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Judge and Jury   Leave a comment

“[T]echnology appears to take over not only seeing but judging as well.  The evidence no longer presents itself nor is received as data to be interpreted but as veridictory statements about the organization of the world.”  (Pg 125, Joseph Dumit, Picturing Personhood)

     When I was a case study this past summer, the doctors decided they would do a SPECT scan on me to measure the metabolites in my brain.  The main focus was to look at my brain choline levels since my blood choline levels were so incredibly low.  The one doctor said something to the effect that they didn’t really know what the SPECT scan would mean, the technology was still fairly new, but it might provide some data regarding the metabolites in my brain.  They said that a computerized graph would chart the levels of each metabolite, of course stimulated via some sort of chemical they put in me intravenously.  So I said sure, I was game.  What was interesting is after the scan I was told my brain metabolites looked good and there was no need to worry.  Now I’m not sitting in a panic by any means, but after last week’s presentation and reading Dumit I have to say:  “Just what exactly did they or didn’t they find out with my SPECT scan?  Was it at all productive?  And what are the consequences should they dismiss my brain chemistry as ‘normal’ due to the SPECT scan?  —or any ‘POTS’ patient for that matter?”  The scan now seems highly arbitrary and ridiculous, and my only real worry is that they will make judgments based on the scan that aren’t necessarily accurate or true.  And I have to wonder just how much their reasoning changed before versus after the scan.  After seeing the actual computerized images were they more convinced of one thing or another, than before they went into the scan with open minds?  Did the colors in the graph persuade their views?  Who exactly determined what the SPECT meant for that matter?  Who got to view the scan?  Why even do the scan?  Were the doctors trying to find solid proof for the memory loss, word retrieval problems, and ‘brain fog’ that I had described to them?  What judgments were made on me the patient and the validity of my narrative based on the scan?  Was I determined more of a drama queen about my symptomology if my brain scans didn’t turn out exceptionally strange to them?

“Expert brain images come to be seen as making the facts visible and being the only objective ‘proof’ that grounds rather than supplements the expert’s truth.  Semiotically, we can see that rather than there being a need for agreement on the chain of representations before logic and rationality can be secured, the rationality and logic of the digital images are being invoked to secure agreement.”  (pg 120, Dumit)

In Picturing Personhood, we are told a story of a judge who chooses to let brain scan images be displayed, but far enough from the jury that they can barely see them, relying mainly on the testimony of experts instead of letting the jurors make judgments on the images themselves.  But for me, as just a patient in general, who exactly are my judge and jury?  And how do scans affect the validity of my patient narrative?  Does a doctor’s empathy or sympathy level change by how abnormal or normal a scan is perceived?



Posted November 9, 2010 by gentyrrell in Uncategorized

Smile or Die: Cells as Selves & Patient as Narrator of the Future   2 comments

In Teratologies; A Cultural Study of Cancer, Jackie Stacey describes Western culture’s new sense of self at the cellular level, a philosophy which seems to agree with both Biomedicine and Alternative Medicine.

“The idea of the cell as a unit of the body which can be influenced by physical and mental ‘input’ is especially appealing because cancer is seen as a disease of cellular dysfunction. ….Rather than being invaded by an external threat, the problem lies within: we may be a danger to ourselves.  Both conventional and alternative accounts represent the cell as a metaphor of the self.”  (Stacey 149)

For me, I see My Spirit as Myself (as opposed to Our Bodies, Ourselves take).  I see my body as a vessel for my soul/ spirit.  In Bright-Sided; How the Relentless Promotion of Positive Thinking Has Underminded America, Barbara Ehrenreich writes, “[T]he body has always seemed to me like a retarded Siamese twin dragging along behind me, a hysteric really, dangerously overreacting, in my case, to everyday allergens and minute ingestions of sugar.”  (I wonder what Ehrenreich constitutes as “me”, whether mind or spirit, but obviously she does not equate body with self, which seems more like a separate troublesome entity.)  (Ehrenreich 21)  I can’t say that I disagree with the body remembering physical trauma, but I don’t necessarily agree that my mind (or even spirit) has control over what my body (or cells) chooses to remember or embrace in the future. 

