Hello from Mexico. For the first time since March of 2020, I am taking a couple weeks off from publishing. (To those of you who just subscribed, this is an awkward hello!) My plan for last and this week had been to publish a series of Inside Medicine
Hi, hoping that studying the pandemic isn't focussed only on next time. Too many of us are still dealing with the effects of *this* time, and feeling vulnerable and unprotected by our communities -- plus suffering from the little-understood ills of long-COVID. Thank you for all you do!
I agree with some other commenters that dealing with COVID is still timely. I especially liked the discussion around your chorus -- it was a good example of how we can incorporate common-sense guidelines to do fun things, but not abandon all precautions. One thing that has been really distressing is how people have gone from maximal precautions to nothing, pretending that it's 2019 again--wholesale abandonment of masking, testing, and even laxness around vaccinating. Surely we can find a happy science-based medium!
I also appreciate your correcting the record on COVID revisionism. Many forget how terrible 2020 was, especially in areas like NY and parts of Italy where the sick really did overwhelm the health-care system, and how necessary "flattening the curve" really was.
Another thing that strikes me is how effective the original vaccines were: it seems like we've effectively eradicated original COVID, haven't we?
And I think in the story of vaccines, one big fact gets constantly overlooked: when we talk about "the unvaccinated" of 2021-2022, there was a huge pool of people who lived everywhere throughout the population and didn't get vaccinated, not because they refused, but because they couldn't: children. I know child-specific testing was necessary, but I would be very interested in a look at how the delay in offering vaccines to *everyone* affected how the pandemic played out, and the rise of delta and omicron variants.
Have a great vacation. I would like to see more cases from your ED career that shed light on how you think when providing care. I really enjoyed the post about headache and how a patient saying ‘I felt like someone suddenly hit me over the head with an anvil’ (or whatever) is a sure ticket to a brain scan.
Thanks! I have so many of these, but I keep waiting for months and months to make sure there are no privacy violations (even after I change the details of the case). But I do indeed have more of these waiting to see the light of day. Also, this is going to be the kind of stuff I will have to put behind a paywall more frequently (see my reply to Chris Henshaw's comment) in order to keep this all sustainable. That is--stuff that I feel the readers *must know* needs to stay free, whereas interesting stuff like this might need to be the "carrot" for upgrades in order to make this all "work."
Have a wonderful time! You may already do this and I just wasn't paying attention, but I'd love to know what books you are reading, especially medical-related fiction and non-fiction. Thanks!
I sometimes do What I’m Reading (usually articles re: medicine published in other outlets), but could do more, if people are interested :).
One question is how to best format that, and whether to do this on a certain day/schedule, or just “whenever.” In the past, I wrote about this stuff, but it could be better to have short audio/video content where I discuss what I found most interesting, etc.
Also, to keep this all sustainable, I’m considering doing 2-3 free posts during the week and a paywalled post on the weekends. The free stuff would be more actionable stuff that I feel the public *needs* to know, and stuff like this might end up behind the paywall more often (though not always).
Bite your tongue! And then ice it with a margarita! Enjoy your well-earned time away. When you're back, I'd love to see any and all hints at the pan-Covid nasal spray vaccine! Of interest is also the dang zoonotic bugs rising up to get us. Lastly, whatever the data guru Benjy Renton wants to throw in the mix, I'd be much obliged. Thank you (both) for all that you do!
I’ve appreciated your COVID dashboard, but never know how to access it between posts. I completely agree with Lynne that navigating endemic COVID is very challenging: I appreciated your article about your chorus and the link to the music-- it was helpful and great performance.
This exactly. Those of us who are currently dealing with Long Covid and/or at higher risk from complications desperately need access to continued information about what’s going on with Covid. It isn’t that I don’t find the rest of what you write about interesting, but the Covid news is what I actually need from a safety perspective.
It would be great if you could include some posts with a One Health angle: the entire ecosystem and non-human animals all have an impact on human health. Human development is rapidly driving zoonotic diseases (ie covid-19!) through multiple mechanisms, including climate, habitat destruction, humans encroaching in previously undeveloped areas, antibiotic use in agriculture and companion animal medicine, etc. I cover this beat from the veterinary side, but it would be great to have a physician provide their perspective when relevant!
Hi there, I would like to see a piece about lead in food. I worked for 10 years for The Maryland Department of the Environment Lead Poisoning Prevention Program from 2007-2017 performing lead poisoned child investigations and inspections of properties for compliance with the state lead laws. We've known about the problem of lead contaminated spices for decades now, and it's always presented on the news like it's a new thing. I'd be happy to talk with you further about my experiences with the Maryland Department of Health and Mental Hygiene, the FDA, and the EPA during my tenure at MDE if you are interested. And thank you so much for your continuing coverage about COVID. It is getting harder and harder to track where things really stand in regard to it as our government and a seeming majority of the population want to pretend that it's over and isn't nearly as bad as it continues to be.
