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How Your Skin Tells Your Story: A Poem

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In the March 3, 2010 issue of JAMA, there is a poem by Sarah Wells called “Hymn of Skin.”  While I enjoyed the whole poem, my favorite part is:

Plastic surgeon of the heavens, how I delight
in a furrowed brow, crow’s feet, age spots—
wrinkle me up a dozen times to show I lived
hard, good, funny—after all beauty, being what it is,

is only skin deep—may my soul seep through
dry scales of later hands, resting tranquil in my lap.
O omniscient dermatologist, what ingenuity,
past hurts evident in scrapes and scars—

a clumsy stumble down uneven concrete stairs,
knees and ankle raw and dripping; pockmarked cheeks
from teenage zits—all healed, in the end, but not forgotten.
How often we need reminders of where we’ve been.

*This blog post was originally published at Suture for a Living*

Steroid Use, BMI, And Risk Of Death

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You might already be aware of this week’s finding if you’ve watched baseball in the past decade or so and noticed that Mark McGwire’s arms are about the circumference of the average ballplayer’s waist in the 70s. But just to be sure, researchers recently compared the BMIs of professional baseball players from 1876 to 2007 to find that, like serving sizes and master bathrooms, they’ve gotten bigger.

Clear, right? But in taking the next step, drawing conclusions from this study, this article from HealthDay gets about as confused as a science article can be. The study authors are concerned because they correlated the ballplayers’ “increased BMIs with an increased risk of death.” (We’re assuming that’s a risk of premature death, since it seems pretty certain that the 1876 team would be dead regardless of their % body fat.)

But a critic of the study argued first that ballplayers’ increasing size is not a health risk, and then that the players might be dying early because they’re using steroids. Um, we’re not scientists, but mightn’t there be a relationship (even a causal one, perhaps?) between steroid use and increased BMI?

*This blog post was originally published at ACP Internist*

Why Does A Salad Cost More Than A Big Mac?

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A reader pointed me out to this current food pyramid subsidy model showing what the daily recommended servings are for each category of food compared with how the federal farm subsidy programs actually work against the goal of a healthy nation.  You can click on the image to enlarge it and take a close look at how powerful lobby groups have become.

There is no reason why dairy and meat farmers should be getting 50 billion dollars in farm subsidies.  And if we are playing the subsidy game (which I think is a fraud), why are vegetables, one of the most healthy things we can put in our mouth, getting slaughtered at the table of entitlement handouts? Read more »

*This blog post was originally published at The Happy Hospitalist*

Is Acupuncture Valuable In Treating Depression?

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One of the basic principles of science-based medicine is that a single study rarely tells us much about any complex topic. Reliable conclusions are derived from an assessment of basic science (i.e prior probability or plausibility) and a pattern of effects across multiple clinical trials. However the mainstream media generally report each study as if it is a breakthrough or the definitive answer to the question at hand. If the many e-mails I receive asking me about such studies are representative, the general public takes a similar approach, perhaps due in part to the media coverage.

I generally do not plan to report on each study that comes out as that would be an endless and ultimately pointless exercise. But occasionally focusing on a specific study is educational, especially if that study is garnering a significant amount of media attention. And so I turn my attention this week to a recent study looking at acupuncture in major depression during pregnancy. The study concludes: Read more »

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

How Are Physicians Using Social Media?

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The time is approaching when businesses will want to capture the eyes and minds of physicians in the social world.  Throwaways and mailouts will give way to more current channels of communication.  Friends in the health
industry ask how they should connect with physicians using social media channels.

The rules really aren’t much different but here are a couple of things the consultants will never tell you:

I’m not on Sermo.  While Sermo and Ozmosis may seem like obvious targets, physician specific verticals are tricky.   The road to the successful physician network is littered with the skeletons of startups who went broke trying to capture our eyeballs.  While its hard to ignore Forrester’s bullish analysis of services like Sermo, I don’t
expect
the enthusiasm to be sustained.  Look to the next iteration of IMedExchange to possibly be a game changer
in this area.  Until then, the connectors who are going to get you where you want to go aren’t necessarily hangin’
with other doctors.  They’re found in the wild. Read more »

*This blog post was originally published at 33 Charts*

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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