As a “Zebra” I spent many years being told my symptoms were psychosomatic and that I was perfectly physically healthy.  After it was determined that there was indeed something wrong with me (even on a metabolic & genetic level) American Alternative medicine culture dictates that if I think of myself as ill I am indeed and thus I am perpetuating my illness; as if my mind has complete control over my body.  This is a distortion of Eastern medicine philosophy which in fact does not see one as controlling the other, but rather a “balance” needs to be in place.  (Stacey 111, 133- 134)

For instance, it is safe to assume that if I allow myself to be in stressful situations and do not take measures to learn to cope with stress, I will physically deteriorate.  Stress worsening symptomology has been proven time and again for me and fellow Dysautonomia patients.

However, the idea of mind control over one’s body takes this to a whole other level.  It creates a cultural dynamic in which the patient, regardless of actually being diagnosed with a physical ailment, is again blamed for their illness. Their negative energy provoked the physical ailment.  And if they do not get better, it is their lack of positive outlook and attitude that caused them to fail in getting better.

Recently, I was at Florida Integrative Medical Center.  (Acupuncture and massage have proven helpful in lessening symptoms.)  When the receptionist asked me if I would like to schedule a next appointment within the week, I laughed and said, “Well, yes, I guess that’s best.  I’m a sicky.  I need all the help I can get—and sooner rather than later.”  The receptionist lightly scolded me for such a statement under the pretense that if I think of myself as a “sicky” this will indeed make me a sick.  I let the comments roll off of me, because I’ve encountered such thinking all too often.  I still find them disturbing though.  To me I finally feel happy to allow myself to think of myself as a “sicky.”  It’s incredibly freeing.  I had denied my true self within a culture of positivism.  By denying my disability itself and then the fears/ anger/ despair it caused me, I automatically set myself up for failure among the healthy.

In her chapter “Smile or Die:  The Bright Side of Cancer,” Barbara Ehrenreich investigates cancer culture from the perspective of a dry-humor cancer survivor herself (and incidentally she is a former cellular immunologist.)  “[R]ather than providing emotional sustenance, the sugar coating of cancer can exact a dreadful cost.  First, it requires the denial of understandable feelings or anger and fear, all of which must be buried under a cosmetic layer of cheer.  This is a great convenience for health workers and even friends of the afflicted, who might prefer fake cheer to complaining, but it is not so easy on the afflicted.” (Ehrenreich, 41)

“Jimmie Holland, a psychiatrist at Memorial Sloan-Kettering Cancer Center in New York, writes that cancer patients experience a kind of victim blaming:

It began to be clear to me about ten years ago that society was placing another undue and inappropriate burden on patients that seemed to come out of the popular beliefs about the mind-body connection.  I would find patients coming in with stories of being told by well meaning friends, ‘I’ve read all about this—if you got cancer, you must have wanted it…’ Even more distressing was the person who said, ‘I know I have to be positive all the time and that is the only way to cope with cancer—but it’s so hard to do.  I know that if I get sad, or scared or upset, I am making my tumor grow faster and I will have shortened my life.’

Clearly, the failure to think positively can weigh on a cancer patient like a second disease.”  (Ehrenreich, 42-43)  The patient has the responsibility to write their own narrative of health (or disease), instead of a divine God or fate determining narrative. (Stacey 8-9, 15)  “What of those who declined rapidly, who cried with fear and terror in the face of death, who live haunted by the threat of cancer returning or for whom there is no hope?  What of those who do not smile bravely?  In the success/failure binarisms of hero narratives these people can only be seen as failures.”  (Stacey 15)


Can the objectification of the body be a positive ideology for women after all?  If Body is not Self, but rather Spirit is Self, what is wrong with the objectification of the body? Its cells are not little personalities, microcosms of self, but rather gears within a vessel.  Wouldn’t objectification of self then promote less blame on the sick for their illnesses, and yet, still promote self-management of care for one’s body?  (like taking the time for a regular oil change in your car, or reading up on your car’s ‘recalls’ that need to be fixed, or listening to the strange sounds your car makes when it is not working properly and then going to a service center to find out what’s wrong).  Are people who buy into a strong mind-body connection less likely to go to their doctors if they think something is wrong, because they think it is something they themselves can control or fix (or “will” themselves better), and if they cannot seem to control or fix themselves then they have somehow failed themselves?



Ehrenreich, Barbara.  Bright-Sided; How the Relentless Promotion of Positive Thinking Has Undermined America. New York: Henry Holt and Company, 2009. Print.

