Why IT is the core of the healthcare renaissance Warning!  I am a practicing doctor who sees real patients using an electronic medical record (EMR).  My sole agenda is to provide the best patient care.  I have no financial stake in information technology (IT).  However, unlike the editorial board at the Wall Street Journal, Mr. Stephen Soumerai of Harvard or Mr. Ross Koppel of the University of Pennsylvania, I have actually ...

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Starve a cold, feed a fever.  Eat a balanced diet, don’t overeat, he is so thin he should fatten up before he wastes away, avoid junk food, she needs to keep her weight down. Our society is obsessed with food and food advice, and nowhere is that more true than when dealing with cancer. Nearly 100% of the time when an oncologist sees a new patient, they are asked about nutrition.  ...

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Is it possible to ignore a cancer?  Prostate cancer infests almost 250,000 men in this country each year and will kill 28,000 men in the United States in 2012, over 200,000 around the world.  Many lose their lives “too soon”, dying in their 60s or even their 50s.  Nonetheless, authorities do not recommend the PSA blood test for routine screening of this disease.  How can this make sense?  Partly this ...

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In his brilliant 1993 satire “Et Tu, Babe,” Mark Leyner proposed a new concept in body art, which is the specialty of “visceral tattoos.”   The narrator travels to Mexico where his chest is opened and the insignia of a “guy surfing a wave of lava, wearing polka-dotted trunks,” is tattooed directly on his heart.  The dye used shows up on CT scans and apparently women, especially x-ray technicians, love it. ...

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Nairobi, Kenya basks under a brilliant sun, its dusty frontier soul, noise, construction and vital humanity speak for a nation and a people rushing into the modern world.  Full of ideas, growing exports and exploding industry, its expanding middle class has seized on education and commerce as the path to tomorrow.  One of the richest nations in Africa, with a new Constitution and new hope, it races forward. Tragically, even ...

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How do you choose a doctor?  Perhaps you start with a recommendation from a friend or a trusted physician, then you look at factors such as training, experience, board certification, access, online reviews and of course that vital issue, how well you like the doctor when you meet him or her.  Tough thing, picking a person you barely know to whom you trust health and life.  To this list, I ...

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I have been practicing medicine for 35 years and the great secret is that it just keeps getting better.  No day goes by without an important learning moment, a unique observation or just the satisfaction of making a difference.  Today I had one of those moments of revelation that will slightly change all days which follow. Stan is a 57-year-old man with curable colon cancer who requires surgery. Unfortunately, that surgery ...

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It turns out that the practice of medicine is just common sense.  If someone has fallen and their hip hurts, it is probably related.   If someone does not have an infection, do not give an antibiotic.  Exercise and good food are, well, good for you.  If it is not broken, do not fix it. Usually, patients understand this basic idea.  The best chance of becoming and staying healthy is the simplest ...

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“The question” comes in several forms:   “Doc, what stage is my cancer?”  “What is my prognosis?” “Can it be cured?” “Am I going to die?” “Have long have I got?” These tough honest words require courage.  “The question” superficially asks for a simple answer.  Time to live.  However, in the real world of life and death, these questions and therefore the answers are far more complex and subtle. Years ago we ...

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If I had to choose my “least favorite” cancer, it would be brain tumors.  This malady is not only challenging to treat, but it attacks in such a personal and disturbing way.  It is hard enough to fight a complex disease, but to do it when the ability to focus and understand is disrupted by brain injury is a terrible curse.  Still we have learned a lot and therapy is ...

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