palmd | October 3, 2009Today begins the Jewish festival of Sukkoth, originally a harvest festival. Like many religious holidays, it carries a mandate for charity. During this time, it is traditional to build a temporary structure called a sukkoh and to do as much living as possible there. It is also traditional to invite guests. In the ancient mythology, some of those guests are the ancestors of the Jewish people such as Abraham, Sarah, Issac, Leah, Rebbekah, Jacob, Rachael, and others. European Jewish mythology is filled with folktales of the Ancestors coming to the sukkoh in disguise to sample the…
palmd | October 3, 2009Times columnist David Brooks would like to distance the conservative movement from Rush Limbaugh, Glenn Beck, and all the other "not true Republicans" out there. His simplistic tactic is to claim that Beck and Limbaugh haven't won the GOP any elections. If elected positions were the only important facts in a democracy, he might have a point. But Beck, Limbaugh, and their allies don't care about elections. They represent a fundamentally anti-democratic philosophy of "if you can't get there democratically, do it the other way."
What are these "other ways"?
Women have apparently screwed…
palmd | October 2, 2009In general, competent adults shouldn't be forced into any medical intervention, but taking on certain jobs comes at the cost of accepting certain responsibilities. As health care workers, we are given special access to people at their most vulnerable, and with this access comes a special responsibility. Most health care institutions require proof of vaccination or proof of immunity for several vaccine-preventable diseases, such as measles, mumps, rubella, and chicken pox. So why is influenza vaccination so controversial? Influenza vaccines are safe and effective. We accept that we must show…
palmd | October 2, 2009When I was younger I took a temp job for the University of California Center on Deafness. I was lucky enough to be taken in and taught by the close-knit deaf community at the Center, and my eyes were opened to the special challenges of deafness in a hearing world. This was before instant messages, when we would set a phone on a coupling device to use the TDD.
I also learned about the special health challenges in the deaf community---doctor visits without interpreters, lack of access to real medical information, especially about HIV. At the time, HIV was hitting the deaf community hard,…
palmd | October 2, 2009In the context of a needy public school classroom, $165.00 is a lot of money. Not enough, but a lot, and every little bit counts. Every $5.00, every re-tweet to let others know helps. Today's headlines show US unemployment continuing to rise, but here in Michigan, that's old news. Unemployment state-wide is over 15%, and in many areas is twice that.
So keep up the hype. If you can't give, email or tweet others about the challenge. While I would have liked to specify science-y projects, my home state is hemorrhaging, so I've picked any at need projects in Michigan.
As for what I should…
palmd | October 2, 2009Of course you know what my answer will be. It was predictable that the death of a girl shortly after receiving an HPV vaccine to prevent cervical cancer would attract the immoral agents of the anti-vaccine movement. Like zombies to brains, they descend on the tragedy, ready to consume it and gain strength. And just as zombies will eat anything cerebral, even Dana Ullman's brains, the fact that the vaccine didn't cause the death won't slow them down a bit. (Have I finished straining the zombie analogy? Maybe...)
The media certainly loves this story. What could be better than a poor,…
palmd | October 1, 2009Fever is a fascinating phenomenon. The biochemistry and physiology of it is fairly well understood (sort of), but historically and presently, it is endowed with great teleologic power. The nearly magical ability of the body to heat up dramatically was noted by the earliest physicians. In the Hippocratean school, fever was often viewed within the humoral framework as an excess of yellow bile and was seen to be beneficial, although it was also recognized that some fevers were a grave sign. Later in the history of medicine, fever was equated with infection as was thought to be "a bad thing"…
palmd | October 1, 2009I really like this DonorsChoose thing. I already got a few donations toward needy Michigan classrooms! I'm so excited that I'm using exclamation points!!
In the past, other ScienceBloggers have set specific goals and offered to mutilated their bodies or whatever for the cause. I'm not quite that brave, but I'd love to get the excitement going. Every little bit helps here in the Great Lakes State, so help us out!
(By the way, those damned GeoBloggers are in on this, and whose life did they ever save? And Dr. Isis? The only heart she has is on the dissection table! C'mon, don't let these…
palmd | September 30, 2009Here in Michigan, schools are hurting---a lot. Classrooms are crowded, schools are closing, supplies are non-existent. Even in "wealthy" districts, the system is failing. Parents, when they can, supply the bulk of classroom supplies.
This is a good time to think about DonorsChoose, a unique charity that allows teachers to create proposals, and donors to choose what to fund. Many of these have matching funds available. Over on my left sidebar you can click over to check out my page, which is devoted to projects in Michigan. Please consider even small donations.
palmd | September 30, 2009I've been putting this off. Today I'm 203.5#. I feel into some bad habits this week.
I've found that routine is my friend. I have a few choices for breakfast at home, a few lunch and dinner choices at the hospital, and a few evening snack choices at home, all of which support my diet.
