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Showing posts from 2021

COVID Divides a Divided Country

For millions of Americans, the pandemic has been disastrous.  We have lost an uncountable number of Americans. We cannot even grasp the magnitude of the loss.  Have you ever stood at the Vietnam Veterans Memorial on the mall in Washington, DC and scanned through the uncountable number of names etched into the Wall?   We have lost well over ten times this number of Americans in the pandemic.  And it’s not over yet.  Beyond those who have died, we have to contemplate family members and friends who have been left behind.  And those who have become seriously ill or even hospitalized or even spent time in an ICU have been changed forever.   And many who escaped the virus were scared that they might become the next victim, particularly before the release of the vaccines.  And now Omicron has swept onto our shores reminding us that the pandemic still lives.  Will we go through the entire Greek alphabet? Similarly, we cannot even calculate the economic devastation and disruption that the pan

Whistleblower Holiday Cheer 2021!

       ‘ Twas the night before Christmas And all through the House, Progressives were screaming, ‘Are you a man or a mouse?’   They wanted it all. No matter the cost. They wanted it now. So much would be lost.   The voted for Biden, Who now is their tool, And dream of ‘reforming’ The filibuster rule.   Pelosi’s been smacked, And Schumer’s been bruised. Does Biden realize That he’s being used?   And while Biden is napping In the White House mansion, The man of the moment, Is Senator Joe Manchin.   And while mainstream Dems Fight with the ‘Squad’, The real threat they face? A circular firing squad! GOP are no better. They have no spines. Trump is their leader. He is divine!   Liz Cheney is out For telling the truth. While others are praised For being uncouth.   How do Republicans The few decent legislators, Run in a primary When they’ll be called ‘Traitors!’?   Kevin McCarthy Unhinged and unraveled,

Is the Physical Examination Still Useful?

Medical students, please read no further. I am going to challenge one of the bedrock beliefs in medical training – the value of the physical examination.   Indeed, I was taught of the primacy of the physical exam as a young pup during my 4 years of medical education in New York City.   I believed it and did my best to acquire these skills from master diagnosticians.   Indeed, this was one of the thrills of being a medical student – learning what those clicks and clacks meant when we listened to hearts with our stethoscopes, seeing changes of diabetes and other diseases when we peered into your eyes with an ophthalmoscope or palpating a pulsating aneurysm that was lurking in your abdomen. An Ophthalmoscope and Otoscope The Eyes and Ears of Medicine I was in awe of these seasoned physicians who could make a diagnosis just by watching a patient walk across the room. While I still think the physical examination is useful, I have found over the years that it is less valuab

Should There Be A COVID-19 Vaccine Mandate?

It is easy to opine on issues that don’t personally affect us.  We’ve all seen folks on television or in our own lives who righteously stake out positions when they are far beyond the reach of their effects.  Conversely, we’ve seen the irony and the hypocrisy of individuals who ‘evolve’ almost instantly when a controversial issue becomes relevant to their personal circumstances.  Senator Rob Portman of my state of Ohio, for example, was against same sex marriage until he wasn’t.  Readers are encouraged to look up what led to a reversal in Senator Portman’s view. Charles Darwin didn't realize that politicians can evolve. The pandemic has also exposed much public (and private) pontification from individuals, businesses, organizations, government agencies – all of whom may have agendas that extend beyond any actual public health concerns.   One issue that has created raw fissures among us is the concept of mandating vaccines.   There are spirited arguments on various sides of this i

Thanksgiving 2022

  This has been a tough year for America and the world.  For many folks and families, it may be challenging to find reasons to feel thankful.  But we must try.  When you’re in a dark room, you might not see a way to let the light in.  Try to find a window that you can crack open.  Or, one of us will do our best to open it from the outside. Wishing blessings, contentment and peace to all. Hoping for a lot more light in the year to come.

