Page 7 - Mecklenburg_Medicine_April-2018

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cystoscopies. When I returned home, I crawled back into bed,
completely spent. If I tried to power through, I was punished by a
headache and exhaustion that lasted the entire day.
I now see I had maintained a barrier to the recognition that such
illnesses could afflict my own family. And, instead of peeking over it, I
stood resolutely behind, expending considerable effort to maintain my
experiences. And embarrassed, as I reflect on all the patients to whom
I may have spoken casually without realizing the impact of my words,
whose profound fatigue I did not appreciate, who endured illnesses
without the support and resources I had. How many times I wondered,
had I dismissed my patients’ questions with bromides masquerading as
answers? I think of the parents whom I nonchalantly reassured without
realizing how their concerns about their children shook their cores.
In my earlier life and career, denial had its uses. It prevented the
paralysis that might have ensued had I realized how fraught with
challenge and sadness the road ahead might be. More recently, my
personal entanglements with suffering have changed me. Where once
I tried to help people with issues I thought I never would encounter,
I now realize their circumstances could be mine. Seeing difficult
situations that have not befallen my family — substance abuse,
estrangement, domestic violence — I now am less likely to judge and
more able to be attuned to the pain.
Charlotte Physicians Lead the Way for Healthier Air
at Hospital Construction Sites
Lawrence Raymond, MD, Thomas Zweng, MD, and Stephen Keener,
MD, MPH, recently celebrated a major clean air victory with leaders of
Novant Health, Atrium Health and Clean Air Carolina, a
Charlotte-based statewide advocacy group. Drs. Raymond and
Keener serve on the advisory board for Medical Advocates
for Healthy Air (MAHA), a Clean Air Carolina initiative. At a
Raymond meeting several years ago, as part of the Mecklenburg County
Medical Society Public Health Committee, they proposed the
use of new construction equipment and anti-idling practices
to reduce toxic diesel emissions at hospital construction
sites. The two healthcare systems worked together in 2017
to develop a facilities standard requiring the use of low-
Zweng emission equipment and anti-idling signage. These measures
will help protect the health of patients, hospital visitors, staff, reducing air pollution leads to improved lung function in children
construction workers and neighbors. The commitment to
prioritize clean construction practices by Novant Health and
Atrium Health serves as a model for other healthcare systems
in North Carolina and the Southeast. According to the EPA,
Keener every dollar spent on reducing diesel pollution results in
$13 in public health benefits. Email MAHA Manager Rachel McIntosh-
Kastrinsky to learn more about the Clean Construction Partnership at
rachel@cleanaircarolina.org.
Lawrence Raymond, MD, Encourages State
Mandatory Idling Limits for Diesel Engines
On October 12, Lawrence Raymond, MD, published a letter to
the editor in the “New England Journal of Medicine” discussing the
recent study by Di et al., 2017, that showed that even at levels below
the National Ambient Air Quality Standard, fine particulate matter
When my dignified, gentle octogenarian patient came with her
granddaughter, and they complained of her memory loss, the anguish
beneath their calm demeanors touched the anguish about my mother in
my own heart. I felt their fear of her loss of her cherished autonomy. I
listened carefully to their concerns. Referring her for further evaluation, I
reassured them I would continue to be her primary care doctor.
And then there was my longstanding patient with cocaine-related
cardiomyopathy, who glowed with pride at her progress in literacy.
I had seen her through years of cocaine abuse, treatment and then
recovery. Though fond of her, I had felt a chasm separated her
problems from mine. Now, as I rejoiced with her, I felt only a fine line
of luck and fate divided us.
Knowing fear, vulnerability, and helplessness has opened me to
empathy and connection with others.
Denial has its place. But having life shatter the protective walls
of denial and free the energy required to maintain them has proved
strangely liberating.
Reprinted version of an essay published in “On Being A Patient” in
Annals of Internal Medicine, December 5, 2017.
Access essay at http://annals.org/aim/article-abstract/2664839/denial.
(PM2.5) can have lethal effects. Dr. Raymond noted that one of the most
dangerous sources of PM2.5 comes from diesel engines, even when they
are idling. He concluded North Carolina should join the other 35 states
that have enacted mandatory idling limits to improve air quality.
Idle-Free Schools Campaign Clears the Air for Kids
Clean Air Carolina’s Clear the Air for Kids Program is
providing educational signage and other air quality resources to
public schools in Mecklenburg, Gaston, Union, Cabarrus, Lincoln
and Rowan counties to discourage
unnecessary idling from cars and
buses on school grounds. Signs will
be placed near school bus lots and
along the drop-off/pick-up line. More
than 800 signs are being provided to
391 schools.
Unnecessary idling is a chronic
community problem that impacts
public health. Most people don’t
realize their vehicles are a source of
air pollution. When buses and cars are
idling at the same time on school campuses they create a plume of
pollution that is hard to escape. Children’s lungs are still developing
and they have a faster breathing rate than adults, making them more
vulnerable to the impacts of pollution. Research has shown that
ages 11-15, a critical period in lung development. Help our children
breathe easier by turning your engine off if you expect to be idling
for less than 30 seconds.
Reprinted with permission from Clean Air Carolina.
Mecklenburg Medicine • April 2018 | 7