December 8th, 2009 by DrCharles in Better Health Network, Book Reviews
Tags: A Pediatric Surgeon In Iraq, Coppola, Iraq, Medic, Pediatric Surgery, Surgery, War
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War can paradoxically bring out the best in people. Despite the violence, tragedy, and pain, there are moments of kindness, compassion, and brave camaraderie. Soldiers band together as brothers and sisters under terrible
circumstances to offer their lives in support of a nation they deem just and vulnerable. Often they are terribly wounded. Families on both sides of the conflict suffer and grieve sickening losses. The reasons for war seldom justify the human misery it causes, but perhaps one type of soldier has the luxury of always being on the right side. Consider the medic, nurse, or military doctor. Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
November 11th, 2009 by DrHarrietHall in Better Health Network, Book Reviews, Quackery Exposed
Tags: Alternative Medicine, CAM, Complementary And Alternative Medicine, Family Medicine, Pharmaceuticals
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That’s the title of a new book by Melvin H. Kirschner, M.D. When I first saw the title, I expected a polemic against conventional medicine. The first line of the Preface reassured me: “Everything we do has a risk-benefit ratio.” Dr. Kirschner took the title from his first pharmacology lecture in medical school. The professor said “I am here to teach you how to poison people.” After a pause, he added, “without killing them, of course.”
He meant that any medicine that has effects has side effects, that the poison is in the dose, and that we must weigh the benefits of any treatment against the risks. Dr. Kirschner has no beef with scientific medicine. He does have a lot of other beefs, mainly with the health insurance industry, the pharmaceutical industry, and alternative medicine. Read more »
*This blog post was originally published at Science-Based Medicine*
November 5th, 2009 by DrNancyBrown in Better Health Network, Book Reviews
Tags: Choices A Novel, Parenting, Pediatrics, Psychology, teens
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Choices: A Novel is a must read for teachers, parents and teenagers, everywhere. A combination of coming-of-age textbook, conversation starter, bite-your-nails, and gotta finish book, it took me by surprise. Laughter, tears, and some great conversations have filled our home this week as we read Choices.
In a nutshell, the main character, 15 year-old Kara, lives in a very sheltered world, attends a girls school, is an outstanding student. Kara seems to know very little about her own feelings and body, and less about those of others, until the star jock from a local school catches her eye and introduces her to the world of parties, drinking, drugs, and sex. Fearing that she is losing his attention, Kara binge drinks, has non-consensual unprotected sex, and gets pregnant. Her life is immediately turned upside down and Kara feels like she is all alone. Read more »
This post, Book Review: Choices: A Novel, was originally published on
Healthine.com by Nancy Brown Ph.D..
October 20th, 2009 by DrToniBrayer in Better Health Network, Book Reviews
Tags: Book, Pediatrics, Physical Medicine And Rehabilitation, The Water Giver, Traumatic Brain Injury
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EverythingHealth strongly recommends a wonderful new book called “The Water Giver” and I predict you will not be able to put it down. Author Joan Ryan is a remarkable writer who takes the reader on a journey she lived when her son, Ryan, sustained a near -fatal severe head and brain injury on a skateboard. It is both a medical drama and a meditation on motherhood.
The book begins with Joan’s description of her son’s learning difficulties and years of psychological and developmental testing. Her style as a mother was to intellectualize, do research and try to fix what was “wrong” with her son. The years went by with family stress and teachers conferences and medical consultations but it wasn’t until the day he fell, that Joan realized some things are too big to be studied and fixed.
The nightmare began when he was 16 and went skateboarding without a helmet. The fall on a hill near their home caused a huge brain bleed that obliterated much of his brain tissue. He remained in a coma for weeks and underwent multiple surgeries to relieve pressure. The book chronicles months of near death events in the Intensive Care Unit that nearly drove his parents insane with worry. I will let you read it to find out how it turns out. Read more »
*This blog post was originally published at EverythingHealth*
September 6th, 2009 by drval in Book Reviews
Tags: Advertising, Cerebral, Communications, Don't Be Such A Scientist, Literal-Minded, Marketing, media, PR, Randy Olson, Story Telling
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Preamble
I’ll never forget the day when I argued for protecting parents against misleading and false information about the treatment of autism. I was working at a large consumer health organization whose mission was to “empower patients with accurate information” so that they could take control of their health. My opposition was himself a physician who requested that our organization publish an article that advised parents of children with autism to seek out DAN! practitioners and chelation therapy.