Stacey, Jackie.  Teratologies; A Cultural Study of Cancer.  London:  Routledge, 1997.  Print.

Posted October 24, 2010 by gentyrrell in Uncategorized

Defining Self. As Patient, Woman, Disabled   8 comments

I would have posted a “comment” to Chris’ post but alas I can’t seem to post comments anymore for some reason without them needing to be “approved” or some such nonsense.

That said, don’t feel cynical Chris.  I too, even as a woman, had issues with the reading.  And I think your question is very valid.  I guess the medical terminology can be seen more as “secrets”, not just the language of The Man, get me?  And by disseminating medical terminology to their female readers, Our Bodies, Ourselves was not so much conforming to the established patriarchal medical community as it was revealing or decoding the medical community’s top secrets.

What types of text were chosen (or not chosen) took on entirely different issues for me concerning this book.

Perhaps Leandra and I will talk more about it during presentation, but we were discussing what quote to post on the first page of our powerpoint.  Leandra had suggested opening with “Since the alienation of women from their bodies has been one of the main aims of male domination, we must take control of our own bodies before we can liberate our minds and be our own people.” (pg 42)

I suggested cutting off the first part of the sentence to just post “[W]e must take control of our own bodies before we can liberate our minds and be our own people.” 

Leandra disagreed with this (rightfully so) on the grounds that this would significantly change the meaning of the quote.  But in regard to our presentation on Patient Support and Advocacy I didn’t think that the change would be a negative one.  Here is what my email argument was:

I hear what you’re saying about the quote being changed by chopping off the front half.  (I was figuring you would bring that up actually)  But I’m okay with it, because it transcends the quote from the feminist movement into the broader patient movement of today.  I don’t think it changes it in a negative way, rather puts a broader up to date spin on it.  The medical community is a patriarchal system.  You know I agree with you on that.  But I like to broaden the scope of wanting to be a patient who wants to know more about my body, not just a woman who wants to know more about my body.  By claiming myself as a “woman patient” (as opposed to “patient”) I am reinforcing the system and its hierchy, and I am setting myself up to fight against oppression right off.  And afterall the book is entitled Our Bodies, Ourselves.  Not Our Female Bodies, Our Female Selves.  There is already a presumption of Body versus Self without engendering either one.

This led to further discussion (and Leandra can better comment on her perspective), but it really made me wonder, perhaps the title of the book was indeed partially an attempt at neutrality? Away from the patriarchal establishment by not even conveying a difference between female and male even in the title?  Perhaps where Chris sees utilization of the established medical terminology as a possible giving into that power hierarchy if you will, I see the title of the book as a way to do the exact opposite, to present a neutral title that will not conform within the hierarchy.  “Our Bodies, Ourselves” as just a title could be feminine or masculine.  There’s nothing gendered about “our”.

Personally, before the debate on the quote took place I had already been reading into the text as to its role with disabled women.  I had already found trouble with equating body as self.

Wells discusses how The Collective tried to emphasize the unification of body through the process of self-exploration from the exterior to the interior.  The body as “whole, and one.” (156)

Also the idea of connecting with the inner self as perhaps a more positive outcome than scrutinizing the outer self was another step towards taking the interior approach.  The exterior could be seen as a marker of objectivity, dividing women by bust size, waistline, skin color, height, etc.  If exterior provides for negative objectivity, then perhaps interior can provide a positive common ground.

“Our culture of surfaces has not established norms for a ‘nice’ liver or the ‘right’ fallopian tubes; the interior of the body, at least for young and healthy women, is a region free of judgment.  It can serve as a ground of positive universality; it is the place where women’s bodies may not all look the same, but all work the same.”  (148)

“Instead of exigent judges, they would become investigators.  Instead of searching for surface flaws, they would discern the subtle workings of interior organs.” (163)  But is it possible to go from “investigators” to “exigent judges” even within the realm of the interior? 

How can disabled women reconcile their bodies as themselves?  If the outside human form is not accepted by society’s norm, and the inside of the body is incredibly unhealthy (organ systems not functioning or even shutting down; nervous system ‘mis-firing’), where can “positive universality” be found?

Wells poses two interesting questions:  “What is a ‘whole’ woman, and what does it mean to represent a woman’s whole body?  When does the representation of variation become a fetishization of racial or age differences?” (144)  Could that extend to fetishization of differences in ability and disability?

