palmd

Next week I'm going to be giving a talk at the 2010 Great Lakes Homeland Security Training Conference & Expo. The title of the talk will be "Medical Blogs: An Under-Recognized Resource for Public Health Awareness and Communication", but I'll probably speak more broadly about web 2.0. In…

A few years ago I was walking through a local mall with my daughter and saw a kid about her age wearing a backpack and holding hands with a young woman. He was a gorgeous little boy, with black hair and huge black eyes. His eyes reminded me of my daughter's. There was a name tag on the backpack…

I never thought it would happen, but here we are. I can smell the ocean, hear the wind in the coconut palms. My arms are leaden from swimming, my shoulders reddened by the sun. A little while ago, I was body surfing. When you catch a wave---really catch it---you are weightless, and it is…

A young relative of mine recently asked me my thoughts about medicine as a career.   It's a relatively common question in my mail bag, and a tough one to answer, especially when asked by strangers.  Career choices are very personal, so I don't like to give advice as much as let people know what…

A few months ago, DrugMonkey reported on a study about how we as health care workers view narcotic users.  Narcotic use and abuse is something we deal with every day and presents many   challenges.  Narcotics are an important tool for controlling pain and many different strategies have been used to…

In the Soviet Union, party membership was everything. Your job, your access to food and other consumer goods, and your apartment all depended on your standing with the party. And votes were simply a tool to provide a patina of legitimacy. No one who liked warm weather voted against the Party.…

Right now I'm feeling rather civilized. I had a yummy brick-oven pizza with my family, including my parents and one of my sisters, and I just finished getting my cranky, over-tired child to sleep. Now I'm sitting at my kitchen table drinking some seriously killer single-malt bought for me by my…

As an internist, my specialty is the prevention and treatment of adult diseases.  One of the most common of these diseases is diabetes. There are two main variants of diabetes: Type I (juvenile) and Type II. Type II accounts for about 95% of the 20 million cases of diabetes in the U.S. Diabetes is…

Bad medical ideas often start with good intentions.  Most doctors are interested in preventing and treating disease, and some diseases are particularly challenging.  Some rise to this challenge, forming clever hypotheses and finding accurate ways to test them, but others aren't so successful. …

Some crazy, currently unbloggable crap is going down around Casa Pal this week, so I'm going to have to open up a bloggy doggy bag for you. I have a nice piece in the works for Sunday or Monday which is brand, spanking new. This was originally published on 5/6/2009. --PalMD Some bad ideas refuse…

The recent arrests of the Hutaree cult here in Michigan are part of a tradition of militant separatism in this part of the country, beginning with the militia movements in the late 20th century and climaxing (hopefully) in the terrorist acts of Timothy McVeigh and Terry Nichols. This latest…

I love Icelandic names. Just reading them makes me think of Vikings and valkyries. One name that I can't get out of my head right now is "Iris Erlingsdottir". She's an Icelandic journalist who put up a pro-vaccine piece on Huffington Post. Not only is the piece pro-vaccine, but it is quite…

It has been alleged by Great Minds such as Jenny McCarthy (D.Goog.) that the US recommends far more vaccinations than other countries.  Her precise statement was, "How come many other countries give their kids one-third as many shots as we do?" She put this into the context of wondering if our…

It's hard to imagine the that the hyperbolic rhetoric that characterized the health care reform debate could get any worse (death panels, etc.). But it will.  Representative John Boehner (Asshat-OH) started it of last night with what amounted to a call for the overthrow of our democracy. "Today we…

After a week of fine weather, the first weekend of spring was forecast to be cold, rainy, and snowy. I love it when they're wrong. I would love to be able to sleep in, but if I can't sleep in, I don't mind the sound of tiny footsteps. After whipping up a batch of heart-shaped Daddy pancakes, the…

Early in the prolonged economic crisis a patient who had lost his factory job came to see me. He no longer had insurance, but he had plenty of health problems. Our office normally doesn't see uninsured patients (we simply can't afford to) but from time to time we make exceptions. I changed his…

A physician friend asked me today if I had seen the survey in the New England Journal of Medicine that says nearly half of us will quit medicine if health care reform passes.   My fried, a life-long Republican, found the numbers difficult to believe.  So did I. The New England Journal of Medicine…

One of the things I love about the blogosphere is the give and take, the ability of people to comment on each others' work, and the diversity of topics. The conversations that take place in the blogosphere have real value (a value which is so far under-recognized and under-utilized). Without the…

(This piece appears today at Science-Based Medicine and is re-posted here today because I like it and I'm lazy. --PalMD) A couple of years ago, a number of us raised concerns about an "investigative reporter" at a Detroit television station.  At the time I noted that investigative reporters serve…

The work up of "fever of unknown origin" (FUO) is a classic exercise in internal medicine. Originally defined as a temperature greater than 38.3°C (101°F) on several occasions for more than three weeks with no diagnosis after one week of inpatient study, the definition has shifted. This…

I learned from a couple of colleagues (who I won't name) a couple of facts that reinforce just how hypocritical, hateful, and inane animal rights activists can be. First, the terrorists are still targeting researcher Dario Ringach. Ringach, a former primate researcher, left the field due to…

Mark Crislip has a nice piece up at Science-Based Medicine about the battle against the medical "de-lightenment". In his post, he looks at some data about what sorts of criteria anti-vaccinationists use in their propaganda. Not surprisingly, appeals to emotion and to pre-existing beliefs are much…

Our beloved, beat-up laptop is ill--very ill. The family is considering consenting to a Do Not Resuscitate order. Symptoms of this grave illness include inability to exit the start up screen and freezing up in "safe mode". The agonal Blue Screen of Death has not yet appeared, but is believed to…

A few months ago, attorney Ames Grawert and I wrote about a defamation case filed by noted anti-vaccine crank Barbara Loe Fisher against respected journalist Amy Wallace, vaccine expert Dr. Paul Offit, and Conde Nast. The suit arose from a statement by Offit in an excellent article by Wallace. At…

The other day I told you about a doctor promoting a dietary supplement for the treatment of HIV, despite the lack of any significant data to support his claims. If there's anything medical bloggers have found over the years is that woo rarely walks alone. In my post I expressed some incredulity…

I was pleased to see that Dr. Kaiser responded to post from earlier this week. If you'll recall, Dr. Jon Kaiser is a doctor in California who is promoting a nutritional supplement to help treat HIV disease. I was hoping his response would be substantive, containing references to data I had missed…

I get all sorts of mail. I get mail from whining Scientologists, suffering patients, angry quacks---and I get lots of promotional material. I get letters from publishers wanting me to review books, letters from pseudo-bloggers wanting me to plug their advertiblog---really, just about anything you…

For some reason I'm really excited about tomorrow's post. I don't usually write very far ahead of time, but this one took a little bit of extra research. You see, I got this letter from a PR firm hyping some altmed doc, and it was much more interesting than the usual similar things I get. It…

Things have been rather busy at Pal's place. For whatever reason, the complexity of patients has been pretty high lately, so I haven't had a chance to get in my usual once or twice a day post. I'm told that "back in the day" internal medicine patients were a bit less complicated. These days, to…

Sexual violence is a huge problem in the US.  Among college-age women, for example, 20-25% report an attempted or completed rape while in college.  Assault itself is prevalent enough to constitute a major public health problem, but add to that the sequelae---STIs, PTSD, fear, etc.---and sexual…