In July, we all got at least one day off to celebrate a very American holiday, Independence Day. If I were a betting man, I would say that many, if not most of you, participated in at least one of those grand old American pastimes: eating hotdogs or apple pie, barbecuing, going to a baseball game, floating in the pool, watching a movie, or … drinking alcohol. After your celebration …
Alcohol’s impact: hangovers and health risks
The Americans with Disabilities Act (ADA) requires that health care entities provide full and equal access for people with disabilities. Physicians must diagnose and treat such individuals, even though they receive little or no training in medical school. It’s tricky when the patient cannot convey where it hurts or describe their pain and may refuse to cooperate with medical procedures.
Many physicians have refused to take on my 35-year-old son, who …
Why health care professionals must back full care continuum for autism and intellectual disabilities
Recently, a group of researchers at the University of California, San Francisco, reported that they may have found the holy grail of pain management. They accomplished this by performing “the first-in-human, long-term direct brain measurement of chronic pain-related neural activity.”
Physicians have long sought a reliable way to detect and track the presence of chronic pain and its response to treatment but have failed completely so far. Old tropes like …
A breakthrough in chronic pain detection?
As an allergist/immunologist, the spectrum of mast cell disorders, including mastocytosis, idiopathic anaphylaxis, chronic hives, and angioedema, is not a new concept. That said, in recent years, we have seen an uptick in patients presenting with a spectrum of symptoms attributed to misbehaving mast cells. Although the medical community has acquired extensive knowledge of these more established diagnoses over time, the newer entity mast cell activation syndrome (MCAS) is not …
Challenges faced by patients with mast cell disorders
How should a patient deal with medical patient abandonment? A Japanese saying is, “It is better to fix the problem than to blame.” This invites a learning and growth opportunity for those with less knowledge and experience. Based on this, let us look at problem-solving for medical abandonment, neglect, and errors. The principle behind this philosophy follows the desire to allow an adversary to maintain face. If they take the …
Dealing with medical abandonment, neglect, and errors
After she developed a serious complication, she wanted to know the facts plainly stated. I told her the treatment would change her quality of life; it would be hard but doable. To this, she replied, “Now, don’t bullsh*t me, I don’t like bullsh*tters.”
These words were uttered by my resilient, 75-year-old patient undergoing peritoneal dialysis. She had recently developed one of the most dreaded complications of this treatment: calciphylaxis.
Her strong will …
A patient’s resilience and the challenge of dialysis
An excerpt from A Caregiver’s Love Story.
Many people will become caregivers in their lifetime, or on the other hand, may need one. A “caregiver” is anyone who gives basic assistance and cares for someone who might be ill, disabled, or frail. There are a wide variety of tasks …
Essential caregiver roles and self-care tips
On many occasions, patients have asked me whether it’s OK to eat fruit. They’re worried about whether they should be eating foods high in sugar. Is fruit in that category? No, it is not. Does anyone really believe that fruit is what’s causing the paired epidemics of diabetes and obesity? This scourge is not being caused by fruit.
Let’s think about this. As long as the sugar in the food you …
Fruit and sugar: Debunking the myths
I am perplexed by two different needles which, when viewed together, illustrate the irrational themes which dominate our shared humanity. They inform me that, despite being a doctor for more than twenty years, I honestly feel dumber each day about human behavior. If, unlike me, you have somehow figured out more along the way, good for you.
The first needle which vexes me was the one stuck in my arm on …
COVID vaccines and weight loss medications: a tale of 2 needles
A 2023 study of middle school-aged children laid out some alarming findings. Scientists recruited more than one hundred and fifty children, all aged twelve, from rural North Carolina public schools. The children were surveyed regarding their social media usage, including Facebook, Instagram, and Snapchat. Some of the kids rarely checked social media (one time or less per day), while others were glued to their screens, checking social media more than …
I’m a neurosurgeon. Social media may change your kid’s brain.
The Kaiser Permanente strike, with over 75,000 impacted employees, is the largest health care strike in the history of the United States. CNN reported that the affected workers are represented by a coalition of unions across California, Colorado, Oregon, and Washington and Oregon.
The strike, which is intended to last four days and involves 40 percent of Kaiser Permanente’s staff, could deeply impact patient care. The reality …
Will Kaiser Permanente see a spike in medical malpractice from the strike?
My fiancée had been complaining on and off about minor knee pain and swelling for months. She kept putting off doing anything about it, because she’s a former college basketball player who had already had two surgeries on that knee, and she assumed it was residual effects from those injuries. But I was having a slow day in clinic, so I told her to come in for an X-ray.
And then …
Don’t put off medical care: X-ray for minor knee pain finds tumor
There are no words more devastating than, “Our hands are tied” to a survivor reporting abuse and seeking some semblance of accountability from a larger institution. “The institution admitted no fault” is a close second.
Picture this sequence: a trusted physician at a renowned academic medical center sees a patient at a vulnerable stage in her life for a regular appointment. As she is exposed for a standard physical exam, he …
The role of institutions in medical misconduct
An excerpt from Life at High G-Force: The Quest of Mayo Clinic Researcher Dr. Earl H Wood.
Tensions were high in the Aero Medical Laboratory at Mayo Clinic in the fall of 1959. The space race with the Soviet Union to send a human into outer space and eventually to the …
Pioneering space race research: G-forces and human physiology
In the early 1990s, complementary and alternative medicine (CAM) began its rise with the development of the National Institutes of Health’s CAM center. However, scientists and clinicians struggled with the decision of whether or not to allow individuals access to information on these CAM approaches. I was part of that discourse as I was invited to speak at a congressional hearing on that very issue. Thankfully for everyone, the right …
What is the physician’s role in the food is medicine movement?
September was National Suicide Prevention Month. In a short while, we also approach the 41st birthday of the late Stephen “tWitch” Boss, a widely beloved dancer and executive producer of The Ellen DeGeneres Show whose death by suicide is still hard to grapple with
tWitch, who initially rose to prominence from the dance competition So You Think You Can Dance, captured the hearts of millions by running social media …
America’s young men are facing a mental health crisis. Can we help them before it’s too late?
An excerpt from Slow Dancing with the Devil: A Son’s Substance Use Disorder, A Mother’s Anguish.
The only time my anxiety was gone, or at least on pause, was when Luke was in a treatment center or sobriety house. I knew he was safe and surrounded by those who understood the …
Addressing dual diagnosis needs in addiction treatment
In a recent podcast conversation with Kevin Pho, MD, we talked about the importance of assertiveness in health care, including the ability to say “No” and the significance of culture in supporting it.
One of the topics we touched on was the influence of both top-down and bottom-up factors, which I want to elaborate on here.
Organizational culture refers to how and why things are done at work and the rules …
Communication, power dynamics, and organizational culture in health care
When we think of symptoms or ailments, they are often a signal to us that there’s something off with our health. Yet, many of us, as well as doctors, often don’t think so much outside the traditional box when it comes to what may be influencing or causing these health issues. I have even experienced this personally in my life.
Some people may even experience ongoing frustrations with concerns failing to …
Everyday dangers unknowingly impacting our health
Just a few weeks ago, the President’s Council of Advisors on Science and Technology (PCAST) issued a report, “A Transformational Effort on Patient Safety.” This was both a “surprise” and “not a surprise” to me because I’m a nurse, a subject matter expert in patient safety, and a shop teacher’s daughter.
PCAST’s call for action was not a surprise because in 2023, care intended to help patients harms them at an …
A shop teacher’s daughter on transforming patient safety
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