An Apple a Day

Dear Colleagues and Friends,

John McCain is a 72 year old man with recurrent melanoma,
hyperlipidemia, degenerative joint disease, and recurrent difficulty
with certain efforts at recall. These are the limited facts the
American people have had access to. Over 1000 pages of medical
records were shown to selected journalists for 3 hours with less than
48 hours of notice. The only medically trained journalist was Sanjey
Gupta, MD from CNN. This is the extent to which the American people
have been informed.

While I am certainly sensitive to the confidential nature of medical
records given the anxiety expressed by many of my patients regarding
the risk of lost coverage or lost jobs in this current health economic
climate, there are certain exceptions for disclosure regarding public
safety. As John McCain knows, a pilots records are comprehensively
available for review by a certifying agency (the FAA, I believe) to
insure the fitness of the pilot and the safety of passengers and the
public at-large. In the election of the President of the United
States of America, that certifying body is the American electorate.

A recurrence of metastatic malignant melanoma would essentially
destroy John McCain's capacity as the Chief Executive and the American
People have yet to receive a full accounting of the facts regarding
his actuarial risk. If he has had regional metastasis, his risk could
be 30% or greater for distant metastasis to the brain, bone, and
lung. As you all know, melanoma is one of the most insidious,
pernicious, and aggressive malignancies our patients must deal with
and that we attempt somewhat pathetically to control with interferon,
interleukins, and dismally active and terribly toxic chemotherapeutic
regimens. In addition, we lack the simple data to sensibly evaluate
his cardiovascular risk as we would any septuagenerian in our exam
rooms.

John McCain should be held accountable by the american people and its
agents, the free press, to release without restriction the entirety of
his medical records. Any hesitation to do so would clearly imply that
there are significant medical concerns about his ability to fulfill
the duties of the President.

Sincerely,

Michael D. Fratkin, MD
Internal Medicine


But the medical issues of McCain's melanoma, hyperlipidemia, past smoking,
and geriatric cognitive decline are also relevant, and should be advocated
by us, as experts beyond the average pundit or reporter.


Dave Kolva, MD
Family Medicine
Oswego/Syracuse, NY