Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
The Limits of Planning
July 27, 2015
Like many Michiganders, I took a summer vacation. And as I always do, I planned the trip thoroughly ... from flights to sights to accommodations to restaurants, but still leaving a few details to spontaneity and serendipity.
This summer's trip was to Newfoundland, where winter was very grudgingly giving up its grip. Everything about summer was slow in coming, and the thousands-of-years-in-the-making icebergs that had drifted down from Greenland were several weeks later than usual to disappear off Newfoundland's coast.
It was a trip that once again reminded me of the limits of planning.
Understand, I am an ardent advocate of planning. First, I am my mother's son who would often say that "Happiness is having a plan." Second, I'm so obsessed with planning that I committed to writing two decades ago what should happen when I die, which actuarial tables inform me should be even longer than two decades in the future.
But once again, all my planning for this vacation failed to provide its best moments. The best accommodation was the one I did not book in advance; the best restaurant was the one I had not heard of before we departed from Michigan; the best iceberg adventure was the one we had on our own after taking a wrong turn, not the commercial tours we took in groups.
Planning is a necessary part of leadership and it is essential for the success of any enterprise. But so is staying open to hunches, going with your gut and learning from mistakes. This often makes for the most memorable vacations as well as the most meaningful vocations.