I cannot get behind fat acceptance, or better stated in medical lingo as “normalizing obesity.” As a physician and as someone who has been obese or morbidly obese my adult life, I know first hand what it’s like to hate my body and feel ashamed of it. I still do this very moment as I type this, that’s something I have to work on.
Funny thing is, I am much more …
Don’t sign off on fat acceptance. Don’t normalize obesity.
I’m a pathologist and the main way I communicate to the outside world — to your doctor and ultimately to you, the patient is via the pathology report. But the short missives I send from behind the microscope lack any excitement and can fall short of full communication.
Here’s the usual story:
Skin left scapula, biopsy
Nodular basal cell carcinoma
Negative for perineural invasion
Margin status: Positive
Doesn’t sound real interesting, does it?
How about a more …
A breakdown of your pathology report
Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different.
I am a family medicine physician dealing with congenital heart disease (CHD). Saying that someone has congenital heart disease …
A physician with congenital heart disease
There exists a large, mostly-underground, growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology.
Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a benzodiazepine news story:
In response to …
Words can hurt those on benzodiazepines
1. Cancer is not rare. Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think. Outside of my work, I can think of 3 people who I know personally that had a childhood cancer. A teammate on my high school basketball team, my sister-in-law, and a high school debate teammate. My guess is that you also know someone from church, a coworker’s …
10 things a pediatric oncologist wants you to know
On a curiously warm morning last February, the minister arrived at my childhood home to guide my father to the other side. When he approached the bedside where all of us were gathered around with the Eagles Pandora radio humming in the background, my dad emerged from a semi-conscious state and sat up as best as he could. “Listen. I am not dying,” he declared. As an early-career researcher focused …
The existential benefits of ginger ale
Trends or challenges have been a part of the fabric of social media for a long time. They have ranged from the benign ice bucket challenge (which raised millions for research on amyotrophic lateral sclerosis) to the highly dangerous Tide pod challenge (which involved eating laundry detergent capsules). All of these internet phenomena involved videotaping an individual who performed a bizarre physical action for the …
The problem with extreme social media challenges
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and …
MKSAP: 49-year-old woman with obesity, hypertension, and type 2 diabetes mellitus
Recently, a respected allergist reassured his audience: the mortality rate for food allergy is very low. The risk of dying in a car crash is much greater than the risk of dying from food allergy. The implication seemed to be that the anxiety around food allergy is misplaced. Though any loss of life is too great; statistically, food allergy deaths are rare. To the food allergy community, it just doesn’t …
Food allergy: Death is not our only fear
If somebody asks you how many bones there are in a human body, please do not blurt out, “206.” The correct answer is nuanced. To respond accurately to the query, you have to address five questions. Who? What? When? Where? Why?
Consider first that humans vary from one another in facial features, hair color, height, and shoe size. Unknown to nearly everybody except …
How many bones in the human body? It’s not what you think.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and swollen glands, but had otherwise felt well. Medical history is otherwise unremarkable, …
MKSAP: 25-year-old man with dark-colored urine
We’ve all been through difficult times. It may be the death of someone we love or suffering abuse with no one to help. In life, many events fly at us that are hard to manage. Many of us just suffer silently through the pain, not allowing anyone in. And even while we do that, we also know that is not the healthiest response.
Many patients come to me struggling with anxiety …
How to deal with hardships in life
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Medical history is notable only for recurrent deep venous thrombosis. She takes no other medications.
On physical …
MKSAP: 77-year-old woman with frequently fluctuating INRs
There are at least 50 words in the Eskimo languages for snow, 25 in mainstream Swedish, and supposedly 180 or so in the Sami language of the nomadic inhabitants of the northernmost parts of Norway, Sweden, and Finland.
But there are even more words than that for “chest pain” among my patients, many of whom do not consistently or fully comprehend the English phrase, “If you have chest pain, call 911 …
The many ways to describe chest pain
Long ago primitive sharks had ridges running down their sides from gill to tail. Later, muscles grew into the folds, and eventually, the central portion of each ridge receded while the ends enlarged to form fins both fore and aft. All was well.
Then one day several hundred million years ago, a fish was swimming blissfully in a shallow pool. The tide went out …
The human hand: not really that good for anything
Urgent care centers are way ahead in prescribing unnecessary, potentially harmful antibiotics that are doing no one any good – at least no patients any good. The owners of the urgent care centers are the ones who are benefitting. And you and your family are being bilked, misled, and harmed.
A recent study published in JAMA Internal Medicine looked at the proportion of antibiotic prescriptions that were made for viral respiratory …
Urgent care centers prescribe more antibiotics. Why is that?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old woman is evaluated for a new-patient visit. Medical history is significant for an eating disorder. Although she has maintained a normal weight for the past 20 years, she notes that prior to that time her weight would fluctuate in a range correlating with BMIs of 17 to 19. She has otherwise …
MKSAP: 55-year-old woman with an eating disorder
All of our 200+ bones have names, which facilitates describing them when we cannot actually hold them or point directly at them. It might be easier to remember the names if they were familiar ones like Robert, Sally, and Kevin, but no such luck. Latin was the original language of science, so the bones received Latin names. Some of those were derived …
Who named our bones? And what were they thinking?
The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake …
A physician’s warning on the keto diet
Recently, a journalist with NPR asked her audience if sleeping with your baby is as dangerous as doctors say. In short, yes, it is very dangerous.
In the article, Michaeleen Doucleff repeatedly trivializes the danger of parents co-sleeping with their baby. She uses anthropological evidence to reassure parents that sleeping with their infant is safe if parents don’t drink, smoke, or use illicit drugs. She makes light …
Sleeping with your baby: Mainstream media gets it wrong
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