Big Medicine & Health

If Big Medicine--the counterpart to Big Government, Big Oil, Big Business, Big Science, and Big Religion--has a capitol city it is Boston. Home of MBH--Man's Best Hospital--and The House of God, among other world famous institutions, Boston is medicine on major steroids. Hah-vahd. BU. Tufts. When I was interviewing at these places for residency, a woman (a med student at Tufts) asked me in a very snotty way how I, a lowly med student from the University of California, got interviews there. I have to say I was young and arrogant enough to tell her that it might have had something to do with being first in my class. She was speechless.

Boston has an excellent community health program. Massachusetts has "universal" health care coverage. There are pharmacies on every corner. Yet the health of Bostonians is no better than that of people in any other American city, and probably a lot worse than most.
Big Medicine is about SICK CARE. Real health care is about prevention and taking care of ones self and others. It's about mental health, exercise, and a life that makes sense. It's about sobriety in all its manifestations. It's not about the biggest or best hospital or the largest endowment or reputation. Real health is seen only among people who care enough about themselves and others that they participate in a healthy community.
Boston rocks. But as I spend the coming weekend there I'd rather have health than Big Medicine.

Mabel is missing....

When I teach anatomy, I am reminded that ours is the only species that has reverence for our dead bodies. Anyone who wants to explore this a bit should read STIFF, by Mary Roach. It will change your views, one way or another.
This morning on WEBZ I heard about Mabel, who died in Tucson, AZ at the ripe age of 89. She was cremated and her ashes sent through the U.S. Mail (bad idea) to her family here in Chicago, who were planning to bury the ashes last week. Unfortunately the package of Mabel's cremains is now "missing." The family is, perhaps understandably, upset. They paid the postage in advance, it seems.
On the other extreme I heard a somewhat less sentimental story of a young Afghan man at a Pakistani madrasa who, thanks to the tender mercies of Islamofascist adults who have chosen a different career path, wants to grow up to be a suicide bomber. His remains will be unlikely to even fit into an envelope, and I'll bet his mother will be pretty upset, too, if her son "succeeds."
The Bible tells us that God told our first parents that from dust they had come and to dust they would return. Actually, given the options above, dust isn't too bad.
It reminds us that what is human about us is not our bodies but our spirits, which science cannot figure out and, I'll wager, never will. I for one am glad. Mabel and the boy above may not enjoy a beautiful day like today but you and I can.

Life, life, and more life....

There has to be life elsewhere in the universe.
Our current view in biology is that life started much earlier in Earth's history and perhaps in places much more supposedly inhospitable to it than we thought. The history of our planet is that in spite of numerous disasters, catastrophes, and extinctions, life persists and extends its reach in the face of all attempts to crush it. Life is adaptable with a really, really big A.
When I was in grade school (before there was color) there were two kingdoms of living things: Animals & Plants. Now there are five: Animals, Plants, Fungi, Monera, and Protists. I predict that soon we will have a sixth: Viruses. (The picture is of a Virus, not a 1950s B-movie alien, BTW.)
And the reason I think there is life throughout the universe? It is a lot "easier" than we thought for life to emerge from the soup. Our corner of spacetime has "only" billions and billions of life forms, with new ones being found every day. Given the number of spacetime coordinates that exist, life elsewhere is inevitable. I doubt we will ever see any of it, but I for one would love to examine a silicon-based life form!

It must be my sluggish metabolism....

It would take a metabolism faster than the speed of light to deal with this, which happens to be a 2-pound McDonald's cheeseburger....
A recent internet diet--for "carblovers" featuring CarbStars--is yet another hoax. I am using it in my classes to discuss physiology and biochemistry. The basics: 1) limit calories to 1200 to 1600 per day; 2) exercise; 3) eat low fat meats & cheeses, veggies, and fruits; 4) eat smaller portions; and
5) eat carbs, heavy on the CarbStars.
What is a CarbStar you ask? Ah, this is the magic ingredient. It is something called a "resistant starch".
Why hasn't anyone told us about CarbStars before?
All sugars are starches to a degree, but these are "special"--they are indigestible.
Meaning they are taking up "space" but have no calories.
Another name for these magic fat-busters? Oat hulls and wheat chaff. Fiber.
Who knew it was this easy? PTTTTH.
Check out the link below to This Is Why You're Fat.
(Thanks to JFDS)
You eat too much and don't exercise enough.
But don't forget the fib...um...CarbStars.
Mom always told you roughage was good for you, and it is. But it's no magic weight loss ingredient.
"Resistant starches"? Hooey.
You will not find this in the index of any biochemistry book I know.

