I’m re-posting my earlier analysis of the Affordable Care Act because of how intensely the controversy that surrounds it has flared again. I’ve updated it to reflect some of the things that have transpired since I first wrote it. I think it’s important that we all understand what’s actually in the law […]
Patients often come to me seeking advice about what they can do to live longer. The number of things that have been proven to extend life, however, remains shockingly small. What follows are things that have enough support in the scientific literature that I generally recommend them (though the strength of the […]
Photo: See-ming Lee
Imagine there was a practice that I could teach you that would reduce your relative risk of having a heart attack by nearly 40%. Imagine also that if you carried out this practice just once a week you’d find yourself feeling less anxious, more confident, better able to enjoy yourself socially, […]
Photo: Sarah Reid
The biggest mistake patients make isn’t what you think. It isn’t turning down tests or treatments their doctors recommend. Nor is it deciding not to take the medicines their doctors prescribe. It isn’t insisting on getting a test or beginning a treatment their doctors recommend against, either, and it isn’t failing […]
Photo: Nickolai Kashirin
Evolution may have been wise in programming us all to avoid pain (given the survival advantage it clearly provides), but one important “unintended” consequence of that programming is that we tend to view pain in general—psychological and physical both—as experiences to be avoided at all costs. This shunning of all pain, […]
I once came up with a metaphor I thought perfectly captured the sheer mass of material my classmates and I were expected to memorize in our first two years of medical school: it was like being asked to enter a grocery store and memorize the names of every product in the store, […]
A common belief, even among doctors, is that almost no one succeeds in losing weight in the long term. And for almost two decades, I’ve counted myself among the skeptics, being able to tally on the fingers of one hand the number of my patients who’ve managed to do it—literally less than […]
My patient smiled a toothless grin and told me, “I feel fine, doc.” But he was far from it. His liver enzymes had risen into the thousands, his skin was a pasty yellow I didn’t need the benefit of sunlight to see, and his albumin (a protein whose level indicates the liver’s […]
I leaned back in my chair and breathed a heavy sigh. My patient, Mr. Rodriguez (not his real name), noticed my discomfort. “I know I should quit,” he told me with a guilty shrug of his shoulders.
“Have you ever tried?” I asked.
“Once,” he replied, “but it didn’t stick.”
Mr. Rodriguez […]
Most people know it’s important to get their bad cholesterol (LDL) down to reduce their risk of heart attacks and strokes. Fewer people know that it’s also important to raise their good cholesterol (HDL) for the same reasons. Almost no one knows, however, that a low HDL likely puts them at a […]