Calling Your Doctor's Office - Frustration #1

There are joys and satisfactions in the practice of medicine.   Indeed, they have sustained me for the past few decades.   I enjoy the work and I continue to be honored that my long-term patients as well as new ones place their trust in me.   Despite my best efforts to deliver perfect advice to every patient every time, I confess that I am a member of the imperfect human species.   I have reminded patients that while I try to offer sound medical advice, I am neither omniscient nor clairvoyant.    If I knew, for example, that the medicine I am prescribing wouldn’t work, or would cause you an unpleasant side effect, then I would not have prescribed it. If you become a ill a week after you have been discharged from the hospital, it does not mean that you were thrown out prematurely.     Excellent medical judgement doesn’t guarantee an excellent outcome.   Conversely, a favorable medical result may occur after mediocre medical care.   There are also frustrations in the everyday medical

Why I Oppose Medical Marijuana

I don't really oppose medical marijuana, only the process that has brought it to market. In general, I hew to the philosophy of  ‘leaving it to the professionals’.   Yes, I support all of us engaging in some measure of due diligence, but I try to select advisors and professionals whom I trust. If they have knowledge and experience that I lack, shouldn't their views carry more weight than mine? In my own life, and probably yours, there are many areas in which I simply am not capable of any due diligence. If a car mechanic, for example, recommends that an expensive part needs to be replaced, I can only hope that this is truly necessary.   If the folks we deal with are honest and experienced, then things will tend to fall into place as they should.   Obviously, for this to work out well, several assumptions need to be true. Many people today soundly reject the ‘leave it to the professionals’ philosophy.   For most of my life, the curricula in our public schools was dictated by

How to Treat Your Upset Stomach

There is a general fascination with the medical profession.  Consider how many television shows over past decades have had a medical motif.  And today’s patients are so über-informed and empowered, that at times they dabble with the practice of medicine themselves as an avocation.  When a patient, for example queries me about Barrett’s esophagus and dysplasia or if I intend to test them for H. pylori, a germ that resides in the stomach, then I know by their use of medical terminology that the office visit will be a  "peer to peer” experience. So, I’ll ask my erudite reader-practitioners to respond to the following medical inquiry.   A patient is suffering from a chronic upset stomach (called dyspepsia) nearly every day.   The cause of the condition cannot be ascertained, and the treatment options are wanting.   Assume that the medical professional has undertaken an appropriate evaluation and that no cause has been discovered.   Assume as well that there is no established treat

Was the Alec Baldwin Shooting Accidental?

Even casual followers of the news are aware that actor Alec Baldwin killed one associate and wounded another during a film rehearsal.  It was a horrible tragedy that captured the nation’s attention.  How could such a thing happen? This is the same question we ask when we learn that a surgeon has removed the wrong kidney.   I’ll leave aside how much attention this tragedy has received in comparison to the intentional killings that occur daily in cities throughout the country.   While all lives are equal, it does not seem that every life receives the same attention. Based on what is now known, it does not seem to me that this shooting was a mere accident that occurred from pure happenstance.   Of course, the shooting was not intentional, but it appears that there was a reckless disregard of established firearm safety protocols.   Investigators will surely discover how a live bullet ended up in Alec Baldwin’s gun.   More facts are emerging daily that indicate a laxity of gun safety an

Jeopardy Host Sidelined but Still Kept His Job?

When improper actions are followed by proportionate and predictable consequences, it serves as an incentive for us to behave better.  Let’s face it.  We are not hardwired to do the right thing. If we were, then there would be no need for thousands of laws, rules and regulations to guide our behavior.  We need laws against theft, insider trading and assault because we have accepted that our natural human inclinations often lead us astray. And, if we were moral creatures by design, parents, teachers and religious leaders would not have to devote so much effort to teaching us to do the right thing. When a consequence is hollow it threatens our confidence in the integrity of the system.   When a professional athlete has committed assault, the investigations and punishments have seemed to be a very different process than we would expect if an ordinary person, like me, were the accused.   We have all witnessed examples of this over the years. Some time ago, Mike Richards, who was anoin

Will We Be Wearing Face Masks Forever?

