“A lie will go round the world while truth is pulling its boots on.” -- C. H. Spurgeon

In 1998 Andrew Wakefield, a British gastroenterologist, published a study in The Lancet reporting on 12 (remember that number) children with developmental delay, 8 of whom were diagnosed with autism within 4 weeks of receiving the MMR (measles, mumps, rubella) vaccine. The s...

This post has a very braggy shamelessly self-promotional part. So allow me to get that out of the way first. In October 2017 I took the American Board of Internal Medicine (ABIM) recertification exam. It’s a day-long multiple-choice test that covers the entire breadth of internal medicine and is done under the watchful eyes of proctors who make sure we only had access to the information betwee...

About half of U.S. adults take some sort of nutritional supplement. (My wife and I are in the other half.) Many supplements have a crucial specific function (vitamin C, for example, is the best and only treatment for scurvy) but their benefits to the general population are unproven. Vitamin D is frequently prescribed to prevent and treat osteoporosis. It is critical in calcium metabolism an...

Lots of my patients have been struck by a miserable cold in the last few weeks. My phone is ringing off the hook (is that a meaningful idiom anymore?) with woeful tales of coughs and runny noses and fatigue and despair. I thought it would be a perfect time to do a little teaching about the common cold, how to treat it, and other diagnoses that it can be mistaken for. But it turns out More

“Oh, a storm is threat'ning My very life today If I don't get some shelter Oh yeah, I'm gonna fade away”

Gimme Shelter by The Rolling Stones

By any measure, last year’s flu season (2017-2018) was very bad. The Centers for Disease Control and Prevention released a report last month estimating that influenza killed about 80,0...

Before we delve into this month’s news about aspirin, let’s briefly review what we think we know. Aspirin is life-saving therapy during a heart attack. In patients who have had a stroke or a heart attack in the past, daily low dose aspirin can prevent a second stroke or heart attack. Ditto in patients who have had bypass surgery or angioplasty or those who have chronic angina (chest pain cause...

Fluoroquinolones are the third most commonly prescribed family of antibiotics in the U.S. for adults, and, in my opinion, the second most fun to say (right behind aminoglycosides). Fluoroquinolones include levofloxacin (Levaquin), ciprofloxacin (Cipro), moxifloxacin (Avelox), ofloxacin, and delafloxacin. Their popularity is well earned; they’re very effective at treating certain bacterial infe...

  “I want to go to the best orthopedist.” I hear this request, or a version of it, all the time. “I want my daughter to see the best cardiologist,” or breast surgeon, or neurologist. I try to explain to patients that there’s no way to figure out who is the single best doctor in a field, or even what it would mean to be the best. Would it mean the best outcomes? The best patient satis...

Shingrix is a new vaccine approved to prevent shingles. What’s shingles? Should you get this vaccine? What if you already had a vaccine for shingles? Good questions. Read on. To understand shingles, we have to understand chicken pox. Chicken pox was an extremely common childhood illness before 1995, when routine vaccination for chicken pox began. Before that, an average of 4 million people ...

“The first principle is that you must not fool yourself – and you are the easiest person to fool.” -- Richard Feynman

This month brought more bad news for coronary artery stents. To understand how far coronary stents have fallen, we have to understand what we’ve been using them for. But first I should explain that coronary stents are life-saving treatments ...