1. Panda Bear, M.D.’s Defending the Pie. An emergency physician’s opinion on medical quackery, “dis-ease”, and what one should be conscious of as a potential patient.

Sure, anybody can see somebody with a cold or some other minor complaint and the odds are good that nothing they do, provided they don’t get too jiggy with it, will do much harm. But let’s suppose that you have never rotated on a medical service or done your share of critical care. Suppose you have never worked in an emergency department or spent a few sloppy months on the labor and delivery floor. Imagine, if you can, seeing a provider for your family’s medical care who is treating your kids but has never had a lick of formal pediatric training or so little that she has never seen the really bad pediatric diseases that look like a little bit of nothing when they first present. Does your chiropractor, for example, know the odds that a fever in a neonate is some flavor of bacteremia that needs aggressive treatment?. Let us further suppose that while your chiropractor has spent hundreds of hours learning how a little normal misallignment in the spine can cause “dis-ease,” he has never had to recognize appendicitis, pancreatitis, or the first subtle hints of colon cancer. In short, while a lot of primary care is routine stuff, little potatoes that the school nurse would have to work at to screw up, not all of it is and if all you’re barely qualified for is to pass sick patients to somebody else as some kind of completely redundant middleman, maybe you should stick to the entertainment business and leave medicine to those with training.

Update (3-28-2008): This post has very intelligently proven its point. And I very much agree with most of its reasons. However, I personally believe that the complementary benefits of the ancient forms of healing should be explored and given its place. Nothing should be unknown to us. We should not block knowledge or even theories from disciplines outside of our hard-wired structures—modern structures at that. While I am totally for research and evidence based principles of care, I think western medicine has no monopoly of truth. Neither does eastern medicine. While there should be some form of check and balance as to proven fact and false claims, integration of these methods of care, especially when of great advantage to the patients, should be given a chance. Integrate the positive practices of these so called alternative principles (I speak mostly about activities like yoga, meditation, art therapy, etc.) as a complementary and gentle arm to patients’ ways to recovery with the current chemotherapy for example, but not cancel chemotherapy all together. As sometimes, some patients (and so do all of us) need positive reminders at the very least. I liken some complementary processes to the process of writing. Many times, it is not what we actually write but the process itself makes us learn and thus evoke self evolution.

2. New York Times’ Mixed Messenger by Peggy Orenstein. A realistic word on reality that has been existing for so long and many preferred to deny, ignore, or pretend otherwise. It is a sincere and sensible essay that I resonate with personally.

A few weeks ago, while stuck at the Chicago airport with my 4-year-old daughter, I struck up a conversation with a woman sitting in the gate area. After a time, she looked at my girl — who resembles my Japanese-American husband — commented on her height and asked, “Do you know if her birth parents were tall?

Most Americans watching Barack Obama’s campaign, even those who don’t support him, appreciate the historic significance of an African-American president. But for parents like me, Obama, as the first biracial candidate, symbolizes something else too: the future of race in this country, the paradigm and paradox of its simultaneous intransigence and disappearance.

I am myself biracial—East Indian and Filipino. In my own high school (a private Chinese school, with a small minority being Filipino — go figure!) in my home country, I experienced being teased for my “different” race. It came in the form of childish or thoughtless (though rarely cruel) comments about my ethnically distinct features and darker complexion—which now is simply seen as an exotic tan. But the reality is, these judgments or stereotyping coming at you in whatever form still speak of the reality that these biases and disrespect are passed on and learned, especially as a child.

This particular life experience along with my other social exposures has led me to further explore through the rest of my curiosity about other races and cultures. It led me to develop an awareness of the existence of the international community. It led me to celebrate my own diverse background. It led me to develop respect towards other people different from myself. This consciousness, sensitivity, and respect should be shared and brought to surface.

3. Dr. Val and the Voice of Reason’s Young Doctors are Easy Targets for Marketing Messages. This post points out the strong need for a more balanced solution to residents’ salary issue in urban areas.

Some attending physicians are understandably annoyed when residents don’t pay close attention to their carefully prepared lectures. Dr. Wes describes his frustration when his young protégés seem more interested in filling their bellies (with pharmaceutical sponsored luncheon fare) than their minds with his years of wisdom. Although I am absolutely sympathetic to Dr. Wes - and always tried hard to be attentive and respectful to my mentors - I wanted to point out that there is an underlying educational crisis at work in urban centers where some residents train. Here’s one NYC resident’s experience:

After taxes, my annual resident salary was about $39K/year. I worked at a hospital in New York City where rent for a small one-bedroom apartment was about $29K/year (which is now closer to $48K). Living on $10K/year in New York City is next to impossible (as you can imagine) and so my survival required undignified behaviors such as crashing “drug rep dinners,” working second jobs on post-call days, and living in crime infested places with lower rents. I got a job as a bartender at a fancy restaurant so that I could get a free meal and some survival cash now and then, and also worked an IT job from home.