Happy Holidays and thank you for continuing Inside Medicine as it’s very important to many! I feel like we non medical peeps still struggle to make sense out of public health. An example, so many doctors are saying if you are not 65 and if you are relatively healthy you don’t need the updated COVID vaccine, yet every public announcement says you do? Here in Texas our state legislators made a law that doctors can’t refuse unvaccinated patients!!!!! How do we live a balanced life without being fearful of COVID 19 and protect those most vulnerable? Enjoy your family and can’t wait to “read more in 24!”
Have a peaceful and relaxing vacation, well-deserved! Are there current or emerging best-practices for effectively countering anti-vax statements being made by everyone from RFK, Jr. to local people on school boards, etc.? Should reports of disease outbreaks include more about the adverse effects reported for each to make it seem less abstract? Maybe publish that picture of a huge room full of kids in iron lungs with polio. Thank for for your important work and ability to share it so we understand.
I have moved this year and found that I had to wait months to get appointments for my Annual Wellness visit - seems as though there has been a reduction in health care workers at all levels - I know my home state of California has just expanded what Nurse Practitioners can do ( Assembly bill passed in September 2020 - probably no coincidence that it was during the pandemic!).
So 2 issues here - first.how to increase numbers of doctors and nurses given what seems like a shortage in many places and second - what efforts are states making similar to California’s expansion of what Nurse Practitioners can do given how the limited numbers of medical schools.
Both would probably help cut down on months long waits for appointments.
I haven't been on vacation since the before times so I'd love to hear your thoughts on how comfy you felt traveling. What made you choose your destination?
As far as other topics:
If you had a magic wand how long would each appointment be; thoughts on private equity in healthcare; who's better: Billy Joel or Bruce Springsteen?
Hi, hoping that studying the pandemic isn't focussed only on next time. Too many of us are still dealing with the effects of *this* time, and feeling vulnerable and unprotected by our communities -- plus suffering from the little-understood ills of long-COVID. Thank you for all you do!
Good point, Lynne! The reality is that it is indeed both.
I agree with some other commenters that dealing with COVID is still timely. I especially liked the discussion around your chorus -- it was a good example of how we can incorporate common-sense guidelines to do fun things, but not abandon all precautions. One thing that has been really distressing is how people have gone from maximal precautions to nothing, pretending that it's 2019 again--wholesale abandonment of masking, testing, and even laxness around vaccinating. Surely we can find a happy science-based medium!
I also appreciate your correcting the record on COVID revisionism. Many forget how terrible 2020 was, especially in areas like NY and parts of Italy where the sick really did overwhelm the health-care system, and how necessary "flattening the curve" really was.
Another thing that strikes me is how effective the original vaccines were: it seems like we've effectively eradicated original COVID, haven't we?
And I think in the story of vaccines, one big fact gets constantly overlooked: when we talk about "the unvaccinated" of 2021-2022, there was a huge pool of people who lived everywhere throughout the population and didn't get vaccinated, not because they refused, but because they couldn't: children. I know child-specific testing was necessary, but I would be very interested in a look at how the delay in offering vaccines to *everyone* affected how the pandemic played out, and the rise of delta and omicron variants.
Have a great vacation. I would like to see more cases from your ED career that shed light on how you think when providing care. I really enjoyed the post about headache and how a patient saying ‘I felt like someone suddenly hit me over the head with an anvil’ (or whatever) is a sure ticket to a brain scan.
Thanks! I have so many of these, but I keep waiting for months and months to make sure there are no privacy violations (even after I change the details of the case). But I do indeed have more of these waiting to see the light of day. Also, this is going to be the kind of stuff I will have to put behind a paywall more frequently (see my reply to Chris Henshaw's comment) in order to keep this all sustainable. That is--stuff that I feel the readers *must know* needs to stay free, whereas interesting stuff like this might need to be the "carrot" for upgrades in order to make this all "work."
Enjoy your vacation.
Thank you!
Have a great vacation!
Thank you, John!
Have a wonderful time! You may already do this and I just wasn't paying attention, but I'd love to know what books you are reading, especially medical-related fiction and non-fiction. Thanks!
Thanks Chris!
I sometimes do What I’m Reading (usually articles re: medicine published in other outlets), but could do more, if people are interested :).
