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Criteria For Screening

Photo: zilupe

I had a patient once who wanted an exercise stress test even though he had neither symptoms nor risk factors to suggest the presence of coronary artery disease (such as chest pain with exertion).  I argued vociferously against it.  However, extenuating circumstances (not relevant here) prompted our mutual decision to go ahead with it anyway.  To our surprise and dismay, it came back positive. Continue reading…

The Problem With Prevention

Photo: Photos8.com

Eating right, exercising, avoiding the sun or using sunscreen, moderating alcohol consumption, abstaining from tobacco use, getting mammograms, Pap smears, colonoscopies—almost every measure we’re asked to take to safeguard our future health is difficult.  It’s a strange paradox that we have to work in some way, to expend energy, and experience discomfort of some kind in order to gain benefit in life.  Wouldn’t it be nice if the most pleasurable things also produced long-term benefit? Continue reading…

Preparation Prevents Piss-Poor Performance

skierOne day, about a year and a half ago, my wife and I were walking along a street near our home when she grabbed my arm and suddenly exclaimed, “I think that woman is in trouble!”

I followed her gaze to a car stopped at a light and saw to my horror a woman being prevented from exiting the passenger side door by the man who was driving.  He held her hair clumped in his hand.  She was screaming and crying and trying to free herself to no avail. Continue reading…