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Showing posts from January, 2026

Medicine Combines Science with Humanity

Medicine is based on science.  But it’s not all science.  There are phenomena that occur that physicians simply cannot explain.  Folks recover from devastating illness, for example, when the medical professionals were resigned to another fate.  And while doctors and scientists rely upon the scientific method and medical evidence, the public has a wider reservoir of tools for healing and support.  Sometimes physicians do as well.  Hope and prayer are in heavy use every day even though these actions fall outside of the traditional scientific paradigm.  All rational creatures behave irrationally at times.   It is still true that many hotels will not have an official 13 th floor in order not to spook superstitious guests.   Crazy or good business practice?   Some may even say it is not rational for a scientist to be religious claiming that science and faith pose a conflict.   Do Faith and Science Intersect? Patients and the rest of...

Artificial Intelligence Erodes Physician Skills

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. My readers know of my trepidation and angst regarding the unstoppable artificial intelligence (AI) tsunami that will disrupt our world.  It will make the arrival of the internet seem quaint by comparison.  Just as we cannot fully contemplate the potential benefits, we cannot fathom the potential harm and destruction it will wreak.  There will AI actions that will cause harm and benefit simultaneously.  For instance, once perfected, driverless vehicles will operate more safely than human controlled cars and trucks.  Former drivers will now be passengers who are free to engage in professional or leisure activities.  However, if you currently earn your living as ...

Should I Choose Cologuard Over Colonoscopy?

Cologuard has become a popular colon cancer screening option.  Indeed, it has many advantages over the traditional colonoscopy. Refer to the list below. No prep! No prep! No time off of work. No driver needed. No procedural risk. Done at home. No driving or other restrictions afterwards.\ Much less expensive. Did I mention there is no prep:? Wow, Cologuard sounds like it will be hard to beat.  Not so fast! Cologuard is a sophisticated stool DNA test that detects altered DNA as well as microscopic blood in the stool. Studies have shown that it detects over 90% of colon cancers.   Keep in mind that the overwhelming number of patients undergoing colonoscopy do not have cancer so that this statistic doesn’t apply to them.   How does this stool DNA test perform with respect to colon polyps, which are the target lesions during colonoscopy?    Cologuard detects only 42% of larger precancerous polyps which seems to me to be rather lackluster performance.  ...

Treating Patients with Dignity

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address  at this link  to receive my posts directly to your inbox. I did hospital work for 30 years until I accepted a position almost 7 years ago as an employed staff gastroenterologist at a rather renown Cleveland-based medical institution.  I have been enjoying the luxury of practicing outpatient gastroenterology exclusively, freed from the rigors of hospital work and weekend and on-call responsibilities.  It’s a job description that I feel I have earned after 3 decades of hard labor, but I was lucky that this position was available to me. During my hospital career, I estimate that I have placed a hundred or so feeding tubes, primarily in elderly patients, many of whom were demented.   (In retrospect, gastroenterologists like me were p...