mementomori | January 27, 2007Sloth...Myopia...Nihilism...Hypocrisy...Ennui...
Just to pronounce them reveals the ugliness within. God forbid anyone should ever have a doctor who worships such character flaws...which reminds me of something:
What better way to illustrate how these faults perform a disservice to patients than by giving examples where yours truly has committed them? Say, maybe this will lead to an invitation to appear on one of those television shows where folks are goaded into self-flagellation! Let's gather 'round kiddies and listen as the C. O. reads chapter seven of How to Be a Fantastic Doctor ,…
mementomori | January 25, 2007Last week a colleague told me about a new patient he had acquired, who had fired his old doctor for failing to diagnose the cause of the patient's rather distressing symptoms. It turns out that my friend had no problem discovering the cause of this patient's suffering, which was due to an unusual presentation of metastatic cancer. The previous doctor apparently led the patient down the diagnostic path marked by the sign "Dead End." Why did the physician who was sacked (not Sacks) fail to come up with the correct answer?
That was a rhetorical question, wasn't it? I beg your pardon.…
mementomori | January 23, 2007As a continuing public service to ScienceBlogs readers we present another edition of "News Youse Can Snooze By":
1. Eating 30 grams of cereal fiber a day cuts the risk of developing breast cancer in half for women up to age 50.
A study of 35,000 women over seven years found those with the highest fibre intake of 30 grams a day had a 50 per cent lower incidence of breast cancer than those eating 20 grams a day. But the effect was only seen in pre-menopausal women up to the age of about 50. In post-menopausal women, a high-fibre diet offered no protection. Professor Janet Cade of the…
mementomori | January 21, 2007His poetry endures because of its directness, and the literal fidelity of his beautifully circumstantial description of nature, of scenes, and places, imbued with a kind of majestic sadness which takes the place of music.
-British Authors of the Nineteenth Century. Ed. Stanley Kunitz. New York: H. W. Wilson, 1936. 16-18.
Matthew Arnold (1822-1888) is generally considered to be one of the three greatest poets of the Victorian Age (the other two being Tennyson and Browning). As lasting as his body of poetry is, his critical essays were more influential to the generations of poets who followed…
mementomori | January 18, 2007In a small study of female college students, researchers found that a caffeine supplement seemed to lessen the muscle pain that crops up a day after a challenging workout.
Just when we got our membership card into the haughty I-Eshew-Coffee club, they publish this little study. We confess we're having trouble trying to figure out this caffeine thing. Every month we hear of some new revelation as to its mythical powers over Homo sapiens. Is caffeine good for you or is it so dangerous to users that they might as well fry their arteries in coconut oil? We certainly know about the call-to-…
mementomori | January 17, 2007"Bush Hails Drop in U.S. Cancer Deaths"
President Bush on Wednesday hailed the downward trend in cancer deaths in the United States, a signal that medicine is making strides in the battling a disease that kills nearly 1,500 Americans a day. "This is the second consecutive year there was a drop in the number of cancer deaths in the United States," Bush said at the National Institutes of Health Laboratories. "And the drop this year was the steepest ever recorded."
This bit of encouraging news really requires little explanation on my part. If you still don't understand how to reduce your risk…
mementomori | January 16, 2007Mirabile dictu, the electric company came by and replaced our downed power line this afternoon. Blogging will resume tout de suite, but first can I at least get the temperature in here above 60 degrees?
(Up from 44, that is).
While cranking up the thermostat in my office today I thought about some of my patients who have been started on a "rigorous" chemotherapy regimen (even oncologists rely on the occasional euphemism). I always worry about the toxicity of such treatment but once it has been given there is no taking it back, so all parties must agree that the decision to start is the…
mementomori | January 14, 2007Once again a despicable ice storm has forced us out of our house...I'm currently living in a tent city run by some Food-For-Oil executives by the banks of the muddy Meramec River in Fenton, Missouri...unable to blog...am using a friend's computer for this message...freezing rain coming down like a backup Egyptian plague as I type...house is 54 degrees and falling...somebody check on Afarensis and make sure he's not in a solid phase, so to speak...Scotch whisky supply running low...send lawyers, guns and money...
mementomori | January 10, 2007Last night after watching one of those intellectual programs on cable television I found myself for some reason reminiscing about school days. I remember spending countless hours in chemistry labs, usually with a partner of dubious genomic origin, manipulating Mother Earth's precious powders and potions in ways designed to earn the highest possible grade with the smallest quantum of comprehension. My laboratory etiquette unfortunately suffered from the effects of "pre-med syndrome," which led to the occasional fistfight against kibitzers or flibbertigibbets with (putative) undiagnosed ADHD…
mementomori | January 9, 2007"One should pour tea into the cup first. This is one of the most controversial points of all; indeed in every family in Britain there are probably two schools of thought on the subject. The milk-first school can bring forward some fairly strong arguments, but I maintain that my own argument is unanswerable. This is that, by putting the tea in first and stirring as one pours, one can exactly regulate the amount of milk whereas one is liable to put in too much milk if one does it the other way round."-George Orwell
Thank you, George, but as my old professor used to say, "You're just rearranging…
mementomori | January 6, 2007These two little maxims seem connected so I would like to share them both:
"Death is not the greatest loss in life. The greatest loss is what dies inside us while we live."
