palmd

You can follow me at the old-new location. Just follow this link. There I will keep you annoyed, entertained, and updated. You can also grab my new feed there.

My formal ethical training began in medical school with an introduction to the basic concepts of medical ethics. This training continued as I encountered difficult cases and thought through them, often with the help of the hospital ethics committee. While I haven't continued my formal education…

The Midwest loves extremes. Our spring is a quick, cold bucket of water to the face, and the fall a brief but intense set of umber and auburn brush strokes on the landscape. Today is neither of those, but still, hot, and humid enough to make breathing uncomfortable. So I'm looking out the window…

I shouldn't see any cases of pertussis ("whooping cough"), but I do. We have a safe, effective and affordable vaccine. But still, people are getting this disease. In the age group I see (adults), immunity has often waned, and if they haven't been revaccinated, they can get the disease and pass…

Since the Pepsipocalypse, several excellent science writers (some of the best, really) have sought out new homes online. You really shouldn't miss them. SciCurious: special shout out to Sci who is one of the best pseudonymous science writers out there, and if she were under her real name would…

Catherine Shoichet, a reporter at CNN, is reporting on a unique (as far as I know) public health intervention. For a few bucks, a randy Switzer can have a three pack of condoms delivered by bike in one hour. How cool is that?

I credit my youngest sister for introducing me to these guys playing this piece, but it might have been my father. I've listened to several different musicians playing this, and none matches these two. None. The vid starts in the middle, but it's still worth watching Rostropovich make the cello…

I was a bit torn when trying to figure out how to approach this piece.  A reader emailed me about an article in the Huffington Post, and there is so much wrong with it that I felt overwhelmed.  My solution is to focus on a few of the problems that can help illuminate broader points. There is a…

Bach's first solo cello suite looks deceptively simple on the page. It doesn't call for virtuosity as such, but to sound like more than an étude requires someone like Pablo Casals.

Yes, this is a repost, sort of. I first put this up on denialism blog in December of 2008. For various reasons, I haven't had a chance to crank out anything fresh this weekend, but this is still a good one, and I've edited it to freshen it up a bit, so don't complain until you read it. --PalMD…

This article is going to be about sex. I promise. But first, some reflections. Well, Pepsipocalypse continues. The Management pulled the ill-conceived PepsiCo nutrition blog, which is a Good Thing. This doesn't change my misgivings about what has happened. As many other bloggers have already…

The crack SEED management team has made some significant changes on the new Pepsi nutrition blog. They have placed a small, grey band on the banner that says "Advertorial" (a word I abhor, but whatever). They have also placed the Pepsi logo everywhere and made it fairly clear that it is Pepsi…

One of the wonderful things about blogs is their independence. Most are hosted by wordpress or blogger and there isn't much advertising or sponsorship. Notable exceptions are blog collectives, such as ScienceBlogs and the Discover Magazine blog network. These networks have significant advantages…

First, I'd like to thank you all on commenting on the weekend's de-lurking post. I really appreciate your taking the time to leave a note. While I write what I feel like, it's nice to get an idea about what sort of things people are reading. For various reasons, I've preferred to write on…

It's worth re-reading this remarkable document from time to time, especially given that it says something very different from what many on the Right and in the Tea Party seem to think. It does, for example, give special importance to representative government; that is, in fact, one of the main…

DrugMonkey has revived a blog meme that originated with uber science writer Ed Yong. It is basically a request for readers to "de-lurk". On any blog, the majority of readers never comment, and the people who do comment tend to so over and over again. Writers are inherently narcissistic. As…

In February, a young woman visited an urgent care clinic complaining of painful vaginal ulcers.  The differential diagnosis of genital ulcers is interesting.  Common sexually transmitted infections such as gonorrhea and chlamydia don't cause ulcers, but syphilis, herpes, chanchroid do (as do other…

ZombiePal, thanks to Ataraxia Theatre Scene: Harpo Studios, Chicago, IL, under heavy guard Dramatis personae: Oprah Winfrey, talk show host; Jenny McCarthy, famous person; Erica Turner, un-dead North Sider Oprah: Jenny, you have been such a maverick. It takes a brave person, one with great…

Many of us who are involved in social media have bemoaned the sluggishness of our own professions in adopting new media. There are two notable developments in my own field that seem to be holding up. The first is the twitter stream for the American Medical News. This is an online and print…

Over a quarter century ago, a young woman was admitted to a New York hospital with fever and agitation. She never walked out. Libby Zion died while under the care of he primary care doctor and two medical residents. The exact cause of death was never identified, but the case led to a forced…

I frequently read about the latest medical and scientific "breakthroughs" in the mainstream media, and in modern media such as sciencedaily.com. One commonality is lack of citations. If I'm lucky, they may cite the source journal or meeting. If I'm really, really lucky, they may even give a…

Author Chris Mooney has a provocative piece up at the Washington Post today. He argues that scientists are misunderstanding the dynamics of science-policy debates. Because, he argues, ideology often trumps scientific fact in the minds of the public, we (scientists) need to work harder to engage…

When you walk into a good coffee shop, you can smell it. It's a smell nothing like the smell of the old, sour coffee sitting in a carafe at the office. It's the smell of dark, dark beans, cracked open, releasing complex odors of fruit and of heat. And as much as I enjoy sitting in a coffee shop…

Medicare is the government health care program for the elderly. For internists such as me, Medicare patients make up around half our practice. Because of historical budget tools, every year Congress goes through the motion of watching our reimbursement cut, and quickly fixing it. It's a terrible…

When it comes to medical blogging, no one has been as consistently good, fresh, and snarky as Orac. Respectful Insolence sets the standard for all other medical blogs, and though Orac may not be a media star like some other med bloggers, his writing has had a significant impact on some important…

I'm looking forward to having some time to read this summer. I've planned a total of two weeks away from work, and if all goes well, I'll get some time to plow through a few good reads. My first trip away will be my usual gig as a camp doctor in Ontario. Last year I brought up The Great…

I visited a physician this week as a patient. The details of the meeting are in the TMI category, but the long a short of it was he gave me advice that the altmed folks wouldn't believe. Surrounded by the most advanced diagnostic technology, armed with a nearly infinite pharmacopoeia, he made a…

I've been teaching internal medicine for a number of years now. The practice of internal medicine falls into two broad categories; inpatient medicine, and outpatient medicine. Because of certain historical imperatives, internal medicine training is heavily biased toward inpatient education, and…

My wife is an accomplished professional. She loves her profession, and she's damned good at it. But she is officially "unemployed", and it kills her every time she has to put that down on a form. So how is it that she came to be unemployed? When we met, MrsPal and I were both working full time…