May 28th, 2011 by RyanDuBosar in Research
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Heart-ache can be a literal thing, as well as a metaphor for all those weepy, jilted-lover torch songs.
Consensus thinking in the peer-review literature is that the parts of one’s brain responsible for physical pain, the dorsal anterior cingulate and anterior insula, also underlie emotional pain.
Researchers at Columbia University in New York recruited 40 people who’d recently ended a romantic relationship, put them in a functional magnetic resonance imaging machine, and recorded their reactions to physical and then emotional pain.
Physical pain was created by heating the person’s left forearm, compared to having the arm merely warmed. Emotional pain was created by looking at pictures of the former partner and remembering the breakup, compared to when looking at a photo of a friend.
The fMRI scans showed physical and emotional pain overlapped in the dorsal anterior cingulate and anterior insula, with overlapping increases in thalamus and right parietal opercular/insular cortex in the right side of the brain (opposite to the left arm).
The theory is that Read more »
*This blog post was originally published at ACP Internist*
May 23rd, 2011 by RyanDuBosar in Humor, Quackery Exposed, True Stories
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Every once in a while, a press release comes along that’s worth mocking publically. Here’s one of them.
In honor of National Mental Health Month, one PR flack pitched Philip Stein watches. In the flack’s words: “The highlighted element of the watch is the brand’s exclusive wellness technology that helps wearers improve sleep and reduce stress. The watch is embedded with a metal disk that emits natural frequencies into the body wearer and in turn, affects the wearer’s energy field. It’s called ‘Natural Frequency Technology’ and is a new patented technology studies suggest help to improve sleep quality and reduces stress.”
Really. That’s what the flack said. Right off the bat, he’s gone from mental health issues to sleepless nights from stress. Not content with confounding the two issues, he continues: “Dr. Jeff Gardere, America’s well-known psychologist, is Chief Medical Executive for Philip Stein Watches and had been running a practice for over 20 years. He recognized during that time that there was a huge need to educate the public on the possible severities of stress and everyday lifestyle changes that everyday people can make without a prescription. Dr. Gardere found a natural way to reduce stress and prescribed his patients with a high-end accessory Philip Stein Watch.”
The psychologist “prescribed” a watch. I wonder if my insurance company would pay for that scrip? Read more »
*This blog post was originally published at ACP Internist*
May 23rd, 2011 by John Mandrola, M.D. in Opinion
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“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*
May 21st, 2011 by DrWes in Opinion
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I wonder if we’re in danger of stifling fun in medicine.
Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community.
There is a social camaraderie in medicine when you train. Maybe it’s the “misery loves company” syndrome. In medical school you stick together through thick and thin because few others understand what you’re going through. You strive for the day when, collectively, you earn the designation of “doctor of medicine.” There’s a strength in numbers.
But as our work flows become regimented, our geographic coverage areas more dispersed, and our hours more fragmented, I’ve seen the loss of the collegiality of the doctor’s lounge being replaced with the coldness of e-mail blasts. I’ve seen the loss of summer picnics with my colleagues’ families replaced with “Doctor Appreciation Day.” After work get-togethers that included our spouses and kids are have long since gone – most of us just want to get back home to re-group for the next day ahead. Read more »
*This blog post was originally published at Dr. Wes*
May 19th, 2011 by Harriet Hall, M.D. in Health Tips, Opinion
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In my recent review of Peter Palmieri’s book Suffer the Children I said I would later try to cover some of the many other important issues he brings up. One of the themes in the book is the process of critical thinking and the various cognitive traps doctors fall into. I will address some of them here. This is not meant to be systematic or comprehensive, but rather a miscellany of things to think about. Some of these overlap.
Diagnostic fetishes
Everything is attributed to a pet diagnosis. Palmieri gives the example of a colleague of his who thinks everything from septic shock to behavior disorders are due to low levels of HDL, which he treats with high doses of niacin. There is a tendency to widen the criteria so that any collection of symptoms can be seen as evidence of the condition. If the hole is big enough, pegs of any shape will fit through. Some doctors attribute everything to food allergies, depression, environmental sensitivities, hormone imbalances, and other favorite diagnoses. CAM is notorious for claiming to have found the one true cause of all disease (subluxations, an imbalance of qi, etc.).
Favorite treatment.
One of his partners put dozens of infants on Cisapride to treat the spitting up that most normal babies do. Even after the manufacturer sent out a warning letter about babies who had died from irregular heart rhythms, she continued using it. Eventually the drug was recalled.
Another colleague prescribed cholestyramine for every patient with diarrhea: not only ineffective but highly illogical.
When I was an intern on the Internal Medicine rotation, the attending physician noticed one day that every single patient on our service was getting guaifenesin. We thought we had ordered it for valid reasons, but I doubt whether everyone benefited from it. Read more »
*This blog post was originally published at Science-Based Medicine*
