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When Puberty Ends

I heard a 23-year-old woman complain: “I must be getting old when 11:00 at night is late.” It got me thinking.

It turns out that the explanation for why teens are natural night owls has recently been elucidated. They can’t help it — they just don’t get tired until way later in the evening. Then, of course, their bodies want to stay asleep well into the next morning in order to feel sufficiently rested. Since most of them are stuck with the artificial structure of school hours, they’re screwed — and condemned to suffer constant fatigue from cumulative sleep deprivation. Old news.

Then I started wondering about the back end of this phenomenon. Even though our American “youth culture” attributes great coolness to late-night happenings, since this pubertal sleep shift is biological, there must come a point at which their pineal glands go back to releasing melatonin at a more reasonable hour. Does 10 years sound about right? I remember not being nearly as enamored of the “all-nighter” by the time medical school rolled around, as opposed to college, where staying up all night was a regular occurrence. Certainly by residency (ages 26 to 30), it was a killer. Read more »

*This blog post was originally published at Musings of a Dinosaur*

There’s Nothing More Important Than Your Health

I don’t do well with pain. I learned that lesson all too well during the birth of my first son when, after 10 hours of labor jump-started by a pitocin drip, I finally got an epidural. Nothing — and I mean nothing — has ever felt as good as the ebbing of that pain. I relearned the lesson during the birth of the second son, this time determined to go natural all the way when, after a few hours, I told the doula to “shut up” and ordered my husband to hunt down the anesthesiologist and “Get me an epidural — NOW!” He listens well.

By the time the third son was born, I had the drill down pat. I was admitted to the hospital to be induced again but this time, as soon as the IV was hooked up and before the first labor pain hit, I had the anesthesiologist in the room putting in the epidural. It was a completely painless birth — and a lot of fun.

My issues with pain extend to my issues with being sick. I simply do not like not feeling ill. I’ve been very lucky and extremely blessed in my life — the most serious thing I’ve ever had wrong with me was strep throat or a stubborn sinus infection. As a medical writer, I’m far too familiar with all the things that could go wrong with me, so I feel guilty even complaining about my minor issues. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

Will Science Succeed With An Anti-Aging Revolution?

The Youth PillWouldn’t it be great if we could find a way to prolong our lives and to keep us healthy right up to the end? Ponce de León never found that Fountain of Youth, but science is still looking. What are the chances science will succeed? How’s it doing so far?

In his new book The Youth Pill: Scientists at the Brink of an Anti-Aging Revolution, David Stipp tries to answer those questions. From the title of the book, I expected hype about resveratrol or some other miracle pill, but instead it is a nuanced, levelheaded, entertaining, informative account of the history and current state of longevity research. It makes that research come alive by telling stories about the people involved, the failures and setbacks, and the agonizingly slow process of teasing out the truth with a series of experiments that often seem to contradict each other.

Anti-aging can mean several things. Extending the average lifespan is not the same as extending the maximum lifespan. Extending lifespan is not the same as preventing the degenerative changes characteristic of aging. Read more »

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

Relational Medicine: The Joy Of Primary Care

I was happy when I looked at [the day’s] schedule. Two husband-and-wife pairs were on my schedule, both of whom have been seeing me for over 10 years. Their visits are comfortable for me — we talk about life and they are genuinely interested in how my family is doing. They remember that I have a son in college, and want to know how my blog and podcast are doing. I can tell that they not only like me as a doctor — they see me, to some degree, as a friend.

Another patient on the schedule is a woman from South America. She has also been seeing me for over 10 years. I helped her through her husband’s sudden death in an accident. She brings me gifts whenever she goes on her trips, and also brings very tasteful gifts for my wife. Today she brought me a Panama hat.

I know these people well. I know about their past illnesses and those of their children. I know about their grandchildren, having hospitalized one of them over the past year for an infection. I know about the trauma in their lives as well as what they take joy in. They tell me about their trips and tell me their opinions about the healthcare reform bill.

I spend a large part of their visits being social. I can do this because I know their medical situation so well. I am their doctor and have an immediate grasp of the context of any new problems in a way that nobody else can. Read more »

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

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 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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