Archive for: December, 2009

New Year's Open Thread

Dec 31 2009 Published by under Narcissistic self-involvement

New Year's Eve. This is a profoundly arbitrary designation---the end of the year, end of the decade---really, there is nothing about December 31st that's any different than any other day. But for historical reasons, this is the secular new year. Looking back on the last 12 or 13 months I can say that I'm happy we're marking a new year and hoping the next year is better.
Even though the New Year holiday takes place at an arbitrary time, as human beings, we look to it as a chance to improve, to change, to have hope.
My wish for the new year is better health for my family and friends.
What's yours?

19 responses so far

Food isn't medicine

Dec 30 2009 Published by under Absurd medical claims, Medicine

The fake doctors at HuffPo are at it again. This time, Patricia Fitzgerald is writing about the "Top 10 Healing Foods of the Decade." The article has just enough correct information in it to be exceptionally wrong.
One of the more ironic aspects to this is her quoting Michael Pollan. I have problems with some of Pollan's ideas, but I like his little saying, "Eat food. Not too much. Mostly plants." When he first wrote this in a New York Times piece, he was arguing against "nutritionism", the idea that you can break foods down into their components and then consume the component nutrients for specific benefit. Instead, he argued, eating real foods in proper amounts is a healthier practice for individuals and societies.

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31 responses so far

Damned lies and idiots

Dec 30 2009 Published by under Absurd medical claims, Medicine, Vaccination inanity

Dr. Sherri Tenpenny is reportedly a doctor, although according to her website, she no longer practices medicine in any recognizable way. Perhaps that's why she utters completely idiotic statements such as this one pointed out to me by Brother Orac:

Study these numbers. We've had SARS, Bird flu and Swine flu. On average, approx. 190 children/year die from the flu. Considering there are about 62M kids under the 14 years of age in the US, this is NOT "statistically signficant" and should not even make the radar screen. See how they manipulate parents into vaccinations?

Next year, PLEASE do not be afraid of the flu. Ever person here should pass this on to at least 25 people! Please pass this to at least 25 friends.

Before we get to the above inane statement, let's see what Dr. Tenpenny claims about her own expertise:

Dr. Sherri Tenpenny is respected as one of the country's most knowledgeable and outspoken physicians regarding the impact of vaccines on health.

As a member of the prestigious National Speaker's Association, Dr. Tenpenny is an outspoken advocate for free choice in healthcare, including the right to refuse vaccination.  

No. No, she's not. Paul Offit is a nationally known vaccine expert. Dr. Tenpenny is not. If you're going to call yourself an expert on vaccines and vaccine-preventable diseases, you should probably have training in infectious disease or immunology and you should probably have published significant research. Tenpenny is a washed-up osteopath who has given up real practice to pursue the one vestige of quackery left in osteopathic education---manipulation. And being "a member of the prestigious National Speakers Association" only means that you are a member of an association of public speakers; it says nothing about your qualifications to speak on any particular topic. No physician with real medical expertise would list something like that rather than, say, their medically-related qualifications.

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112 responses so far

Raw milk---another spectacularly bad idea

Dec 28 2009 Published by under Absurd medical claims, Medicine

I've never understood food fads. Michael Pollan's maxim, "Eat food. Not too much. Mostly plants," has always seemed like reasonable, practical advice. Maybe it's a disease of plenty---we have so much food, we have to find new ways to conceptualize it. Unless you live in an inner city, you can go to any market and find large quantities of foodstuffs, both healthy and unhealthy. Food in this country is cheap and plentiful and, for the most part, safe. Self-"regulated" industrialized production has contributed to problems with bacterial contamination of meats and produce, but food- and water-borne illness is still relatively rare in the US compared to the developing world.

The industrial food production that has led to monsters such as "thousand-cow burgers" needs a lot of work. Mass production and distribution can introduce many different opportunities for contamination. Once a contaminated beef patty reaches the kitchen, opportunities for illness multiply. Even if you cook the burger thoroughly, you can still be sickened by contaminated counters and utensils.

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104 responses so far

Merry Christmas

Dec 25 2009 Published by under Narcissistic self-involvement

Merry Christmas to my readers who celebrate this one. For those of you who do, you may sometimes wonder what those of us who don't are doing today. Well, I find that Christmas is a great time to work at the hospital. It gives my Christian colleagues a break. Here in Michigan Jewish groups have traditionally worked various missions and shelters to give Christian charity workers a break. This year local Muslims will be joining Jews to help out. Detroit has large and strong Muslim and Jewish communities, and anything that brings them together is generally a very good thing. Conflicts between these communities tend to center around things happening very far from here, so focusing on our own local problems and working together to help our communities is good to see.
Some non-Christians still celebrate the secular aspects of Christmas, but most of us do not. Because Christian establishments are usually closed, a tradition of going out for Chinese food on Christmas has developed in many urban and suburban Jewish communities. When we go to a movie and a Chinese restaurant on Christmas Eve and Christmas Day, we see lots of people we know.
So whether you celebrate Christmas or not, I hope you all have a wonderful couple of days off with family and friends.

