KITCHEN TABLE CHATS

Pull up a chair in my domestic church and let's chat!

I have worn many labels (Not in any particular order): Catholic, Wife, Mom,Gramma, Doctor, Major, Soccer Mom, Military Wife, Professor, Fellow.

All of these filter my views of the world. I hope that like St. Monica, I can through prayer, words and example, lead my children and others to Faith.
"The important thing is that we do not let a single day go by in vain without putting it to good use for eternity"--Blessed Franz J├Ągerst├Ątter

Monday, November 30, 2009

A Catholic Cyber Monday

If you are like I am, and prefer to do your Christmas shopping while tapping on a keyboard, sipping good coffee, and listening to beautiful music, I suggest you check out this article on products made by religious communities.

Sunday, November 29, 2009

Happy New (Liturgical) Year!

Today is the first Sunday of Advent. You can read more about truly celebrating this important liturgical season here. This is a great time for making spiritual resolutions. Keep in mind the principle of pizza dough spirituality.

Tuesday, November 24, 2009

Manhattan Declaration

Join your voice to this effort! This statement initially signed by over 150 Catholics, Orthodox, and evangelical Christians has grown to a movement with over 90,000 signatures. This statement affirms the principles of the sanctity of life, marriage, and religious marriage.

Tuesday, November 17, 2009

New mammogram recommendations are actually a victory of science over politics

Before you read this post, take the time to read the response I wrote to RAnn's comment on the last post. The reason for this is that I mentioned the U.S. Preventive Services Task Force (USPSTF) there as well. This is an old entity that is doing what politicians have neither the spine nor the competence to do--defining what is medically necessary or prudent to do. If you read through the USPSTF recommendations, you will be surprised to see how little the recommendations entail. A lot of the preventive testing we do is based on giving the patient peace of mind. It is a luxury, not a necessity.

The USPSTF analysis of the benefits of various breast cancer screening modalities just hit the airwaves. It would be a mistake to lump this analysis in with the Obamacare rationing arguments. The lack of efficacy in breast self-exams and the questionable benefit of mammograms for women in their forties is not new information. This has been known for at least a decade. Ten years ago I got dirty looks at a coffee klatch when a woman was lamenting the death of one of our neighbors from breast cancer and exhorting us to make sure we were doing our breast exams. I probably should have kept my mouth shut, but the scientist in me had to mention that the evidence did not back up the efficacy of regular breast self-exams.

It is important to understand that the new mammogram recommendations pertain to women who have no increased risk factors like a family history or known genetic mutations. The USPSTF now says that women should not begin mammogram testing until age 50. Women in their forties face a higher risk from the testing than they do from breast cancer. Most screening tests are going to be negative. A significant number of the positive tests are false positives. A positive test requires follow-up testing. This follow up testing is much more invasive than the screening test and has risks. Biopsies are surgical procedures. Surgery is never risk free.

Understand as well that the previous recommendations were not based on science. They were the result of medical politics. Breast cancer before age fifty and breast cancer after age fifty are two different diseases. Actually, there is nothing magical about age fifty, but that is just a convenient age to distinguish between pre-menopausal and post-menopausal women. For screening to be effective the screening test must be specific enough to minimize the false positives and sensitive enough to minimize the false negatives. The screening must catch the disease early enough to do something about it. The more aggressive the disease, the more frequently the screening needs to be done in order to affect the outcome of the disease process. Breast cancer in the woman under age fifty or pre-menopausal tends to be much more aggressive than breast cancer in the post-menopausal woman. Therefore, based on the sound principles of preventive screening pre-menopausal women should be screened more frequently than post-menopausal women. But that is not what was recommended. Women in their forties were encouraged to be screened every two years while women over the age of fifty were screened yearly.

The truth is that screening asymptomatic women in their forties has never demonstrated a significant increase in their survival from breast cancer. The advances in survivability are the result in advances of therapy not detection. But radiologist make money from mammograms. They want everyone screened. Surgeons make money doing biopsies. They like the revenue generated by positive mammograms. The American Cancer Society needs the backing of these two medical specialties to get breast cancer prevention going. Therefore, the resultant standards were a matter of compromise. Screening was extended to women in their forties but only every two years because they really don't need it at all. Post-menopausal women who really do benefit from mammograms are screened yearly. Once these recommendations are uttered, no doctor dares to practice according to science because failing to follow these guidelines leads to gross malpractice liability.

