Learn 'How Not to Die'

Dec. 1, 2008 — -- Medical examiner Jan Garavaglia has penned a book that just may add years to your life. In "How Not to Die," the doctor gives instructions for identifying unintentional ways we hurt our bodies.

She draws from her years of experience and gives information on how to live better and smarter. Read an excerpt of the book below and check out the "GMA" library.

Doctor Dreads Taking It on the Jaw

I followed the infection underneath his breastbone like a trail of bread crumbs all the way up to his jaw. The trail teemed with pus, the army of white blood cells that had marched through the walls of blood vessels to fight invading microorganisms. I had never seen anything like it before. Bacteria had waged a protracted war with his body's immune system–and won. I wondered how fifty-year-old Victor Baca could have developed such a virulent infection.

Ten days earlier, Victor had been in perfect health. Then he started complaining of back and shoulder pain and a sore throat. The symptoms kept him in bed and unable to go to work. Even so, he didn't seek medical attention. But as the pain worsened, Victor realized something was terribly wrong, and he called 911.

The dispatcher alerted an ambulance. Paramedics arrived, found him critically ill, and went to work immediately. Despite their aggressive intervention, including cardiopulmonary resuscitation (CPR), Victor slipped away, causes unknown. As I often do in cases involving unusual infections, after the autopsy I consulted Dr. Mark Wallace, an infectious disease specialist and an internal medicine physician, who also happens to be my husband. An infectious disease specialist tracks down bacteria and viruses, decodes their defenses and their weaknesses, and figures out what will kill them. Mark believed–and I concurred–that all the evidence proved that a bacterial infection had originated in Victor's mouth, shockingly, from the most ordinary of health problems: a common dental infection.

This infection probably migrated from a decayed tooth into the surrounding bone and tissue in his jaw and caused an abscess, a cavity containing pus surrounded by inflamed tissue. Many of us have probably had an abscess at one time or another. They can show up externally (in the gums or in a hair follicle) or internally (in an organ), and some types are more severe than others. Once a pocket of pus breaks through the thin bone surrounding the tooth sockets, bacteria can spread through the tissue planes of the neck and into the chest.

By the time Victor sought medical attention, bacteria had likely reached his bloodstream and caused multisystem organ failure. This infection was the source of all his pain–and the cause of his death. Before penicillin was discovered in 1928, bacterial infections like Victor's were the leading cause of death in the United States.

Today, due to widespread use of antibiotics, head and neck infections rarely kill, unless you have no access to, or reject, basic medical or dental care. For some unknown reason, Victor decided not to see a doctor, even as the unchecked infection spread to his chest and the pain became excruciating. What began as a run-of-the-mill oral infection became a fight for survival.

Eventually, Victor's organs ceased functioning, and he died. The tragedy was compounded by the fact that Victor's death could easily have been prevented. A routine course of antibiotics provided in a timely manner would have stopped the infection in its tracks.

Checked Out

As with the case of Victor Baca, I've seen firsthand the terrible complications that can arise when people don't go to the doctor, ignore a physician's advice, or decide to take medical matters into their own hands.

Another example from my case files is that of Kim Atani, age forty-eight. She was a woman who could have lived a long, normal life had she received proper medical care. Kim, who was blind, and her husband, Simon, were living in their Orlando home when Simon found her collapsed on the bedroom floor.

ISBN 978-0-307-40914-0

Copyright © 2008 by Atlas Media Corp. and Jan Garavaglia, M.D.