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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…

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Microscopic Photo of E. Coli

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.

But you can read this and other special material that isn’t included in my blog just by signing up for my free newsletter.

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Estelle Toby Goldstein, MD
The Renegade Doctor

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“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…

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The old guys were right.

Cover of The Maltese Falcon by Dashiell Hammett (1930)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…

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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…

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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?…

Filed under Family, Nutrition, Research, weight by on . Comment#

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The Next Oprah?

There is a vacancy at the top --- who better?

A little fun for the holiday.  Happy and Safe Memorial Day from Dr. G.

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It is a sad fact of modern life that it takes tragedy to bring important information to the notice of the general public.  In this case – the death of a young person participating in sports. Read more on Sports Dangers Are Too Often Revealed In Tragedy…

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Stories about children having children are no longer the stuff that tabloid news is made of. They are everyday occurrences, although not usually as dramatic as the ten year old reported recently, in a cultural setting where such things are accepted — a cultural setting of gypsies that transcends usual divisions of governments and countries. I remember from my French medical education, how whenever a person of that group needed medical care, we were told that the person in question was in the family of their “king,” and special favors were requested as such.  I remember encampments in hospital parking lots, and very seductive young women dancing around for coins.

They reminded me of what Esmeralda in the “Hunchback of Notre Dame” ( the classic novel by Victor Hugo) must have looked like.  I stopped romanticizing them when someone who ran away quickly, and was allegedly one of “them,” tried to rifle my purse outside the hospital. All anyone has to do is open their eyes on the streets of the large cities of southern California, to see people who look like children (at least to Golden Oldies such as my husband and myself) who are pushing carriages full of babies and surrounded by tiny children orbiting the vehicle like satellites.

The question is — what is going on, and why. Read more on Early Puberty Causes — Chemical And Social…

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I Am A Doctor, But I Don’t Play One On TV

Personality-wise, the cranky and inconsiderate title character of the hit TV series House, MD are mirror opposites.  I actually LIKE people – especially people who need help (patients).

Obviously many people enjoy this series, since it is one of the highest rated. But for me, the challenge is to out-diagnose him.

In case you’ve never watched, the formula for each episode is a seemingly straight-forward illness, which (of course) is the wrong diagnosis.  The rest of the show is slapping another diagnosis on the patient, and testing the patient, which makes the patient worse.  Read more on Being Locked-In May Not Be So Bad For Everybody…