MD Whistleblower

Don’t expect this humble blogger to explain Donald Trump’s broad and sustained GOP support, if our most seasoned political pundits are flummoxed.   Why is this man with no prior political or governmental experience trumping all of his competitors? Is he ahead because he is right on, or is he leading because the competitors are way off? Like most folks, the conventional politicians are by and large an uninspiring lot who offer scripted screeds that are canned and calculated.  Indeed, most political junkees like me can almost orate their stump speeches, since they vary little from speech to speech. Trump Appears to have no 'Special Interests' The conventional candidates often rail against ‘special interests’, a pejorative term that conjures up an evil group that is possessed by greed that tramples over the public good to serve themselves.  I challenge you to identify a candidate who has not spewed vitriol against these nefarious ‘special interests’.   When they

It’s Labor Day tomorrow when we pause to honor those whose labor has laid down the scaffolding of this nation.  Are we all in agreement who the honoree is on this federal holiday?  Labor Day - A Sad Day for Cows Originally, the holiday was to honor the labor unions, organizations that emerged over a century ago as a response to unfair and unsafe labor practices.  I certainly honor the working man for their contributions. There are carpenters and electricians who work for themselves, not for  labor unions.  Is the holiday for them also? What about the rest of us?  I’m a physician.  I work hard and hope that I am making some contribution toward the public good.  Is this holiday for me also? Business owners and management work long hours, often beyond traditional shifts, to maintain the success of their companies.  Is this holiday for them? Artists labor long hours coloring canvases or sculpting provocative creations.  Should they work tomorrow or are they ent

Doctors do not know everything.    We make mistakes and mistakes in judgment.  Sometimes we make the mistake of speaking when we should keep silent.  At times, patients ask us questions that we can’t or shouldn’t answer; and yet we do.  It shouldn’t be our objective to force certainty into an issue which is amorphous and murky.  Here’s a response that I recommend in situations where certainty is elusive. “I don’t know.” I saw a patient for the first time when he was sent to me for a colonoscopy.  Prior to the procedure, we interviewed him to be acquainted with his medical history.  We are always particularly interested in the cardiac and pulmonary history, as these conditions impact on the risk of the procedures and the anesthesia.   This patient had a lung resection.   He related the details which left my staff and me aghast. “The doctors told me that I had cancer and would be dead in 3 months.” Of course, it is not possible for a spectator to imagine the horror o

We are in the Age of Spin as the presidential campaigns percolate along.  So much fun to watch!  It’s a performance in doublespeak, deflection and distraction that is so obvious, that even a person who knows no English can spot it.  I used to get exasperated when I would watch a politician dodge the question posed, but now I view it as pure entertainment.   I’m glad I made this transition, particularly since I live in Ohio where we will see more spinning than anywhere else. Spinning is an old profession. To those who are unschooled in spinning recognition, keep your ear out for these phrases which are classic spin initiators. ‘…what I will say…’ ‘The question we should be asking…’ ‘I have always said…’ Let me illustrate. Reporter:  Do you support the president’s Iran deal? Spinner:     The question we should be asking is why are we caving to the Ayatollahs? Reporter:  Do you support a path to citizenship for the 12 million undocumented immigrants?

We all should know the difference between a slogan and real substance.   One of these has size and shape while the other is just a shadow.   Why then, is the slogan so powerful? A slogan is one of the weapons wielded by the Guardians of Political Correctness.  They will point toward the slogan du jour, and then, with cameras rolling, demand to know if you support it.  Even a moment’s hesitancy will be taken as weakness.   Expect to see your waffling go viral for all to see, edited down and sans context.  Politicians Advised to Avoid Waffles. During a presidential election, this practice is omnipresent.  Mr. Bush, do you support fair trade ? Mrs. Clinton, is your immigration policy to give amnesty to all illegal aliens? Mr. Cruz, do you believe in the rule of law ? These questions cannot be adequately answered with a reflexive yes or no.   The slogans contained within these 'gotcha' questions point to complex and nuanced issues that need layered responses. 