Acids and bases...oh, my!

Acids give up electrons, bases accept them.

Acidity is a mechanism many organism use to defend or protect themselves. Alkalinity is less common in animals but frequent in plants.
Life in general is exquisitely adapted to maintain a close to neutral pH (the measure of alkalinity/acidity).
Variances from neutrality almost always indicate a pathological process. The goal of treatment is to correct the UNDERLYING disorder, not just the pH itself.
When in doubt, HIT THE BOOKS!

What does it mean to "know" something?

One of the best tools I received in "how-to-be-a teacher school" was Bloom's Taxonomy of thinking skills. It was very useful for middle school students and is critical for college or professional ones.

Having the facts (Knowledge and Comprehension) is necessary but insufficient for scientific literacy, much less competency as a clinician. One must know how to use the information (Application). Beyond that, one must be able to critically assess the data from which the information was obtained and determine if it is applicable to the current problem (Analysis) and then integrate that with other information that is pertinent (Synthesis).

MOST IMPORTANTLY, the clinician must be able to address the SO WHAT? questions, the WHY DO I CARE ABOUT THIS? issues (Evaluation). In my classes, we will constantly be pursuing the higher order thinking skills (HOTS) and assessments will be directed to that end.

Not only is it more effective to teach and learn in this manner, IT IS A LOT MORE FUN!

The agony and the ecstasy

The Bible tells us, correctly, that we are "fearfully and wonderfully made."
Unfortunately, as we age the emphasis is on the former.
The price we pay for at least one of our evolutionary advantages
(upright walking) is osteoarthritis.
There are ways to deal with this, the best two being weight control and exercise.
Take charge today!

The History of Medicine and Science

The history of medicine does not, unfortunately, demonstrate the same quality of inquiry as that of science. On occasion an individual, like Hippocrates (right), practiced medicine based on the known science; more commonly the practice of medicine was based on sometimes bizarre "beliefs". It wasn't until the latter part of the 19th century that medicine became a true science. Even today clinicians often practice based on personal bias and belief rather than data. I will consistently emphasize the scientific process of inquiry in my interactions with students, and will expect them to have the same perspective.
We ARE scientists!

Be kind to your joints!

Joints have certainly benefited from evolutionary development. Stephen Jay Gould, the Darwinian who proposed the theory of punctuated equilibrium, often points out that the products of evolution are not "progressive" but "adaptive." This means that key evolutionary features have allowed for major functional improvements--like JOINTS--but they may be associated with less than desirable "side effects"--ARTHRITIS and JOINT TRAUMA. I think most of us would accept the latter as small prices to pay for walking upright, dancing, playing tennis, and painting! Appreciate your joints today!

Physics first?

Today I get to meet my microbiology/chemistry students.
I hope they are OK with me instead of Mr. Frick.
The PHYSICS FIRST movement is gaining ground in science education, thankfully.
Since the discovery of the atom it has been clear that the basic science is physics, which is the science of matter and energy; chemistry is the next "layer", followed by biology.
Think about it....

Skin & bones?

These were our topics this week in A&P, WEEK 2 already!
It should be noted that though obesity is an epidemic and is very clearly a risk factor for premature morbidity and mortality, so is excessive "thinness." Anorexia nervosa, a condition affecting primarily adolescent females, can be fatal. Actuarial tables show that morbidity and mortality rise as BMI drops below normal! One theory of why this may be the case is that excessively low BMI is associated with suicide. (NOTE: ASSOCIATIONS and CORRELATIONS DO NOT INDICATE CAUSALITY!)
SO--take care of your skin (NO SMOKING, avoid UV light in any form) and your bones (proper amounts of vitamin D, calcium, and exercise) and that will contribute to keeping what's in between at a healthy place, too!

Object lessons....

<---George Hamilton, The Tan Man

One of the fun things about teaching and also being a clinician is using object lessons. Today in class we talked about skin and I could use my recently obtained tan as such an example of what NOT to do!
That being said, I enjoyed getting it and also enjoy being back!

Bermuda!

