Memorial Day

May 26th, 2008

I’ve been waiting two months for an inspiration to resume blogging (nice not to have deadlines) but today is Memorial Day and the fire is lit.

George Will published a great column yesterday called “The Last Doughboy” in which he paid tribute to our last surviving WWI soldier, who is a spry 107 and not only served in France with over 4 million other Americans but spent most of WWII in a Japanese prison camp, having been a civilian contractor in Manila on December 7, 1941.

Our nation is at war but I wonder where we’d be without the thousands [...] Continue Reading…

Sibling Units

March 23rd, 2008

Somewhere in his adolescence my oldest started referring to his sister and brothers as Sibling Units. Perhaps he preferred to think of them as having been created in a high-tech factory rather than in the regular way. Anyway over the course of a long career as a pediatrician, father and grandfather I’ve developed certain generalizations about the birth order of children. I believe it was Mark Twain who said “All generalizations are false including this one”, so this is far from a scientific tract.

Sibling Unit #1 tends to be the most successful, most pleasing to adults, most neurotic, and [...] Continue Reading…

Take a Number

March 13th, 2008

Most of you will be surprised to learn that doctors in California went on strike about 32 years ago, seeing only emergencies for several days. That got the attention of the so-called public servants in Sacramento and they passed an emergency malpractice reform package called AB 1xx. The best feature was a cap of $250,000 on pain and suffering, or non-economic damages. This allowed insurance companies to plan for future risks and kept some of them from leaving the state. Many key states such as Florida have no such law, and certain fields of medicine such as obstetrics and [...] Continue Reading…

A Kid With Something Extra

March 10th, 2008

Ricky is 19 months old and doesn’t like me. Oh, he’s friendly enough if he has his clothes on and his parents are holding him at a safe distance. He babbles and delights his audience of the moment, but when I have to do my doctorly stuff he gives me as much as I can handle.

Some people would say he has no business being here. For one thing he came through two life-threatening heart surgeries very early in life. And then there’s that “extra” thing, a 47th chromosome that marks him as a Down’s Syndrome child with a [...] Continue Reading…

Red Measles Redux

March 6th, 2008

Rubeola, a.k.a. red measles, has been targeted for eradication by the WHO but that goal has proved elusive. My first opinion blog. “Science vs. Truth” discussed some of the reasons why.

A recent CDC bulletin shows the good news and the bad about this ancient scourge. An athletic competition in Pennsylvania drew 265,000 participants and spectators from eight foreign countries and all parts of the USA. A 12-year-old Japanese boy was incubating measles when he arrived in PA after several changes of planes. His team and the Taiwanese shared transportation.

The good news: only six more cases of measles could [...] Continue Reading…

Build It and They Will Come

February 24th, 2008

“It” was a baseball field, but rather than an Iowa corn field, this one was on the grounds of the venerable Philadelphia General Hospital (built by Ben Franklin) where I took my internship.

Medical graduates must serve at least a year of training before being eligible to practice medicine. The internship no longer exists as such, perhaps because the memo about the Emancipation Proclamation finally got to the powers that be. As was typical of the time, I worked 90-plus-hour weeks for $100 a month. It had been $59 the year before but some interns’ wives marched to City [...] Continue Reading…

Epidemiologist

February 15th, 2008

My wife loves to regale new patients with my resumé, including announcing that I am an epidemiologist (or was, actually). Folks sound impressed but I suspect they’d be hard-pressed to define what that means. I’m glad you asked.

CDC in Atlanta, originally created to combat malaria, had by the early 50’s become the world’s top communicable disease command post. In order to put trained investigators at the scene of outbreaks and research facilities they came up with an elite group called the Epidemic Intelligence Service (EIS) which took about two dozen physicians, veterinarians and statisticians yearly, trained them and assigned [...] Continue Reading…

The Good Cough

February 14th, 2008

Ever notice that everyone describes his cough as “bad”? This post is a somewhat tongue-in-cheek defense of the lowly cough (except for those who cough in theaters, which should be a hanging offense.)

Why do we cough? To clear our airway of bothersome stuff: pollen, bacteria, viruses, toxins and the cellular reaction to them, collectively known as mucus. If not for the cough reflex our lungs would be like vacuum-cleaner bags.

When do we cough? The timing can indicate the cause. Exercising, especially in dry windy weather triggers an asthmatic cough in many people. Breathing via the nose helps humidify [...] Continue Reading…

DOA

February 10th, 2008

The scene was grim but familiar. A gurney arrived on the floor carrying a motionless young man. The attendant casually remarked, “Just another drug overdose; he’s DOA” (dead on arrival). I was in my infectious disease fellowship at Los Angeles County/USC Medical Center.

The patient was a 14-year-old black boy. He had been brought to the Emergency Department by police ambulance. He was admitted because the ED doesn’t like to handle deaths. We had no history. His mother came along soon afterward, and when the cause of death was suggested to her she became outraged. “My boy didn’t do [...] Continue Reading…

Lioness

February 2nd, 2008

Choosing pediatrics raised many an eyebrow among colleagues and friends, and still does on occasion. Most have trouble imagining how I stand the screaming kids all day (“What screaming?” I reply). Others can’t imagine putting up with all those (fill in your own adjective) mothers.

Truthfully, I’ve never regretted my choice. Kids do grow up; by 3 most are great patients, and many have stayed with me and are bringing me their children. Mothers continually inspire me, and this entry is about one of those mothers who taught me that a wounded baby can turn a mother into a [...] Continue Reading…