While the specific term "placebo" didn't enter the medical lexicon until the late 18th century, ancient physicians were intimately aware of the effect. The ancient Greek, Indian, and Chinese traditions all leveraged the capacity of belief, trust, and suggestion to facilitate healing. However, with medicine’s scientific turn, the placebo has garnered a negative connotation of… Continue reading The Set and the Setting
Category: health care
EHR as the Sun
The HITECH Act was passed in 2009 to promote and expand the adoption of health information technology with the objective to improve care processes, the quality of care, and overall health system productivity. Although the push to digitize medical records has mostly been accomplished, as Electronic Health Records (EHRs) have become ubiquitous in healthcare, the… Continue reading EHR as the Sun
The History and Physical
The history and physical exam are firmly established methods in the practice of medicine, with an ancient pedigree. Their origins can be traced 2500 years ago to Hippocrates, who naturalized the concept of disease and introduced the methodology of the history and physical exam. Diseases no longer needed divine explanations, but could be studied like… Continue reading The History and Physical
Death by Dashboards
Due to the glacial pace of evolutionary adaptation in many if not most ways, the genome could be considered a lagging indicator. It is tuned to invariants of a bygone regime - the environment of evolutionary adaptedness (EEA). Life would probably be not as robust and diversified if it had to solely rely on a… Continue reading Death by Dashboards
The Person and the Situation
It has almost become a truism to attribute the causes of diseases to social determinants of health (SDOH). By one estimate, SDOH account for 60% of premature death in the United States. According to the CDC, SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age. While… Continue reading The Person and the Situation
The Wanderer
A core functionality of biological organisms is to track regularities in the environment and utilize those regularities as a substrate for predictions. In general, organisms that can identify markers of risk, danger, and safety and respond appropriately to those markers are better adapted than organisms that lack this functionality. Thus, the largely reflexive fight-flight-freeze responses… Continue reading The Wanderer
The Art of Progress
As I wrote in my last essay, real world evidence (RWE) generated from “big” real world data (RWD) is upending the hegemony of traditional randomized controlled trials and the evidence hierarchy. RWE is being used for epidemiological evidence to identify targets for drug development, for safety surveillance of approved medical products, for examining changes in patterns… Continue reading The Art of Progress
Evidence of, Evidence for
In the human world, ideas and concepts are more robust and impactful than anything organic or material. Concepts and ideas often outlive their originators. As culture, language and their embedded concepts multiply and diverge, exchange and reconvene, they shape our world in unpredictable ways. One concept that has evolved to loom over all aspects of… Continue reading Evidence of, Evidence for
A Tale of a Springbok
In my last essay, I wrote about the bold (if foolish) springbok who left the safety of the herd and made his way to the watering hole on a sweltering Namibian day. Although he seemed to be aware and on the lookout for theoretical lions as he episodically and intently scanned the periphery, he was… Continue reading A Tale of a Springbok
Unknown Unknowns
Picture a late morning scene at a watering hole in Etosha National Park in Namibia. The sun is getting close to its apex position in the sky, its fierce rays pierce through the cloudless sky onto the ground. All types of animals from a family of majestic African elephants to a tower of leggy giraffes… Continue reading Unknown Unknowns
The Present of Things Past
As stated in one of Zeno’s nine paradoxes, an arrow in flight is “somewhere” and “somewhere in transit”, implying the flow of time as a continuum. Thereafter, approximately a thousand years after Zeno, the theologian Augustine of Hippo attempted to categorize time by writing, “perhaps it would be exact to say: there are three times -… Continue reading The Present of Things Past
The Single Aim
Evolutionary biologist Leslie Orgel’s second rule of biology states that “evolution is smarter than you are.” Evolution and its mechanisms can explain much of the seemingly boundless complexity and organization evident in biological ecosystems. As I discussed in my last essay, biological evolution with its objective function of survival and reproduction driven by the processes… Continue reading The Single Aim
Culture Clash
William Faulkner wrote, “all human behavior is unpredictable, and considering man’s frailty...and the ramshackle universe he functions in, it’s all irrational.” Despite this claim, scientists from disciplines ranging from economics and mathematics to anthropology and psychology have laboriously attempted to uncover patterns within the morass. Game theory is one such approach that starts with the… Continue reading Culture Clash
Similarities in Dissimilars
The name Homo sapiens was applied by the 18th-century taxonomist Carolus Linnaeus in 1758. Sapien - the wise - suggests that the defining attribute of our species is a distinct and unparalleled cognition. We think differently from all other animals, and we are able to share those thoughts with one another in ways that are… Continue reading Similarities in Dissimilars
I err, therefore I am
When talking about the human mental capabilities, in The Symbolic Species, Terrence Deacon stated that “biologically, we are just another ape. Mentally, we are new phylum of organism.” This wondrous and unfathomably complex organ - the brain - has enabled us to become the most dominant species of the planet. With a unique capacity to… Continue reading I err, therefore I am
S-Fxn 