COVID-19: The forgotten victims

I’ve written previously about the massive public health impact of government responses to the pandemic: The United Nations estimates that global poverty trends will be reversed for the first time since 1998, pushing “half a billion people into destitution.” The World Health Organization recently warned that lockdown-induced shortages and disruptions in vaccine distribution (reported in…

Worth reading: Suicidality is increasing in the US

More bad news. Between 2005 and 2015, the suicide fatality rate in the US increased 13% among those aged 20-64. Suicide attempts increased among all age groups. “Suicide attempts increased in females, adolescents, and older people, while suicide fatalities (mainly shootings and hangings) increased in those aged 20 to 64. The finding that both incidence…

COVID-19 is not the “great equalizer”

Maria Abi-Habib writing for NYT, “For the first time since 1998, the World Bank says, global poverty rates are forecast to rise. By the end of the year, half a billion people may be pushed into destitution, largely because of the pandemic, the United Nations estimates. … Since 2000, Bangladesh brought 33 million people —…

Sara Crager on right heart failure

Although I’ve been a religiously devoted listener of Scott Weingart’s EMCrit podcast for over five years, I haven’t previously shared an episode here on the blog. EMCrit recently featured a grand rounds lecture from Sara Crager on right heart failure that’s among the best lectures I’ve heard. Dr. Crager brilliantly distills complex physiology into a…

Worth reading: On Schmaltz

An article on lost heritage and Jewish identity by the pediatrician Daniel Summers. On Schmaltz How a Jewish cookbook helped me recover my lost heritage I was fortunate enough not to have struggled with identity in the same way pediatrician Daniel Summers did in his childhood, realizing that he was gay in an evangelical, fundamentalist…

Worth reading: Less is more in intensive care

Catherine Auriemma et al. writing in Intensive Care Medicine: “The notion that ‘less is (or may be) more’ in intensive care medicine has been contemplated by experts for decades. However, not until Kox and Pickkers’ review in 2013 had there been careful consideration of the evidence supporting this theory.1 Their thought-provoking article focused specifically on…

Worth reading: The Case for Waking

Poetry and medicine, from Janis Lou Harrington in JAMA: https://jamanetwork.com/journals/jama/article-abstract/2757230 The Case for Waking “I. Beside my husband’s ICU bed, I plead my case for waking, hold my palm flat as a bible, place his warm hand on mine. His face inscrutable beneath a bandage wreath, he breathes on his own, his heart pumps, his…

Worth reading: Communicating ICU Prognosis

A randomized trial published today in JAMA Network Open, with the useful visual abstract below. TL;DR: Participants who viewed videos using indirect or redirection language perceived the physician to be more optimistic than those who viewed a video of the physician answering the question directly. This is troubling because it suggests that that the families…

Worth reading: “My only crime is my face,” Perspective from Mary Oyama Mittwer and Miné Okubo

While browsing through an online museum exhibit, I came across an excerpt from this compelling article written during the internment of Japanese Americans in World War II. I managed to find a scan of the full article hosted by the UC Berkeley Library. The writer describes her family’s internment experience until their release in 1943,…

Worth reading: Opioid Prescribing in the Midst of Crisis – Myths and Realities

https://www.nejm.org/doi/full/10.1056/NEJMp1914257 Great perspective from Michael L. Barnett, M.D., in NEJM. Sadly, it’s paywalled, but I share a useful table from the article below. Barnett describes the current state of opioid prescribing as an over-correction, in which the terrible opioid overdose epidemic has led public health officials and providers to move too far in the opposite…