Black Medicine

lead_960Medical drama TV shows were my favorite thing growing up.  I watched so many that it might be natural to give some sort of credit to these shows for inspiring me to pursue a career in medicine.  But the sheer number of these shows, past and present, tells me that the public remains very curious and interested in what goes on with all the doctors and nurses and techs inside hospitals.  Quincy M.E., Trapper John M.D., M*A*S*H, Doogie Howser M.D., General Hospital, St. Elsewhere, ER, Grey’s Anatomy, House, Scrubs…this is just a sampling of my walk down memory lane.

What’s interesting to me is that you could always tell who the doctor was on TV. The doctor, of course, was the person with a stethoscope in one hand and a cup of coffee in the other.  That’s just the doctor image, I guess.  And it’s undeniable that there is some accuracy to that image.  When I started medical school, I wasn’t a coffee drinker.  I mean, I’d had an occasional cup here and there, sure, but I recognized it as an acquired taste.  And boy did I ever acquire it.  I guess when you’re in Rome, you do as the Romans do.  By the time I was graduating medical school, Starbucks was putting their coffee shops right inside hospital lobbies and cafeterias.  I remember one attending who would always give me a few bucks and send me out on break to go get him yet another cup of coffee…”Get yourself one too” he’d always say.

naslovnaIt’s a wonder why – with this tight association between doctors and coffee – there hasn’t been more of an effort to promote the bond to boost coffee sales. It certainly hasn’t gone unnoticed, though, with Dunkin’ Donuts releasing a study showing nurses and doctors holding the top few spots for “Professions Most Dependent on Coffee“.  While the ethics of outright promotion are probably a limiting factor, that hasn’t stopped medical research from working to find beneficial effects from drinking the black liquid.

Coffee has been linked to improved brain health (decreased depression and rates of Alzheimer’s and Parkinson’s), protection from liver cancer, boosting of vision health, reduction in Type 2 diabetes, as well as being the largest source of antioxidants consumed the US.  It has been disproven that coffee increases your risk for hypertension, heart attack, sudden death, or arrhythmia….and indeed, a large prospective study has been published in the NEJM showing an inverse relationship between coffee consumption and mortality.  In other words, the more coffee you drink, the longer you might be likely to live!  How’s THAT for an endorsement?

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From the NEJM study: Drinking coffee was a significant protective factor against mortality in all categories of death, except for cancer (since heavy coffee drinkers also tended to smoke cigarettes).

For once, it seems that medicine will be on the right side of conspicuous consumption when it comes to extolling the virtues of coffee.  And in a case of the tail wagging the dog, a governmental health authority in Queensland, Australia has advised doctors to consume 400mg of caffeine (up to 6 cups of coffee) while on shift in order to counteract fatigue and prevent patient deaths.  But in general, doctors seem to be consuming more and more coffee as it is.

Screen Shot 2017-03-07 at 9.57.47 PMIf I had to hazard a guess, I would have put anesthesiologists right up there at the top of the list of most-caffeinated medical specialties.  It’s surprising, then, how wrong I would have been.  In a 2014 observational study published in the British Medical Journal, the purchasing habits of physicians at a large teaching hospital in Switzerland was tracked across nearly 71,000 cups of coffee purchased in the hospital canteen and correlated by specialty.  Anesthesiologists came in dead last for the least number of coffees purchased per person by quite a wide margin.  Funny enough, the study’s authors speculated that anesthesiologists were either too busy to drink coffee or more likely had their own coffee machine down in the ORs.

In any case, it seems like a foregone conclusion that doctors are inextricably linked to coffee consumption.  But you never know.  Things can change.  And in the world of medicine, things can change drastically.  A new study can be published tomorrow showing nothing but the ills and risks of drinking coffee, and everything changes again.  The important thing, though, is that we are looking and trying to make sure that we serve as good examples to the patients we care for.  And generally speaking, I’m okay with the image of a doctor with the ubiquitous cup of java in one hand, because it could be worse…it used to be much worse

 

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