Wells notes on pg 69 that disabled women did not like being referred to as “they”, but instead “wanted all readers to think of being able-bodied as a temporary state.”

I find great conflict with much of this reading so perhaps someone else in the class can add some clarity.  As a disabled woman, if able-bodied is a temporary state then am I to assume that myself is a temporary state as well?  I don’t want to end up representing variation to the point of fetishization, but whether or not I look at my body from the exterior or interior it is broken, and how can I then connect that broken body with myself without going mad?  For me, I find a disconnect of body, but rather my spirit, myself—not my body, myself—is the key to healthy self image.


Posted October 12, 2010 by gentyrrell in Uncategorized

Cruel Bait & Switch? Just unfair or medically unethical?   7 comments

      Many times doctors make decisions about what a patient should or shouldn’t have tested, many times unbeknownst to the patient that these decisions are even being made.  Throughout _How Doctors Think_, Jerome Groopman also touched on the constant decision process for which the patient is unawares.   I assert though that usually if a clinician suspects something may be very wrong, but conclusion requires further investigation (maybe more invasive testing), then the clinician pushes the patient to have that test, to further investigate.  For example, this past summer I had suspected I was developing skin cancer and so I saw a Dermatologist.  My grandfather has skin cancer and I had already mentally prepared myself that the area of skin would probably have to be biopsied/removed, but before any discussion could take place the doctor was already strongly trying to convince me that the area should be biopsied immediately.  In fact I had to interject, “Really, it’s okay doc.  I figured you would have to remove it.”  (it turned out to be precancerous and caught just in time).  

     Yet, while reading Rayna Rapp’s _Testing Women, Testing the Fetus_, I found it quite interesting that in regard to amniocentesis the entire decision is put on the patient (and possibly in conjunction with her spouse) whether to have this test at all and what the results really mean for the mother’s/ couple’s future, the future of the fetus (whether birth or abortion), and how the decisions will effect the entire family unit.  The patient is not only past the role of unaware passive patient, but past the role of participating patient.  The patient acts as major decision maker in a culturally, socially, and medically complex situation.  Certainly it cannot be an easy decision, as Rayna Rapp points out:  “Ending a pregnancy to which one is already committed because of a particular diagnosed disability forces each woman to act as a moral philosopher of the limits, adjudicating the standards guarding entry into the human community for which she serves as normalizing gatekeeper.”  pg 131

     Rapp also recalls many interviews that discuss the humanization of the fetus taking place through sexing the fetus and the utilization of sonogram technology:

“Let’s face it, knowing the sex made it go from a fetus to a child.”  (Marise Blanc, 35, white college professor) pg 123

“I was hoping I’d never have to make this choice, to become responsible for choosing the kind of baby I’d get, the kind of baby we’d accept.  But everyone, my doctors, my parents, my friends, everyone urged me to. . . have amniocentesis.  Now, I guess I’m having a modern baby.  And they all told me I’d feel more in control.  But I guess I feel less in control.  It’s still my baby, but only if it’s good enough to be our baby, if you see what I mean.”  (Nancy Smithers, 36, white lawyer) pg 127

“So I went off to have the sonogram….and they begin to refer to the fetus as ‘he’….. It became a real baby.  I didn’t realize what a sonogram really was, what they show you up on that screen. …..I mean there was a person there, inside my body, looking out at me.  It was too strange.  And too traumatic to have an abortion after that.  That’s what the sonogram did.”  (Carol Seeger, 42, white museum curator) pg 127

“If they hadn’t interpreted, it would have just been gray blobs, and now, I’m more frightened to get the results of the amnio back.”  (Daphne McCade, 41, white college professor) pg 126

     So with weight of the decision in mind, is it truly ethical to portray the fetus as a human being/ baby prior to getting amniocentesis results back?  Should ultrasounds/ sonograms not be shown to patients prior to amnio results?  Should doctors and technicians not be allowed to refer to the fetus as “he” or “she” or “baby” until it is clear after amnio results what decision has been made?

     Certainly right-to-lifers would view this as a key measure to keep women from having abortions, by humanizing the fetus so that abortion would be as traumatic as possible, but is that really the medically ethical way to go?  Is that wreckless use of technology?