About a week before I write this, I met a man for the first time.  Though it is unlikely that I will see him again, it is unlikely that I will forget him. This was a side trip for us, as we meandered for a weekend through the beauty and nostalgia of Ohio.  Once you find yourself about an hour south of Cleveland, you are in a Land of Barns, where cornfields and cattle punctuate the countryside.  There are miles and miles of open roads unblemished by Starbucks, CVS or Big Box Retail.  Is the air truly fresher or does it just seem that way? On the Open Road in Ohio We drove out to meet this man to examine his wares.  The GPS faithfully led us to the desired location, but we assumed that we were misled as there was no business sign to alert customers like us.  Not quite the marketing strategy we know from city life where advertisements will soon appear on toilet paper.   He has an unusual profession, which I will not identify, as this might be enough to identify him which wo

While we have all heard the adage, any publicity is good publicity, I don’t agree.   See if you agree that the subjects of the following hypothetical headlines would have preferred anonymity. Local Surgeon Loses Scalpel – in Patient’s Abdomen Teacher Pursues New Career as Porn Star Restaurant Owner Claims Rats are Really Pets Planned Parenthood is in the news.  Several videos, surreptitiously taken, have been released showing discussions between Planned Parenthood personnel and folks who were pretending to be interested in procuring fetal parts.  It is illegal under federal law for Planned Parenthood to make a profit selling fetal parts.  More fact gathering will be necessary to determine if a legal line has been violated.  Legalities aside, the videos have generated revulsion across the ideological spectrum by how unseemly and casual the Planned Parenthood folks discussed a subject with huge ethical and legal ramifications.  The public heard how the abortion technique cou

In medicine and beyond, folks just want stuff to be true.  Sometimes, we believe stuff that is unproven, but might be true.  We doctors recommend such treatments to patients every day.  On other occasions, a benefit of a drug or food item is extrapolated way beyond the data.  For example, if Nexium is known to be effective against stomach ulcers, then why not use it for patients with stomach aches who are ulcer-free?  There’s not a gastroenterologist on the planet that hasn’t engaged in this therapeutic mission creep.  More interestingly, folks often persist in beliefs that have been disproven.  The notion, for example, that certain vaccinations can cause autism has been thoroughly debunked by rigorous scientific study, yet there remain diehards who defy the science.  Curiously, many unproven or disproven practices have gained a fair measure of street cred in the Court of Political Correctness.  Keeping a gluten-free diet today is downright chic.  Colonic cleansing is the bomb.  K

Profiling in this country is highly discouraged and is illegal in many circumstances.  Anti-profilers decry this technique which, they argue, unfairly targets innocent individuals violating their rights.  Our beloved Transportation Security Administration, or TSA, is charged not to use profiling as a screening tool.  Personally, I object to this prohibtion.  While an individual’s rights are important, it must be weighed against the rights of the community.  Our cherished rights to free speech and assembly are not absolute. I have flown on El Al airlines, whose personnel actively profile in an effort to keep its passengers safe.  Anyone who has been a passenger on this airline will likely agree with me that he has never felt safer on an airplane.  I have a right not be blown up, and if profiling further minimizes this risk, then call me a fan. Last year, my mother, who appears as threatening as a school librarian, was patted down twice when she traveled to visit me in Cleveland. 

Patients are entitled to receive medical advice 24 hours a day.   If you call your doctor at 3 a.m., you will reach a physician who will advise you.   Of course, it may not be your own personal physician as this individual cannot be expected to be available 365 days a year until he retires.  Physicians partner with colleagues who share on-call responsibility for evenings, holidays and weekends.   For example, my gastroenterology group has 3 physicians who take turns during the off ours to be available for our patients. Here are some tips for patients who are seeking advice after hours from the on-call physician. When possible, call your doctor before sundown. I advise against calling the doctor after hours for a question that only your own physician can answer, unless an emergent situation is suspected.   For example, the on-call physician will not know what the next step will be if next week’s colonoscopy is negative. If you call after hours for advice on a medical is

