Bernard Lown (1921 – 2021)

Dr. Bernard Lown, the Harvard cardiologist who invented the first effective heart defibrillator and was one of a group of co-founders of an international organization that won the 1985 Nobel Peace Prize for its campaign against nuclear war, died on on February 16, 2021 at his home in Chestnut Hill, Mass. He was 99. If you are not familiar with Dr. Lown, the NY Times Obituary is a good place to begin. His book, “The Lost Art of Healing” (1996) was inspirational reading for me. Here are my notes if anyone wants to see them. Here are some excerpts from the Preface: Medicine’s profound crisis, I believe, is only partially … Continue reading

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H. Jack Geiger M.D.

A Doctor Who Fought Social Ills, Dies at 95 He used medicine to take on poverty, racism and the threat of nuclear destruction. I’ve heard about Jack Geiger for decades – but didn’t know what a picaresque life he led!  After reading his obit in the 12.29.20 NY Times, I can’t wait for the movie starring Harrison Ford to screen. Excerpts: NY Times Obit. Dr. H. Jack Geiger, who ran away to Harlem as a teenager and emerged a lifelong civil rights activist, helping to bring medical care and services to impoverished regions and to start two antiwar doctors groups that shared in Nobel Peace Prizes, died on Monday at … Continue reading

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W.H. Auden on The Skin Microbiome

A New Year Greeting The poet, W.H. Auden, matriculated at Christ Church, Oxford in 1925 with a scholarship to study Biology. This poem should interest physicians, especially dermatologists. Had Auden become a biologist, think what the world might have lost! Osler quotes Lowell: “We reward the discoverer of an anaesthetic for the body and make him a member of all the societies, but him who finds a nepenthe for the soul we elect into the small Academy of the Immortals.’” (from John Keats: The Apothecary Poet, in The Alabama Student.) This poem was published in Scientific American in 1969 On this day tradition allots         to taking … Continue reading

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Polypharmacy: an Introduction

We recently came across a great video to introduce this subject. Bohemian Polypharmacy on Youtube A good review article on this topic is: How polypharmacy has become a medical burden worldwide. “Taking a multitude of medicines, whether they are prescription drugs, OTC treatments, herbal or dietary supplements — known as polypharmacy — is not only a burden for patients, it can be dangerous. We need a way to mitigate the danger of unwanted drug interactions and improve drug adherence to essential medicines, and this is as true for the United States as it is in Europe. It is imperative that patients are empowered to make informed decisions about the medicines … Continue reading

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Campaigns of Fear

It’s Time to Scare People About Covid — We need a Campaign of Fear Our public messaging about the virus should explain the real costs — in graphic terms — of catching the virus. by Elisabeth RosenthalNY Times  Dec. 7, 2020 Link to Article. (If the link doesn’t work — here is the article.) I still remember exactly where I was sitting decades ago, during the short film shown in class: For a few painful minutes, we watched a woman talking mechanically, raspily through a hole in her throat, pausing occasionally to gasp for air. The public service message: This is what can happen if you smoke. I had nightmares … Continue reading

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COI: Alive & Thriving at NEJM

COI: Alive and Thriving at the NEJM by David J. Elpern, M.D. Abstract: As a reader of the New England Journal of Medicine for more than 50 years, I have observed its growing entanglements with the pharmaceutical industry.  This analysis of a recent NEJM research article highlights authorial and editorial conflicts of interest (COI) and discusses how the Journal benefits financially from pharmaceutical advertisements for the very drug reported on in the Original Article.  What does this say about top tier medical publishing when the world’s most prestigious medical journal is clearly intertwined with the drug industry? The December 3, 2020 issue of the New England Journal of Medicine (NEJM), … Continue reading

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Tomisaku Kawasaki – Obituary

“Not many physicians have a disease named after them. Tomisaku (“Tomi”) Kawasaki, who has died in June 2020 at the age of 95, was one of the few. Kawasaki disease, a rare inflammatory autoimmune disorder found in young children, is his namesake. In recent months, this syndrome has been in the global media spotlight as pediatricians discuss its similarity to the complications of covid-19 in children.” The October 16, 2020 issue of the British Medical Journal has a moving obituary of this humble, but iconic pediatrician. A pdf of the BMJ obituary is attached below.

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All The President’s Doctors

All the President’s Doctors: Walter Read and the Collusion of Anonymityby A.R. Pito Even today, Michael Balint’s seminal book, “The Doctor, His Patient and the Illness” is essential to understanding how patients are managed and treated by physicians and caregivers.  When one considers Team Trump at Walter Read we see this on a granular level. Excerpts from Balint’s book: Chapter 7: The Collusion of AnonymityIn difficult cases, the general practitioner [PCP} does not, as a rule, carry the burden of responsibility alone. The appearance of consultants introduces a number of new factors in the doctor-patient relationship The term the collusion of anonymity refers to who is responsible for the patient … Continue reading

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Tracking Dermatological Articles in PubMed 1980- 2019

The past 20 years has seen progress in treating some skin disorders, in particular psoriasis and atopic dermatitis.  PubMed shows a big increase in the number of articles published on atopic dermatitis and psoriasis in contrast to those on other common skin disorders, such as warts and contact dermatitis. PubMed Psoriasis

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Marketing Pharmaceutical Science for Prestige and Profit

Marketing Pharmaceutical Science for Prestige and Profit PREPRINT By David J Elpern, M.D. As a dermatologist, I have observed the profusion of research articles on psoriasis over the past two decades.  A graph of these from PubMed illustrates the five-fold increase in references since the first biologic, infliximab, was approved by the FDA in 1998. (Figure 1) This increase in scientific studies has coincided with a profusion of new therapies for psoriasis and may reflect the pharmaceutical industry’s interest in developing and promoting costly new treatments for this common chronic skin disorder.  With this in mind, a recent article in the New England Journal of Medicine, “Trial of Roflumilast Cream … Continue reading

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