I prepared my remarks with the utmost care and delivered them to a committee of our lay executives. I cited examples of children who had died during chelation treatments, explained exactly why there was no evidence that chelation therapy could improve the symptoms of autism and in fact was based on the false premise that “heavy metals” in vaccines were implicated in the etiology of the disease. I concluded that it would be irresponsible for the company to publish such misleading advice/information for parents, and would in fact be counter to our entire mission.
My physician opponent suggested that it was our company’s duty to inform parents of all their options, that we should not be judgmental about treatments, and that I was part of a paternalistic medical establishment that tried to silence creative thinking.
The committee ended up siding with my opponent. I was flabbergasted and asked one of the committee members what on earth they were thinking. She simply shrugged and said that my opponent was more likable than I was.
This experience marked the beginning of my journey towards fighting fire with fire – understanding that being right is not the same as being influential, and that “winning” an argument (where lives are on the line) requires a different skill set than I learned in my scientific training.
Book Review
And so it was with great interest that I picked up Randy Olson’s book, Don’t Be Such A Scientist: Talking Substance In An Age Of Style. I was pleased to see that other scientists had experienced the same revelation – that we need to be more communication-savvy to become more societally-influential.
Olson’s book outline is simple: four “don’ts” and one “do.” Don’t be so cerebral, literal-minded, poor at telling stories, or unlikeable. Do be the voice of science. He begins his book with a captivating story: a marine biologist goes to Hollywood and is shredded by an acting teacher for being incapable of raw emotion. Most scientists will get a good chuckle out of this narrative and will relate to Olson’s culture shock.
As the book winds along, the reader is introduced to a series of the author’s former girlfriends. He reminisces:
She would listen to me talk and talk and talk to the old folks and finally, by the end of the day, she would have had enough. So her favorite thing to do in the evening was, when I was done talking, to look deeply, romantically, lovingly into my eyes and say in a soft and seductive Germanic voice… “You bore me.”… p.82
Another girlfriend developed an affectionate nickname for me, “Chief Longwind,” which she would abbreviate when I’d get going on something and just say, “That’s enough for tonight, Chief.” p.83
Unfortunately, as these ladies noted, Olson’s strong suit is not compelling dialog – a tragic irony for a book written to inspire more effective science communication. Nonetheless, since scientists are rarely deterred by boredom, I think that there are some conceptual gems worth unearthing.
These are my top 5 take-home messages:
1. Communicate in a human way – be humorous, tell stories, don’t feel as if you have to present all the details. The goal is to get people curious enough to ask more questions.
2. Broad audiences prefer style over substance – learn to be bilingual (to speak with academics versus a general audience).
3. Marketing is critical for influence. The creators of Napoleon Dynamite spent a few hundred thousand dollars on production and $10 million on advertising/marketing. The movie grossed $50 million. Scientists who wish to be influential (or get their message across broadly) must bow the knee to the marketing gods.
4. Some people are naturally good communicators, others are not. Find the good ones and make them spokespeople. “The strongest voice is that of a single individual.” p. 166
5. Likability trumps everything. People make snap judgments about whether or not they like you, and your message’s impact is dependent upon your likability factor. Likability is related to humor, emotion, and passion. p. 148
And so, Don’t Be Such A Scientist offers some great food for thought – and I suppose if it hadn’t been written by a scientist it might also have been a more engaging read! But who am I to say, I’m still trying to bend my mind around the idea that Americans don’t care about facts.
