1 . Healing with Happiness

Dr. Hunter “Patch” Adams decided early in his life that he wanted to help make the world better. Many of the patients who have visited his hospital would agree that he has done just that.

Adams was born in Washington, DC., but lived in many parts of the world while growing up. As a child Adams performed well in school. When he grew up. Adams decided to become a doctor. During his medical training he developed his own style of working with patients.     1    

He was friendly and thought of ways to make them laugh, hoping to make them feel better. Some of Adams’s teachers were not pleased with his way of treating patients. These teachers believed that being friends with patients could get in the way of being a good doctor. Adams did not let his teachers’ attitude stop him from trying to make patients laugh. One day he dressed in a clown costume.     2     After that, Adams continued to wear silly costumes while studying to be a doctor.

After he finished medical school, Adams and 20 of his friends opened their own hospital. They named their hospital the Gesundheit! Institute. Gesundheit means “health” in the German language.     3     Like at all hospitals, the doctors and nurses at Adams’s hospital worked to make sick patients well again. But Adams’s hospital also provided fun activities for patients. They could garden and fish.     4     Adams thought the patients would begin to feel better if they were engaged in things they enjoyed doing.

Adams has written books about his style of healing patients. He writes that you don’t have to be a doctor to help someone feel better.     5     Sometimes letting someone know you care can be the most powerful cure of all.

3 . Most people have no idea what to do with their old drugs. Unused or expired(到期的) medicines lying around at home can get into the wrong hands, leading to accidental poisoning or drug overdose. When drugs are flushed or sent to landfill(垃圾场), the medicines can pollute our groundwater, rivers, and streams, threatening human and sea life.

In an effort to find a solution for drugs kept in medicine boxes or waterways, the U.S. Drug Enforcement Administration launched its first National Take-Back Day in September 2010. In the drug take-back program, the returned drugs are sent to medical waste incinerators(焚烧炉). However, the process of transporting and burning such waste can release greenhouse gas emissions that could be potentially greater than those generated if the drugs were poured into landfills.

“But take-back programs are preferred as they reduce the risk of drug misuse and the incineration effectively eliminates the entrance of these medicines into our nation’s waters,” says Tim Carroll, a spokesperson for the U.S. Environmental Protection Agency.

Perhaps surprisingly, not all unused medicines need to be thrown away. Every year five billion dollars’ worth of unexpired medicines end up being deserted in the U.S. “We’re wasting a lot of medicines which are already paid for,” says Anandi Law, a patient engagement specialist. “Millions of U.S. adults skip or delay getting their prescriptions(处方) filled due to high costs. We could give them to somebody else who needs it.”

Now, at least 40 states have passed legislation establishing drug donation(捐赠) programs that allow drug manufacturers, medical and long-term care facilities, and sometimes individuals to donate their unused drugs. For example, since its start in 2007, Iowa’s program, SafeNetRx, has served more than 117,000 patients and redistributed nearly 54-million-dollar worth of medicines and supplies. Georgia’s program was formally launched in 2018, and it has already filled prescriptions worth over 50 million dollars.

“All of these efforts are still relatively new,” Carroll says. “We still have a long way to go until households change their habits.”

4 . Elizabeth wouldn’t walk or talk as an infant. Angela’s left leg was so enlarged that it hurt to stand. Emma needed a breathing machine just to sleep. Their suffering may take different forms, but their stories share a common thread: Neither they nor their families knew what was actually causing these issues.

Undiagnosed diseases are more common than you might think. Tens of millions of Americans likely suffer from disorders they cannot name. For many, the symptoms are minor. But in some cases, patients come to their doctors with serious problems caused by diseases that challenge medical knowledge.

Those cases are precisely where the Undiagnosed Diseases Network (UDN) steps in. Established in 2008, the UDN’s mission is to provide answers for patients with diseases that doctors are unable to diagnose. Anyone can apply to the program and the UDN works hard to screen every application it receives.

