October 19th, 2011 by Steve Novella, M.D. in Health Tips, Research
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The discovery of various vitamins – essential micronutrients that cause disease when deficient – was one of the great advances of modern scientific medicine. This knowledge also led to several highly successful public health campaigns, such as vitamin-D supplementation to prevent rickets.
Today vitamins have a deserved reputation for being an important part of overall health. However, their reputation has gone beyond the science and taken on almost mythical proportions. Perhaps it is due to aggressive marketing from the supplement industry, perhaps recent generations have grown up being told by their parents thousands of times how important it is to take their vitamins, or eat vitamin-rich food. Culture also plays a role – Popeye eating spinach to make himself super strong is an example this pervasive message.
Regardless of the cause, the general feeling is that vitamins Read more »
*This blog post was originally published at Science-Based Medicine*
September 27th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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I recently saw a teenage boy with headaches. His father, wringing his hands, said that the headaches had been present for two years; but that the child had never been evaluated for them. No imaging, no neurologist. No insurance, of course.
A family friend, another child, had been diagnosed with a brain tumor. The family of my patient was terrified. Where to turn? They were, reasonably, concerned about cost.
Contrast that with the woman I saw on state assistance. Read more »
*This blog post was originally published at edwinleap.com*
September 17th, 2011 by Bongi in True Stories
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In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.
As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future. Read more »
*This blog post was originally published at other things amanzi*
September 12th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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Nostalgia for the house-call
Not too long ago, I made a house call. As a physician accustomed to working in the emergency department of a hospital, this was quite a change of pace. But it involved dear friends and their sick child, and it was a joy. We had spoken on the phone and I had some concerns about their infant, who was stricken with a high fever. When I went to their home I took only my stethoscope. That and my experience as a physician and parent of four.
When I walked through the door on Friday evening there were candles burning as dinner was prepared. There were no florescent lights. There was none of the chaos of a waiting room. No ambulances idled outside. No bloody, angry drunk screamed profanities. No one was stood by their exam room door, arms crossed in annoyance with waiting. It was a quiet place to be; and the child, on his worried mother’s hip, was quiet as well. He was in a place where he felt safe and was thus able to tolerate my poking and prodding.
I examined him and decided that he was not seriously ill. Because his mother had described him as lethargic when we spoke, I had been concerned that he might have meningitis. This was not actually the case. His parents and I were obviously relieved.
After he was dosed with ibuprofen and put to bed, I chatted a while with his mom and dad, then left for home. As I drove home I realized that Read more »
*This blog post was originally published at edwinleap.com*
August 26th, 2011 by Edwin Leap, M.D. in Opinion
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This might sting a little…
When I was a child, I was often painted orange with Merthiolate. My grandmother, like every good grandmother, kept a bottle handy at all times. Merthiolate was an antiseptic, containing Mercury, that was marketed for cuts and scrapes.
A fall on the gravel, a slide on the pavement, a run through the briar patch and you’d be sitting on the kitchen table while grandma colored you orange with the magical elixir, which incidentally burned like fire!
On a recent emergency department shift, we were colluding about the general state of drug-seeking in America, which has been enabled by our ‘nothing should hurt’ ideology. One of my dear friends, Nurse Nancy, had a realization; an epiphany, really. Read more »
*This blog post was originally published at edwinleap.com*
