When I was in medical school, our nutrition researchers taught us that vitamins didn't do much good and only made expensive urine (where the water soluble ones end up).  We did learn about the classic vitamin deficiencies like scurvy, beriberi, rickets, etc.  But the evidence that healthy people should take vitamins was marginal at best. Is our search for immortality the reason that we turn to the pill or potion?  Do ...

Read more...

"Hey doc, I saw on an ad on the TV last night about this new asthma inhaler.  Shouldn't I give it a try?" This type of question would occur several times a week.  When I started practicing medicine it was considered unethical to advertise medical treatments.  Now, we're bombarded with enticements for tests and treatments.  The inhaler the patient requested cost $264 a month -- more than double what he was ...

Read more...

Ben's first symptom was coughing up blood.  The cancer had been silently growing for months, if not a few years.  He had no pain or shortness of breath.  The chest x-ray showed a "5cm L hilar mass" and the subsequent CT scan showed enlarged lymph nodes and likely spread to the liver. "So Doc, what is it?  A cancer?  How much time do you give me?"  All these questions on a ...

Read more...

Elton John had it right: “It’s sad, so sad.  Why can’t we talk it over. Oh, it seems to me that sorry seems to be the hardest word.”  Mistakes are all to common in medicine, but can we say the “hardest word” when we’re involved? Example 1: There’s a diagnosis of recurrent lymphoma in the ICU. The oncologist gives a phone order for cytoxan, prednisone, and vincristine. The recorder, working a double ...

Read more...

Les called me about his PSA. "Jim, it's rising and now up to eleven and they're recommending treatment.  What would you do?" Even as a long retired MD, I still get medical calls from friends and relatives.  Actually, I feel honored and try to do my best, researching the latest journal articles and editorial opinions.  Of course, the prostate cancer literature is cloudy at best with scant evidence that the huge number ...

Read more...

John and Eva had ongoing conversations about their home which was now far too big for their needs and lots of trouble and expense to repair and keep up.  John said, "It's the yard, the leaves, the painting, and general repair and replacement problems.  What's next to go?  The refrigerator or me?"  Eva was tired of shopping and cooking.  Her arthritis was slowing her down.  She told John, "Ok, you ...

Read more...

Elton John had it right: "It's sad, so sad.  Why can't we talk it over. Oh, it seems to me that sorry seems to be the hardest word." Mistakes are all to common in medicine, but can we say the "hardest word" when we're involved? Example 1: There's a diagnosis of recurrent lymphoma in the ICU. The oncologist gives a phone order for cytoxan, prednisone, and vincristine. The recorder, working a double shift, ...

Read more...

Vermont became the first state to enact a law authorizing physician-assisted suicide through the legislative process.  As the governor signed the bill, Jean Mallary watched carefully over his shoulder. She’s the widow of the late Dick Mallary, a former speaker of the House and U.S. Congressman.  Mallary was in pain and suffered from terminal cancer when he chose to end his life over a year ago. Jean Mallary’s story ...

Read more...

Bobby was admitted to the hospital once again with overwhelming fatigue and shortness of breath. Yet this 37 year old farmer looked the picture of health. He grew up on a farm rising before dawn, milking cows and working long days in the fields with hay or corn. He was never seriously ill as a child and was a good football halfback in high school. But this was his third admission ...

Read more...

Pierre arrives at the construction site, has his morning coffee and croissant, then ascends the scaffold to begin his work.  He felt a little woozy this morning but ignored it.  Becoming more dizzy, he loses his balance and falls two stories fracturing his femur and pelvis.  On arrival the paramedics find his health smart card in his wallet, scan it, and instantly have his medical records including medications, allergies and ...

Read more...

4 Pages

Most Popular