-Norman Cousins (1915-1990)
Of all the quotations written about living and dying I find this one to be absolutely stunning, a soft reminder of the shame of allowing the universal vicissitudes - so daunting at the beginning, so trifling at the end - to ruin your life.
"If something comes to life in others because of you, then you have made an approach to immortality."
-Norman Cousins
Not that we all sit around wailing…
mementomori | January 4, 2007DUSP6! MMD! STAT1! ERBB3! LCK!
Was ist diese? CB radio patter? Pilot to co-pilot chatter? 3rd-and-long huddle banter?
Of course not - that would be too easy. These cryptograms represent five different genes found within non-small cell lung cancers (NSCLC) that predict the both the relapse-free and overall survival of patients at the Taichung Veterans General Hospital in Taiwan who underwent surgical removal of early stage NSCLC, as reported in this week's New England Journal of Medicine.
By the way, if you've ever wondered why scientists use so many acronyms, here's a good example. The…
mementomori | January 2, 2007[Editor's Note: this is an entry in an occasional series; parts I-IV can be found here.]
If one needs a bit of cheering up these days, say after inadvertantly watching one of those cable talk shows, here's a suggestion: read about the medical advances made since the end of World War II. They are numerous and impressive. Despite the well-documented inequalities in disseminating proper care to the world's unhealthy one forgets that just a few decades ago there were no effective treatments for a multitude of diseases.
Only a nihilist would refuse to acknowledge that we are living longer and…
mementomori | December 29, 2006As 2006 draws to a close I believe it is appropriate to list a few New Year's resolutions in the hope that they inspire the gentle reader to probity, if not an appearance on Oprah. No, these resolutions are not mine. After an unfortunate incident I refuse to commit any more promises to paper, especially on December 31st. Of course this not only makes a visit to Burger King more enjoyable but leaves one free to snicker at joggers, penny-pinchers and other goody-two-shoes who are in the midst of rectifying their various sins of omission and commission.
I don't mind snooping at other people'…
mementomori | December 27, 2006Olive oil diet cuts your risk of cancer
A new study suggests that consuming 5 teaspoons of olive oil - either virgin, common or refined - reduces one's risk of developing cancer. Here's how they came to this conclusion:
People in Mediterranean countries such as Spain and Italy live longer than those in other European countries, while rates of breast, colon, ovarian and prostate cancer are much lower.
Very interesting, but we already know this. Would a volunteer please raise his or her hand and ask "Why?"
Dr [Henrik] Poulsen and his team at Copenhagen University Hospital studied a large…
mementomori | December 26, 2006This op-ed piece by Dr. Pauline Chen in today's New York Times reminded me of one of my deficiencies [Only one? If he had any sense he'd catalog the whole lot and publish it under the title "Don't Let This Happen to You." -Ed.] as a physician. The title of the story says it all:
The Most-Avoided Conversation in Medicine
What is this conversation that is not taking place between patients and their doctors, and why is it so difficult to perform? As I read the title I tried to think of another conversation besides the one that was shouting inside my head, the one that begins with the gambit…
mementomori | December 23, 2006Since I'm going to be busy tomorrow night celebrating Christmas I thought I'd share this poem with you a day early. It was written by a five foot two manic-depressive (putative), intellectually brilliant, Oxford educated Jesuit priest who died of typhoid fever at the age of 44.
If you haven't had the chance yet, meet Father Gerald Manley Hopkins. His Wikipedia entry is a perfect introduction to his body of work. One of the amazing facts of his life is that his poetry was published in 1918 - 29 years after his death. Hopkins is considered one of the greatest poets of the Victorian age, and…
mementomori | December 22, 2006"Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract"
"At the risk of upsetting many proponents of alternative medicine, I also contend that intuition is no substitute for evidence."
-Edzard Ernst, professor of complementary medicine, Department of Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter
Holy Nostrums, Batman! Someone is actually criticizing one of the most popular anti-cancer treatments on the shelf of the corner store with the sign Natural Cures Only hanging above it. Professor Edzard…
mementomori | December 21, 2006There are two ways to live: you can live as if nothing is a miracle; you can live as if everything is a miracle.
-Albert Einstein
Let us go singing as far as we go: the road will be less tedious.
-Vergil
One of the peculiar aspects of my job is that I often have the bitter pleasure of meeting people whose time left in this world is as brief as the arrogant reign of summer. Just as the evening breeze begins to chill, these patients wither and fall quietly to earth for the simple reason that they are fatally stricken with cancer. Modern day treatments can eradicate some malignancies but there…
mementomori | December 19, 2006A new study of 351 women aged 45-55 and suffering from perimenopausal hot flashes found the taking the popular dietary supplement black cohosh (Popular? Well, now I wouldn't say that. Alcohol, cigarettes and anti-depressants are popular. I don't see anybody spending a billion or two on media ads for this stuff...) was no more effective than placebo in reducing the number of episodes per day.
The yearlong study of 351 women suffering from hot flashes and night sweats found that those given black cohosh got about the same amount of relief as those who took a placebo. And those groups saw…