July 23rd, 2009 by DrPaulSAuerbach in Better Health Network, Book Reviews
Tags: Dangers, Deaths, Dehydration, Falls, Flash Flood, Grand Canyon, Murder, Over The Edge: Death In Grand Canyon, Suicide
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Michael Gighlieri and Thomas Myers are coauthors of Over the Edge: Death In Grand Canyon, which is one heck of an interesting read. It is an encyclopedic rendition of all of the fatal accidents known (at the time of the writing) to have occurred in the Grand Canyon. The over-arching observation, made by the authors and almost certainly by the readers, is that the vast majority of these deaths were avoidable. Failure to recognize risk, or frank disregard for hazards, led to tragic loss of human lives. For every person who died, countless more suffered.
Early in the book and at intervals thereafter, the authors apologize for the graphic descriptions and for articulating the opinion that the fatalities were avoidable. They are apologizing for accurately observing that people can be uninformed, or informed and foolish. There is, of course, an element of risk inherent in many outdoor recreational activities, but the authors present an entirely different spin on risk - namely, unambiguously unnecessary risk. They are correct - too many people have paid the price, in the theme of this book, with loss of life and great emotional suffering (presumably) to family and friends.
There is a bit of adventure in the telling of tales, but this is not an adventure book. It is, rather, a series of accountings, some written in great detail and some more superficially. There is nothing boring about this book, but it is easily put down after a section is completed.
From the back cover: “Two veterans of decades of adventuring in Grand Canyon chronicle the first complete and comprehensive history of Grand Canyon misadventures. These episodes span the entire era of visitation from the time of the first river exploration by John Wesley Powell and his crew of 1869 to that of tourists falling off its rims today. These accounts of the nearly 600 people who have met untimely deaths in the Canyon set a new high water mark for offering the most astounding array of adventures, misadventures, and lifesaving lessons published between two covers. Over the Edge promises to be the most intense yet informative book on Grand Canyon ever written.”
The major and minor sections represent the categories of accidents: falls from the rims, falls within the canyon, heat illness (and dehydration), flash floods, river accidents (including crossings and drownings), air accidents, rockfall, envenomations, freak accidents, suicide, and murders.
The book is replete with lessons learned and safety advice - all of it useful for educators, adventurers, explorers, search and rescue personnel, and casual visitors. The book truly serves a purpose, which is to articulate history in such a way that the reader can learn from it, and hopefully, avoid the catastrophes that befell the unfortunate victims portrayed in these tales. Other interesting books co-authored by Dr. Myers are Fateful Journey - Injury and Death on Colorado River Trips in Grand Canyon and Grand Obsession - Harvey Butchart and the Exploration of Grand Canyon.
This post, Book Review: Over the Edge: Death in Grand Canyon, was originally published on
Healthine.com by Paul S Auerbach M.D., M.S..
July 9th, 2009 by drval in Book Reviews, Medblogger Shout Outs, Opinion
Tags: Christianity, Creationism, Director, Faith, Francis Collins, Intelligent Design, NIH, Science Based Medicine
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Francis Collins, M.D., Ph.D., is probably best known for his leadership of the Human Genome Project, though his discoveries of the Cystic Fibrosis, Huntington’s, and Neurofibromatosis genes are also extraordinary accomplishments. Dr. Collins is a world-renowned scientist and geneticist, and also a committed Christian. In his recent best-selling book, The Language Of God, Dr. Collins attempts to harmonize his commitment to both science and religion.
Some critics (such as Richard Dawkins) have expressed reservations about Dr. Collins’ faith, wondering if it might cloud his scientific judgment. Since Collins was rumored to be the most likely candidate for directorship of the NIH (and he was nominated for the position yesterday, but must be confirmed), and because I wanted to know if Dawkins et al. had any reason for concern, I decided to read The Language Of God.
First of all, Christians are a rather heterogeneous group - with a range of viewpoints on evolution, science, and the interpretation of Biblical texts. On one extreme there are Christians (often referred to as “young earth creationists” or simply “creationists”) who believe in an absolutely literal interpretation of the Genesis story, and see evolution as antithetical to true faith. Dr. Collins suggests that as many as 45% of Christians may actually be in this camp.
On the other end of the spectrum are Christians who embrace evolution, accept and promote scientific thinking, and understand the Bible to be a blend of poetry, allegory, and historical literature. While they see the Genesis account of creation as poetic, the Gospel accounts of Jesus’ life and teachings are considered to be more literal.
