shutterstock_161298866 "The chief difficulty Alice found at first was in managing her flamingo: She succeeded in getting its body tucked away, comfortably enough, under her arm, with its legs hanging down, but generally, just as she had got its neck nicely straightened out, and was going to give the hedgehog a blow with its head, it would twist itself round and look up ...

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Disneyland is in the news, and not because it is the most magical place on earth.   It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far.  Unvaccinated children are being kept home from school in some California districts and vaccination requirements once again have become a battleground between  public health agencies and the “right ...

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janis babson I was 8-years-old in June 1963 when the Readers’ Digest arrived in the mail inside its little brown paper wrapper. As usual, I sat down in my favorite overstuffed chair with my skinny legs dangling over the side arm and started at the beginning,  reading the jokes, the short articles and stories on harrowing adventures and rescues, pets that had been ...

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'Tis the season to be coughing ... It no longer takes an epidemiologist looking at absenteeism rates in schools to predict the start of influenza season.  For several years now there have been sophisticated models using search engine terms to monitor increasing incidence of febrile cough illness in regions of the world. Or just ask a primary care clinic what its waiting room sounds like these days.   A chorus of coughs, high, ...

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This is a speech I gave recently at our local hospital when I was given a "physician of the year" award for my work managing medical detox in our community for 20 years. At first, when I was told about this honor, I was really unsure why my clinical work in medical detox would warrant "physician of the year." I am not as skilled a diagnostician as many of you. I’m not ...

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Several years ago, a young woman I’d been seeing in clinic weekly for about a month to initiate treatment for depression called late Friday afternoon to cancel an upcoming appointment for the following Monday and did not reschedule. The receptionist sent me a message as is our policy for patients who cancel and do not reschedule. It gave me a bad feeling that she was not following through on her treatment plan and ...

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shutterstock_94195759 This wasn’t just plain terrible, this was fancy terrible. This was terrible with raisins in it. -Dorothy Parker More and more of my clinic time is devoted to evaluation and treatment of depression and anxiety rather than sore throats, coughs, UTIs and sprains/strains.  An outbreak of overwhelming misery is climbing to epidemic proportions in our society. A majority of the patients who are coming in for ...

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Nothing seems to please a fly so much as to be taken for a currant; and if it can be baked in a cake and palmed off on the unwary, it dies happy. -Mark Twain Returning to clinic after time off for a summer break, I worry I’m like a fly hiding among the black currants hoping to eventually become part of the currant cake.  Just maybe no one will notice I don’t ...

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shutterstock_118283776 Nothing was helping.  Everything had been tried for a week of the most intensive critical care possible.  A twenty year old man, completely healthy only two weeks previously, was holding on to life by a mere thread and nothing and no one could stop his dying. His battle had been lost against MRSA pneumonia precipitated by a brief influenza-like illness.   Despite aggressive hemodynamic, ...

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Even doctors must become patients eventually, and often challenging patients at that.  We know enough to be dangerous but not enough to be in charge.  We want to question everything but try not to.  We can tend to be catastrophic thinkers because that is how we are trained to be, but fear being alarmists.  We want our care providers to actually like us, when we know they inwardly cringe knowing ...

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