14 responses so far

Gird your loins---please

Dec 25 2009 Published by under Medicine

Do you know how many people have chlamydia? Syphilis? No?
Me either. But it's a lot. Depending on the group evaluated, chlamydia rates among young women range from 7-15%. And with STDs, there is always at least one other victim.
The holidays tend to be a time of seeing old friends and drinking with them. I see a lot of STDs after the holidays.
Both men and women can carry STDs without symptoms, but in women, these infections can ravage the reproductive organs leading to ectopic pregnancies, infertility, and other long-term health problems.
If infertility doesn't sound so bad, you might want to think about the other STDs that travel with gonorrhea and chlamydia. HIV doesn't go away. Syphilis often isn't discovered until it's caused significant damage to the nervous system and blood vessels.
All of these illnesses can be easily avoided by proper use of latex condoms and by seeking appropriate health care. Men with penile discharge should see a doctor immediately. Women with vaginal discharge should as well, and they should make sure to ask their doctors for yearly gonorrhea and chlamydia screening when they get their pap smears.
Look, I don't mind stamping out disease---it's lots of fun. But the best way to deal with disease is to prevent it. Merry Christmas, Happy New Year, and when you run to the store for more booze, don't forget the condoms.

20 responses so far

Fantasy is powerful, especially if you're a delusional idiot like Chopra

Wouldn't it be cool if after we died we didn't...die? Just like in the fairy tales, we could go to some place where we play harps on clouds and eat marshmallows for breakfast; we could play with our dead dogs, and somehow manage to live in harmony with all of our dead lovers. Unless we go to a place of flames and unending agony. Or maybe we become squid-like creatures in the oceans of Titan--all are equally (un)likely.

Except to those so mired in thanatophobia and fantasy that they can no longer reason properly. It's not like this is a new problem, but my eyes were bleeding after seeing Deepak Chopra on Larry King the other night (transcript here). Chopra launched into his usual vitalist idiocy.  The reason I even care about this is that Chopra promotes himself as a doctor and often applies his dualist religious beliefs to medicine.  Eww.  

Chopra's approach is always one of unfounded assertion and ridicule.  He asserts his belief, and then ridicules those who ask him what the hell he's talking about.  Here, let him show you:

There's a lot of interesting science that our consciousness, which is the place where we perceive, think, emote, imagine, have insight, intuition, choice-making -- that this part of us is not a product of our brain.
You know, scientists have, until recently, believed that, you know, just like your gallbladder secretes bile and your pancreas secretes pancreatic juice, your brain secretes imagination...

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41 responses so far

Waiting is the hardest part

Dec 23 2009 Published by under Medicine

Human beings are an interesting mix of fragility and hardiness, and we have a tendency to overestimate both traits. We also tend to be somewhat over-confident in our own ability to make sense of patterns. This combination of traits often blinds us to the real magnitude of risks we encounter every day---we're often scared of airplanes, but very few people have cigarette phobias. And when we really do get sick, in our desperation our faults often become magnified. As patients we often cast blindly for hope; as doctors we look to give hope, but the hope we give must be qualified by reality.

I would love to tell a patient of mine, "hey, everything's gonna be alright, so don't you worry about a thing." But that's not the way life works. Finding new ways to prevent and treat disease is a slow process and no amount of wishing can speed it up. One of my favorite examples is the discovery of Gleevec, a drug for chronic myeloid leukemia (CML). First, the mechanism of the disease had to be discovered. Then someone had to come up with a molecule to target. Then small trials had to be run to assess the drug for safety and potential efficacy. Then larger trials were done to get a better handle on efficacy and on less common side effects. And when all that worked out, the drug was marketed. Though not a common disease, CML does kill people, and lots of people died waiting for this drug. They also died before anyone knew the cause of the disease and before anyone had conceived of a way to fight it. And they still die, but not as many as used to. Many other candidate drugs to treat CML and other diseases have come and gone, and people have lived and died.  

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3 responses so far

Multiple Sclerosis and Irrational Exuberance

Dec 21 2009 Published by under Medicine

Multiple sclerosis (MS) is fascinating illness that can range from mild annoyance to debilitating nightmare. The frightening nature and unclear cause of the disease makes it a magnet for questionable medical therapies (i.e. quackery). A piece published last week in (surprise!) the Huffington Post helps fuel the fires of suspicion and paranoia while failing to shed any light on the future of MS research.

Multiple sclerosis is a disease of the nervous system. Its victims develop symptoms based on what part of the nervous system is affected. For example, if MS attacks the optic nerve, a patient may experience blurry vision or blindness. If it affects the motor areas of the brain that controls the left leg, the patient will develop weakness in the left leg. Typically, the symptoms will last a certain period of time and then improve, but often not completely back to normal.

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52 responses so far

DC, same-sex marriage, and racial stereotypes

Dec 17 2009 Published by under Uncategorized

I was listening to Tell Me More yesterday and was drawn into the story.
The host interviewed Michael Crawford, a DC-based activist. He attempted to debunk the idea that black communities are strongly anti-gay marriage. They played a clip of former DC mayor Marion Barry explaining how he personally might approve of gay marriage but he felt he had to represent his constituents by voting against it. Crawford called him out on a couple of scores. First, Crawford pointed out that Barry gave no polling data. Then he pointed out that he has the support of a large coalition of clergy, contradicting Barry's claim that clergy don't support gay marriage. His most important point, though was this:

Traditionally we have not put the rights of a minority up for a public vote.

Really, there's no better argument. It leaves those who oppose marriage equality with nowhere else to go rhetorically. They are either bigots who want the law to support their own biases, or they are bigots who want cover from other bigots on a ballot.

11 responses so far

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