The death rate is down and the life expectancy is up. “Nothing but good news,” says the statistician.
Perhaps our prevention programs and treatments are working. Statistics are unwieldy things, but these are so general, the news of less death and more life can only be seductive. I want to look at it closer. I want to look at the differentiations among groups, which I doubt have changed. If you ever wondered about women living longer than men, both in the African-American race and the Euro-American races, you should have seen my waiting room the day I encountered a soft spoken and personable but physically-challenged African-American man. He was surrounded by obviously smitten females bearing gifts. Two of the three young ladies offered him homemade baked goods and made a point of telling the third she did not have a chance because she only had a dozen store-bought doughnuts. Read more on Why Do Some People Live Longer Than Others?…
If you have a choice and are not involved in an emergency, you can improve your chances of coming out of the hospital alive if you time it right.
I have read lots of articles suggesting that mortality in American hospitals is higher around July 1, when a new group of trainees finish medical school and start in their hospital based clinical training positions. This is not just an aberration in the USA, but apparently is also true in the U. K, where the new training programs start on August 1. Another cause of in-hospital mortality has been identified — When nursing staff falls below certain target levels, patients die. I do recall that nursing schools, at least when I was close to such things, did not have the same kind of fixed scheduling for trainees that medical schools did. When nursing students were present, they always seemed to be observing and logging in time, although whenever they had procedures, they were more rigorously monitored than physicians. Read more on How To Get Out Of The Hospital Alive…
Filed under Disease, Doctors, News by on Jun 2nd, 2011. Comment. 
The old guys were right.
I mean the really old guys, the ones who wrote over one hundred years ago. The guys like Freud and Janet who said that mostly everything that shapes people’s lives seems to be trauma — whether or not modern authors agree.
I have seen an anorectic whose trauma was a passer-by in a crowd who told her that she was too fat for anyone to have sex with, and then keep walking. I have seen a sufferer of OCD (obsessive-compulsive disorder) who was told she was filthy when she was a kid. She later became so excited about cleanliness she missed nights of sleep to tidy the living room.
But although very real causes of pathology, these seem too trivial to be real traumas for most people.
Others are too horrible to be denied. Read more on PTSD From Sexual Trauma — Learning That Life Is Not Always Fair…
Filed under PTSD by on Jun 3rd, 2011. Comment.
“Nations make their histories to fit their illusions” — Walter Lippmann (twice Pulitzer Prize winning newspaper columnist).
I remember years ago taking care of a Vietnam war veteran who told me, “what everybody says is wrong. There ARE atheists in foxholes and they is me.”
To be a member of the wrong religion is a very dangerous condition, as many Muslim-Americans have found out in this new millennium. Read more on Thank God I’m Not An Atheist…
Filed under News, politics, Religion by on Jun 8th, 2011. Comment.
Cute but deadly E. Coli
Subscribers to my newsletter got to read my inside information and some exclusive insights on the E. Coli disaster that is devastating Germany.
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The Renegade Doctor
Filed under Disease by on Jun 12th, 2011. Comment.
I had a patient once, long ago and far away, who was the worst “Caffeine Fiend” – properly known as “caffeinism” in medical lingo — I had ever heard of.
He was only 27 but depression and obesity added ten or fifteen years to his appearance. He was single and did not have much of a social life, but he did not much care. He was one of the earlier generation of people to build himself a career doing something with computers, with some sort of techie abilities which I could not understand at all. That enabled him to work from home at least part of the time, and only occasionally would he have to make a mad run to and from his employers’ office. This was in rural northern California, somewhat removed from the Silicon Valley mainstream of this type of activity.
The “from” part was important, as he did not much like to hang around with other humans, much preferring the company of his computer. Read more on Tale Of A Caffeine Fiend…
Filed under depression, Diagnosis, eating disorders, Stimulants, weight by on Jun 16th, 2011. Comment.
If I had to pick a favorite neurotransmitter, I would have to pick acetylcholine (ACh). As a matter of fact, I did. I ordered a custom-made necklace featuring my three favorite neurotransmitters – and ACh was the first in line.
The others? Well, since you are interested — dopamine and serotonin. And I always wear this necklace, these days.
Some ancient cultures have worshipped the herb rosemary as a symbol of memory. Me, I much prefer the molecule at my neck which, in addition to its well-known role at the neuromuscular end plate, where it translates neural impulses into motor contraction, is also essential for memory.
That teensy little nucleus basalis of Meynert, which looked kind of blue-gray when last I saw it on the front of a cadaver’s brainstem – and pretty faded when Alzheimer’s is present– has gone and given up a few of its secrets.
Let’s go to an epidemiologic mess, such as Attention deficit hyperactivity disorder (ADHD), and all of its subtypes and such, most of which I think are artifacts and do not exist — although (mostly untrained) adults often attribute them to children who annoy them.
A lot of these kids have anticholinerases (read: organophosphates ), originally meant for insecticides and Nazi nerve gases, inside them. Same with people with Alzheimer’s.
So I’m not just some “know-it-all” – I’m a one-woman ACh fan club. And this I swear on whatever Holy document you wish – I even dressed up as a Choline molecule TWICE for Halloween. Once before I met my husband, and then again – because he wanted to see how cuddly a molecule could look –- again a few years ago. He called me his “Choline Cutie.”
Of course, I was not built to scale – being somewhere near 300 lbs. when I dressed that way. But the placement of the atoms was absolutely perfect.
ACh was the first neurotransmitter discovered – back in the 1920s — so I think it is about time it got recognition.
Anyone want to join the fan club?
... or the psychopharmacology expert.
Filed under Memory by on Jun 17th, 2011. 2 Comments.
I have gone with my beloved husband in the last couple of weeks to a few venues so clearly classified as “dive bars” that I have searched in vain for a depth gauge on the wall. The treasure we seek – karaoke. These establishments are not the province of the landed gentry, and we are generally as out-of-place as a fish in a cloud. The treasures we find unperformed songs in the depth of confused directories whose organization defies even an amateur cryptologist (me). Read more on Karaoke As A Mental Health Program…
Filed under Psychology by on Jun 21st, 2011. Comment.
Despite his appearance, my patient claimed he was a good boy with no disciplinary problems — no gang affiliation, nothing.
That’s why he was so shocked when somebody shot him.
The young man was just 20 years old and a product of his environment – inner-city LA. He was obese and had shaved his head, and probably could be cast on any of the cop shows on TV as a suspect in the case of the week.
Yet he could think of no reason why he got shot. Read more on Tincture Of Time…
Filed under medicine, News by on Jun 21st, 2011. Comment.
I was between patients with my door open in one of the many clinics I have covered and this staffer slipped in, this woman who is in the process of trying to “dress up” because she has just realized that she does not have a boyfriend. She trusts me, asks me about personal things. In this case, she slipped into my office because she needed to adjust her bra, and I was the only person in the office, and it was obviously a “man-free zone.” “Damned underwire!” she mumbled, adjusting herself.
“Why the hell do you need underwire?” I asked her. Read more on Are You Wearing A Wire? (Bra That Is —)…
Filed under Education, News by on Jun 27th, 2011. Comment.