surgery
oracknows | October 11, 2017QEDCon is fast approaching (indeed, I can't believe I have to leave for Manchester tomorrow night), and because my talk there will be about the phenomenon of "integrative medicine," I've been thinking a lot about it. As I put together my slides, I can't help but see my talk evolving to encompass both "integrative" medicine and what I like to refer to as quackademic medicine, but that's not surprising. The two phenomenon are related, and it's hard to determine which has a more pernicious effect on science in medicine.
One aspect of quackademic medicine that I probably don't write about as much…
oracknows | March 13, 2017[NOTE: Due to the windstorm last week, I was knocked out of the blogging game for a while and even had to stay in a hotel for one night. We did get our power back late Friday night, but we also didn't get Internet back until much later in the weekend, because our cable went out too. So, I thought I'd have a new post for today, but, alas, I did not. So, continuing on the them of Friday, I thought I'd repost an article of a sort that I almost never do any more. This one was posted over 11 years ago and was last reposted over 5 years ago. Tomorrow, I'll definitely be back.]
The patient list for…
oracknows | August 3, 2016It is an article of faith among believers in alternative cancer cures that conventional oncology consists mainly of a bunch of money-hungry surgeons and oncologists who want nothing more than to cut, poison, and burn patients with cancer and charge them enormous sums of money to do so for as long as they can until the poisonous chemotherapy finally kills them. It is an evil and malicious caricature, of course. People don’t endure four years of medical school, three to five years of residency, and three years of fellowship in order to be able to cut, poison, and burn without regard for whether…
oracknows | April 18, 2016It sucks to be diagnosed with cancer at any age, but it especially sucks to be young and diagnosed with cancer. The prompt application of science-based cancer treatment is important for anyone with cancer, but it’s especially important for young people with cancer, because they have the most life-years to lose if they dawdle or pursue quackery. That’s why I get particularly perturbed about young people with cancer whose parents choose (or who themselves choose) quackery over science-based medicine, and it’s why I become the most perturbed of all when I learn of stories of children being…
oracknows | January 24, 2016It's a seldom mentioned aspect of my professional history that I used to do a lot of trauma surgery in my youth. I did my residency at a program that included a county hospital with a busy trauma program where I saw quite a bit of vehicular carnage and an urban hospital (which has since closed) where I saw a fair amount of what we in the surgery biz call gun and knife club action. During my time as a PhD student, I moonlighted as a flight physician for the local helicopter rescue service, Metro Life Flight, where I took care of patients with everything from cardiac disease requiring transfer…
oracknows | January 12, 2016Every so often there are studies that I really mean to write about but, for whatever reason, don't manage to get to. Sometimes I get a chance to get back to them. Sometimes I don't. This time around I'm getting back to such a topic. This time around it's a topic I've been meaning to write about is based on a couple of studies that came out three weeks ago that illustrate why, even if a patient ultimately comes around to science-based treatment of his cancer, the delay due to seeking out unscientific treatments can have real consequences.Consider this (probably) the last unfinished bit of…
oracknows | November 23, 2015As a surgeon and skeptic, I find neurosurgeon turned presidential candidate Ben Carson to be particularly troubling. I realize that I've said this before, but it's hard for me not to revisit his strange case given that the New York Times just ran a rather revealing profile of him over the weekend, part of which included Dr. Carson answering criticism for the really dumb things he's said about vaccines, evolution, and the like. People like Ben Carson are useful examples of how highly intelligent people who are incredibly competent in one area can also demonstrate unbelievable ignorance in…
oracknows | October 8, 2015Yesterday, I wrote about the winner of the Nobel Prize in Physiology or Medicine, Youyou Tu, who, after screening 2,000 herbal treatments from traditional Chinese medicine (TCM) for anti-malaria activity, finally discovered Artemisinin. She isolated it from the plant in which it is found, using modern chemistry to isolate it, purify it, and later chemically modify it to make it more active against malaria. Tu deserved the Nobel Prize for her years of screening. As I pointed out, contrary to how the awarding of the Nobel Prize to Tu is being spun, it is not a validation of TCM, but rather of…
oracknows | July 9, 2015As much as I write about the foibles, pseudoscience, and misadventures of cranks and quacks that endanger patients. However, never let it be said that I don't also pay attention to the foibles and misadventures of real doctors that endanger patients. Sometimes that occurs due to incompetence. Sometimes it's due to the persistent use of invasive modalities that have been shown not to work far longer than they should have been abandoned (e.g., vertebroplasty). Sometimes it's poor judgment. Of course, because I'm a surgeon, I tend to gravitate towards discussions of surgery when I leave my usual…
dr. dolittle | May 26, 2015Speaking of octopuses, the ability for the animals to squeeze through narrow openings has inspired the creation of a new surgical robotic device that can squeeze into a patient's body.
