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H1N1 Flu and Back to School: Focus on Prevention

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It used to be that we’d get all our kids settled back to school and then enjoy a bit of a pause before the other shoe fell with the inevitable concern over another flu season. With Swine Flu, Influenza H1N1 not taking a summer vacation and showing no signs of letting up, we didn’t have that luxury this year.

I went onto My Fox Boston this morning and talked with Keba Arnold about this very unique flu season with 2 influenza strains traveling among us and offered some practical tips to not only prevent the flu but be ready should it impact your town’s schools:

Don’t try and absorb everything at once. Focus on prevention today and I’ll help keep you informed as we learn more about the flu shots your family will need, when they will be available, and any breaking CDC alerts that are important for your family’s well being during the flu season.

*This blog post was originally published at Dr. Gwenn Is In*

The Friday Funny: Science Versus Pseudoscience

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I know this one’s been floating around the blogosphere for a while, but it finally made its way to me at a time when I needed something lighthearted and amusing (warning: some profanity and at least one use of the “F” word):

Best quotes:

“Well, science doesn’t know everything.” Well, science knows it doesn’t know anything, otherwise it would stop … But just because science doesn’t know everything doesn’t mean you can fill in the gaps with whatever fairytale most appeals to you.”

…”nutritionist” isn’t a protected term. Anyone can call themselves a nutritionist. “Dietitician” is the legally protected term. “Dietician” is like dentist, and “nutritionist” is like tootheologist.”

“I’m sorry if you’re into homeopathy. It’s water. How often does it need to be said? It’s just water. You’re healing yourself. Why don’t you give yourself the credit?

I just wish more comics did routines like this. Sometimes humor can get the message through where analysis can’t.

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

Will The Battle Against Obesity Spur On Eating Disorders?

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At a time when two thirds of Americans are either overweight or obese, health officials are correctly warning that most of us need to lose weight. But we may be setting ourselves up for a surge in eating disorders.

The two main types of eating disorders are food restricting (commonly referred to as “anorexia”) and binge eating and purging (commonly referred to as “bulimia”). The disorders typically begin in adolescence and affect women much more commonly than men.

Statistics are tough to come by – partly because of under-diagnosis and incomplete reporting – but a
recent review estimated that 500,000 women in the U.S. have anorexia and 1-2 million women have bulimia.

The National Eating Disorders Association has a higher estimate, with “as many as 10 million females and 1 million males” suffering from either one of the two disorders. Recent reviews have reported that 90 percent of patients with bulimia are female but the rate in men appears to be increasing in recent years.

A key feature of an eating disorder is the disparity between perception and reality. Over the past thirty years, obesity (BMI >= 95th percentile) in teenagers increased from 5.0 percent to 17.6 percent. While that rate has skyrocketed, it’s still much lower than the perceived rate of obesity among students.

Among children in grades nine through 12, 10 percent of females were obese and 15.5 percent were “at risk” for becoming obese (BMI >=85 percentile but <95th percentile). Yet 38.1 percent of students described themselves as overweight and 61.7 percent were trying to lose weight.

Put another way, more than half the women trying to lose weight were not overweight.

Why do people who are not overweight think they need to lose weight? There’s no simple explanation. Experts believe that genetic, environmental, psychological, and social factors can all play a role in eating disorders.
Studies suggest that movies, magazines, and television contribute to eating disorders by idealizing overly thin women and exacerbating body dissatisfaction, especially in people with low self-esteem. Fashion magazines often feature models with obvious signs of anorexia. The theme is clear: less is more.

My intuition tells me we’re at a tricky point in the national discussion of weight. Since research suggests that the wrong public message can be especially dangerous for patients at risk of an eating disorder, we need to be very careful as we develop strategies against obesity. As they create their plans, agencies such as the Centers for Disease Control (CDC) should include experts in eating disorders.

For this week’s CBS Doc Dot Com, I talk to Leslie Lipton and her father, Roger, about how Leslie has successfully battled anorexia. Click below to watch the video:


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I also interviewed Dr. B. Timothy Walsh, a renowned expert on eating disorders and Professor of Psychiatry at Columbia University Medical Center and author of the book, “If Your Adolescent Has an Eating Disorder.” Click below to watch the video:


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Google Wave – For Scientists

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Cameron Neylon posted a nice video about how scientists may use Google Wave in the future. I saw it myself in action at this year’s Science Foo Camp in San Francisco, but it would be nice to have a really huge base of early adopters soon.

*This blog post was originally published at ScienceRoll*

Cancer Needs A Bailout

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Senator Ted Kennedy’s death from brain cancer underscores the urgent need for more funding of basic cancer research.  Despite the best efforts of a team of top doctors, Kennedy died 15 months after the diagnosis of a malignant brain tumor called glioblastoma.  Over the past ten years, some progress has been made against this deadly illness and the silhouettes of some promising new approaches are becoming visible.  But our treatment options remain woefully inadequate.
The annual budget of the National Cancer Institute (NCI) is just under $5 billion.
With over 560,000 cancer deaths each year, that comes to less than $10,000 in research spent for every cancer death. That simply is not enough money spent on a problem that strikes almost 1.5 million Americans each year and causes nearly one of four deaths.
Research for certain cancers is especially under funded.  Earlier this year, I helplessly watched a dear friend and patient die from esophageal cancer, both of us knowing that only 22 million dollars each year – about $1,500 per death – was being spent by the NCI on the disease annually.  One reason is that patients with esophageal cancer don’t have a strong advocacy group to push for their fair share of the funding pie.  Lung cancer, which tops the list of cancer killers in America, only gets about $1,500 per death.   At the top of the list based on research spending per death are cervical cancer (about $19,000), breast cancer (about $14,000) and brain cancer (about $12,000).
Click here for a chart that I compiled with the help of statisticians at the NCI that breaks down government spending on the top cancers.

Of course, there shouldn’t have to be a competition among cancer advocacy groups.  There should be adequate funding of basic medical research to help discover the underlying cellular mechanisms that many cancers share and that hold the key to prevention, early diagnosis and effective treatment.  But there’s not enough money for our young researchers.  In 1980, almost 25 percent of first independent government grants went to scientists under age 35; that figure has plummeted to only 4 percent as the first-grant age rose from 34 to 42.
Faced with increasing competition for shrinking dollars, many of our best and brightest are considering other careers.
My cancer patients desperately need a bailout.  The best way to increase our spending on cancer research responsibly is through health care reform.  The Institute of Medicine has estimated that about 20 percent of the annual $2.5 trillion in health care costs is unnecessary. That’s $500 billion annually or 100 times the current budget of the National Cancer Institute.  There could be no better tribute to Senator Kennedy or wiser investment in our own futures than to fix a broken system that threatens to bankrupt us while inadequately addressing one of our most devastating health problems.

For this week’s CBS Doc Dot Com, I take you behind the scenes to an edit bay at the CBS Broadcast Center in New York.  I talk to Dr. Henry Friedman, an expert on brain cancer.  He is co-deputy director of the Preston Robert Tisch Brain Tumor Center at Duke University Medical Center.  In addition to hearing about the latest treatments for the disease, you’ll see the secret behind how we do long-distance interviews for the CBS Evening News with Katie Couric.


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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…

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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…

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Latest Cartoon

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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…

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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…

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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…

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