I don’t foresee them disappearing from the public landscape anytime soon. I think there will be a segment of the population that will continue to wear masks even after the pandemic has subsided.   Indeed, there are parts of the world where donning a face mask is routine. And as we have all seen, there is a vocal segment of the population that will refuse mask wearing regardless of the circumstances.   For example, sitting governors, with a keen eye for politics, have ordered that no mask mandates can be instituted in their states.   Score 1 for Politics and 0 for Science. Just as our country has not experienced its last hurricane or wildfire, there are other pandemics lurking over the horizon.   So, over time, mask wearing will rise periodically when nature’s germ warfare strikes us again. 'The Mask Stays!' I also suspect that many health care institutions will require their staffs to wear masks long after the public will have been advised that masking is no longer advi

Doctors Spreading COVID-19 Vaccine Misinformation

( As published recently in Should a physician who spreads misinformation on coronavirus vaccines lose his medical license?  Would this violate the doctor’s right to free speech?  Shouldn’t physicians be able to offer their patients counsel and advice that differs from mainstream medical thought?  Every profession has ethical and legal requirements to maintain the integrity of the profession as well as the public trust. ·       If an attorney lies to a judge, then this lawyer can expect to be severely sanctioned.  ·       If a public-school teacher instructs science students that the world was created exactly as recorded in the Book of Genesis, then professional repercussions are expected. ·       If a police officer is discovered to have planted evidence to justify an arrest, then the officer will likely face criminal penalties. In the medical profession, there are also professional and ethical boundaries that practitioners must respect.  Consider these flagrant violatio

I won’t take the COVID-19 vaccine!

 Recently, I faced 3 patients who had chosen not to receive a COVID-19 vaccine.  Interestingly, each had a different reason underlying their hesitancy.  The first patient gave an adamant refusal that there is no way he would ever submit to the vaccine.   He didn’t trust the government.   The second patient offered the canard that the approval process was rushed.   The third patient had simply procrastinated.   Her family members had all been vaccinated and she has received many other vaccinations.   She was simply perched on the fence and hadn’t moved. I offered counsel to Patients #2 and #3 as I felt there was a chance I might have impact with them.   I hope that I did. Stop Vaccine Tyranny! The walls are closing in on the unvaccinated.   With the recent formal Food and Drug Administration (FDA) approval of the Pfizer vaccine, and the increasing number of businesses, organizations and venues that will only admit the vaccinated, the vast space that the unvaccinated have inhabited

TSA Fails to Protect Passengers from COVID-19

We are taught from a young age to finish the entire job.  I confess that I still need reminding on this virtue. I suspect that all of us must plead guilty to partial task completion from time to time.   Have you ever washed some of the dishes remaining in the sink?   How about cleaning out part of the garage and rationalizing that this is enough work for one day.   How many of us have projects around the house that are waiting patiently for our attention as they sit frozen in time? There are more stark examples   when stopping short if the finish line is downright absurd. Consider some examples extracted from my imagination. An artist paints only on one side of the canvas, and I don’t mean for artistic reasons. A car wash cleans only the rear section of automobiles. A publisher distributes books that are 100 pages short of their true length. Silly, right? It’s easy to conjure up similar examples regarding the medical universe. A surgeon washes only one hand prior to surge

Religious Exemptions to the COVID-19 Vaccine

We have all been counseled to avoid discussing religion and politics in order to reduce the risk of a hostile encounter.  I recall being reminded of this maxim when dining with a new acquaintance many years ago.  My response?  ‘That’s all I like to talk about!’ I am writing this at 9:30 a.m. on a Saturday and I’ve already had multiple conversations – both directly and electronically – with people in my life on both of these radioactive subjects.  As far as I know, all of the friendships remain whole.  Indeed, these debates and exchanges serve to fortify our friendships rather than to threaten them. I recognized that discussing religion can be fraught for many individuals and might be best avoided for them.  Same with politics.  Many a thanksgiving dinner has been sullied by someone who decides to serve as the family turkey  Look at the national response when a Colorado baker refused to bake a wedding cake for gay couple in 2012.  The cake shop owner claimed this violated his religi

The Meaning of Labor Day 2021

Labor Day, which honors American workers, was established well over a century ago in 1894. The holiday emerged from a cauldron of worker unrest protesting against harsh, unfair and unsafe working conditions.  Indeed, there were strikes and even violence in the early years of the fight for workers’ rights.  Over the ensuing decades, organized labor gained membership and power as increasing numbers of workers sought out union protections.   Those numbers have declined over time for several reasons.  Currently, about 11% of workers belong to unions. While I have not always supported organized labor’s positions and actions, I certainly agree that every employee -union or non-union - is entitled to a fair wage and safe working conditions. It’s been a very tough year for labor and for the rest of us.   When a company or a business is forced to close by an enemy that we can’t see or touch, toxic ripples spread out far and wide.    When a restaurant shuts down, for example, imagine how man