Today, the UDN covers 12 clinical sites around the country, and has evaluated over 1,400 patients. More than 400 of those patients have received a diagnosis thanks to the UDN. In some of these cases, the network is able to match a patient with an already known condition. In others, UDN researchers must work to describe an entirely new disease and enter it into the medical dictionary. The program has added at least 25 entirely new diseases in this way. Additionally, the UDN covers the cost of the tests, meaning patients aren’t burdened with crushing medical debt.

This kind of groundbreaking work helps more than just the patients themselves. Insights from studying rare diseases offer new knowledge about the human body that can benefit all of us. For example, the discovery of statins, a class of drugs commonly recommended today to help regulate high blood pressure, arose from the study of a rare genetic disorder.

“I think they’ve really advanced and changed the whole model for how we approach many of these illnesses,” says Anne Pariser, director of the Office of Rare Diseases Research. She says the UDN’s multidisciplinary approach — bringing different specialists together to talk about challenging cases — has helped advance the field of rare disease research, especially when it comes to genetic diseases.

Living with a disease without a name can be its own kind of suffering. “You grow up feeling like, I’m in this, crazy, all by myself, and no one really understands me,” says Angela Moon, a UDN participant. For patients like her, the UDN offers hope for treatment, but also for finally being seen.

5 . A lot of us think that we should visit the dentist every six months. Whether those check-ups are really necessary is, however, a matter of debate. In 2000, three-quarters of dentists surveyed in New York were recommending six-monthly check-ups, despite the absence of evidence. Today, many organizations still recommend six-monthly check-ups. But for several decades some have been arguing that the choice of six months as the ideal space between visits is rather questionable. For example, Aubrey Sheiham, a professor of dental public health, published a paper complaining about the lack of evidence for six-monthly check-ups. Almost 40 years, he’s still making the same point.

Last year the Cochrane Collaboration performed a review of the research that had been done and they were disappointed with what they found. The quality and quantity of the research was simply too poor to back up the idea of six-monthly check-ups.

There’s something else we have to bear in mind. Even when a study finds, for example, that children who go to the dentist frequently have fewer fillings (填充物), there may be other factors (因素) at work. Those same children may have other advantages; they may eat more healthily and have better quality dental equipment.

How often should you visit the dentist, then? Bodies like Nice, which provides guidance for the National Health Service in England and Wales, say that the frequency of dental visits all depends on the individual. They recommend that children go at least once a year because their teeth can decay (蛀蚀) faster, while adults without problems can wait as long as two years. They even go as far as to say that longer than two years is OK for people who have shown commitment to caring for their teeth.

Where does this leave the rest of us the next time we receive a card in the mail reminding us our next dental visit is due? We’d all like an excuse to go less often, and the good news is that if you don’t have any problems you can probably wait a little longer than six months between visits. But exactly how long you can wait before your appointment with the dentist’s chair will depend on the assessment you and your dentist make of your own risk.

7 . Lifesaving heart operation

When Tal Golesworthy was told he needed lifesaving heart operation in 1993, he said no. Golesworthy has Marfan syndrome （马凡氏综合症）.

Back in 1993, when he was living in the west of England, his doctor told him that the aorta（主动脉）in his heart was so enlarged that it would unavoidable burst unless he underwent major operation.

“They talked through the options,” says Golesworthy, “and I was not interested. The operation really didn’t look attractive.” What he particularly didn't like was having to be on blood thinners after the operation, something that would prevent blood clots（血栓）but presented its own risks: “I was riding motorbikes then, and skiing, so my whole lifestyle would have been affected.” By 2000, however, his condition had worsened. Realizing something had to be done. Golesworthy put his years of experience as research — and — development engineer to good use. He decided he would fix himself. “Learning new stuff and developing new ideas, that was my job,” Golesworthy says.

The aorta, he thought, needed support on the outside. And wrapping something around the outside of the aorta would require a special operation. So Golesworthy subjected himself to 30 hours in an MRI scanner; used 3D printing to create a physical exact copy of the part of his heart. “Luckily, I’d done a lot of work with technical materials,” he says.

Strong determination coupled with an original yet practical solution won him the support of two leading surgeons and helped him raise the money to develop his idea. In May 2004, at the age of 47, he became the guinea pig for his own invention. The operation was a success.