint, it is also wrong. The fact that

early detection of a disease yields a higher survival rate coupled with these

study’s results illustrate that there is a significant unfairness embedded in our

Continued on next page

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Consider this situation: the government guarantees treatment to every person

who walks into emergency room doors; in fact, it is illegal to not give a patient

emergency room treatment. It would be cruel otherwise to imagine a situation

in which someone with a sudden heart attack or gunshot wound were denied

treatment simply because of their lack of insurance. This law guaranteeing

emergency room treatment sends out the message that healthcare is indeed a

right, and it makes sense. What does not make sense is the fact that emergency

room treatment is guaranteed whereas other forms of healthcare is not. The

message we are now sending is that healthcare is a right, but only to a certain

extent. Some may argue that we are not denying this healthcare; after all, it is

available, but at a price. But when you look at the statistics and see that people

are denying themselves medical care because they do not have the money to do

so, healthcare becomes a privilege. How does it make sense that refusing treat-

ment in the emergency room is illegal, when refusing treatment all other times

is not? On a pragmatic note, since the emergency room may be the only finan-

cially viable option for those who are uninsured, they may go there instead of

the doctor’s office. However, a trip to the emergency room actually costs six

times the amount of money that a trip to the doctor’s office costs.

Continued on next page

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Universal healthcare makes sense both morally and pragmatically. The big picture

is that universal healthcare saves lives; case closed. Yet opponents still find little

things to pick at, such as wrongly arguing that the government would mishandle

the health system. However, if we look at the system we have now, we see that

31% of money spent on healthcare goes to private insurance companies’ adminis-

trative and bureaucratic processes. Now if that isn’t waste, what is? Opponents

also say that under universal healthcare there will be no choice; this argument is

just plain wrong, as President Obama has specifically stated that there will be

choice. Opponents also use the term “socialized medicine” as a way to paint an

aura of negativity around it. However, universal healthcare is a method of funding

healthcare, not of providing it. After all, the physicians would not be government

employees. The government funds public education, but no one calls it

“socialized education.”

But for all this back-and-forth on the littlest details, while important when dis-cussing the logistics of a whole new system of doing things, it is important to not forget that universal healthcare would save lives. Enough said.

- Jamie Yao

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According to an article in “New Scientist”, the Endocrine Society has recently is-

sued international guidelines that offer doctors advice on how to treat teenagers

with extreme gender identity disorders. They recommend that such teenagers be

given drugs to postpone puberty. This would then allow them to have "thinking

time" to decide which gender suites them

and if they want to begin gender reassignment before the onset of body changes

related to puberty. The article states that treatment is being offered in the Neth-

erlands and, "in Canada, Australia, Germany, and a handful of clinics in the US.

However, it remains deeply controversial, with countries including the UK refus-

ing to allow medical intervention until the age of 16, by which time puberty is

usually in full swing." The controversial question is whether or not to allow teen-

agers the option to postpone puberty and if they are mature enough for making

such a life-changing choice. Read about what one of your fellow Care Extenders

has to say on this matter on the next page.

Should Teenagers with Extreme Gender

Identity Disorders be Given the Right to

Postpone Puberty by taking Drugs?

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The body works in many different ways to create a healthy human being and in-

troducing drugs into its system may stress or throw off this delicate balance. It is

not known whether these patients will eventually "orient themselves correctly"

and we'll never know if we continue to introduce new drugs into a developing

body. As all of us know, a teenager goes through a lot of changes physically AND

mentally when they reach puberty. It is not realistic to think that puberty can be

stopped for awhile and then started WITHOUT some consequences to the body.

Everyone reaches puberty at different times because their body works in its own

way. Let the body work like it is supposed to work naturally. Holding off puberty

just causes unforeseen problems in the body and should not be an acceptable

way to give patients "more thinking time". Your bodies autonomic functions

work 24/7 until the day you die. Do you think the body can just stop without

consequences when the mind decides it needs time to think about things? Not a

chance.

A transwoman with "XY" written on her

hand, at a October 2005 protest in Paris.

-Joshua Bornstein

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Recent Medical News:

THE SWINE FLU OUTBREAK

Too much hysteria?

In the last few weeks, a virus called Influenza A (H1N1) has infected nations

worldwide, creating a potential pandemic. With its start from a small village in

Mexico, this flu has managed to make its way across the border into the United

States, further up into Canada, and across oceans into Austria, China, Costa Rica,

Denmark, France, Germany, Ireland, Israel, Netherlands, New Zealand, Republic

of Korea, Spain, Switzerland, and the United Kingdom. Yet, despite its rapid

spread and the rising number of victims, many are saying that the threat the vi-

rus poses is overblown.

According to Congressman Ron Paul, a Republican from Texas, “There is too

much hysteria in the country and so far, there hasn’t been that great a danger.

It’s overblown, grossly so.” In talking about the virus, he pointed out that the

only deaths in the United States thus far was that of the 22-month-old boy in

Texas who was visiting from Mexico, a 33 year old Texas female resident, and a

man in Washington State. All other deaths (19) occurred in Mexico. Yet, despite

the low number of fatalities in the United States, many have become hysterical

about catching this new virus.