Politics and the Pandemic - Progress Denied

Over the course of this pandemic, we have learned a lot about the country, our leaders and ourselves – and not all of it has been good.  One thing we have learned is that anything can be politicized.  Will anyone be shocked, for example, if a protest movement develops demanding that that Mother’s Day either be abolished or renamed?   Overall, Governor Mike DeWine has provided sober guidance and directives here in Ohio.  I think that his performance during the pandemic will be an important reason why he will be reelected in 2022.  Interestingly, although he is a bonafide conservative, he will face primary threats from the right in a state that Trump handily won in the past 2 presidential elections.  As we all have learned in November 2016, anything can happen. But, DeWine, like every other political leader considered the political impact of public health decisions. Governor DeWine Understands the Pandemic and Politics. In April 2020, he issued a mask mandate for customers and empl

Biden Botches Afghanistan - Where Does the Buck Stop?

 We have all witnessed the debacle from our clumsy and precipitous withdrawal of our military from Afghanistan.  The humanitarian and moral disaster was as astonishing as it was avoidable.  Not only do our allies and our adversaries correctly point out our incompetence, but so do members of the the president’s own political party and administration.  Perhaps, this is an issue that might unite the Democrats and the GOP.  Indeed, the record contradicts President Biden’s claim that no military experts warned him that his plan risked chaos and catastrophe.   All of us certainly heard the president reassure us only weeks ago that the Taliban were unlikely to prevail in the short term and there would certainly not be a ‘Saigon moment’, recalling an iconic and humiliating scene from 1975. The president also claimed that he was handcuffed to withdraw troops as he needed to honor the prior agreement between the Taliban and the former administration.   This is malarkey!   First of all, Presi

How Much Do You Know About Covid? Test Your Knowledge!

 There isn’t a person, a pet or a plant in this country who is not aware of COVID-19.  With regret, but not surprisingly, the pandemic has struck back as it successfully targets the unvaccinated community.  We have to hope that this outbreak will be the last gasp of the pandemic and not that of many ailing Americans. The nation has been deluged with information, misinformation and disinformation.   We confront facts and alternative facts.   Even legitimate public health experts are not consistently singing from the same hymnal. So, I thought this was an apt opportunity to test your knowledge on the novel coronavirus with ten True or False questions – no multiple choice or essay.   What could be easier?   And there is no penalty for guessing.   Answers appear at the foot of this post.   Good luck.   Let the games begin. How Much Do You Know?   The Delta variant is so named since this strain was brought in from overseas by a Delta airline pilot. CNN, a leading cable news sta

How Do We Reach Herd Immunity Against COVID-19?

Last week I conjectured that the Center for Disease Control and Prevention (CDC) obfuscated when they recently recommended that vaccinated individuals resume indoor masking under certain circumstances.  My speculation was that the policy was justified but that the CDC was not forthcoming in explaining the rationale for the policy revision. The revised re-masking recommendation, as with every other aspect in this pandemic, has only further polarized a nation that seems to be trying very hard not to heal itself literally and politically.   I predict that our collective political affliction will long outlast the coronavirus plague.   I routinely ask patients if they have received the COVID-19 vaccine.   Recently, a patient replied that has not received one.   I asked what his concerns were and he firmly responded that he would never get vaccinated against the coronavirus.   Not much space for dialogue here. The CDC and public health experts admit that masks are not the antidote.  

CDC Reverses Indoor Mask Policy - Are We Getting the Whole Truth?

Depending upon your politics, the Center for Disease Control and Prevention (CDC) has either shamelessly reversed course or simply issued a new guideline in response to new medical evidence. Indeed, many are hostile to the agency’s recent 'new & improved' recommendation that those who have been vaccinated against COVID-19 mask up when indoors in regions where the Delta variant is highly prevalent. The dissenters point out that this directly contradicts very recent CDC and public health expert advice that clearly stated that those vaccinated could be safely liberated from their face masks.  In fact, this demasking was offered as a direct incentive to those who remained hesitant to roll up their sleeves.  The CDC and its supporters maintain that their new policy on masking the vaccinated is based on a sound review of recent data, which they tarried in releasing.  I am a rationalist who practices gastroenterology guided by medical evidence.   Despite some missteps, I have la