Intermittent Fasting For Weight Loss (And Its Other Health Benefits)

In recent years, interest in intermittent fasting—that is, not eating at all for a certain number of days per week—has been increasing. Intermittent fasting (IF) has been practiced worldwide based mostly on traditional, cultural, or religious grounds, but recent experimental data suggest it’s not only safe but also effective for achieving weight loss. What’s more, evidence is accumulating that it can produce a myriad of other health benefits. In this article, I summarize the data supporting the use of IF and include my recommendations for who might want to try it and how they should do it. Continue reading…

Too Much Care

hospital bedsNot long ago, one of my elderly patients (who gave me permission to tell this story) began requiring blood transfusions for a condition known as ischemic colitis. Usually it occurs because there are blockages present in the arteries that supply blood to the colon and, starved of blood, the inner lining of the colon becomes inflamed. But her arteries, it turns out, are normal. So we term her ischemic colitis microscopic because we consider the blockages to be in the tiny arterioles. Unfortunately, in her, it’s entirely unclear why these tiny arterioles should be blocked at all. But at whatever level the blockage of blood flow occurs, the predominant symptom is the same: continuous bleeding from the colon. Continue reading…

How To Achieve Balance, Redux

tightropeEvery once in a while (or perhaps more frequently than I’d like to admit) I find myself overwhelmed by my own life.  Taking care of patients, blogging, writing, maintaining relationships (with my wife, son, family, friends, and co-workers), exercising, practicing Buddhism, marketing my writing, answering pages, answering emails, handling unforeseen crises, cleaning out our cats’ litter boxes—suffice it to say one of my greatest challenges is not only getting all these things done day after day but also finding time to enjoy a few leisure activities, too. Continue reading…

Saving Primary Care

ImagineBlackBack_edited-2In the twenty years I’ve been a primary care physician at the University of Chicago I’ve had the opportunity to do many challenging and interesting things. I ran primary care for seven years, led the implementation of an enterprise-wide electronic medical record system for six years, and served as the assistant vice president for Student Health and Counseling Services for four years. Nowhere else but in academic medicine could a primary care doctor find the opportunity to reinvent himself so often and so dramatically without having to change employers. Continue reading…

Genetically Modified Organisms (GMOs) And You

Photo: Woodleywonderworks

Photo: Woodleywonderworks

Despite the public controversy over the safety of genetically modified organisms (GMOs), in the scientific community the controversy is considered misplaced. The National Academy of Sciences has reviewed the safety of GMOs twice, once in 2000 and again in 2004. Both reviews concluded that genetically modified crops pose no threat to human health (though the reports noted that GMOs do have the potential to create allergens that might alter the nutritional quality of food). Continue reading…

Decision Making At The End Of Life, Redux

In the hospital

Photo: Phalinn Ooi

When I was a third-year medical student rotating for the first time on a general medicine service inpatient ward, my team admitted a thirty-year-old woman in acute congestive heart failure. That a thirty-year-old was in congestive heart failure was unusual enough. Even more shocking was the cause: an echocardiogram revealed a tumor sitting on top of her mitral valve preventing the normal flow of blood out of her lungs to the left side of her heart. No one on my team, including the attending physician, had ever seen anything like it. A CT scan revealed widely metastatic cancer throughout her entire body—it looked as if every square inch of her had been splattered with buckshot—with no obvious dominant lesion to suggest its point of origin. Continue reading…

The Importance Of Good Influences, Redux


Photo: Brian Snelson

While I was growing up, my brothers (I’m the eldest of four boys) often chided me for being so much like my father. I suppose it was inevitable that I would be; firstborn children tend to be rule followers (if you believe in the significance of birth order) and I fit the stereotype.  Some boys use their fathers to push against as they struggle to establish their own independent identities. I used mine as a role model.

My decision to do this was largely, though not entirely, unconscious. Continue reading…

How To Help People Grieve

Photo: Beverly

Photo: Beverly

After a prolonged, debilitating illness, two weeks ago my father–at long last–died. As a physician, I’ve observed many people experience loss, but this is the first time I’ve lost someone close to me. This has, not surprisingly, put me on the receiving end of many condolences. Yet unable to rid myself of my analytical mind even in the midst of grief, I’ve found myself noting that the level of comfort people have in supporting others who are grieving seems to vary as much as the number of ways in which people grieve. And while everyone who’s expressed their condolences for my loss has been wonderful, I’d like to offer some guidelines for those who feel awkward when called upon to express support for people who are grieving and don’t feel they know how. Continue reading…

The Art Of Microcompromise, Redux

“What do you want for dinner?” I asked my wife.


Photo: ralphbijker

“I don’t know,” she answered.  “What do you want?”

“How about hamburgers?”

“No, I don’t want hamburgers.”

“What do you want then?”

“I don’t know…pasta.” Continue reading…

My Father Is Dying

my dadSomewhere around 2004 or so—I no longer remember the exact year—my father was diagnosed with Parkinson’s disease. We’d been wondering why his legs had been feeling weak, and at first had thought he might have cervical spinal stenosis (a condition in which the spinal cord becomes compressed in the neck). But when the tell-tale cogwheel rigidity appeared, a neurologist confirmed Parkinson’s was the cause. We weren’t too concerned as even I, with my doctor’s knowledge, considered Parkinson’s primarily a disorder of movement, and a treatable one at that. I’d had many patients with Parkinson’s whom I’d cared for over the years and all seemed to me to have maintained a fairly good quality of life right up until they died. Continue reading…