What caused the USPSTF to finally stand up for science is they now have the evidence that the incidence of bad outcomes from screening and follow-up testing are worse than the bad outcomes from the disease (breast cancer) for which the screening is being done. Let me tell you a tale about the hazards of medical testing. When I was a medical student, a gentleman came into the emergency room complaining of crushing substernal chest pain radiating to his left arm and shortness of breath. This is the classic description of a heart attack. This man was admitted for a cardiac work-up. Amazingly, his EKG and cardiac enzymes were normal. However, with such a classic history we had to investigate further. A stress test was inconclusive. He had to undergo a cardiac catheterization. The catheterization procedure triggered an arrhythmia that caused him to go into cardiac arrest. This is a known risk of cardiac catheterization. He was revived with electric shocks. His cardiac arteries, however, were clear. The complication of his cardiac arrest, however, lead to some kidney damage. He required dialysis until his kidneys recovered. After two months in the hospital it was revealed that he had never really had chest pain in the first place. He had been caught in an embezzlement scheme and in order to delay judicial proceeding he came into the emergency room with symptoms that would guarantee his admission and delay his having to testify. His little ruse nearly killed him. Invasive medical testing is not something to be taken lightly.

So how should such a finding play out in the health care system? Taxpayer funded health care should not have to provide screening mammograms to asymptomatic women in their forties. If a woman in her forties wants to buy a screening mammogram, she should be able to choose to do so. She should be fully informed about the risks this entails and the lack of evidence that such a mammogram will improve her survival of breast cancer. Her priority in the queue of women waiting to get a screening mammogram should be below those women over age fifty for whom mammograms have been shown to provide a benefit.

Monday, November 16, 2009

"Death Panels" revisited

Just in case the prospect of Obamacare hasn't scared the bejeesus out of you already, read this article in the Wall Street Journal. Then take a look at this article to see why health care rationing is contrary to Catholic moral teaching.

A Catholic Guide to End-of-Life care

My son had surgery this past Friday. All went well. However, as part of the admission process I was handed a booklet on advanced medical directives. Imagine my surprise when I read that nutrition and hydration are considered "life-prolonging" therapies and therefore should be withheld so that you don't prolong the dying process. This is contrary to Catholic moral teaching. Read more about this here and find out what you can do to protect yourself from the immoral end-of-life care in many secular institutions.

Thursday, November 12, 2009

Archdiocese of Washington forced to reconsider social service partnerships with D.C. city

Washington D.C. is close to passing a same-sex marriage law with such narrow exemptions for religious freedom that the Archdiocese of Washington feels it must end formal partnerships with the city in order to remain faithful to Catholic religious principles. Read more here.

Have Catholic bishops abandoned pro-lifers on health care reform?

Judie Brown at the American Life League has issued a statement strongly critical of the US Catholic bishops because they have dropped vigorous opposition to the House health care bill now that the Stupak amendment has passed. I think the bishops are steering a cautious but wise course. They speak stridently on matters of morals but defer on issues of prudential judgment. This preserves their voices as those of spiritual leaders rather than partisan shills. Read more here.

Wednesday, November 11, 2009

Annual Veterans Day Post--Mother of a Soldier

I published the following on Veterans Day the last two years. It seems fitting to publish it again. The picture is my oldest son. He is currently stationed at Ft. Hood. After the recent tragedy there, I again ask that you keep him and all our military in your prayers. Consider adding this Rosary to your devotions.

Using the sorrowful mysteries:
Agony in the garden: for deployed soldiers and their safety
Scourging at the pillar: for wounded soldiers and for their healing
Crowning with thorns: for deceased soldiers and repose of their souls
Carrying of the cross: for families of deployed, wounded and deceased soldiers, and for strength and comfort.
Crucifixion: for our nation, for the victims of war and for peace in the world.
And now for an encore presentation of Mother of a Soldier:




Yesterday evening I received this picture from my son. He is a senior at Texas A&M and in the
Corps of Cadets. If all goes as planned he will be commissioned as an officer in the United States Army. Just last week he received his branch assignment, Combat Engineers. He is thrilled.

