A physician, like anyone, can be a poor explainer of things for several reasons, but foremost among these is the tendency to use medical jargon. This is not a problem unique to doctors. When I take my car in for repairs, I often must ask the mechanic to explain what is wrong in a way I can understand. I have a rudimentary understanding of what the various parts of the ...

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Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have ...

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Children are relatively healthy overall. Although 25% of the American population is under the age of 19, only 2% of annual deaths occur in this age group. There was a time when the contributions of diseases to pediatric death rates were much higher. Declines in deaths from infectious disease or cancer, the result of early diagnosis, vaccinations, antibiotics, and medical and surgical treatment, have given way to increases in deaths from ...

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Attention deficit hyperactivity disorder (ADHD) is a common diagnosis in children today, and is increasingly a diagnosis assigned to adults, too. ADHD is a real thing, despite some having some skeptics and a few outright denialists; differences in brain scans between persons who have it and who don’t show there is a definite physiological basis for the disorder. But in practice, we don’t do brain scans. We base the diagnosis on ...

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The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data demonstrating their usefulness behind some well-defined disorders is pretty scant. Their potential usefulness in many ...

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I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue ...

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Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough is like none you have ever heard from him before. It sounds like a barking seal at the circus -- a brassy, ...

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The stethoscope. Nothings says “I’m a doctor” more than the stethoscope in a pocket or draped around the neck. Forty-five years ago when I got my first one, a gift from my physician-father, the former was more common. Then we were more likely to wear coats — white coats or suit coats — and pockets were available. I had suit coats in which the lining was worn out from the ...

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I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or 
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I first posted about this subject a couple of years ago but it’s so fascinating to me I’m writing about it again. I happened to run across this study containing some amazing information. It’s from a publication called The Journal of Voice. The link is to the abstract — the complete article is behind a paywall but I can get it for anybody who’s interested in reading the whole study in ...

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