medicine
oracknows | October 19, 2009Every so often, as the health care reform initiative spearheaded by the Obama Administration wends its way through Congress (or, more precisely, wend their ways through Congress, given that there are multiple bills coming from multiple committees in both Houses), I've warned about various chicanery from woo-friendly legislators trying to legitimize by legislation where they've failed by science various "alternative" medicine practices. This began much earlier this year, when I pointed out how Senator Tom Harkin (D-IA) invited the Four Horsemen of the Woo-pocalypse to the Senate to testify.…
palmd | October 18, 2009Dr. Weil is often seen as the smiling "mainstream" of alternative medicine. He's a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you've decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence. …
palmd | October 17, 2009A couple of days ago I posted a cranky rant that most doctors can relate to. But folks aren't too interested in what doctors think, apparently, so let's examine what others think.
I confessed my behavior to a number of nurses in a local hospital, and the summary response was, "I would not wake a doctor up for a throat lozenge, and don't be such an asshole."
Responses on the blog were roughly of two types: nurses need to do their jobs so you should take whatever they dish out you arrogant prick; you're an arrogant prick; and hospitals should create rational policies, you arrogant pig.
I've…
oracknows | October 17, 2009Here we go again. The 2009 recipient of the Richard Dawkins Award, anti-vaccine wingnut and lover of cancer quackery Bill Maher, decided to use the occasion of the season finale of Real Time with Bill Maher to answer some of the criticisms that have been leveled against him. All I can say is this: I'm incredibly grateful that this is the season finale of Maher's show. I don't think I can take much more of his moronic anti-science stances being proudly trumpeted.
It was painful to watch and showed very much that Bill Maher still doesn't get it. In fact, if anything, he escalated his quack…
From one skeptic to the 2009 recipient of the Richard Dawkins Award: Stop being an anti-vaccine loon
oracknows | October 16, 2009Well, here's something refreshing. In fact, it's so refreshing that I just had to link to it. Michael Shermer, renowned skeptic and the publisher of Skeptic, has decided to school the Atheist Alliance International 2009 recipient of the Richard Dawkins Award, anti-vaccine kook Bill Maher, over the nonsense about alternative medicine, vaccines, and conspiracy theories about big pharma that Maher regularly likes to lay down.
Even better, he did it on what is normally a repository of anti-vaccine pseudoscience, The Huffington Post, in the form of An Open Letter to Bill Maher on Vaccinations.…
palmd | October 16, 2009Recent discussions around here reminded me that it's time again to talk about what it's like to be in a hospital, and how to survive the experience.
But first, as we move into the last two weeks of our very-successful Donors Choose challenge, I'd like to invite health care professionals in particular to participate. Gifts are tax-deductible and help out needy Michigan school kids with specific, vetted projects that are often useful for several years.
Micro-donation is a great way to go. While big gifts are great, even a couple of bucks add up quickly, especially on challenges with Gates…
oracknows | October 16, 2009I'm back.
If there's one thing I've noticed in the nearly five years that I've been doing this blog thing, it's that getting started again after taking even a few days off is hard. There's a bit of paralysis that sets in. I get used to not having to think about what I want to write, and often there are a number of things that I almost certainly would have written about. Fortunately, for at least one of them, PalMD took care of it it for me. Otherwise, the blogger whose post he deconstructed would have tasted a bit of the ol' not-so-Respectful Insolence for in essence laying down a load of po-…
oracknows | October 15, 2009As I mentioned on Friday, I'm in Chicago right now attending the American College of Surgeons annual meeting, where I was until last evening. Unfortunately, I got back too late and was too tired to lay down some fresh Insolence, Respectful or otherwise. Fear not, though. I'll get to it. In the meantime, here's a blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you.
By the way, even though this post is three years old, the problem described in it has only gotten worse in the…
oracknows | October 14, 2009As I mentioned on Friday, over the last few days I was in Chicago attending the American College of Surgeons annual meeting. At least, that's where I was until last evening. Unfortunately, I got back home too late and was thus too tired to lay down some fresh Insolence, Respectful or otherwise, for your edification today. Fear not, though. I'll get to it. In the meantime, here's another blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you.
Well, this is encouraging to see: A…
oracknows | October 14, 2009As I mentioned on Friday, I'm in Chicago right now attending the American College of Surgeons annual meeting, where I'll be until Wednesday afternoon, and may not be able to post anything new before Thursday afternoon or Friday. If there are any of my readers who happen to be surgeons attending the meeting, drop me a line and maybe we can get together. In the meantime, here's a blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you.
It seems like only yesterday that I was…
palmd | October 14, 2009I'm very worried about the change in seasons, and about eating in response to stress. I'm starting to worry that I can't do this. My sleep patters are terrible, due to work. It's hard to eat better when you don't feel well and you're used to treating mood with food.
