Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

A Little Girl’s First Cavity

Sometimes a picture’s worth 1000 words. Poor kid. My sister-in-law snapped this photo today. Not a fun way to enter a new year… I think we’re all feeling a little bit like this, with the economy “messed up” and record unemployment levels. Let’s hope that 2010 brings some relief!


The Decade’s Top 5 Threats To Science In Medicine

As 2009 comes to an end, it seems that everyone is creating year-in-review lists. I thought I’d jump on the list band wagon and offer my purely subjective top 5 threats to rational thought in healthcare and medicine.

Of course, it strikes me as rather ironic that we’re having this discussion – who knew that medicine could be divorced from science in the first place? I thought the two went hand-in-hand, like a nice antigen and its receptor… and yet, here we are, on the verge of tremendous technological breakthroughs (thanks to advances in our understanding of molecular genetics, immunology, and biochemistry, etc.), faced with a growing number of people who prefer to resort to placebo-based remedies (such as heavy-metal laced herbs or vigorously shaken water) and Christian Science Prayer.

And so, without further ado, here’s my list of the top 5 threats to science in medicine for 2009 and beyond: Read more »

*This blog post was originally published at Science-Based Medicine*

A Humorous ER Admission For Marijuana Use

Whenever drugs are involved in a patient’s admission, the outcome is either craziness or comedy.  Methamphetamines and cocaine seem to be the popular drugs of choice requiring admission. These people are usually angry and agitated.  However, it seems like pot humor always adds a little touch of the unexpected to an otherwise boring admission.

Take for example the 27 year old truck driver who was brought in by his roommate for “acting weird’. What happens when you mix a little marijuana and a little alcohol?  You get Happy’s pot humor post of the day. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

What Is Hand Rejuvenation?

I took this photo when my mom was in the hospital earlier this year. My hand looks like I wash dishes for a living. Her hand shows many of the spots that come with age and sun exposure: actinic keratosis, liver spots, etc.

There is a decent article that gives an overview of hand rejuvenation in the Sept/October issue of the Aesthetic Surgery Journal.

The epidermis thins as we age. Lentigines, actinic keratoses and seborrheic keratoses, general dyschromia, and textural roughness appear. Capillary fragility may make bruising common. Fat atrophy may make tendons and bony prominences more noticeable and the veins appear to bulge.

The article goes through the available treatments: chemical peels, vein sclerotherapy, fillers, laser therapy, intense pulsed light (IPL) therapy, fractional skin therapy, and Thermage.

It also reminds us that caution must be exercised as hand skin has relatively few adnexal structures and therefore has less capacity to replace the epidermis.

Read more »

*This blog post was originally published at Suture for a Living*

Lithium for ALS – Angioplasty for MS: Why We Should Be Cautious About Medical “Breakthroughs”

Peter Lipson reported Monday about new research suggesting that Multiple Sclerosis may be caused by venous blockage. He correctly characterized some of the hype surrounding this story as “irrational exuberance.”

This is a phenomenon all too common in the media – taking the preliminary research of an individual or group (always presented as a maverick) and declaring it a “stunning breakthrough,” combined with the ubiquitous personal anecdote of someone “saved” by the new treatment.

The medical community, meanwhile, responds with appropriate caution and healthy skepticism. Looks interesting – let’s see some more research. There is a reason for such a response from experts – experience. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »