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How To Brighten Your Physician’s Day

I walked around the office today with a little extra spring in my step. It felt really good to be a doctor this day.

So when good sensations come, I always look back on why they happened. (Like cyclists do when they have really good legs. Maybe it was that bee pollen?)

But like having good legs on the bike, good sensations in the office come from more than one thing.

Eight hours of sleep?

A morning hug from my best friend, my wife Staci?

Two coffees?

A really good blueberry muffin?

No arrhythmia overnight in the AF ablation patients?

Good thresholds on yesterday’s (evidenced-based) ICD?

Perhaps.

But I felt really springy after being greeted by this… Read more »

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

Statins Reduce Heart Disease Risk, But Probably Not Because They Lower Cholesterol

When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers.

“…My cholesterol is this…What do you think?”

“…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.”

All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa.

I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?”

But more often than not people want to know about cholesterol.

Okay. It just so happens that this week brought some very interesting news concerning the treatment of abnormal cholesterol lab values. News that big-picture docs have to like. Read more »

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

Stop Watches May Be Better Than CT Scans At Predicting Heart Disease

It is hardly news to say that we need better means to predict who will die of heart disease. No matter how much you may hear about medical errors, hospital acquired infections, or even distracted driving, it’s still heart disease that kills the most of us.

The inflammation that begins narrowing our arteries starts when we are young. It percolates quietly, stealth-like for years. The young usually skate by unscathed. But all the cookies, beers, chips, inactivity and work stress adds up. The tension of life squeezes our arteries, daring them to crack or fissure. This cataclysm is one of the ways that middle age may introduce herself.

A friend, or colleague, or sibling dies suddenly of heart problems. Those of us that our “masters-aged” have likely felt these sensations of sadness, and then the reality that they may be next.

“I should probably come in and get a check-up,” is something I hear frequently in the doctor’s lounge after such a tragedy.

I agree. When you are old enough to use reading glasses it is time to think about what lurks inside your heart’s blood vessels.

But herein lies the catch. Read more »

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

Differences Between American And German Healthcare Systems: One Physician’s Perspective

I have been in Hamburg, Germany for the past five days. I enjoyed an amazing opportunity to visit one of the world’s most respected heart rhythm labs. Among other things, the main purpose was to learn a new way to ablate atrial fibrillation.

It was an incredible learning experience, one for which I owe an enormous debt of gratitude to the kind and generous people of Dr Karl-Heinz Kuck’s EP lab. Though these people are famous, they treated me as a respected colleague.

Details of all that I learned regarding this newly-approved ablation technique is a matter for future posts. Suffice it to say, I already feel like a better AF doctor.

For now, may I highlight a few of the more striking differences between Europe and the States, as noted by a Kentuckian on his first trip across the Atlantic? Read more »

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

Perfectionism Will Keep You Cramped And Insane Your Whole Life

“Perfectionism is the voice of the oppressor, the enemy of the people. It will keep you cramped and insane your whole life…

…I think perfectionism is based on the obsessive belief that if you run carefully enough, hitting each stepping stone just right, you won’t have to die. The truth is that you will die anyway and that a lot of people who aren’t even looking at their feet are going to do a whole lot better than you, and have a lot more fun while they’re doing it.”

—Anne Lamott, Bird by Bird

Wow.

This paragraph hit me between the eyes. I’ve now read it about ten times in the past 24 hours. Ms Lamott was talking about the first draft of a manuscript. Just get it down on paper, willy-nilly, free lance, she said. Let loose and enjoy yourself she goes on to advise.

But these words spoke to me about so many other things in life. Read more »

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

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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