Thursday, October 8, 2009

Some Other Disease: A call to action.



This blog is a warning. “Some other disease” or SOD will soon become the leading killer of elderly patients in the United States. SOD arose insidiously and seems to be killing patients who would otherwise not have died.

I have heard about this growing pandemic of SOD in many settings. An oncologist recently warned of this crisis, “we are getting so good at slowing the growth of tumors with targeted therapies that patients will end up dying of some other disease.” Likewise, a heart failure physician recently cautioned, “we are getting so good with these new generation left ventricular assist devices that patients end up dying of some other disease.” Infectious disease specialists have been concerned about SOD for years: “we have turned HIV into a chronic disease where patients generally die of some other disease.” Even geriatricians are talking about it, “if we could get a drug to slow the progression of Alzheimer’s disease then elderly patients would end up dying of some other disease.”

What is this SOD?

In the near future, the single organ doctors (another type of SOD) will be so successful at single organ conditions that there may not even be 10 leading causes of death, but simply one - SOD. We need to reallocate a large portion of the nation’s research agenda to discover the cause and cure of SOD.

When patients choose to have many of these innovative medical therapies, do they realize that they are staring down the barrel of a death by SOD? Perhaps one day we will live in a world where we can say “we have gotten so good at treating SOD that people don’t actually die.” Only then will our health care agenda will be fully realized.

8 comments:

Alex Smith said...

Funny Dan! But if they don't die of "some other disease," they'll die of "old age," an insidious, ubiquitous, and inexorably progressive disease...

Eric Widera said...

There is always T.B.A.

Dan Matlock said...

I suppose we musn't forget Sudden Elder Death Syndrome either.

Patrice Villars said...

Too funny and too true. My favorite line from the SEDS link is 'Over 99 percent of elders between the ages of 100 and 105 die of SEDS," Korsgaard said. "As a researcher and caregiver, I can't think of a scenario more gut-wrenching than that of a healthy and contented centenarian slipping into a deep slumber and never awakening."' We live in a strange culture that spends billions of research and advertising dollars on slowly down the natural aging process and not growing old. Not dying would be a spiritual and environmental disaster. Bring on SOD!

Jan Henderson said...

Very well done. It was the "we're getting so good" claims that made me suspicious. This utopian vision reminds me of the claim that it's not in the (business) interest of medicine for people to be healthy. There's a slick, deceptive logic to that statement, and I'd like to see it intelligently refuted.

I'm reminded of instructions for filling out death certificates, which are designed for epidemiologists. The cause of death should never be listed as cardiac or respiratory arrest, since we already know that someone who is dead is not breathing. "The elderly decedent should have a clear and distinct etiological sequence for cause of death, if possible. Terms such as senescence, infirmity, old age, and advanced age have little value for public health or medical research. Age is recorded elsewhere on the certificate."

Chrissy Kistler said...

I love this post! Just thought I should say.

ken covinsky said...

Dan--this is totally funny and profound!

Christian Sinclair, MD said...

This post was featured in the November 2009 edition of Palliative Care Grand Rounds!

Congratulations and thanks for contributing to the palliative care blogosphere.

Dan, you should really think about working this up more and submitting it to the end of year BMJ joke issue. I'd be happy to work with you on it.