“How many lives did you save today, Dad?”
That is what my kids would ask me, rather sarcastically, many years ago, when they were young and when I arrived home late, missing our game of backyard basketball. They knew I was a neurologist. And, of course, they knew I didn’t exactly save lives since, as I had explained to them many times, my job consisted of giving folks lots of medications …
In June, the FDA approved aducanumab (Aduhelm) to treat patients with Alzheimer’s disease using the agency’s accelerated approval pathway, despite significant concerns about the evidence regarding the drug’s safety and effectiveness. The agency’s approval decision contradicted the recommendations of its own advisory committee, which voted overwhelmingly against the evidence presented in support of the drug. Soon after approval, three members of the committee resigned in protest. …
“When I was diagnosed as gene-positive for HD, just over ten years ago, there wasn’t anything promising on the horizon in terms of a cure. It has only been since new clinical trials were announced in the past few years that I have allowed myself to feel a tiny bit of …
The Food and Drug Administration (FDA) negated the recommendation of its expert panel and approved Aduhelm to treat Alzheimer’s dementia (AD), contending that the possible benefit trumped the lack of evidence of efficacy. The FDA was inexcusably in error in making this decision. Aside from the likely lack of benefit, the use of this drug can result in many negative consequences that make its use ethically questionable.
The manufacturer submitted two …
I have dedicated 35 years of my life as a nurse: in the ICU for 33 years and behavioral health/intensive management for the last two.
I thought it would be time to take a break from ICU nursing. Surely behavioral health would be a lot easier — kind of a slide into my near-future retirement.
I entered into the land of psychotics and schizophrenics, bipolar, homeless, dangerous patients from prison, like those …
In 2019, we (authors SM, LC) initiated a research study on the experience of care partners of people with Parkinson’s disease psychosis (PDP). Among other activities, participants wrote a letter to their care recipient’s doctor to the prompt: “Understanding that you know the most about this person, specifically their PD psychosis because you likely spend the most time with them (certainly more time than the doctor gets to spend with …
Before you jump on the diet bandwagon with your brother-in-law (who’s crowing about shedding all that weight with so little effort), think about the potential downside.
The problem with an ill-thought-out diet:
Fad diets are designed to take off weight as quickly as possible. They often ignore the long-term effects that might occur regarding both the brain and spine. Someone embarking on a radical weight loss …
Brain science explains why visualization improves performance in the real world, helps make better decisions, and minimizes errors.
Before performing surgery, let’s say for a herniated disc, I stand in front of a white porcelain sink. Antiseptic bubbles cover my hands and drip from my forearms. The surgery takes place in my mind, playing like a movie on the inside of my eyelids: The setting of retractors, …
“I think I’m having a stroke.”
The words struggled to leave my mouth as I spoke to the 9-1-1 operator. Emotionally in disbelief, the words seemed so unusual to say in the first person. Ten minutes earlier, overwhelming nausea and drenching sweats woke me abruptly from sleep. Thinking it was something I ate, I immediately regretted the preceding meal that must have been responsible. My attempt to get to the bathroom …
Assessment without definition: a flat tire on the road of progress
Even though we have known about prions for decades, very little progress has been made in defining what a prion is vs. what a prion is not, how they get into the brain, and how prion diseases are different from other neurodegenerative diseases. Phenomenologically these definitions can vary widely. To some, a prion causes a deadly, …
Serious soul searching can give anybody a headache, but when a young woman asked me that, I was taken aback in my neurosurgery clinic. Huh? I said. Do you know René Descartes? The pineal gland is the “seat of the soul.” Well, my pineal gland has a cyst and is more like the “seat of my misery.” It turns out this eloquent young woman in her early 20s was a …
Some of you may have heard it on the playground. Others might have used it in jest. I’m not going to write it. I’m just going to call it the R-word because it’s that disgusting.
It’s a slur against people with intellectual disabilities that you will see peppered in many news stories.
NFL player Janoris Jenkins was cut from the New York Giants for using the word; Khloé Kardashian promised to “do …
It’s been dubbed “COVID brain fog,” the neurological symptoms suffered by an estimated 80 percent of people who are hospitalized with COVID-19. These are early dementia-like neurological problems that patients face even after recovering from COVID-19, and there is a concern that people who recover from the disease have a higher risk of long-term cognitive decline.
We have always encouraged people age 50 and over to undergo a baseline cognitive assessment. …
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Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy in which the body’s immune system attacks peripheral nerves. Clinical and epidemiological evidence seems to indicate that most cases are preceded by an infection such as Campylobacter jejuni enteritis, but in many cases, no cause is identified.
GBS is characterized by symmetrical muscle weakness that begins in the legs and ascends. The degree of weakness can vary from mild difficulty with ambulation …
Before direct-to-consumer ads, physicians tried to reassure patients they were probably fine. Today, drug ads and online symptom checkers do just the opposite. The most insidious are “unbranded” ads that scare people about a disease without mentioning the drug they are trying to sell. Notable unbranded disease campaigns sell the obscure exocrine pancreatic insufficiency, shift work sleep disorder, and non-24-hour, sleep-wake disorder. Unbranded advertising is designed to appear like a …
The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works. Not for the better!
The various cable …
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“90 percent of what you will learn over the next four years will be wrong in a couple of decades from now.”
Speaking to a lecture hall of 120 first-year medical students, our professor’s prophecy seemed to fall on deaf ears. Looking around, I saw no concerned students, no diminishment of our collective enthusiasm. For me, however, his words of caution struck a chord on that first day of medical school.
As …
On several occasions, most recently during a press conference in March 2019, Speaker of the House Nancy Pelosi has advocated changing the voting age to 16. Pelosi told reporters that lowering the voting age would increase engagement in politics among younger Americans and would help drive a higher level of voter awareness and turnout.
Speaker Pelosi is not the only prominent lawmaker to advocate for a lowered voting age. Also in …
The incidence of brain trauma has been rising in recent years. According to the Centers for Disease Control and Prevention (CDC), emergency department visits related to traumatic brain injury (TBI) increased by 53 percent in the U.S. from 2006 to 2014. For 2014 alone, the CDC reported about 2.87 million TBI-related visits, hospitalizations, and deaths. Reports of concussions in high school athletes have also increased in recent …
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A patient walks into the doctor’s office and says:
I hate feeling this way. Yes, I know it’s not cancer and it won’t kill me, but this shaking has made me a different person. I can’t sign my name. I drop and spill things all the time. I’m afraid to pick up my baby grandson. I don’t go out anymore because I’m embarrassed. And I don’t know what can be done. …
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