Spring Update on Prior Posts
Although I write the definitive entries on topics in this blog, new information trickles in after publication. The new studies are often not worth an entire entry, recapitulating prior essays, but the new information is still worth a mention. What follows are updates on topics covered in prior SBM posts. Raw Milk In Oregon we are having a small outbreak of infections...
Drinking from the Fire Hose: Odds and Ends on the Gasping Oppression aka influenza
I spend most of my time taking care of hospitalized patients with acute infections and issues of public health are, outside of infection control, not a high priority. Vaccinations in training were always like clean water and fresh food: their benefit was a given and I never needed to consider the benefits and subtleties of vaccination. There is just so much time...
Feet of Clay
It has been tough in Portland this year. The Trailblazers, our NBA, and only professional team, started out on a tear, then went right down the toilet. It is painful to see such promise dribbled away. Sigh. Why is elation always followed by disappointment? Everyone and everything has feet of clay. Except Cassius Marcellus. At the beginning of March the NEJM had...
The Species in the Feces: Probiotics and the Microbiome
I do not understand the interest many appear to have in their bowels and the movement there of. But then, I pay little attention to most of my body functions as long they are functioning within reasonable parameters, and as I get older the definition of reasonable is increasingly flexible. The elderly especially seem to obsess about their bowels. My theory is...
The Application of Science
It all seemed so easy In 2010 an article was published in the New England Journal of Medicine, Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus . Patients were screened for Staphylcoccus aureus ( including MRSA, methicillin resistant Staphylococcus aureus) and those that were positive underwent a 5 day perioperative decontamination procedure with chlorhexidine baths and an antibiotic, mupirocin, in the...
Perpetual Motion: More on the Bravewell Report
I’m not here to convince people that we are right, although it would be nice if it turned out that way. I’m here to tell the truth and let readers decide for themselves.” — Kimball Atwood, Science Based Medicine, Bravewell Bimbo Eruptions I had been too inarticulate to formulate what is essentially my approach to this blog: to tell the truth. That...
Applied Kinesiology: Nonsense on Full Automatic
I start these entries about a week before their due date, and when I saw Dr Hall’s Applied Kinesiology (AK) post from Tuesday, I thought the heck, there goes my post for Friday. After reading Harriet’s post, I think mine will be both complementary and alternative, and perhaps even integrative, to her entry. I do have one quibble with her post. She...
Placebo Again.
Medicine is simultaneously both easy and hard. As an Infectious Disease doctor, my day can be summed up with the phrase “me find bug, me kill bug, me go home.” Sometimes it is just that simple. A lot of the time it isn’t. I may not be certain what the infection is, or even if the patient has an infection, or allergies...
Alas poor Craniosacral. A SCAM of infinite jest, of most excellent fancy.
It is hard to Sokalize alternative medicine. The closest has been buttock reflexology/acupuncture, but that is a tame example. Given the propensity for projections of the human body to appear on the iris, hand, foot, tongue, and ear, postulating a similar pattern on the buttocks are simple variations on a common SCAM (Supplements, Complementary and Alternative Medicine) theme. The buttocks? Not really...
A Seal of Approval
I have never belonged to the American Medical Association. As a student I didn’t want to pay the dues. As a practicing physician I am of the opinion that the AMA has two often mutually exclusive goals (promoting physician income and patient care) and they are doing both badly. In the 1990’s the AMA entered into a contract with Sunbeam to get...