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Such an hysteria has had an unprecedented negative impact on hospitals and

particularly emergency rooms in the United States. Cathy Gichema, a nurse in

Pikesville, Maryland stated “We have people without symptoms going into the

emergency rooms asking to be screened for swine flu at the expense of people

with real illness.” The principal of Emergent Medical Associates, Dr. Mark Bell, op-

erates 18 emergency departments in Southern California and shares Cathy

Gichema’s sentiments. He said, “ I haven’t seen such a panic among communi-

ties perhaps ever. Right now, people think if they have a cough or a cold, they’re

going to die. That’s a scary, frightening place to be in. I wish that this hysteria

had not occurred and that we had tempered a little bit of our opinions and

thoughts and fears in the media.”

Yet, government and health officials claim that the concern is justified because

the virus which is considered a hybrid of swine, avian, and human flu, has the po-

tential to jump from person to person with great ease. The President in a mes-

sage to the nation stated that there is “cause for concern but not alarm.” Much of

the hysteria is caused by knowledge of past outbreaks and the effects, including

the 1918 Spanish flu pandemic that killed approximately 20 million people. Yet,

World Health Organization spokesman Gregory Hartl believes that the world is

better prepared in the 21st century to handle such a situation. This is evident

with the distribution of 2.4 million doses of a common anti-viral drug to 72 na-

tions by World Health Organization.

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This hysteria has had an impact on the economy, particularly for Mexico. The

Mexican Government ordered the temporary closure of 35,000 public venues.

As a result, thousands of workers have been staying home, many waiting anx-

iously to get back to work. Guillermo Jimenez, a waiter who hasn’t worked in a

week claimed, “I can hold for maybe another week or two and that’s it. We

don’t have any money. We have mouths to feed. I don’t know what I’m going to

do now.” A graduate student in Marina del Ray, California, Anthony Markovich,

believes that we should focus on the diseases that bring about more fatalities,

like Malaria which kills thousands of people daily or HIV. He stated, “This is a

joke compared to other things going on. Malaria is killing thousands of people

daily, the economy is not getting any better, it is time to move on.”

So, while this swine flu is definitely a cause for concern, is the hysteria unjusti-

fied? 700 or more cases is indeed horrible, however, in the context of the en-

tire world is it really that much? Please read the following page on the steps

that should be taken to stay healthy.

Many airports have increased their cleaning regimes. In this picture, workers

at a South Korean airport disinfect a terminal.

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What You Can Do To Stay Healthy

Stay informed. The website will be updated regularly as infor-mation becomes available. (http://www.cdc.gov/h1n1flu/)

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

Take everyday actions to stay healthy. Cover your nose and mouth with a tissue when you cough or

sneeze. Throw the tissue in the trash after you use it. Wash your hands often with soap and water, especially after

you cough or sneeze. Alcohol-based hands cleaners are also effective.

Avoid touching your eyes, nose or mouth. Germs spread that way.

Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Follow public health advice regarding school closures, avoid-

ing crowds and other social distancing measures. Develop a family emergency plan as a precaution. This

should include storing a supply of food, medicines, face-masks, alcohol-based hand rubs and other essential supplies.

Call 1-800-CDC-INFO for more information. Copyright: CDC.GOV

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Congratulations to the

Care Extenders

of this Rotation!!!!

7W-CTU

Felina Kelly

Debbie Martins

8-NORTH

Chris Lawrence

Harpreet Singh

Heather Slattery

CCL

Sophia Gitisetan

CCU

Hannah Tan

CTICU

Armin Arshi

David Kirakossian

ER-A

Christina Castro

Tinh Nguyen

Kiran Alluri

ER-B

Ann-Marie Rounkle

Evan Vellios

Greeters/OR Escorts

Kyle Nguyen

Eric Kwok

ICU

Victor Tu

Elaina Ngo

Theresa Nguyen

LD-A

Daniel Garcia

LD-B

Monet McCord

Ramee Younes

LKC

Dominic Hovsepian

MED-SURG

Holly Vu

NICU

Alvin Chan

Kristin Harris

ONCOLOGY/

SM PEDS

Daphne Le

Stephanie Wang

Eleanor Rogers

Bianca Kissel

ORTHOPAEDICS/

ACU

Jacklyn Ha

RR PEDS

Venus Vakhshori

POSTPARTUM

Dora Lendvai

Patrica Schannong

Tiffany Tran

RADIOLOGY/MRI

Kelly Joy Valignota

Azim Laiwalla

Yenith Ang

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A great big thanks to the amazing people on Staff!

Executive Staff

Department Coordinators

Special Projects Coordinators

Want to be more involved in the Care Extender Program?

Writing for the newsletter is a great way to STAND OUT and put your two cents in about any health– care issues

and share your Care Extender experiences.

We are on the web: www.geocities.com/careextenders!!!

Colleen Caldwell Laura Collis Tony Klochkov

Eric Low Maria Bezchinsky Igor Kagan

Megan Segal Spencer Yeh Jenna Nawa

Kyle Nguyen Michael Pham Patrick Lu

Stephen Ku Kathleen Parker Roxana Ghashghaei

Jeanne Chai Jonathan Phuong Christopher Bartlett

Ferdows Ather Tracy Wang Eric Kwok

Frances Javier Tracy Fong Maggie Pham

Samantha Briones Rita Tufenkjian Dominic Hovsepian

Ivette Zelaya

Silva Thomas Amy Ngan

Jenna Nawa Christine Thang