Category Archives: Elpern, David J.

A Fish Named Heather: Another casualty in the drug wars

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We have had a crazy drug policy in the U.S. since 1914, and we dictate it to most of the world. The War on Drugs is masterfully covered in Johann Hari’s important new book, “Chasing the Scream.” The small players in the drug wars are easily entrapped. Witness the sad case of Heather Alfonso, a Connecticut nurse practitioner who has been indicted for getting kickbacks from Insys Therapeutics, the maker of the powerful pain medication, Subsys. Ms. Alfonso is being pilloried while thousands of physicians give worthless CME lectures on medications every day in the U.S. She was a dupe to her handler (a PhARMA product manager) in the company’s … Continue reading →

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Akamai Skin Works

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Announcement: Coming Soon to Havi Welcome to The Akamai Skin Works (ASW). Our new suite, in the penthouse of the Third Millennium Medical Building, houses the vanguard of 21st Century dermatologic care. It is a model endorsed by the Global Academy of Skin Physicians and Minimally-Effective Physician Extenders (GASP-MEPE). We are at the cutting edge of efficient, rapid and profit-driven dermatology and minimally-effective, but maximally lucrative, medical care. Akamai’s founder, Dr. Liam Ganifski, and his team of associate dermatologists, physician extenders, medical assistants, front desk greeters, billing specialists, scribes, cosmetic consultants, estheticians and lawyers are here to address your every cutaneous need. Just bring a valid insurance card, credit card … Continue reading →

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My Narrow Road through Deep Cyber-space

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This road – no one goes down it – autumn evenings. Basho  PDF for easier reading: The Narrow Road Through Cyber-Medicine Abstract: This essay describes a 25-year medical odyssey through the universe of cyberspace. It chronicles the author’s adventures with teledermatology, the medical humanities and the online medical literature. The explorations continue but the author does not know the next ports-of-call. He can only “hope the voyage is a long one,/full of adventure, full of discovery.”1Keywords: cybermedicine, blogs, pathography Forty years ago, when I decided to make dermatology my life’s work, the specialty was a far cry from what it has become. It was not then what I call and … Continue reading →

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Hot Spots 2.0 Syllabus

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This is the syllabus for the 2015 Hot Spots 2.0 program.  Links to the talks are included for those presentations that the authors wish to share. Hot Spots West Vancouver Introductory Remarks It is fitting to begin with Osler, a Canadian, who wrote: “No class of men needs friction so much as physicians; no class gets less. The daily round of a busy practitioner tends to develop an egoism of a most intense kind, to which there is not antidote. The few setbacks are forgotten, the mistakes are often buried, and then years of successful work tend to make a man touchy, dogmatic, intolerant of correction, and abominably self- centered. … Continue reading →

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Plastic Surgery – Gangnam Style

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“We want to have surgeries while we are young so we can have our new faces for a long time,” About Face by Patricia Marx New Yorker, March 23, 2015 This is a fascinating essay about Plastic Surgery in South Korea, the current world capitol of plastic surgery.  Full Article. Excerpts: If you want to feel bad about your looks, spend some time in Seoul. An eerily high number of women there—and men, too—look like anime princesses. South Koreans do not merely brood about their physiognomy. They put their money where their mouths—and eyes and noses—used to be. It has been estimated that between one-fifth and one-third of women in … Continue reading →

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The Great Imitator

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“Know syphilis in all its manifestations and relations, and all other things clinical will be added unto you.” Sir William Osler Henry Foong, a dermatologist from Malaysia and a good friend, recently wrote me about a patient he’d seen with primary syphilis. The disease we used to call “lues” or notate with the Greek letter ∑ (sigma) is becoming more common in Malaysia, in his experience. This reminded me of a memorable case I saw in the late winter or early spring of 1973. At the time, I was a first year of dermatology residency at New York University. I was not a happy camper. I was tired of New … Continue reading →

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ODEAR: Most-Favored Specialties

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Hi, Dr. Elpern, I am contacting you in hopes that you may be able to assist me in attaining my goal of gaining acceptance to a Dermatology residency, and also to see if you had any advice on how to shine during my dermatology rotations, or any contacts at my away school who may assist me in research opportunities such as case reports/letters. I receive emails like this with regularity.  In the 1960s when I was in medical school, dermatologists were at, or near, the bottom of the physician feeding chain.  Internists, with their haughty demeanor, were the self-proclaimed real brains of medicine and lorded it over most other practitioners.  Radiologists … Continue reading →

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Stations of the Heart: Book Review

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“Stations of the Heart: Parting with a son” by Robert Lischer is a moving and important book by the father of a 33 yo man with metastatic melanoma.  It chronicles the last three months of Adam Lischer’s life.  The book describes the medical, spiritual and philosophical aspects of Adam’s death.  It’s a valuable resource.  I have typed out a few pages of quotations which may interest you.. There are many medical details that a dermatologist would like to know, but they are less important than the view from the family’s standpoint. See Book Review: Stations of the Heart. Quotations from Stations of the Heart.

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Zen and Dermatology Practice

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Zen Buddhism has a lot to teach us as physicians, as dermatologists. Consider these two quotes from respected roshi: The practice is the teacher. Your practice is your teacher. Maurine Stuart. Teaching is not difficult, Listening is not difficult either. What is truly difficult is to become conscious of what you have in yourself and be able to use it as your own.   DT Suzuki, The Marvelous Cat

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Music as Complement to Surgery

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Dermatologists perform office surgery almost daily. Our awareness of the growing interest in, and literature on, music as an adjunct in the perioperative period led us to survey the use of music during 100 consecutive office procedures in a dermatology practice.  We found that the effects of music were salutary for patients and the investigators.  Music is a simple, inexpensive, safe and effective adjunct to office surgery. We hope that this report will be of help to physicians who wish to provide music to ease patients during office procedures. For full paper:  Music and Surgery Appendix: Music Study Appendix Keywords: music, medicine, surgery, perioperative, playlists, dermatologist, dermatology

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