Collins’ views are very representative of the scientific end of the Christian spectrum. In fact, he spends several chapters attempting to help creationists embrace evolution. He takes great pains to explain how irrational it is to deny the evidence we have (both from a genetic, and an archeological/basic science perspective) for evolution. He argues that evolution is not an enemy of faith, but rather an enlightening look at how God’s creative process works.
Collins also takes on “Intelligent Design (ID),” exposing it as a PR play, not a true scientific theory. He suggests that ID is an “argument from personal incredulity” expressed in the language of mathematics, biochemistry, and genetics. Furthermore, Collins explains that ID proponents have confused the unknown with the unknowable - there is no current “irreducible complexity” that cannot be explained by evolutionary theory. We don’t need a “God of the gaps” to explain what we’ve yet to learn.
One of the more interesting parts of the book is Dr. Collins’ mathematical review of the incredibly low odds of the right blend of atoms/elements and the correct rate of expansion of the universe to occur by chance. He argues that certain atomic particles needed to be present in unequal and varying amounts at the earliest moment of the Big Bang to produce - eventually - the right conditions for life as we know it. He uses this analogy: it’s possible that a poker player could randomly obtain a straight flush in 50 consecutive hands. However, a more plausible explanation is that he’s cheating. In the same way, the universe could have come into being by coincidence, but it’s more likely that it was a coordinated event.
Collins’ argument for the existence of God is compelling to me. His explanation of why he chose to become a Christian is a little less so. Collins often resorts to lengthy quotes of C.S. Lewis in lieu of his own theological rationale - but I suppose we can forgive him for this. He is first and foremost a scientist, not a theologian, and his book simply reflects that fact. [Those interested in a more compelling theological rationale for Christianity might try Timothy Keller’s, The Reason For God: Belief In An Age Of Skepticism.]
In summary, Collins claims to believe in “theistic evolution.” He says that few people have heard of it because it harmonizes science and religion - and “harmony is boring” and doesn’t have a PR agenda. Nonetheless, he finds it internally consistent and intellectually satisfying. The material world is best understood through scientific inquiry, the spiritual world cannot be tested or understood by science. Matters of conscience, morality, and a yearning for answers to questions that may not be resolved empirically (What happens to us after death? What existed before the Big Bang? Is there a soul?) are matters best left for religion.
After reading The Language Of God, I feel confident that Collins is a reasonable person. He embraces science more successfully than many people of faith, and I didn’t notice anything about his beliefs that would make me question his ability to lead the NIH in true, scientific inquiry. In fact, The Language Of God may embolden other Christians to join the Science-Based Medicine movement by offering them a rational way to allow faith and science to co-exist. I hope that scientists who hold atheist or agnostic religious views will embrace this small group of evolutionary theists as religious moderates who fully support scientific orthodoxy.
June 21st, 2009 by drval in Book Reviews
Tags: Babies, Colic, Colic Solved, Food Allergies, Gastric Reflux, Gastroenterology, GERD, Pediatric Gastroenterology, Pediatrics, Reflux
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Have you ever been seated next to a screaming infant in an airplane? If so, you know that even short flights can feel like an eternity. But the question is: why is the baby so miserable? Is there something that can be done to ease their discomfort?
According to pediatric gastroenterologist Dr. Bryan Vartabedian, the answer is a resounding “Yes!” In his new book, Colic Solved Dr. Vartabedian (or “Doctor_V” as he is known on Twitter) describes why unexplained fussiness may often be caused by gastroesophageal reflux disease. Doctor V explains that “colic” is an old-fashioned term to describe the behavior of uncomfortable babies. Colic is not a medical diagnosis anymore than “crying” is… and fortunately the underlying cause of “colic” has been discovered so that it can also be treated.
I met Doctor V at a conference in Albuquerque, New Mexico a couple of months ago. Before our introduction I had no idea that he spent all of his clinical time examining and treating screaming babies - but once that fact was revealed, I understood immediately that he was the right guy for the job. Doctor V is a tolerant, affable man with a tremendous sense of humor and a voice made for radio. He is not easily flustered and has a genuine curiosity about others and their life stories. In fact, there’s something soothing about Doctor V - something that makes you feel that everything’s going to be ok.