An EU team created STIFFness controllable Flexible and Learnable manipulator for surgical OPerations, dubbed "STIFF-FLOP", made from silicone. Unlike conventional robots used during surgeries, the idea behind STIFF-FLOP is to be able to navigate around organs inside the body and minimize potential damage to healthy tissues. Its movements are controlled by pneumatic actuators. To create stiffness, they…
oracknows | April 17, 2015If there's one doctor who irritates me possibly more than any other, it's got to be "America's Doctor," a.k.a. Dr. Mehmet Oz, thanks to The Dr. Oz Show. He's been an all too frequent topic on this blog and at my not-so-super-secret other blog. Of course, I refer to him as "America's quack," because, well, that's what he is. Ever since Oprah Winfrey found him and elevated him from a promising young academic cardiothoracic surgeon with a penchant for woo to America's quack, I've been pointing out how much dubious medicine and outright quackery he's been pushing, including homeopathy, faith…
oracknows | March 26, 2015I happen to be in Houston right now attending the Society of Surgical Oncology annual meeting. Sadly, I'm only about 12 miles away from the lair of everybody's favorite faux clinical researcher and purveyor of a cancer cure that isn't, Stanislaw Burzynski. Such is life. In any case, this conference is all about cancer and how we treat it surgically. That includes prophylactic surgery designed to prevent cancer in people at very high risk. Prophylactic surgery to prevent cancer is never a decision that should be undertaken lightly and almost never is, rants from quacks notwithstanding that…
oracknows | March 4, 2015I hadn't planned on discussing the death of Jess Ainscough again, figuring two posts in a row were enough for now, barring new information. Besides, I was getting a little tired of the seemingly unending stream of her fans castigating me for being "insensitive" and saying it was "too soon" to discuss her death and wasn't sure I wanted to reawaken that discussion, which is only now finally dying down. This was a young Australian woman who was unfortunate enough to be diagnosed with a rare form of sarcoma at age 22 for which the only known treatment with a reasonable chance of providing her…
oracknows | November 7, 2014
Gayle DeLong has been diagnosed with what she refers to as “autism-induced” breast cancer.” She’s even given it an abbreviation, AIBC. Unfortunately, as you might be able to tell by the name she’s given her breast cancer, she is also showing signs of falling into the same errors in thinking with respect to her breast cancer as she clearly has with respect to autism. As a breast cancer surgeon, regardless of my personal opinion of DeLong’s anti-vaccine beliefs, I can only hope that she comes to her senses and undergoes science-based treatment, but I fear she will not, as you will see. Her…
oracknows | September 28, 2014
One of the central themes of this blog from the very beginning is that all medicine, regardless of where it comes from or how it was developed, should be held to a single science-based standard with regards to efficacy, effectiveness, and safety. I tend to focus primarily on “complementary and alternative medicine” (CAM), now more commonly known as “integrative medicine,” (1) because I believe it to be undermining the scientific basis of medicine and allowing outright quackery (or, as I like to refer to it, quackademic medicine) to infiltrate medical academia, which is fast becoming medical…
oracknows | September 22, 2014Regular readers know that I’ve been a big Star Trek geek (more or less) ever since I first discovered reruns of the original Star Trek episodes in the 1970s, having been too young (but not by much!) to have caught the show during its original 1966-1969 run. True, my interest waxed and waned through the years—for instance, I loved Star Trek: The Next Generation, while Star Trek: Enterprise and Star Trek: Voyager pretty much left me cold—but even now I still find myself liking the rebooted movie series. In the original series, my favorite characters tended to alternate between Spock, the Vulcan…
dr. dolittle | September 16, 2014No joke. George (the goldfish) had developed a rather large tumor over the past year and the owners loved the fish so much, they spent $200 to have the life-threatening tumor surgically removed:
oracknows | September 14, 2014
In a past life, before I became so specialized, I was a general surgeon. Like all surgical oncologists and even breast surgeons, before I became a specialist, I had to do a general surgery residency. In addition to the usual cancer problems a general surgeon faces, the two most common being breast and colon cancer, I learned to deal with the most common non-cancer problems that general surgeons deal with, such as gallbladder problems, hernias, bowel obstructions, and the like. Unfortunately, those problems include anorectal problems (not my favorite!) including hemorrhoids.
Basically,…
oracknows | August 15, 2014
A lot of medical specialties have throwaway newspapers/magazines that are supported by advertising and somehow mysteriously managed to show up for free in the mailboxes of their practitioners. In my case, I’ve found myself on the subscription list for such papers about oncology, but, given that I trained as a general surgeon. I’m Board-certified as a general surgeon. When I have to recertify in about three years, it will be as a general surgeon, which was really fun to try to do last time after having specialized as a breast cancer surgeon and will likely be even more fun next time, when I…
oracknows | May 28, 2014Although I'm a translational researcher, I'm also a surgeon. That was my first and primary training and only later did I decide to get my PhD during my residency, when the opportunity to do so with a decent stipend presented itself. From my perspective, clinical research in surgery is difficult, arguably more difficult than it is for other medical modalities, at least in some ways. For instance, in surgery, it usually very difficult to do a double-blind placebo-controlled trial. For one thing, doing "sham" surgery on patients in the placebo arm is ethically dicey, and it's very hard to…