This will be our 7th trip to this island paradise.
There is lots of science, especially ecology, geography, and, of course, beachology. :-)
We are staying at the Granaway House, on the left. The beaches, under the heading, do look like this and the sand really is pink.
The Islands, remnants of a volcanic atoll, are pictured on the right. They have a fascinating history, a unique culture, and wonderful food.
No postings until we return!

Welcome, students!

Medical folklore and quackery....

It has been very humid lately, which set me to thinking about those people who say they can tell when a storm is coming because their joints ache. This led me to folklore in medicine. My father, who was a psychologist, said that since all people have minds all people think they are psychologists. Well, since all people have bodies all people think they are body experts.
Au contraire.
My 30 years of experience as a clinician have shown me that the average adult is woefully ignorant of how his/her body works. If he/she has no idea what the normal functioning of the body looks like how can he/she know if some "remedy" for an ailment makes sense or might even be dangerous?
They don't.
That's where nurses come in, in many cases. Patients are often afraid to ask their doctors questions (I won't go there now....) so one of a nurse's most important jobs is education. As Chamberlain students begin their road to the BSN they will work with me on what we call "basic sciences." They are basic because they are required to understand health and disease and therefore to be an effective medical professional.
Medical folklore and quackery cost patients millions of dollars each year, and can kill. We want patients to be well educated so that they can participate fully in their care.
That is why we need to know this stuff! And "we" includes patients, too!
When in doubt, look up the DATA; don't rely on the magic box (pictured above) sent to you by Cousin Jane or sold on the Internet.
Knowledge is power, especially when it comes to health. Health professionals hold our knowledge in trust for the public, and should share it and the science behind it freely.

Happy scientific 4th!

Ben Franklin was a real scientist, though the story of the kite is likely a myth, since most people that have tried to do what he supposedly did have been electrocuted or even killed. He did figure out that lightening was electricity, though. Who knew? His participation in the Revolution was consistent with his scientific world view. The quest for knowledge requires freedom. One of the saddest examples of oppression trashing the scientific endeavor is what happened to Russian science under Stalin; true scientific obscenity is exemplified by what Hitler's doctors did during the Holocaust.

Good science and freedom--they go together!

What is our responsibility?

To me, the so-called "conflict" between faith and science is bogus. The God in whom I have faith is the Father of science. Science is simply the process of exploring and trying to understand His world. So-called "conservatives" interpret the Biblical mandate to man/woman that they exercise stewardship over the Earth as exploiting it. I do not accept this. We are responsible for preserving the Earth and caring for it, and the technology and intellectual abilities that God has allowed us to evolve (yes, He understands X-rays) are to be used in accordance with His laws, not ours.

The tragedy in the Gulf was brought about by poor stewardship, greed, arrogance, and really, really bad "science". The only remedy for it is better use of the intelligence and creativity God has granted us. He does not take "sides"; we should seek to be on His.

Monera Rock!

While MONERA would be a great name for a rock band, it is actually the kingdom name for bacteria, the most plentiful, important, and successful organisms on the planet, accounting for around 60% (or more) of the biomass. I am excited that I get to teach microbiology!
We have many, many more bacteria in and on our bodies than there are people on earth, and most of them (the bacteria, NOT the people!) are either benign or helpful. We would literally die without a colon full of the much maligned E. coli. So, if you want to study life and liberty this weekend, pick up a book about bacteria. You'll be fascinated!

Vampires!?

Blood!?

1. Animals evolved blood to carry oxygen, glucose, and other nutrients to cells and carbon dioxide and waste products away.
2. Blood also provides the mechanism by which the products of cells--proteins--circulate and tell other cells what to do and how to do it.
3. ERGO: NO BLOOD, NO LIFE. There are, of course, some exceptions but the FUNCTION of blood is present in all multicellular organisms.
4. Vampire bats are not the only creatures who drink or eat blood. Blood has been part of the diet of carnivores or omnivores "forever."
5. Unfiltered, "raw" blood is also a major source of microbial infection. The dietary prohibition against blood that exists in many religious traditions is probably based on this fact.
6. Blood is eaten/drunk in several forms: liquid, in puddings, and in meat/casserole concoctions.
7. What we euphemistically call "juice" in meat is, in fact, blood or some component thereof. Get over it.
8. Fantasy vampirism is stupid. Vampirism is a metaphor for sexual predation. It is NOT "romantic".
9. Blood pudding is GROSS!!
10. Questions? Let me know.