As I think about this, it is only fitting that I received this picture on Veteran’s Day. November 11 was initially the day we commemorated the end of World War I—the eleventh hour of the eleventh day of the eleventh month. However, contrary to the hopes of the time, World War I was not the war to end all wars. In the decades that followed, thousands of men and women have stepped up to serve in the United States military. November 11 is now a day to honor all of them.

Back in July I wrote this post about the growing gap between those who serve in the military and those who do not. I sent this post to Rochelle Reed, editor of the San Luis Obispo Tribune, who wrote of her disappointment when her son chose to join the Army. She responded with a cordial note that asked in all sincerity how I could reconcile my life of faith with service in the military. I sent her this response:

Every time a human being is killed it represents tragic human failure. The United States military does not seek out opportunities to kill. Rather, the military is a defensive body. The members of the military swear an oath to uphold and defend the ideals and principles of the American Constitution even to the point of giving their own lives. No one detests the horrors of war and seeks peace more than soldiers.

It is interesting that you should ask how a soldier can reconcile military service with the Commandment not to kill. I just spent last evening with Fr. Michael Duesterhaus. He is a Catholic priest and a Marine Chaplain. He has already done two tours in Iraq and will leave for a third tour in June. His work has taken him to the outermost reaches of Iraq. He fully supports and affirms the military mission in Iraq. He sees great value in the work done by our military there. He sees no contradiction in military service and the service of God.

I believe the reason for this is that the mission of the military in Iraq is to defend the freedom and dignity of every Iraqi citizen as this nation establishes itself as a democracy. When enemies of this mission try to undermine it with deadly violence, a military response with deadly force may be required. As I said above, every time a human being is killed it represents a tragic human failure. However, it is not always the failure of our military. If a policeman kills a criminal who is threatening to murder his hostages, it is not necessarily the failure of the policeman. I feel the same way about the use of military force. It should never be used wantonly. Every effort must be made to settle disputes via peaceful means. The use of military force represents a diplomatic failure.

The military does not decide when diplomacy has succeeded or failed. That is the job of statesmen. Notice I said statesmen, not politicians. Politicians have partisan agendas to increase their own power. Statesmen have no agenda other than to seek the greater good for their nation. I do believe we have far too many politicians in both political parties and not enough statesmen. When the military is told the nation needs the force the military can bring to bear, the soldier responds bravely. There is no joy in killing. There is no place for vengeance. The military should never be used to settle a score.

Has every decision to use military force been correct? No. Has every military member behaved with the integrity and honor expected of a soldier? No. Just as there are teachers, clergy, journalists, and politicians who betray the ideals of their profession, there are soldiers who do not live up to legacy of honor of the United States military.

I do hope you are proud of your son. It reflects very well on the job you have done as a parent that he will so generously serve a cause much greater than himself. I am sorry others have not communicated this to you. I hope that both you and your son are able to see that members of the military are not blood-thirsty war mongers. Rather they are honorable men and women seeking to do what is right for our country so that our democratic principles are preserved for future generations.

Monday, November 09, 2009

Mattie Stepanek the Messenger

I was not sure how I would feel reading the story of someone who idolized Jimmy Carter and Oprah. I can now tell you that the story of Mattie Stepanek as told by his mother Jeni Stepanek is a must-read for teens and adults alike. My full review of the book Messenger is here.

The story of Mattie Stepanek has very little to do with politics or ideology. It has everything to do with understanding that every life is valuable. Every life has a purpose ordained by God. The challenge is to find and live that purpose.

Put this book on your reading list. It can be life-changing.



(I did receive a free review copy of this book)

Thursday, November 05, 2009

Prayers Please

Please say a prayer for all those suffering from the deaths and injuries suffered at Ft. Hood. My son is stationed there. He texted me to say he is fine, just still locked down. It is a tragedy. May all affected feel the mercy and healing of God's grace.