It’s the birthday of the nation, the Fourth of July.  John Adams proclaimed in a letter to his dearest wife Abigail that this day “will be celebrated by succeeding Generations, as the great anniversary Festival…with Pomp and Parade, with Shews, Games, Sports, Guns, Bells, Bonfires and Illuminations from one End of this Continent to the other from this Time forward forever more.” Years later, in an amazing twist of historical fate, John Adams and Thomas Jefferson would each ascend to heaven on the very same Fourth of July. 'Illuminations' These days, many of our historical figures and symbols are under review, judged in the context of current mores and sensibilities, always a process to be undertaken with care.  The Confederate flag is being banished from government property, as it should be.  During an earlier part of my life, I was sensitive to the argument that this flag properly honored the heritage of Confederate forefathers.  A little wiser now, I now reali

Bariatric surgery, including gastric bypass surgery, has become a popular remedy for obesity in this country.  Hospitals have weighed in on this issue and are marketing this service directly to the public who are ever willing customers of this slenderizing surgery.  I have many patients who have undergone the procedure and the results have been variable.   It’s too dismissive for me to refer to gastrointestinal bypass (GIB) as a ‘procedure’ as it is major surgery with major potential complications.  There are several types of bariatric surgery available today, but GIB is the standard surgery performed. It profoundly reroutes the guts and changes every day of your life.  This is not like undergoing a heart bypass surgery when after a period of recovery you resume your normal life.  After GIB, there is no normal life afterwards.  Your life is irrevocably altered.  Meals are such a significant and personal part of our lives.  Think of all of life’s celebrations and you will recognize

The Deflategate investigation has concluded that it was more probable than not that Tom Brady had general awareness of the mysterious shrinking footballs.  Now the fun started.  Although t he investigator, Ted Wells, is highly regarded for his probity and objectivity, he was attacked by Brady supporters for what they argue were his tendentious findings.  As is so true today in our political world, when allegations are true and damaging, attack the messenger.  Physicists from prestigious universities brought us back to high school science class with theories suggesting how the squishy pigskins could have been the result of natural phenomena.  I think the science was a little squishy here.   It was, however, sentimental for me to relive the tender memories from high school physics about the exciting relationships between pressure and volume.  There’s nothing like a discussion of the ideal gas law to liven up a dull evening.  Would Sir Isaac Newton have given Brady a pass?

Every week, I am asked by patients if their heartburn medicine causes osteoporosis.  The most effective heartburn medicines are called proton pump inhibitors, or PPIs.  If you watch more than an hour of TV per week, then you have seen ads for some of them.   Nexium, Prilosec and Protonix are 3 examples of these medicines. Many of them are now available over-the-counter at reduced dosages.  Patients today are incredibly informed, and sometimes misinformed, about their medical conditions and their treatments.  Most of their information is from the internet, and it’s easy for patients to become unwittingly trapped in the world wide web. The information dangling in cyberspace is entirely unregulated.  Information can be made to appear authoritative and objective when it actually is a paid advertisement.  Many blogs may appear to function to inform the public, when their true purpose is to serve the corporation that sponsors it.  If you are learning about probiotics, for exampl

Racism and prejudice are endemic in America.  Many of us reflexively answer, No , if we are asked if we are prejudiced.  I don’t.  I say yes. While I do my best to give everyone a fair shake, I grew up in a white suburban family in the latter decades of the last century.   My friends, my parent’s friends and all those we associated with were all the same color.  In elementary school, there was but a single black girl in our classroom. Is it possible for a white kid to grow up surrounded by all of the overt and covert prejudicial and stereotypical influences and somehow emerge pure?   I don’t think so.   Prejudice today among those of us who consider ourselves to be enlightened is more subtle and often hard to recognize. I don’t want to overplay this here.  I often feel that a charge of prejudice with regard to race, gender, age or religion is spurious and is launched to advance a personal or a political agenda.  We all know this to be true and these instances deserve condemna