Of life’s two certainties, death, and cataracts, it seems statins defer one and prompt the other, although not necessarily in the same person. If you blindly love life, you may be blinded by your love for life. In the HOPE-3 trial, ethnically diverse people without cardiovascular disease were randomized to 10 mg of rosuvastatin daily and placebo. The treatment group had fewer primary events: death from myocardial infarction (MI), non-fatal ...

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It is possible that in a few months from now, only Nate Silver’s prediction models will stand between Donald Trump and the White House. I will leave it to future anthropologists to write about the significance of that moment. For now, the question, “What will President Trump be doing when he is not building a wall?” has assumed salience. This is relatively easy to answer when it comes to health policy. ...

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"'Normal' is one of the most powerful words a radiologist can use." - Curtis P. Langlotz, professor of radiology, Stanford University After I used “clinically correlate” thrice in a row in my report, the attending radiologist asked, “How would you feel if the referring clinician said on the requisition for the study 'correlate with images'? When you ask them to clinically correlate, you’re reminding them to do their job.” I had been a ...

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Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long. Surgeon and writer, Atul Gawande, explores the medicalization of ageing and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and ...

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I enjoyed Agatha Christie’s Hercule Poirot. Not only did the ingenious Belgian solve the murder so artfully. But someone identifiable is killed, and someone identifiable is the killer. Epidemiological studies are whodunits, too. Except you don’t know who has been killed, what the murder weapon is, or who the killer is. You only know that a murder may have happened. A study found a higher incidence of breast cancer with ...

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I don’t subscribe to conspiracy theories. I never believed a second shot was fired. Nor do I believe that Bill Clinton was stalked on the grassy knoll. So I won’t speculate that Martin Shkreli’s arrest for alleged securities fraud that happened years ago is related to his raising Daraprim’s price by 5,500 percent. Just because something isn’t suspicious doesn’t mean that it isn’t odd. Shkreli is a perfect poster child for rapacious ...

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In times of shortage, we find out what we value most. And in these times of relative penury in the job market for radiologists, it appears that employers value -- above and beyond anything else -- the general radiologist. Yes, the general radiologist. The radiologist who is able and willing in one shift to perform a barium enema, follow the intricate anatomy of the inner ear on an MRI of the ...

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The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save ...

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Britain’s health secretary wants to uncharm his way to a revolution. To galvanize support for a seven-day National Health Service (NHS), which the NHS was before Jeremy Hunt’s radical plans, and still is, he asserted that thousands die because there is a shortage of senior doctors during weekends. This is an expedient interpretation of a study which showed that mortality was higher in patients admitted on weekends. Hunt ignored the
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Recently, I was dining with elite radiologists. In that uncomfortable silence between dessert and the check, I said, “radiology must shift the traditional paradigm by creating value streams using disruptive innovation to leverage population health to build strong ecosystems and a robust ectoplasm.” I was experimenting if excreted verbiage hastens the check. Instead, it sparked a vigorous conversation about disruptive innovation, compelling me to drink more cognac. In health care, no two ...

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