MD Whistleblower

  I have seen many alcoholics during my gastroenterology career.   It is likely in the majority of cases that I was not aware of their abuse history.   Patients often deny or minimize their alcohol history when queried.   “Do you use alcohol regularly?” “Only socially.” At this point the physician and the patient engage in a linguistic tete-a-tete on the precise meaning of ‘socially’. Patients are more forthright about their habits when they have a medical condition that has a clear an obvious connection to alcohol, such as jaundice or liver injury.   And, if family members are present, they often serve as fact checkers and truth tellers. What is my approach to these patients?    Do I wave my arms and preach like an evangelist that they should throw their bottles away?   Do I tell them that they must quit or face medical damnation?  Do I threaten to sever them from my practice if they persist with their addiction?   I have adopted a rather different approach.   I do not advis

 Yesterday, I entered a convenience store for a small item with my mask securely in place. I also do my best to maintain adequate distance from others, but it seem that others have a much more relaxed view on this.  I approached the check out line and stood behind two maskless men.   Why?  Is it possible that they are not aware that every state and national health expert recommends mask wearing? Yes, there was some confusion on this initially, but all of the experts are singing from the same hymnal now.  It’s an act of ignorance and selfishness.  How do they justify putting themselves, other customers like me and store employees at risk of contracting COVID-19?  Is this the example they choose to set for their children, friends and coworkers?  Or, are these just folks who don’t like to be told what to do? If the nation had not become a cauldron of anger, I might have approached these men to engage them in a conversation.   But, not these days.   Yesterday’s Road Rag e has morphed int

We are all hopeful that effective treatments against COVID-19 will emerge in the next 1-2 years.   The first round of medicines will be replaced with superior alternatives.   This is called progress.   But as of now, we have no effective therapy.   I have already expressed my skepticism over chloroquine and hydroxychloroquine, whose popularity and usage had skyrocketed despite the absence of credible and persuasive medical evidence of efficacy, but the initial sugar-high has dampened.     Clinical trials are in progress on various agents and will bring some clarity to the issue.   Scientists throughout the world are working doggedly to create an effective vaccine.   This won’t be easy.   The forecasts of an effective vaccine in 12-18 months may prove to be wildly optimistic.   Consider that the common cold which tortures tens of millions of us every year is also caused by a coronavirus.   No protective vaccine against cold viruses has been created and scientists have had decade

In general, I’ve been wearing a mask when I’m out and about.   I continue to believe that maintaining adequate distance between me and the next guy is more important than masking up.   I’ve seen many folks who must not agree with me as they have no qualms about breaking the recommended 6 feet barrier while donning a mask.   One of my criticisms of masking up is my suspicion that folks would feel more protected than they are and would reduce their social distancing range from 6 feet to 6 inches. And, does the public truly understand that the mask is to protect others?  And, it may also be possible that the mask wearer may also enjoy some personal protection. Of course, the messaging on masking has been atrocious.  On February 29th the Surgeon General implored us in ALL CAPS on a tweet to STOP BUYING MASKS!  His advice has since 'evolved' and is now in line with the consensus of all responsible public health leaders to mask up. And yet, we have a segment of folks who re

If the nation were any more divided, then we would be occupying two different planets.  As I have written, and indeed you all know, there is no issue that cannot be politicized.  Would any of us, for example, have ever divined that the wearing of masks during a pandemic would become a fractious political issue and not a simple public health measure?   I’ll bet that if a legislator wanted to offer a proclamation honoring the nation’s mothers, that some quarter of our society would challenge it on some basis. Earlier this week, the Attorney General of the State of New York (AG) announced that the National Rifle Association (NRA) was so systemically corrupt that it needed to be dismantled entirely.   She levels serious charges of corruption against NRA leadership and has hinted that there may also be violations of the IRS code, which presumably would invite a federal response. NRA in the Crosshairs I heard her discussing the charges earlier today on a liberal cable station and to my e

Life is so much easier when we can rely upon a playbook to guide us over and around obstacles.   Indeed, many professions are devoted to creating policies and procedures to help businesses, individuals and organizations navigate through rough currents.   In general, these prepared plans are created to address challenges that are either known from prior outbreaks or can reasonably be assumed to be potential adverse events.   For example, regions of the country that have suffered from natural disasters would be expected to have contingency plans in place to prepare for the next arrival of Mother Nature.   Navigating Through Rough Currents How comfortable it is when facing a dilemma to be able to pull a binder off the shelf for advice. Of course, as anyone alive knows, we don’t have a binder, an advisor, a parent or a GOOGLE site that can reliably land us safely when confronted with adversity.   So many issues require us to rely upon our experience and judgement and to lea