Discussing aching joints, sore muscles and tender limbs is all in our day’s work. We are rheumatologists; we deal in misery. But trying to parse the true meaning of these terms is among the most vexing of clinical challenges.
What Listening to Lungs Might Teach About Rheumatic Disease
One of your first clinical assignments as a medical student was likely to have been the lung exam. Its key descriptors may still resonate in your mind: inspection, palpation, percussion and auscultation. Proudly parading down the hospital corridors, your newly purchased stethoscope snugly tucked inside your lab coat pocket, you carefully place its cold metal…
Gene Manipulation Has Potential to Alter Genomes, Impact Society
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…
Looking Back on Rheumatology in 2015, Leaping Forward to the Year Ahead
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…
When Sense Disorders Signal Immune System Interactions
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),…
Attracting More Medical Students to Rheumatology
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…
Connective Tissue Disorders Lack Societal Concern, Financial Support
“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…
Can Systemic Inflammation Influence Mood?
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…
How Non-Transferable EHRs Have Affected Physician Practices
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…
How Celebrities, Senators, Dietary Supplements Muddle Medicine
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…
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