The good news is that despite my backsliding this week, I'm down to 201#. Yeah, it would have been better if I hadn't eaten a bunch of chocolate gelt (CostCo, Belgian, nut-free). Still, my overall change in habits is gradually paying off.
oracknows | October 13, 2009As I mentioned on Friday, I'm in Chicago right now attending the American College of Surgeons annual meeting, where I'll be until Wednesday afternoon. If there are any of my readers who happen to be surgeons attending the meeting, drop me a line and maybe we can get together. In the meantime, here's a blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you.
Alright, I'll come right out and admit it up front. There was no part one to this piece. Well, there was, but it wasn't on…
palmd | October 13, 2009My readers are pretty bright, and for that I am thankful. As you have no doubt noted, I posted a nice, cranky rant this morning. Shall we examine it dispassionately in the light of day?
Any doctor who takes care of inpatients walks a fine line. As most nurses know, docs can be real assholes. While asshole-ism is never justified, it is sometimes explainable. Many hospitals are unable or unwilling to implement standing orders for basic comfort measures. It is theoretically possible to write a ton of "prn" orders to cover any contingency, but it's unlikely.
For the non-medical folks, I'd…
oracknows | October 13, 2009As I mentioned on Friday, I'm in Chicago right now attending the American College of Surgeons annual meeting, where I'll be until Wednesday afternoon. If there are any of my readers who happen to be surgeons attending the meeting, drop me a line and maybe we can get together. In the meantime, here's a blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you.
I tried not to write about the altie obsession with "detoxification" again. Really, I did. It gets repetitive, and I don't…
ddobbs | October 13, 2009
Mount Pisgah, diving into Lake Willoughby, way up noth
Vermont, my chosen and beloved place of residence, took the top spot last week in the Commonwealth's "State Scorecard" for healthcare, which ranks states based on access, quality, costs, and health outcomes.
For people who live elsewhere, this report adds one more thing to add to the list of Things That Make Vermont Cool. (This is a jump up from second place in the 2007 scorecard.) For people who live here, this report raises amazement -- and the feeling that it must be very bad indeed everywhere else.
Vermont's health system is a mess…
palmd | October 13, 2009Dear RN,
Thank you for choosing a difficult, sometimes thankless, but often rewarding profession. We need more people like you. And please know that I am available by pager 7 days a week, 24 hours a day for my patients. If anything goes wrong, I'd like to hear about it. My training has prepared me to answer pages at any time, switching instantly from sleep to work mode, and to give that order for a chest X-ray and intravenous furosemide to help our mutual patient who is having difficulty breathing.
I also appreciate that you are thinking not just of the life-or-death needs of my patients…
oracknows | October 12, 2009As I mentioned on Friday, I'm in Chicago right now attending the American College of Surgeons annual meeting, where I'll be until Wednesday afternoon. If there are any of my readers who happen to be surgeons attending the meeting, drop me a line and maybe we can get together. In the meantime, here's a blast from the past from the past. This post first reared its ugly head almost exactly three years ago; so if you haven't been reading at least three years, it's new to you. Unfortunately, I see nothing that has changed since I originally wrote this. If anything, I underestimated the problem.…
scientificactivist | October 12, 2009I recently had the pleasure of writing an op-ed piece about health care reform for my hometown newspaper, the Fort Worth Star-Telegram, and it ran in the paper today. You can check it out online here. I grew up reading the Star-Telegram, so this was an exciting opportunity.
My article discusses the need for robust health care reform in the form of a strong public option, comparing and contrasting my health care experiences in the US and the UK to build my case. For regular readers of my blog, you will note that this is a theme I have often explored.
I would have preferred that the Star-…
palmd | October 12, 2009A reader sent me an interesting post from her own blog. It's well-written, compelling, and betrays an exceptional intelligence. It's also completely wrong.
The piece is called, "Bias, Racism, and Alternative Medicine", an intriguing title. The first part tries to establish that "Western medicine" in one of many ways of understanding health and disease. She starts with some personal anecdotes---always interesting, rarely generalizable:
While receiving Western biomedical treatment for ADD, the side effects of my therapy convinced me that western medication alone would not provide a solution…
j7uy5 | October 12, 2009This is about chronic fatigue syndrome and the association with
XMRV. I apologize in advance for the provocative title, and the
subsequent gratuitous references to the Nobel Prize, but there is a
point to this.
Take a look at this summary of the "old-fashioned disease":
During the nineteenth century general paresis of the insane
emerged as a new psychiatric disorder which was extremely common and
completely devastating. While retrospective studies have found earlier
instances of what may have been the same disorder, the first clearly
identified examples of paresis among the insane were…