Essays

Thrashing in the Emergency Department

The work of an emergency physician is an exercise in multitasking. We see multiple patients in parallel and respond to all the responsibilities that come with this patient care in addition to being aware of new, potentially sick patients. A typical workflow includes signing EKGs of new patients, documenting on a patient encounter, responding to… Continue reading Thrashing in the Emergency Department

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Thoughts Think Themselves

The physicist, Neils Bohr, said: “prediction is hard, especially about the future.” The statement was made in jest, but no matter what the fortune tellers, prognosticators, priests, or experts say, humans cannot perceive the future, but can only infer it. These inferences enable us to assess risk and react to opportunities presented by the environment. These inferences range… Continue reading Thoughts Think Themselves

Truth Springs from Arguments

Nature is saturated with feedback mechanisms ranging in scale from the molecular to the macroscopic. Feedback is defined as the process of mutual causal interaction: where A affects B and B affects A. This interaction creates a circuit of effects, so any change in A, causes a change in B, which in turn causes a… Continue reading Truth Springs from Arguments

Tail Events

The human brain (like any other organ) has evolved for specific environments and is constrained by its chemistry and historical contingencies. In my last post, I discussed the cognitive blind spots that play a role in the epidemic of over-testing and over-treating in medicine. Human decision making is notoriously ill equipped to distinguish between low… Continue reading Tail Events

Medicine, the science of uncertainty

In a recent article, it was estimated that at least $200 billion is wasted annually on excessive testing and treatment. The impact of the overly aggressive, extraneous care is not only financial in nature but also generates mistakes and injuries believed to cause 30,000 deaths each year. In 1979 the founders of the field of behavioral… Continue reading Medicine, the science of uncertainty

Desktop Medicine

As I discussed in my last post, Claude Shannon defined information as the number of bits needed to communicate an arrangement or state of a system. The fundamental problem of communication is not to make oneself understood, but to reproduce “at one point either exactly or approximately a message selected at another point.” The destination… Continue reading Desktop Medicine

It from Bit

The universe is composed of energy, matter, and information. However, it is not energy nor matter that makes the Earth unique, but information. No known place in the known universe holds more information than Earth.  It is said, our planet is to information what a black hole is to matter and what a star is… Continue reading It from Bit

Poppy Powered

Humans have a long and complex history with plants. Long before civilization and even prior to the Agricultural Revolution, humans had realized that plants have a multitude effects on human physiology including appetite suppression, pain relief, energy supply, and immune system stimulation. It has been hypothesized that the adoption of an omnivorous diet was a… Continue reading Poppy Powered

History of the Joy Plant 

In an evolutionary blink of the eye, the Agricultural Revolution changed the course of world history. It not only catapulted the homo sapien population, but also propelled a few plants into becoming the most successful species in the history of the earth. Wheat, maize, rice, and potatoes went from being wild, uncultivated crops to accounting… Continue reading History of the Joy Plant 

Sugar Daddy

Sugar has played a key role in the history of humanity since it was domesticated on the island of New Guinea approximately 10,000 years ago. The New Guineans picked the cane and ate it raw. They, like billions of people afterwards, were hooked and the sugar cane was featured prominently in their myths. Thereafter, sugar… Continue reading Sugar Daddy

Evolution is Cleverer Than You 

Aging or senescence  is defined as the “progressive, generalized impairment of function, resulting in a loss of adaptive response to stress.” The desire to overcome this seemingly inevitable decline is as old as human consciousness. There are ancient stories abound speaking to the quest for immortality. The ever illusive elixir of life restores the youth of anyone… Continue reading Evolution is Cleverer Than You 

Fountain of Youth

Maximum lifespan is defined as the maximum number of time members of a species have been observed to live. According to the Hebrew Bible, Methuselah lived until the age of 969. More contemporaneously, Jeanne Calment, holds the distinction for the longest recorded human lifespan of 122 years. When she was born in 1875, the germ theory of… Continue reading Fountain of Youth

First Do No Harm

The word iatrogenesis is derived from the Greek language meaning “brought forth by healer.” It is defined as the “inadvertent and preventable induction of disease or complications by the medical treatment or procedures of a physician or surgeon.” Iatrogenesis in medicine has been recognized for as long as Western medical history has been recorded. Approximately… Continue reading First Do No Harm

The Average is for the Average

In the 19th century, Adolph Quetelet developed the notion of a physically average human “who is characterized by the mean values of measured variables that follow a normal distribution.” According to him, “the determination of the average man is not not merely a matter of speculative curiosity; it may represent the most important service to… Continue reading The Average is for the Average

Mobility and Mortality (M&Ms)

Mobility is defined as the ability to move freely and easily. After the initial magical moments when we take our first steps and until we begin to lose this mobility under the insidious burden of chronic disease, this mobility is mostly taken for granted. However, it is the hallmark of our humanity, evolutionarily and developmentally.… Continue reading Mobility and Mortality (M&Ms)