One question is how to best format that, and whether to do this on a certain day/schedule, or just “whenever.” In the past, I wrote about this stuff, but it could be better to have short audio/video content where I discuss what I found most interesting, etc.
Also, to keep this all sustainable, I’m considering doing 2-3 free posts during the week and a paywalled post on the weekends. The free stuff would be more actionable stuff that I feel the public *needs* to know, and stuff like this might end up behind the paywall more often (though not always).
Happy Happy Vacation! Enjoy!!
Thank you! I probably jinxed it and there will be major breaking news that I need to comment on ;)
Bite your tongue! And then ice it with a margarita! Enjoy your well-earned time away. When you're back, I'd love to see any and all hints at the pan-Covid nasal spray vaccine! Of interest is also the dang zoonotic bugs rising up to get us. Lastly, whatever the data guru Benjy Renton wants to throw in the mix, I'd be much obliged. Thank you (both) for all that you do!
I’ve appreciated your COVID dashboard, but never know how to access it between posts. I completely agree with Lynne that navigating endemic COVID is very challenging: I appreciated your article about your chorus and the link to the music-- it was helpful and great performance.
This exactly. Those of us who are currently dealing with Long Covid and/or at higher risk from complications desperately need access to continued information about what’s going on with Covid. It isn’t that I don’t find the rest of what you write about interesting, but the Covid news is what I actually need from a safety perspective.
It would be great if you could include some posts with a One Health angle: the entire ecosystem and non-human animals all have an impact on human health. Human development is rapidly driving zoonotic diseases (ie covid-19!) through multiple mechanisms, including climate, habitat destruction, humans encroaching in previously undeveloped areas, antibiotic use in agriculture and companion animal medicine, etc. I cover this beat from the veterinary side, but it would be great to have a physician provide their perspective when relevant!
Thanks, Eric. I think this was the angle in one post from this year: https://insidemedicine.substack.com/p/last-week-was-likely-the-deadliest
But I agree, this is an area deserving more attention!
Hi there, I would like to see a piece about lead in food. I worked for 10 years for The Maryland Department of the Environment Lead Poisoning Prevention Program from 2007-2017 performing lead poisoned child investigations and inspections of properties for compliance with the state lead laws. We've known about the problem of lead contaminated spices for decades now, and it's always presented on the news like it's a new thing. I'd be happy to talk with you further about my experiences with the Maryland Department of Health and Mental Hygiene, the FDA, and the EPA during my tenure at MDE if you are interested. And thank you so much for your continuing coverage about COVID. It is getting harder and harder to track where things really stand in regard to it as our government and a seeming majority of the population want to pretend that it's over and isn't nearly as bad as it continues to be.
Happy Holidays and thank you for continuing Inside Medicine as it’s very important to many! I feel like we non medical peeps still struggle to make sense out of public health. An example, so many doctors are saying if you are not 65 and if you are relatively healthy you don’t need the updated COVID vaccine, yet every public announcement says you do? Here in Texas our state legislators made a law that doctors can’t refuse unvaccinated patients!!!!! How do we live a balanced life without being fearful of COVID 19 and protect those most vulnerable? Enjoy your family and can’t wait to “read more in 24!”
Have a peaceful and relaxing vacation, well-deserved! Are there current or emerging best-practices for effectively countering anti-vax statements being made by everyone from RFK, Jr. to local people on school boards, etc.? Should reports of disease outbreaks include more about the adverse effects reported for each to make it seem less abstract? Maybe publish that picture of a huge room full of kids in iron lungs with polio. Thank for for your important work and ability to share it so we understand.
They will twist anything and are beyond help.
Here’s a good argument for vaccinating during pregnancy: https://www.ijidonline.com/article/S1201-9712(23)00802-0/fulltext
Will they care? Nah.
I have moved this year and found that I had to wait months to get appointments for my Annual Wellness visit - seems as though there has been a reduction in health care workers at all levels - I know my home state of California has just expanded what Nurse Practitioners can do ( Assembly bill passed in September 2020 - probably no coincidence that it was during the pandemic!).
So 2 issues here - first.how to increase numbers of doctors and nurses given what seems like a shortage in many places and second - what efforts are states making similar to California’s expansion of what Nurse Practitioners can do given how the limited numbers of medical schools.
Both would probably help cut down on months long waits for appointments.
Happy holidays! I hope you can disconnect!
Enjoy your vacation!
I haven't been on vacation since the before times so I'd love to hear your thoughts on how comfy you felt traveling. What made you choose your destination?
As far as other topics:
If you had a magic wand how long would each appointment be; thoughts on private equity in healthcare; who's better: Billy Joel or Bruce Springsteen?