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
Essays
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)
Solvitur Ambulando
My wife and I recently spent a magnificent three weeks in Southern Africa. We were amazed at the wildlife in Botswana’s and Namibia’s national parks, which are the closest approximation of the freedom the animals enjoyed in their past. Unlike the not too distant past, the watering holes scattered around Etosha National Park were the… Continue reading Solvitur Ambulando
A Bayesian EHR
As an Emergency physician, my job is to make predictions. Throughout the day (and night), I make predictions related to treatment outcomes, management plans, and patient dispositions. These predictions are often fraught with risk (but mostly uncertainty) and I am constantly aware that every decision I make is inherently probabilistic. The framework that most physicians lean… Continue reading A Bayesian EHR
Hunger games
Hara hachi bu is a Confucian adage that dates back 2500 years and instructs people to eat until they are 80% full. The Okinawans from Japan use this mantra before every meal, enabling them to be mindful of their food consumption. Elderly Okinawans have among the lowest mortality rates in the world from a multitude… Continue reading Hunger games
Between a Carbohydrate and a Fat Place
For the vast majority of human history, survival has been a desperate effort with a mixture of luck and lot of vigor. Energy sources have been scarce, and consequently, traits that optimized energy storage and conservation have gained prominence. In response to this history, we have utilized technology to create an environment where energy sources… Continue reading Between a Carbohydrate and a Fat Place
Over-Pharmaceuticalized
I recently read an interesting book titled, Overdiagnosed: Making People Sick in Pursuit of Health. In the book, Dr. Welch talks about the dangers of over-diagnosis and how it is “biggest problem posed by modern medicine.” Over-diagnosis is defined as the diagnoses that will never cause symptoms or death and generally occurs because doctors seek… Continue reading Over-Pharmaceuticalized
Brain Drain
Data, information, and the patient-physician encounter are at the heart of medicine and health. William Osler (the father of modern medicine) recognized early the role of patient-focused data-driven decision making when he stated that, “the practice of medicine is an art, based on science.” Translated into modern medicine, the physician gathers information from “indirect” sources… Continue reading Brain Drain
What’s the DALY
Aging is the defined as the gradual functional and structural decline of an organism, resulting in an increasing risk of disease, impairment, and mortality over the life span. It is thought to be reliant upon a balance of exposure and resiliency. By 2050, the world population aged 80 years and above will more than triple… Continue reading What’s the DALY
Fat Outside, Fit Inside
In a recent study in JAMA, nearly 75% of men and 65% of women between the ages of 25-54 were classified as overweight (BMI>25) or obese (BMI>30). These numbers have dramatically increased in the last 40 years. In response to this rising epidemic, a multibillion dollar weight loss industry ranging from diet companies and supplement… Continue reading Fat Outside, Fit Inside
The Art of Medicine
David Sackett was widely known as the “father of the evidence-based medicine” movement recently died. He defined evidence based medicine (EBM) as the “conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” It is a set of best practices based on rigorous experimental data and seeks to… Continue reading The Art of Medicine
S-Fxn 