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Latest Posts

The Vocal Strength Of A Lion Helps Us Understand The Weak Voice In Some Humans

Researchers in Iowa have discovered what makes a lion or tiger roar so effectively. Apparently, there is a layer of fat within large feline vocal cords that makes the vocal cords especially prone to vibrate easily with minimal exhalation effort.

What import does this have to humans?

Well, there are patients who have a very weak voice due to vocal cord atrophy as well as vocal cord paralysis. Standard interventions include voice therapy as well as surgical procedures using an implant or injectable material in order to “bulk” up the vocal cord.

In fact Read more »

*This blog post was originally published at Fauquier ENT Blog*

Changing The Feel Of The Physical Exam

I suffer with herniated lumbar disks.  L4-L5 bulges and ruptures on occasion.  If you catch me on the wrong day I have a little curvature to my back representing the spasm that makes me miserable.

I saw an extremely well-referenced orthopedic surgeon in consultation recently.  But through the course of my visit he never touched me.  We spent an extraordinary amount of time examining my MRI.  Together in front of a large monitor we looked at every angle of my spine with me asking questions.  I could see first hand what had been keeping me up at night.  I could understand why certain positions make me comfortable.  What we drew from those images could never be determined with human hands.  In my experience as a patient, I consider it Read more »

*This blog post was originally published at 33 Charts*

Scientists Study The Shape Of The Nose And Its Relationship With Climate

The basic function of the human nose is to warm and humidify the air before it reaches the lungs. Because of the wide variation of human habitats from the polar cold and dry air to the equatorial hot and humid weather, one would expect the nose to accommodate to these climate extremes accordingly through evolutionary pressures.

In essence, logically one would expect the nose to change shape to enhance time that air is in contact with the warm and moist nasal interior in cold and dry climates compared to the opposite environmental extreme.

German scientists evaluated this hypothesis through Read more »

*This blog post was originally published at Fauquier ENT Blog*

Doctors Are Human, Too

It’s all too easy to try and quantify everything in medicine. We are, after all, under the widely held delusion that medicine is like physics. A thing that follows fixed, predictable mathematical models. A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease.

This belief is also held by the government, which doesn’t want to pay for readmissions or mistakes. Because it is believed that all things in medicine can be known from an exam, some labs, some tests, and some studies.

Nevertheless, things happen. Disease are transmitted in public or by families. Medications don’t always work. Bodies change. Bodies age. Humans are non-compliant. Humans are suffering from physiologic phenomena we can’t yet comprehend. Viruses are synergistic with other diseases.

The immunity of our patients is affected by their happiness, their diet, their work history, their family. The algorithms necessary to make medicine anything like physics would be mathematically beyond comprehension. Read more »

*This blog post was originally published at*

Medicine Is A Human Thing

If there is a central theme to this blog, it is this: Medicine is a human thing.

On the Facebook page of my podcast, I recently asked for readers to tell me some of the “war stories” they have from the doctor’s office. What are some of the bad things doctors do wrong? I quickly followed this with the flip side, asking readers to comment on the best interactions that they’ve had with their doctors.

The response was overwhelming, and equally quick to both rant and rave. They told stories about doctors who didn’t listen, explain, or even talk with them. They told about arrogance and disconnectedness from the people from whom they were seeking help. They also told about doctors who took extra effort to listen and to reach out in communication. They talked about doctors who genuinely seemed to value them as humans. 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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