And so it’s no surprise that Colic Solved is a written expression of Doctor V’s winsome personality. Every chapter is filled with empathy and reassurance, yet with a clear path forward for teasing out the real cause of a baby’s misery. In most cases, “colic” is actually caused by milk protein allergy or infant reflux (a painful burning sensation caused by regurgitating stomach acid). Doctor V carefully explains how to tell the difference, and what to do about it. Interspersed are amusing vignettes called “Tales From The Crib” in which parents with difficult-to-soothe babies navigate their way towards a resolution.
But best of all, Doctor V does not hesitate to do some good old fashioned myth-busting when it comes to exaggerated claims not based on scientific evidence. Infant formula makers, baby bottle makers, and baby product manufacturers are notorious enablers of magical thinking - moms and dads purchase all kinds of products in a desperate attempt to soothe their babies. Unfortunately, most of these solutions do not treat the root cause of the problem - though businesses thrive on colic cures for desperate parents.
Here’s an excerpt of Doctor V’s exposé of a common soy formula myth (p. 117):
Soy Formula - Do You Feel Lucky?
One of the first impulses for parents with a screaming baby is to reach for soy formula. It sounds all natural and easy to digest. But the role of soy formula in the milk-allergic baby is very misunderstood…
The real problem with soy formula comes with the belief that it’s a reasonable cure for the allergic baby. But up to 50% of babies who are allergic to cow’s milk will react to soy protein in a similar way, so if you or your pediatrician chooses to treat your allergic baby with soy formula, you should consider it a gamble…
Colic Solved is a gem of a book. It’s witty, wise, and well written - a must-read for any parent of a chronically fussy baby. I also think that pediatricians and family physicians should strongly consider prescribing this book to parents of unhappy infants. There’s probably no better way to solve colic once and for all.
April 14th, 2009 by drval in Book Reviews
Tags: Dr. Jill Grimes, Family Medicine, Hepatology, HIV/AIDS, Infectious Disease, Internal Medicine, Johns Hopkins University Press, Obstetrics And Gynecology, Seductive Delusions, Seductive Delusions How Everyday People Catch STDs, sexually transmitted diseases, STD, STI, Urology
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I recently met the author (Dr. Jill Grimes) of Seductive Delusions: How Everyday People Catch STDs at the AMA’s 29th Annual Medical Communications Conference in Albuquerque, New Mexico. Jill is a family physician in Austin, Texas, with a kind and down-to-earth demeanor. Jill is the type of doctor you like immediately - she makes you feel at ease because of her unpretentiousness.
Jill told me that she wrote Seductive Delusions out of sadness and frustration with her inability to protect young people from STDs. Jill saw new cases of sexually transmitted diseases in her patients every week, and wanted very badly to reverse this trend. No amount of counseling “after the fact” had a sufficient effect on new cases, so she decided to launch a preemptive strike: an educational book targeting those who never thought they could contract an STD.
Seductive Delusions uses a “case based learning” approach to educating readers about STDs. Each chapter begins with two true life stories about young people who succumb to STDs. Characters are based upon the lives of patients whom Jill has treated over the years, but stories are blended to protect anonymity. The story-telling format (followed by fact-based summaries) makes the content more entertaining and engaging to read. I doubt that a textbook could hold readers’ attention as effectively as Seductive Delusions does.
I chose to read Seductive Delusions cover-to-cover in 2 sittings, and such a concentrated dose of horror stories made me feel hesitant about ever having sex again. I can also say that there was one uncomfortable moment in an airplane (I read the book on the way back from Albuquerque) when the man sitting next to me glanced at the cover and gave me a very shifty look, and spent the rest of the flight leaning noticeably towards the seat on the opposite side.
