I saw the movie Cake tonight. I felt it was my duty. I am, after all, a pain specialist. I’d read that it was gritty, honest, and accurate, and that Jennifer Aniston was very convincing. I found all that to be true. It’s the show’s first weekend in Louisville theatres, and the crowd at this 5:30 p.m. showing was decidedly mature, reverently attentive, and noticeably equipped with more walkers and canes than ...

Read more...

The big medical news recently was that sitting hours a day is taking years from our lives, whether we exercise or not. We have heard similar things before, so the now reiterated message is: Yes, we are sitting on a major health risk. Sitting is the major health risk! The new study, a meta-analysis in the Annals of Internal Medicine, purportedly adds precision to the estimate of risk. There ...

Read more...

“Hefur þú lært um Staphylococcus aureus?” I almost don’t recognize the bacteria name because my grandmother pronounces it differently in Icelandic. “Já–” I’m about to translate my microbiology flashcard for her when she interrupts, her hands busy kneading the cookie dough and her eyes on my little sister near the oven. That’s the bacteria that almost killed her eleven years ago, she tells me. I can hear her words building up. This ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased ...

Read more...

The really incredible advances in the treatment of hepatitis C bring to life several relevant questions as we move forward into 2015. First, who should be treating hepatitis C patients (primary care providers, gastroenterologists, infectious disease specialists)? Second, can we really afford to use these new treatments? I recently discussed this topic with my GI and hepatology colleagues in AGA Perspectives, the bi-monthly opinion magazine of the
Read more...

Even I am not immune to influenza. In Northeastern Ohio, there have been more hospitalizations and school closings this year from influenza. And, let me tell you, as a family physician who also sees patients in the hospital and the office, we have seen a lot more respiratory illnesses versus last year. No, I'm not one of those Dr. Oz hypocrites who skip the influenza vaccine. We already know the 
Read more...

This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the ...

Read more...

As a pathologist, I recognize the importance of every diagnosis. Behind each slide is a patient, a family, a network of family and friends. A string of dominoes that is set into motion with my diagnosis. All treatment begins with a diagnosis. Each day I make these diagnoses, but on holidays, it takes on even more meaning. As the rest of the world is celebrating the season, coming together, medicine ...

Read more...

Recently, at a holiday meal with my extended family, it came to light that neither of my typically developing teenage children really knows how to tie his or her shoes. It seems that for the past decade or so, both have been using the “bunny ears” technique introduced to preschoolers for tying their shoes. My children appear never to have moved on from there to the mature “around the tree” ...

Read more...

Last August, the American Academy of Pediatrics (AAP) issued a statement regarding school start times, really a plea to all middle and high schools to start the school day no earlier than 8:30 a.m. The statement emerged as a result of accumulating evidence showing that earlier school start times effectively restrict an adolescent’s ability to get regular healthful sleep. The timing of the AAP’s statement came on the heels of another sentinel event ...

Read more...