There are a lot of things wrong with medicine today. A lot. But they aren’t the things most people typically focus on. I genuinely believe that the number one problem with our healthcare system is the people in it and how they are compelled to behave. I started down this somewhat offensive pathway here in […]
In the movie Edge of Darkness, Mel Gibson plays a cop whose daughter was murdered in front of him. During the movie, he uncovers the conspiracy that led to her murder and he discovers that one of his closest and oldest friends, Bill, a fellow cop, was in on it. In a dramatic scene in his […]
I wrote a short piece recently about the safety and efficacy of vaccines that has now been read almost half a million times. Hundreds of messages, comments, and emails later, I’ve learned that I am both the best thing since sliced bread and also a horrible human being who will rot in hell. I was […]
Here was a conversation in recent car ride: Daughter: Penny has 5 children, 1st is January, 2nd kid February, 3rd is called March, 4th is April. What is the name of the 5th Me (after considerable, don’t-want-to-be-shown-up-again thought): I don’t know. Tell me. Daughter: What is the name of the 5th child. Me: I don’t know! […]
A newborn with congenital rubella. Many of my patients choose not to vaccinate their children. I welcome these patients and, frankly, love each of them. I love that they are passionate about their responsibility as moms and take the time to research and educate themselves about things that affect their kids. I love that they […]
Headlines are everything. They frame the way we read an article, how we remember it, and whether we choose to read it in the first place. In the world of click-bait journalism, authors have become experts at crafting headlines to maximum effect – even if it means lying or at least misleading. This dangerous trend […]
Egyptian depiction of circumcision from 1360 BC I get this question a lot and have avoided writing about it for some time. But, alas, we mustn’t be afraid of a little controversy on howardisms. So here goes: Should we electively circumcise newborn boys? All decisions in medicine should be made through an ethical framework that balances […]
Only in the last decade or so has there been much desire on the part of Obstetricians to develop techniques for preventing lacerations and tears at the time of vaginal delivery. In past years, episiotomy was commonplace for women at risk of tearing, and even after episiotomy was shown to be a harmful practice in […]
Two things drive me crazy, and a third vexes my soul: Over-diagnosis of subchorionic hematoma; Inappropriate counseling and recommendations regarding subchorionic hematoma; And inappropriate management of placental lakes. Not a week goes by that I don’t see a patient who has presented to an emergency department somewhere, diagnosed with a (questionable) subchorionic hematoma or placental […]
If you read (or produce) scientific literature, you are hopefully aware of and use some system to appreciate how good a particular type of study is. Most “Levels of Evidence” charts organize different types of evidence into some sort of 5 tier system, with the highest level of evidence, Level 1, being the best. Level […]
