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Why I Don't Tell Alcoholics to Quit Drinking.

  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

Do I Ask Someone to Wear a Mask?

 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

When will there be a Coronavirus Vaccine?

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

Why We Should Wear Face Masks During COVID-19

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