We had a very stressful week at Casa Pal, mostly due to friends' illnesses, and while I didn't "stress eat" as much as I might have (the donuts don't count, honey), I was thrown off my routine.
But I'm back on track and we'll see how things go.
palmd | September 30, 2009The state of Michigan is facing massive budget cuts which will further eviscerate the Medicaid program. If the legislature passes it's budget as planned, massive cuts to Medicaid will reduce federal matching funds further limiting access to health care for the state's many uninsured. It's not clear if there is a way out of this, other than a massive overhaul of the nation's health care system.
But lawmakers are looking for termporizing measures. One of these is to levy a tax on doctors. This is insane.
Medicaid pays pennies on the dollar so many physicians (my practice included) cannot…
palmd | September 29, 2009Here's how this is going to work. Thanks to a reader, I have a case for you, which I'll present in parts. I will try to make the information accessible to both professionals and lay-people. I'll start with the barest of information and rather than guess what's going on right away, I'd like to see people organize their thoughts into broad categories based on the initial symptoms. One way to think about this is to think about what, anatomically, is in the area of question---in other words, what can go wrong there. Then, think of types of disease---vascular, anatomic, infectious, allergic,…
palmd | September 28, 2009Dr. Jerome Groopman, whose writing I generally enjoy, put out a book a couple of years ago called How Doctors Think. It examined, well, how doctors think, how they think they think, and what the future holds for diagnosing disease. It's a good book, but with some faulty assumptions. I'm not the guy to write about how decisions are made---I don't know enough about the field, a field which needs much more research. But most doctors do not, as is sometimes posited, make diagnoses via algorithm. Nor are we slavishly bound to statistical likelihood, as the use of likelihood ratios and, er,…
palmd | September 27, 2009Warning: this post has a long, boring prologue. Proceed at your own risk.
I am an expert in the prevention and treatment of adult diseases. That's what I do from well before the sun rises until well after it sets every day of every week. To become an expert and retain this status is not a simple task. After college I completed four years of medical school, three years of residency in my specialty, and chose to become "board-certified". There are doctors who are not board certified in their specialties, and there's nothing nefarious about that---all that is required to practice medicine…
palmd | September 25, 2009The stupid truly burns brightly in this one. Dana Ullman, known to readers of Respectful Insolence, Science-based Medicine, and this blog as Hahnemann's cognitively impaired bulldog, has started blogging at the Huffington Post. It's certainly an appropriate venue for his brand of cult medicine belief, but that doesn't make it any less painful. His inaugural piece, entitled The Wisdom of Symptoms: Respecting the Body's Intelligence betrays a stunning level of ignorance of basic human biology.
I have good and bad news about the human body: it is neither wise nor foolish, good nor evil, nor is…
palmd | September 24, 2009I'm not a psychiatrist, and I won't guess what motivates someone like Doug Bremner. On his blog, he posted a picture showing the head of a cancer surgeon/researcher/blogger pasted onto a large beast. A little man is doing something to the beast.
An armchair psychiatrist might make silly suppositions based on the image of a little man bent over toward what looks like the genitalia of a large beast, but also like a little man eviscerating the beast with a big tool (which is not part of the little man...he's just holding it). But images probably don't mean anything anyway.
Bremner is a…
palmd | September 24, 2009It's like this: science requires a tolerance of failure. If your shiny, happy hypothesis fails to stand up to rigorous scrutiny, you drop it and move on. If instead of a true, disposable hypothesis, you have a fixed belief that will not change based on the data, you are delusional. Boosters of alternative medicine prefer the term "maverick" to "lunatic" but in the two are often the same.
It is nearly impossible to get someone to abandon a belief in alternative medicine, no matter how strong the evidence against it. Study after study has failed to validate homeopathy as anything other…
palmd | September 24, 2009So the weight loss continues at a slow but steady pace. The exercise has been not so good; I was doing fine until I re-injured my back. Now it's just an excuse.
I've started getting up early to get PalKid to kindergarten. I suppose I could get up just a bit earlier and ride the bike. I'm not looking at exercise as a weight loss tool, but as a way to regain good health.
My morning meal is generally a high fiber cereal, oatmeal, or a bagel. Earlier I was doing eggs, but I got tired of the extra time and effort. The key to the cereal is a small serving size. I do OK until lunch and…
palmd | September 23, 2009Two-Oh-Friggin-Three! Yippee!
(woulda been better without the damned brisket)
palmd | September 23, 2009In case you didn't know, Science Blogs is owned by a company called Seed Media Group. They invite bloggers, host them, give them tech support, and use their blogs to post ad content. And that's it. Bloggers are offered small compensation based on blog hits, but for most bloggers, this ads up to very little. Blog content is independent in every way but one: blogging is by invitation only. Once you're here, you can write whatever you want.
But conspiracy theorists are likely to be unimpressed by this. Seed's ads are everything from major corporate sponsors to google adsense garbage that…