Bottomline:  Is it medically ethical to sit there and say, “Oh look at your new baby girl, see?  That’s her feet right there, over there, see that’s her hands….” and then do an amniocentesis on the pregnant patient, come back a couple weeks later and say, “Uh, it has a serious disability… we need to discuss your options” i.e., abortion?

And even if the amnio results come back with flying colors, was it worth putting the mother/ couple through a rollercoaster of emotions between humanization of the fetus until the time in which they get the amnio results back?



Rapp, Rayna.  _Testing Women, Testing the Fetus_. New York: Routledge, 1999. Print.

Groopman, Jerome.  _How Doctors Think_. New York: Houghton Mifflin, 2007. Print.

Posted September 28, 2010 by gentyrrell in Uncategorized

Cyberchondria: Just Another Way to Say it’s All In Your Head?   2 comments

I’ve been avoiding this assignment like the black plague.

Seriously, the assignment to look up cyberchondria-related sites made me cringe. (Sorry Dr Scott!)  I’m the classic example of someone who was probably deemed a cybercondriac (and certainly deemed a hypoconchondriac) by a lot of doctors.  If it wasn’t for my internet searching I wouldn’t have gotten diagnosed as the first documented case betaine/ trimethylglycine deficiency in the entire world, and the first documented human case (as opposed to laboratory mouse specimen) of a specific choline transporter genetic defect.   

So I went from site to site getting more offended with each minute.  I don’t deny that Cyberconchondria happens.  However, I feel like it’s just a new term to say “it’s all in your head” when you’re sitting there truly sick in the doctor’s office and they can’t seem to find anything wrong with you.

This site least offended me:

“What is Cyberchondria?”

by Emilie Sennebogen

What intrigued me was a section entitled “The Impact of the Internet on Doctor-Patient Relationships” in which it acknowledges maybe it isn’t so bad to research illness online, because it prompts patients to ask more informed questions of their doctors and open up a whole new dialogue.

I’m including a second site as well…..

I think this site only starts to touch on my leeriness of jumping on the cyberchondria-calling bandwagon:

“E-patients, Cyberchondriacs, and Why We Should Stop Calling Names”

by Susannah Fox on August 30, 2010

But what really got me about this last site was their attitude that:  Patients look up information online, so the medical community needs to just deal.  Researching online is an accepted practice; Get over it. 

They also talk about how the terms “e-patient” and “cyberchondriac” can alienate patients from the medical community.  They should be regarded as “patients” period without a stigma attached to being an informed patient.

Is the term “Cyberchondria” just another slur to put an informed patient in his/her place?  What happens when a truly physically sick person diagnoses his/herself with “Cyberchondria” as opposed to going to a doctor for answers? 

Anyway, it’s difficult for me to try to maintain some objectivity in this particular topic, so I fully realize that and I sincerely apologize for my strong bias.  😉

I tend to agree generalized websites like the ones listed below (ie., are not necessarily very accurate or helpful.  I see their guidance as useful as apartment-search or roommate-search sites (and I’ve moved into new apartments 7 times in my adult life).  They also all tend to crash my computer.  With symptom-checking and diagnosis-researching I tend to go the route of accumulating tons of scientific research online (like NIH, Mayo, Vanderbilt, etc, via PUBMED search), but if there’s a perhaps “better” self-diagnosis-aid site I think it is Mayo Clinic’s:

Genevieve Tyrrell

Posted September 21, 2010 by gentyrrell in Uncategorized

Rhetoric vs. Coercion   5 comments

In order for physicians or medical students to become more successful communicators with their patients and thus better doctors, I think the key is for physicians to recognize and understand the implications of their roles as rhetors capable of manifesting their authority over patients in a manner that might demean a patient’s social status, or even intelligence.  (Lay, page 27, regarding Paul Stair’s _The Social Transformation of American Medicine_)

Segal brings up an interesting observation that sometimes family members of patients (or even patients themselves) include biomedical terms within the dialogue of treatment options.  (Segal, 109)  This may be a way for the patient/family member to meet the physician half way in a language barrier that could so easily turn into a coercive situation otherwise. (Segal, 91)  Or this may be a way for a patient to exert a sense of personal power within a situation where they feel like they may be belittled or patronized as laymen unable to participate in making complicated medical decisions. (Segal, 109 & Lay, 30)

In my own personal endeavors (or mishaps) as a patient, on one hand I have experienced physicians who enjoy communication involving terminology that they commonly use within the medical field, and on the other hand I’ve also encountered physicians who try to return me to laymen-speak as though to exert control over a secret language within a club that I am not a part of nor should I try to be.  Some doctors feel like, “Oh thank God she gets what I’m talking about and I don’t need to water the information down.”  Whereas other doctors I sense an irritability that I’m trying to gain a balance within medical rhetoric in which I too can speak the secret language.  They would rather I stayed “in my place” so to speak, as uninformed patient.   

