Archive for: September, 2009

BMI TMI

Sep 23 2009 Published by under Medicine

Two-Oh-Friggin-Three! Yippee!
(woulda been better without the damned brisket)

2 responses so far

Stupid, stupid burning bright

Sep 23 2009 Published by under Medicine

In case you didn't know, Science Blogs is owned by a company called Seed Media Group. They invite bloggers, host them, give them tech support, and use their blogs to post ad content. And that's it. Bloggers are offered small compensation based on blog hits, but for most bloggers, this ads up to very little. Blog content is independent in every way but one: blogging is by invitation only. Once you're here, you can write whatever you want.

But conspiracy theorists are likely to be unimpressed by this. Seed's ads are everything from major corporate sponsors to google adsense garbage that sometimes turns out ads for fake cancer cures and chelation therapy, but in the eyes of some, anyone who blogs here must be in the thrall some sponsor or other. This is of course impossible, given that the sponsors often offer contradictory services (Merck ads, anti-vaccine ads, etc). I have not infrequently had in depth and sometimes heated discussions with my fellow bloggers about various ads and whether and how they reflect on our images as individual bloggers.

The peace I've come to is this: to provide me with a place to blog, Seed needs advertisers. Despite this, they do not pressure me to write favorable pieces. There was a MasterCard ad up earlier today, and if I decided to slam the immoral usurious practices of the credit card companies, no one from Seed would say a word to me.

That's why Age of Autism's latest rant against Scienceblogs is wrong before it even begins. The entire post is blindingly stupid. I'm not stretching it too much to assume that one or more of my fellow bloggers are going to write a thorough fisking of the piece, so I'd like to share just a little helping of the stupid. In addition to the fixed, false belief that all seventy or so of us are in the thrall of Big Pharma, this guy can't think clearly enough to write a coherent rant. Writing style can reveal a lot about thinking styles, so let's look at an excerpt:

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18 responses so far

Science-based medicine blog---too successful

Sep 22 2009 Published by under meta-blag

Science-based medicine, my other blogging venue, is temporarily down. The posts are written by a stable of fantastic professionals, and they are always a good read---except for today. Recently, we migrated to a new server and shortly thereafter, the blog became buggy until it crashed completely. The culprit appears to be traffic---lots of traffic. That's a good thing (unless it's a DDOS attack, which is not completely implausible).
So, Steve Novella, the guru behind SBM and many other skeptical ventures is moving us to a new host where all will be unicorns and rainbows. Stay tuned.

9 responses so far

Shamans in the hospital---barbarians at the gate?

Sep 21 2009 Published by under Medicine

As my readers know, I take a very hard line on alternative medicine, not because I just don't like it, but because it harms, both actively with dangerous treatments, and passively by keeping people from effective science-based treatments. So what am I to think about a hospital in California that is now allowing Hmong shamans to perform healing rituals on patients?

There is a long history of religious and quasi-religious beliefs interfering with good health care. This interference comes in many forms.

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16 responses so far

I cannot cure the common cold

Sep 18 2009 Published by under Medicine

Within 72 hours of starting kindergarten, my daughter caught a cold, and within 72 hours of that, she gave it to me.

The common cold sucks. It affects millions of people every year causing misery and lost days of school and work. It's terribly hard to prevent, and there aren't really any effective treatments. Vitamin C, Echinacea, zinc---all useless. Newer, more expensive antihistamines and steroid nasal sprays, both of which are great for allergies, don't seem to help either.  I find myself dispensing lots of grandmotherly advice this time of year. Thankfully, tonight is Rosh Hashanna and there's very likely to be chicken soup, which always feels good on a sore throat. Hot tea with honey, warm saline nasal irrigation, oral decongestants, antihistamines, and ibuprofen can all help mitigate symptoms, but nothing makes a cold go away faster. A depressingly large number of patients want The Secret Cold Cure that I must be withholding from them.  I remind them that if I had this secret cure, I'd be a very wealthy man.  Antibiotics are also useless (and dangerous).  

The loathsome National Center or Complementary and Alternative Medicine displays the usual foolishly tenacious (and wrong) thinking about some cold remedies:

What the Science Says

  • Study results are mixed on whether echinacea effectively treats colds or flu. For example, two NCCAM-funded studies did not find a benefit from echinacea, either as Echinacea purpurea fresh-pressed juice for treating colds in children, or as an unrefined mixture of Echinacea angustifolia root and Echinacea purpurea
    root and herb in adults. However, other studies have shown that
    echinacea may be beneficial in treating upper respiratory infections.
  • Most studies to date indicate that echinacea does not appear to prevent colds or other infections.
  • NCCAM is continuing to support the study of echinacea for the
    treatment of upper respiratory infections. NCCAM is also studying
    echinacea for its potential effects on the immune system.

In other words, the science says that Echinacea is useless for the prevention or treatment of colds, but they'll keep looking at it until a false positive result on a study helps justify their continued drain on precious resources.  After all, the people demand it (or at least Tom Harkin does).

