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Oncologist Considers Heat-Based Cancer Treatment

There’s so much weird and exciting cancer news this week, it’s hard to keep up!

Double-kudos to Andrew Pollack on his front-page and careful coverage in the New York Times of the hyperthermic intraperitoneal chemotherapy (Hipec) technique that’s being used at some name-brand health care facilities to treat colon cancer.

First, he spares no detail in the Times describing the seemingly primitive, crude method:

….For hours on a recent morning at the University of California, San Diego, Dr. Andrew Lowy painstakingly performed the therapy on a patient.

After slicing the man’s belly wide open, Read more »

*This blog post was originally published at Medical Lessons*

In The News: Boosting Disease Prevention And Unethical TV Doctors

An article in the New York Times this week looks at a raft of new public health initiatives passed by Congress that are aimed at boosting disease prevention. Examples include requiring restaurants with at least 20 locations to include nutrition information on their menus and mandating employers with at least 50 employees to allow new mothers to express breast milk at work. In addition, Medicaid will now cover smoking cessation counseling for pregnant women and Medicare beneficiaries will be eligible for an annual physical. The initiatives are expected to eventually save money by decreasing the country’s chronic disease burden. (New York Times)

Researchers from Johns Hopkins University recently did a study applying physicians’ ethical codes to the conduct of the fictional doctors on “Grey’s Anatomy” and “House, M.D.” Perhaps to no one’s surprise, TV doctors are behaving very badly. As the abstract of the study states, both shows feature “egregious deviations from the norms of professionalism and contain exemplary depictions of professionalism to a much lesser degree.” (Philadelphia Inquirer, Journal of Medical Ethics)

*This blog post was originally published at ACP Internist*

Fecal Transplants: Getting To The Bottom Of The Matter

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The blogosphere has been buzzing lately about the idea of “fecal transplants,” probably because this treatment (first studied in the 80′s) was recently mentioned on Grey’s Anatomy. Proponents of the therapy (which involves the introduction of donor stool into a patient via enema or naso-gastric tube) say that it can rejuvenate intestinal flora and cure c. diff colitis, and various inflammatory bowel disorders. I had my doubts about these claims and decided to interview gastroenterologist Dr. Brian Fennerty to get to the bottom (sorry abou the bad pun) of this issue.

Dr. Fennerty is a Professor of Medicine in the Division of Gastroenterology at Oregon Health & Science University in Portland, Oregon, where he also serves as Section Chief of Gastroenterology.

Listen to the podcast here:

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Dr. Val: What exactly is a “fecal transplant?”

Dr. Fennerty: First, by way of background, you need to understand that the GI tract is populated with thousands of varieties of “good” bacteria that are essential for our health. If we didn’t have bacteria in our colon and small intestine, we would die. Fecal transplantation is the repopulation of a person’s gut bacteria (flora) with fecal matter from somebody else. Some argue that this helps to treat certain diseases.

Dr. Val: How is this procedure performed?

Dr. Fennerty: As it was originally described, fecal transplantation involved removing the undigested food particles from the stool sample of a “healthy” person, and then spinning it so that a pellet (of hundreds of thousands of species and quasi-species of bacteria) remains. The pellet is then introduced to the patient through a nasogastric tube into the small intestine, or the pellet can be resuspended in liquid and introduced into the rectum via an enema. The idea is that the bacteria will colonize the patient’s colon and squeeze out the bad bacteria that are in there.

Dr. Val: What are fecal transplants purported to do?

Read more »

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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