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Latest Posts

Diabetic Considers All She’s Learned In The Last 25 Years With The Disease

What I’ve learned in the last twenty-five years with type 1 diabetes:

  • Some of what “they” said is wrong.  It just is.
  • There are times when “they” make a good point, and it’s up to us as patients to figure out what information we react to.
  • The needles don’t hurt as much now as they did then.  Lancets have become smaller and sharper, syringes can make the same claim.  Insulin pump sites, once they’re in, usually go without being noticed.  Same goes for Dexcom sensors.  (But “painfree” is a misnomer and so subjective that medical device advertisers had best just steer clear of that word entirely.  All needles pinch at least a little bit.)
  • Progress isn’t always shown in tangible technological examples.  Sometimes progress is being able to look at a blood sugar number without feeling judged by it. Or to look in the mirror without wishing you were different.
  • There is life after diagnosis.
  • Diabetes is sometimes funny.  It has to be. Read more »

*This blog post was originally published at Six Until Me.*

Culinary Metaphor Used To Understand Gene-Environment Interactions

a pie cut in almost half with the smaller piece labeled Environmental and the larger piece labeled GeneticA recent article in the Archives of General Psychiatry by Hallmayer et al. discussed the role of genetic and environmental factors in autism and autism spectrum disorders (ASD).  The study was a heritability analysis of 192 pairs of twins, which attributed 37 percent of the variation in risk of autism to genetic factors and 55 percent to shared environmental factors.  The authors contrasted their findings with those of previous studies, which had given genetics a much higher share (up to 90%).

Rather than contradicting previous research, the new results provide more evidence that autism, like many other common diseases, results from both genetic and environmental factors.  The way that these elements – often called “nature and nurture” – influence health outcomes has been discussed for decades but is often misunderstood, even among scientists.

Disease Causation is Not as Easy as… Pie Read more »

*This blog post was originally published at Genomics and Health Impact Blog*

The Man Who Died Well


One of my favorite patients died last week.

My reaction to this was not quite what you would think: I smiled.  No, I didn’t smile because of his death; I smiled because of his life.  I smiled because I got to be a part of that life.  His death wasn’t his tragic end, it was the exclamation point to his life.

I am around a lot of death – it’s one of the things that makes being a doctor different from other jobs.  My goal with all of my patients is to keep them healthy, to relieve their pain, and to do my best to keep them alive.  Ultimately, though, it’s a losing battle; 100% of them will eventually die.  That’s why I don’t like statistics about how many people who die due to inadequate doctoring.  Our job is to resist an irresistible force.  We are standing up to the hurricane, the avalanche, the flood. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Alternative Medicine’s Flawed Reasoning: The One True Cause of All Disease

Chiropractors, homeopaths, naturopaths, acupuncturists, and other alternative medicine practitioners constantly criticize mainstream medicine for “only treating the symptoms,” while alternative medicine allegedly treats “the underlying causes” of disease.

Nope. Not true. Exactly backwards. Think about it. When you go to a doctor with a fever, does he just treat the symptom? No, he tries to figure out what’s causing the fever and if it’s pneumonia, he identifies which microbe is responsible and gives you the right drugs to treat that particular infection. If you have abdominal pain, does the doctor just give you narcotics to treat the symptom of pain? No, he tries to figure out what’s causing the pain and if he determines you have acute appendicitis he operates to remove your appendix. Read more »

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

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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