One thing that really struck me in our reading of _The Rhetoric of Midwifery_ by Mary Lay, is just how important simple reiteration of a concept, attitude, perception, or idea can eventually evolve into legitimacy, even within the medical community which society views as an arena that bases its actions on statistical data and thorough research.  “In contexts in which technology impacts health and safety, rhetorical scholars are just beginning to recognize how, as Beverly Sauer observes, ‘the conventions of public discourse sanction the exclusion of alternative voices and thus perpetuate [a] salient and silent power structure’ and how ‘the notion of expertise excludes women’s experiential knowledge.’”  (Lay, 29)  Physician accuracy, skill, and even legitimacy based on higher social status and prestige may eliminate the midwives as authoritative on anything.  The medical community exerts control in many areas within society beyond the scope of medicine, in turn society accepts that un-tested dominance as legitimacy, which in turn allows medicine to continue asserting its scope of authority and also intensify authority for which it exerts within the field of medicine.  And if there’s no one to contradict or question the method to the madness, then madness alone prevails?  And contradiction or questioning cannot arise unless there is a balance in communication; unless it is truly rhetoric and not “coercion.” (Lay, 91)  I believe this extends far beyond Segal’s chapter on Death and Dying, because this battle between rhetoric versus coercion can be found in any area of medicine.

For instance, as Lay points out, some women feel either alienated enough from the medical community or much more empowered by midwifery home delivery to proceed with breech births at home without a medical doctor present.  Within the parameters of the standard medical paradigm, “when faced with a persistent breech baby—one not turning head down in the womb—[a pregnant woman] might be urged to schedule a cesarean rather than being given information on how she or her caregiver might successfully turn the baby.” (Lay 23, 24)

In order for the midwives to “gain” authority within the community at large (whether society or in specifically medicine), they needed to bring about the recognition of a “knowledge system based on women’s experiential and embodied knowledge.” (Lay, 30)  In fact, one strategy of persuasion seemed to be the common goal of “protecting the public from harm.” (Lay, 34)

I wonder:  Can patient-doctor communication create a positive rhetoric if only the patient and the doctor first evaluate what is the desired goal at large or even specific outcome hoped for?  Can boundaries of medical “science” versus “embodied knowledge” be brought down by a common goal if that goal is definitively established from the get go?  And if patients in turn felt a stronger sense of personal power throughout the process of being a patient, would they be less likely to shy away from standard medicine altogether?

Yet, I have to also wonder how much fear of lawsuits will prevent good, balanced rhetoric to take place.  Aren’t hospitals more concerned with covering their own asses, so to speak, then of open discussion concerning all options?


Lay, Mary M. The Rhetoric of Midwifery: Gender, Knowledge, and Power. New Brunswick: Rutgers UP, 2000. Print.

Segal, Judy Z.  Health and the Rhetoric of Medicine. Carbondale: Southern Illnois UP, 2008. Retrieved September 11, 2010, from netLibrary.

Posted September 14, 2010 by gentyrrell in Uncategorized

“In Need of Diagnosis, Inc., Non-Profit Organization”   Leave a comment

(Recommended through NIH Undiagnosed and Rare Diseases program) I found this link that I thought was quite interesting considering this week’s seminar on patient empowerment:

In Need Of Diagnosis, Inc., a  Non-Profit Organization based here in Orlando, FL.

They make an interesting point on the opening page:

“Though the United States economy is characterized as a free market system, this is not the case with the medical system.  The patient has little say regarding the type of services made available.  This needs to change.  The patient must become a knowledgeable consumer of medical services.  Collectively they can make positive changes.  The public needs to make their interest in the matter of more timely and accurate diagnosis known.  Only then will they be able to influence how public health dollars are spent.”

Posted September 7, 2010 by gentyrrell in Uncategorized