That being said, I did enjoy the book. Jill’s characters have an innocent quality to them - like the cast from “Leave It To Beaver.” And I think that was exactly her point - you’d never expect the Cleaver family to be touched by STDs, and yet the truth is that they are succumbing to them in record numbers. Part of the danger of being one of those supposedly “low risk” individuals is that sufficient precautions against STDs are not taken due to a false sense of security.
I had assumed from the title of the book that “everyday people” would include a wider range of characters than were presented. I have been concerned about the reemergence of STDs, for example, in the retiree community in Florida, and thought that Seductive Delusions might touch on that unexpected risk group. However, the target demographic for the book is the late teen to thirty-something heterosexual male and female. I agree with Jill that there’s an educational gap there - but I would have enjoyed her casting a wider net.
The other potential short coming of the book is that the narratives describing how the various characters contracted an STD are so engaging that the reader is left disappointed at never hearing about the long-term outcomes for these individuals. I became emotionally invested in the story (for example) of how Evan contracted HIV from his very first girlfriend (a woman who had been with a man who used IV drugs prior to dating Evan). I felt as if I were there with Evan when he received the devastating news about being HIV positive, and then he drifted away from the pages of the book never to be heard from again. The lack of resolution left me with an uneasy feeling - probably the same feeling that Emergency Medicine physicians experience at the end of each shift.
Nonetheless, I would highly recommend this book to all sexually active young people. It is eye-opening and disturbing in the right sort of way. It’s the kind of book that will help people think twice before they become intimate with others, and take stock of the true health risks involved. I can only hope, along with Jill, that this book will reach the right eyeballs at the right time - and reduce the devastating spread of sexually transmitted diseases in America and beyond.
April 4th, 2009 by drval in Book Reviews
Tags: Cardiology, Cholesterol, Jie Jack Li, Pharmaceuticals, Research, Science Based Medicine, Statins, Triumph Of The Heart
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Triumph of the Heart, as its name does not suggest, is about science. The book’s author, Jie Jack Li, is a medicinal chemist who meticulously reviews the history relevant to the discovery of lipid-lowering drugs. He spares no details, even recounting the amusing quarrels and quirks of the scientists engaged in the “apocryphal showdowns” leading to the manufacture of cholesterol in a laboratory.
The personalities of the various scientists and Nobel laureates described in the book are highly entertaining. From beating one another with umbrellas, to insisting on wearing blue clothing only, to egos so large and unappealing as to empty an entire academic center of all its promising young recruits, one has the distinct impression that brilliance does not go hand-in-hand with grace.
That being said, each of these scientists did seem to share a common approach to research: carefully testing hypotheses, repeating peer study results to confirm them, and patiently exploring complex biochemical pathways over periods of decades. The physicians, physicists, and chemists showed an incredible ability to doggedly pursue answers to specific questions – understanding that the results might influence human health. But even more importantly, they were each willing to invest their careers in analysis that may never lead to anything more than a dead end. In fact, the book is full of examples of great ideas, developed over decades, that did not lead to a marketable drug. In some cases the research was halted due to lack of efficacy, in others political forces or personal whims influenced the course.
What strikes me about the scientists described in Triumph of the Heart, is how rare it is nowadays for people to have the sort of patience required for laboratory work. In an age where kids suffer from iPhone and video game addictions, young adults expect a relaxed work environment with high salaries and no accountability, and adults are flummoxed by stores that are not open 24 hours… who has time for the hard work of science? Even The Onion, my favorite spoof newspaper, mocks modern attention spans calling science “hard.”
Triumph of the Heart is about much more than the discovery and development of statins. It traces the historical development of the first antibiotics, pain medicines, diuretics, and steroids, the rise, fall and merger of drug companies, patent wars, the unethical conduct of some researchers, and the financial pressures that shaped the industry, both in the U.S. and abroad. Other than Mr. Li’s inability to resist his chemist’s urge to delve into advanced concepts in organic chemistry (around mid-book) as a physician I found Triumph of the Heart to be quite interesting, and well researched.
The most important take away, however, is that science is about hard work, attention to detail, innovative thinking, advanced analytic skills, serendipity, and the patience of Job. Triumph of the Heart reminds us all what good science is about, and how life-saving discoveries are made.
