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

Latest Posts

A “Can Do” Attitude Is Highly Heart-Healthy

Whenever a patient asks whether they can exercise, or go here, or there, I liken it to them asking whether they can live life. My answer is always the same…YES. The alternative seems terrible.

In this regard, moving on in the face of illness, let me share with you the writings of a very famous twitteratti, my friend, Melissa T (or @drSnit). Her post today about “doing sick well” struck my optimistic neurons.

You may wonder, how it is possible; putting sick and well together in the same sentence?  Let me share her writings…

Dr Snit, author of the blog, “Living with Lupus–But Dying of Everything Else,” should know. She lives with the disease called Lupus–a mysterious ailment known for its flares of inflammation. These spasms of joint, muscle and overall body aches make a post-ride soreness feel like nothing. It’s a tough lot having Lupus.

But yet, Dr Snit stomps forward in life–in defiance of the most inflamed of the inflammatory diseases. She writes Read more »

*This blog post was originally published at Dr John M*

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

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 »

Commented - Most Popular Articles