palmd | July 21, 2009Having a daughter in my late 30's, I began my fatherhood journey a bit later than many. I don't have much to compare it with, but I do wonder how I'm going to keep up with the little princess. Mrs. Pal got us a Trail-a-Bike for Father's day---that's one of those "half bikes" you hook up to your own, effectively creating a tandem bike. PalKid can hold on and peddle if she feels like it. That's a serious workout. When we were up north, I dragged her everywhere (and vice versa) and she dropped off too sleep nice and early every evening (which I wish I could have done, but 7:30 is pretty…
palmd | July 21, 2009Dear Fred:
First, I'd like to thank you for guarding the integrity of the swimming pool in my folks' neighborhood. I know they feel safer because of you.
On that proud day twenty years ago, the day they handed you the thin cotton t-shirt with the banded collar and sleeves that reads "Pool Monitor", who could have known the proud years of service that would follow? I know I couldn't have because I was in college writing a paper on The Authoritarian Personality (classic Adorno, you should read it).
Your recent service is to be especially praised. When my wife fell asleep in the sun by the…
palmd | July 20, 2009In 1994, Congress enacted the Dietary Supplement Health and Education Act (DSHEA). This act allows for the marketing and sales of "dietary supplements" with little or no regulation. This act is the work of folks like Tom Harkin (who took large contributions from Herbalife) and Orrin Hatch, whose state of Utah is home to many supplement companies.
DSHEA has a couple of very important consequences (aside from filling the pockets of supplement makers).
What does the FDA require of "supplements"?
Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement…
palmd | July 19, 2009One of my Sciblings, one Ethan Siegel has issued a charity challenge. If one hundred commenters head over to his place and leave a comment assuring him that they will donate 10 USD to the charity of their choice, and name the charity, he will cut off his luxuriant locks.
Please, do it. His hair has, like, its own zip code or something.
palmd | July 19, 2009Yes, this post is a repeat from long ago, but I was reminded dig it up after reading a piece at a friend's blog. Thanks for indulging me. --PalMD
If Bob Dylan provides the soundtrack for much of my life, then coffee provides the "smelltrack". I did not start to drink coffee until I was about 20. My best friend of 18 years told me I should learn to, as I might need it. He also told me to drink it black, because I might not always have cream and sugar, but I still might need the coffee. So, I started to drink it. Now, this was terrible coffee...institutional, stale, sour, just generally…
palmd | July 19, 2009Yes, the new PalCast is finally up. Get it through the feed or on iTunes. Perfect for 18min30sec car rides!
palmd | July 17, 2009If you've dipped even one toe into the science blogosphere lately, you've seen discussion of Chris Mooney and Sheril Kirshenbaum's new book, Unscientific America: How scientific illiteracy threatens our future. I have very little interest in the arguments currently raging but not because I don't care. The book makes interesting arguments, some of which I agree with, and some of which I don't. More important, however, is that the authors have a track record of being listened to (cf The Republican War on Science). In a crisis that involves communication (i.e. of scientific knowledge), it…
palmd | July 16, 2009An old medical joke goes like this:
An oncologist goes to check on his patient, a 90 year-old man with Alzheimer's disease and metastatic pancreatic cancer. The doc is about to start him on a new round of chemo, but when he goes to the patient's room, he's not there.
He demands of the nurse, "Where's my patient?"
"He took a turn for the worse and was transferred to the ICU. He looks like he's reached the end."
"My patients don't just die!" he says as he picks up the bag of chemo and marches to the ICU. When he gets there, he asks the charge nurse where he can find his patient.
"I'm sorry,…
palmd | July 15, 2009I've frequently written that alternative medicine beliefs are much like religion, and often cult-like. When reading about alternative medicine, you'll often encounter charismatic leaders, faith in the unknowable, and conversion experiences. A fine example of the latter is currently up at the Huffington Post. It's written by "Dr" Patricia Fitzgerald, HuffPo's "wellness editor". Just to remind you of her credentials, she is a "Licensed Acupuncturist, Cert. Clinical Nutritionist, Homeopath, [and] Author." In other words, she's not a doctor in any well-recognized sense of the word.
Her…
palmd | July 15, 2009Influenza is a fascinating virus. When it undergoes antigenic shift, as the novel H1N1 ("swine") flu did, it efficiently evades most people's immune systems. Non-novel flu strains are bad enough, but antigenically novel strains can have a ridiculously high attack rate. John Barry's book, The Great Influenza, is a (usually*) terrific read, and describes very clearly what can happen when a novel influenza virus encounters a naive population. In the case of the 1918 pandemic, the circulating virus had not only a very high attack rate, but was also violently virulent, killing a large…
palmd | July 14, 2009I've got a lot of patients who are worried about health care reform. Most of it is expressed in right-wing radio talking points. They quite literally believe that they will no longer be able to choose their doctor, or that other doom and gloom events are imminent.
Have they no experience with government? Health care reform isn't going to happen quickly. When it does, it will likely have an American character. While socialized medicine works very well in some other countries, Americans just aren't into it, even if it were to work. Whatever I may think about it, it's a non-starter.…
palmd | July 13, 2009By now, we all know that the Huffington Post represents the zombification of medical news---interesting ideas are taken, eviscerated of any real meaning, their innards replaced with pablum, and the reanimated creature set loose on the world.
Reanimation of the undead is, it would seem, a rather addictive behavior, because HuffPo just keeps at it. Another one of their fake experts is "Dr" John Neustadt. The scare quotes indicate that John is not a doctor in any recognized sense: he's a "naturopathic doctor", representing a fringe, vitalistic health cult. But that fact isn't made clear.…
palmd | July 12, 2009A month ago, I was diagnosing several cases of influenza-like illness (ILI) every day. Then, as suddenly as it began, it disappeared---no ILI, no positive nasal swabs for influenza A (and hence H1N1/swine flu)---just the usual strep throat, poison ivy, ankle sprains, etc. So what happened?
The new influenza A/H1N1 (hereafter called "H1N1" or "swine" flu) emerged early this year and rapidly became pandemic. It caused a "second" flu season, ramping up just as the usual winter flu epidemic was winding down. This graph shows vividly the two-peak flu season we have this year due to the new…
palmd | July 9, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
Urinary tract infections (UTIs…
palmd | July 8, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
I met this beautiful woman the…
palmd | July 7, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
Mr. D. is one of those guys who…
palmd | July 6, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
I can't tell you the number of…
palmd | July 5, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
I love fountain pens, but I'm…
palmd | July 4, 2009On July 4th at 5 a.m., I'm loading the family into the car and driving very far away, where cellphones, pagers, and most critically the internet, do not work. Blogging has been very hard for me lately. I love writing, but due to work and family mishegos it's been hard to keep up with the posting. I'm hoping a stint up in the woods providing medical supervision to 400 souls will be rejuvenating. While I'm gone, I'll leave you with some of my favorite posts about the human side of medicine. I hope you enjoy reading them again, or for the first time. --PalMD
I am often the bearer of bad…
palmd | July 3, 2009Yes, every skeptic on the web has posted this, but it is irresistible. Remember, yanks, that A&E in the UK is not a boring cable TV channel but what they call an ER.