As a frequent traveler to multiple time zones for over 25 years, I rarely get jet lag but was curious to read your article “Jet lag: Why you get it and how you can avoid it” [Jan. 1]. In my experience, there are two critical ideas for avoiding jet lag: resetting your watch immediately and changing your mind-set. In my unscientific observation, most people like to complain that they have jet lag, often convincing themselves that they have it by dwelling on what time it really is at home. I never do that. The minute I get on the plane, I set my watch to whatever time it is in the country I’m traveling to and only think about what time it is at home when I’m on my return flight. That and exercising as soon as possible are the best prevention I know.
Kathy Borrus, Washington
As I read “A doctor sees a hospital fail his mother” [Jan. 1], my mind raced with scenarios that might explain, or further confound, the case. What if the oncologist had not attended quickly to Jonathan Welch’s mother because he was saving another patient’s life? What if her transit to the intensive care unit had been delayed not because of carelessness, but because the ICU was full of patients even more ill and with an even greater need for interventions?
I bring up these questions not to make excuses but to suggest that when a patient is failed by the health-care system, he/she has been failed by more than one doctor, situation or policy. Our interventions have become too sophisticated, and our system too complex, to rely on one person, or even a few people. We need policies and protocols that are idiot-proof.
What if Mrs. Welch had a primary doctor who knew her well — or, better yet, a “medical home” of coordinators, nurses and staff who were familiar with her medical and personal history? This group could be accessible, be informed and have a personal relationship with Mrs. Welch. Before she ever hit the ER, they would have been coordinating care with her specialists, familiar with her latest tests and treatments, and even have discussed her wishes and goals in the event of such a dire situation. And when Dr. Welch was wondering whom to call in the middle of the night, he could have dialed one number, to one doctor’s office, and trusted that this one action would activate a team to fill in the gaps and help navigate a system that was breaking down.
In my practice as a family doctor, my patients’ specialists and I are members of one health-care team. We function best when we are each operating within our area of expertise while also coordinating our tasks. When patients like Mrs. Welch get sick, it is their oncologists’ job to treat their cancer, their intensivists’ job to fix their low blood pressure and my job to make sure we are doing all of that in a way that works best for the patient and his or her unique, personal standard of care.
This is most definitely a work in progress, but it is exactly where medicine should be headed.
Jennifer Martini, Falls Church