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Evidently, more and more of us are abandoning Dr. Google and seeking medical advice ... from Dr. TikTok. Highly caffeinated drinks will no longer be the go-to lift. That's because we now have adrenal cocktails developed to treat the mythical disease of adrenal fatigue. PT Barnum strikes again.

Doctors use “diagnostic” labels to describe a condition or constellation of symptoms and signs before determining treatment or rendering a prognosis. Diagnostic criteria generally remain static and serve as a collective reference point for the medical world. Not so for the diagnosis of “excited delirium.”  Not only has the meaning of “excited delirium” morphed over time, but the legal community has conscripted it for non-medical purposes, like defending claims of excessive force by police officers. Recently, the medical community rejected this use and “revoked” the diagnosis. Who benefits?

Can being one with nature harm nature?
For Climate Change - Having your meat and eating it too.
“VUCA stands for Volatility, Uncertainty, Complexity and Ambiguity.
Advice from a bad mother

Everyone is using, embedding – or about to use and embed – Artificial Intelligence in their work. I am not so concerned about the imminent arrival of SkyNet; those bits and pieces are already in place. What concerns me more is that A.I., already a misnomer, will increasingly become real stupidity and hurt patients along the way.

We know the beat of our heart varies over time, increasing with exertion and slowing with rest or meditation. But, stable as those variations may appear, they vary even within those intervals. Dr. George Lundberg, former long-time editor of JAMA, muses about those variations – termed heart rate variability – and what they might tell us.

Ten thousand steps for exercise and health, much like ten thousand hours to become an “expert,” are magic quantifications passed down without clear origins. Some researchers sought some scientific clarity.

I remember answering patients’ questions in the office (or on the phone later when the fog of what I had told them had dissipated) and there were other “concerns.” Today, more and more doctor-patient discourse is digital and comes at a cost, both financial and medical.

In this radio conversation, Lars Larson and I discuss his concerns about the testing and approval process for new drugs and medical procedures in the United States.

In my radio conversation with Lars Larson, we discussed concerns about the Veterans Administration (VA) potentially allowing optometrists to perform laser eye surgery on veterans for glaucoma.

In this conversation on "CBS Eye on the World," John Batchelor and I discuss the development of a universal vaccine to prevent COVID-19. John has received multiple COVID-19 vaccinations and was curious about the concept of a universal vaccine that would protect against all – even future – variants of the virus.

We know stress can be dangerous, although treatment is not lacking. Pharmaceuticals abound, and more are in development. But reports are emerging that drugs may be addictive, they don’t work well in mild or moderate cases, and it's hard to wean off them. What’s a patient to do?

The perils of Thanksgiving! Hellish traffic, Aunt Gertrude's bunions, and a whole bunch of toxic chemicals. We are all doomed.

Much published science and the "knowledge" resulting from it is likely wrong and sends researchers chasing false leads. Without research integrity, we don’t know what we know, so it is incumbent on the scientific community to find solutions.

The Fourth Turning and Complexity
Can a medication change our brain’s anatomy?
Are colonoscopies helpful?
Can the value of chicken soup be quantified?

The pandemic’s successful expansion of pharmacists’ scope of practice to include vaccinations has given some people the idea that pharmacists can fill other gaps in primary care, like prescribing medications for our greatest comorbidity, high blood pressure, or hypertension. A new, deeply flawed analysis of the economic benefits suggests savings of money and lives.

On November 11th, America honors and celebrates our veterans. November 11th was originally Armistice Day to commemorate the cease-fire of the Great War, World War I, that took place at the eleventh hour of the eleventh day of the eleventh month.
I know many veterans personally. Lots of family and friends served. Most honorably left their military service unharmed. Some left the service with deep wounds and scars. And some did not make it back alive. On Veterans Day, we thank them all for their service.

The uptake of the current COVID vaccine is running at about 7% of the U.S. population. Pfizer is taking a significant write-off. After the pandemic, our trust in vaccinations has reached a nadir. It's a far cry from our behavior concerning smallpox in 1947 when, over eight days, over 4 million New Yorkers were vaccinated. Or compared to 1961, when 90% of the at-risk population got vaccinated against polio.

Last year, Congress passed the Mainstreaming Addiction Treatment (MAT) Act, seeking to expand access to buprenorphine, a proven treatment for opioid use disorder. However, a recent proposal by the Drug Enforcement Administration threatens to undermine Congress' intention. Now, some members of Congress appear ready to push back.

While largely ineffective medications for the treatment of Alzheimer’s Disease have gotten a great deal of press, an “orphan” disease – sickle cell disease – is in a similar situation. It is a devastating disease, and there seems to be a gene treatment on the horizon, one that comes with risks and benefits. How do patients calculate what to do?

The U.S. Government doesn't want to hear the message: The Centers for Disease Control and the Veterans Administration published practice guidelines on the prescription of opioid pain relievers in 2022 that they knew were unsupported by science and harmful to public health. The Department of Health and Human Services is stone-walling repeated demands for a senior staff review of these issues.

Answer: It could be. Stress kills. Rarely, but not never. And then there is anxiety, which subsumes a host of related diagnoses. The terms are often co-mingled, with the latter tending to diffuse the dangers of the former. Let’s take a deeper look.

VUCA?
Race in science
Pass the ammo
Sushi and lateral transmission

This could be big. All physicians or cancer researchers have been taught forever that a certain class of cancer drugs works by stopping mitosis, hence cancer cell division. However, a group at the University of Wisconsin discovered that everything we thought we knew about drugs like Taxol and vincristine - decades of textbooks - is wrong. The ramifications could reshape cancer drug research.

Roadside drug tests are unreliable, so why are they so widely used in the U.S.? Meanwhile, researchers who make "health disparities" the focus of their work sometimes misrepresent their results. Here's a textbook example from a study that used pulse oximetry to measure disparities in COVID-19 treatment.

At the beginning of the year, the CDC and FDA noted “a preliminary safety signal for ischemic stroke among persons aged ≥65 years” who had received the COVID bi-valent vaccine, as well as a similar but "higher" signal in individuals receiving the influenza vaccine at the same time. Now, a study has confirmed that safety signal.