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NIH Director Francis Collins Jams With Aerosmith’s Joe Perry At Capitol Building

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Rudy Tanzi, Joe Perry, Francis Collins

I know. I was just as surprised as you are. Dr. Francis Collins, former director of the Human Genome Project, author of The Language Of God, and new director of the National Institutes of Health performed live in front of a group of Washington locals at the Capitol building today. He actually jammed with Aerosmith’s Joe Perry in an “unplugged” performance of Bob Dylan’s, “The Times They Are A Changin’.” This is not the kind of thing one expects in the hallowed halls of the Capitol building. But maybe it’s time to expect the unexpected?

I happened to have my reporter’s microphone with me in the audience so I recorded the song. The vocalist is Dr. Collins, Joe Perry does a guitar solo near the end, and Dr. Rudy Tanzi is on harmonica. The sound quality is… well… it’s what you’d expect from a hand-held microphone. But it’s worth a listen, just to get to know our new NIH director a little better!

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Delta Goodrem

Australian pop star and cancer survivor Delta Goodrem followed Dr. Collins with this acapella beauty (again, forgive the sound quality):

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A few things struck me about the event. First of all, Francis Collins is more of a “firecracker” than I expected. I read and reviewed his book recently, and his vivacious personality did not come through in its pages as well as it did on the stage with Joe Perry. He’s a fun-loving guy, a serious scientist, and very committed to advancing research and encouraging young people to rekindle their interest in discovery. That’s all very good news for America.

Secondly, I was touched by Joe Perry’s story about wanting to be a marine biologist when he grew up. Apparently he had a learning disability of some sort that was not addressed in school. For that reason, his test scores suffered and he looked for ways to excel outside of the classroom. His bright mind discovered an immediate affinity for music, and he poured himself into a career as a rocker. He still yearns for the ocean, though, and is a certified diver. As I looked at Joe, I kept thinking – my gosh, he might have been the next Jacques Cousteau if he had more help in school. But brilliance finds its own way to flourish – and Aerosmith became his outlet instead.

Thirdly, I realized that there are in fact a few congressmen with their heads screwed on straight when it comes to science. I had almost lost hope after watching video footage of Tom Harkin instructing scientists to validate his opinions rather than test whether or not certain things were true. Yikes. But the three co-chairs of the congressional biomedical research caucus, Reps Brian Bilbray, Mike Castle, and Rush Holt, seemed to truly understand some of the issues facing the advancement of medical research – and are determined to move America forward.

And finally, I noted that there wasn’t a single female or minority “rock star scientist” in the program. That made me a little bit sad. Are we really that rare? I guess we still have a long way to go on that front… And since Dr. Collins mentioned that only 15% of US students are enrolled in science or engineering bachelors’ programs (compare that to 50% in China or 75% in India) we are soon going to be playing catch up with the rest of the world in terms of scientific discovery.

So we’ve got our work cut out for us folks – with our youth’s waning interest in science education, the excessive red tape that is slowing down the process of producing cures, and the public getting their medical advice from the likes of Jenny McCarthy, there has never been a more important time to restore science to its rightful place.

Maybe Francis Collins is going to “bring sexy back” to science?

Whatever works!

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More info on the Rock Stars Of Science program.


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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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