Every so often, a major scientific breakthrough profoundly alters the trajectory of scientific research. In the 1960s, microbiologists sparked the recombinant-DNA revolution with the discovery that bacteria have innate immune systems based on restriction enzymes. These enzymes bind and cut invading viral genomes at specific short sequences, and scientists rapidly repurposed them to cut and…
My dear friends, we come to praise Caesar. As we march toward 2016, we ought to acknowledge the great Roman emperor’s role in creating a proper calendar. At the start of Caesar’s reign, the calendar year lasted 355 days, 10¼ days fewer than the time it took the earth to fully orbit the sun.1 Although…
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…
Updated Oct. 22, 2015 (revised to delete inaccurate statistics) The cold, hard facts: This year’s rheumatology fellowship applicant pool resembles those of prior years. It is extremely diverse; every continent is represented, save Antarctica. It is somewhat larger, due in part to the growing influx of graduates from the cluster of Caribbean-based medical schools, where…
“Love is the bone and sinew of my curse.” —Sylvia Plath Cutting the Cord Here’s the problem: No one grows up wanting to seek the cure for bursitis—or tendonitis or just about any of the other seemingly mundane maladies afflicting our body’s scaffolding. Meniscal tears, fasciitis, tendinopathies—the list is endless. Chances are, your college essay…
The Friday night press release: When a politician or any public figure needs to disclose unfavorable news, chances are they will release it sometime on a late Friday afternoon or evening, hoping that nobody is paying attention. In fact, this behavior was coined “the take out the trash day” on the television political drama, The…
Full disclosure: I am not a rabid fan of dogs. None rank among my best friends. Perhaps my antipathy stems from a memorable childhood event, when I was chased down the street where I lived by a neighbor’s large and not-so-friendly hound. He seemed to be twice my size, and this explains why I may…
It’s disheartening to stand by and watch helplessly as your patient dies a slow, painful death. In spring 1990, I had the misfortune of living through such a distressing experience. Strange happenings in New Mexico & Japan Ellen was a bookkeeper in her late 40s, living quietly in suburban Boston. For years, she hid a…
Tuesday, Jan. 20, a busy morning lay ahead for the staff of the cardiovascular surgery clinic. There were several new patients to see. No doubt, many of them were anxious to hear whether the skills of the surgeons they were going to meet could help them live another day. There were countless follow-up visits and…
High health insurance deductibles, physician charges, medication expenses spur patients to seek less costly lab testing, surgical procedures, prescription drugs