Who can blame cold victims though.  Right now, I'm feeling their pain; I'd love that secret cure.  But I'm only a couple of hours away from my mother-in-law's chicken soup, and that'll do just fine.

43 responses so far

Writer's block open thread

Sep 16 2009 Published by under Narcissistic self-involvement

There are so many things I want to blog about today, but the muse just isn't with me. But I have a deal with myself to at least put out a little something once or twice a day (and my diet updates don't count).
Things I'm happy about today:

  • I'm keeping to my diet very well.
  • My child is not only surviving kindergarten but wants to be dropped off and have me disappear.

Things I'm finding painful today:

  • I'm keeping to my diet very well.
  • My child is not only surviving kindergarten but wants to be dropped off and have me disappear.

10 responses so far

BMI TMI update

Sep 16 2009 Published by under Medicine

I started this little adventure on August 5th, and at the time my BMI was over 30 and I weighed about 212#. Today, it's 203#.
It's an interesting journey. For the first time, I've found what seems like a sustainable way to eat healthy. I feel like I'm actually a good role model for my daughter and my patients. I've also eaten several acres of lettuce.
In the beginning I stated that if you're not hungry, you're doing it wrong, and was taken to task by many educated readers. And while I don't always feel hungry, I do wonder about certain phenotypic differences between individuals. "Hunger" is a slippery term, but let's all assume that we all mean about the same thing. I'm standing by my line, but with modification---many of us who are phenotypically fat will feel very hungry when dieting, no matter what types of foods we eat.
Either way, things are working.

5 responses so far

Put a fork in it?

Sep 15 2009 Published by under Absurd medical claims, Medicine

A recent piece of mine caused a bit of a "blogwar", if you will. It lead to a "rebuttal" on Dr. Bremner's blog, and an additional response from Dr. David Gorski. The discussion has been interesting (no, not Doug's incoherent response, but the comments and emails of others). One letter in particular helps sum up the ideologic rift between science-based medicine and "everything else".
The following was written by a physician:

I would ask Drs Gorski and Lipson if an iconoclast like Dr Bremner might be serving a valuable role as gadfly to an entrenched failing status quo in bio-medicine who have made the mistake of deifying science? I would posit that the very essence of science is always and incessantly asking the question- "is it possible that I may be wrong?". And I strongly support the return of narrative- the patient's individual story- to the practice of medicine. The incomparable Sir William Osler, one of my heros in medicine, knew that well.
I believe that of all the determinants of successful US bio-medicine medicine going forward that a strong dose of humility is in very tall order.
To make progress our egos must die first- a basic psychiatric principle. It is much better and much more important to be tolerant and kind than to be right.
I support Dr Doug Bremner's role as a colorful and passionate iconoclast. We need more like him.

This deserves a thorough fisking, given that it is rife with logical fallacies. Let's take the first (run on) sentence:

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7 responses so far

Do you even know what real evil is?

Sep 14 2009 Published by under Medicine

There has been a murmur (albeit an insane one) at many of the anti-Obama and anti-health care reform rallies about the Nazi "T4" program, something most Americans have never heard of. The absurd analogy apparently goes like this: the Nazis euthanized undesirables, and the proposed health bill would effectively do the same thing, therefore Obama is Hitler.
Let's back up a bit. Aktion T4 was Hitler's personal pet program of tasking the medical community to identify and murder those considered "incurable". In practice, this meant the murder of the mentally ill and cognitively disabled---the total murdered was probably about 100,000 German and Polish children and adults with various mental and physical disabilities----or at least said to have these disabilities. This was not a "euthanasia" program, but a carefully organized mass murder based on Hitler's ideas of "fitness" and "hygiene".

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21 responses so far

Health care---an obvious moral imperative

Sep 14 2009 Published by under Health care reform, Medicine

I got a little cranky earlier during a facebook discussion, then heard the voice of a friend in the back of my head saying, "Blog it! Blog that shit!"
And I was about to, when the hospital called with a minor crisis, and then I realized it was the probably one of the last nice days of they year, so I went to the pool with the family, then my wife made a yummy dinner...you get the idea. Anyway, here's the deal. I was reading this piece in the Times about a woman with a complex disease who died at least in part because of our Byzantine health care system. It was a familiar story.
And it's not just a compelling anecdote---this is every day. I'm just one physician and I regularly see horrors like this. The conservative/libertarian philosophy that encourages this sort of system is sick---immoral, unjust, and sick. It's hard for me to understand how otherwise moral-appearing people cannot see that medical care, like air, food, water, roads, and schools is not "just another commodity". I admit I just don't get it. This ultra-libertarian view of health care is a form of social insanity.
There is no justification for failing to create a just system--none. The cost is trivial compared to the cost of doing nothing. Ours current system is rife with irrational rationing and wasteful spending on profit-driven middle-men.
Health care is not just another industry where unfettered competition and "red in tooth and claw" capitalism benefits all. The profit motive kills. It kills trust, it kills people.
Ultimately, all the bluster and hot air expended defending the status quo because of cost, ideology, or whatever is immoral bullshit.

17 responses so far

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