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The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.


Infantile Obesity

A new study from the University of Oregon suggests that children who gain weight rapidly after age 2 will grow up to have heart problemns and become obese.

This study, which was carried out using Finnish medical records from the 1940s, suggests that when food is pushed on children over the age of 2 to help them grow, it tends to create more body fat without necessarily increasing height or muscle mass.

(If you are wondering why Finland, and why the 1940s, here's why. Researchers often use Scandanavian countries for studies because they tend to be homogenous populations. That is, there is not a lot of ethnic variation in the population. This makes comparing data from different cities and towns easier. The reason for using 1940s data is that the researchers wanted to know how these kids turned out when they grew up. You have to go back before 1950 to find children who are now well into middle age. It takes that long for heart disease to show up.)

I have long believed that it is wrong to force children to eat more than they want to. Many parents worry endlessly about their children not eating enough. But kids know when they are hungry. They can read the signals from their own bodies and will eat when they get hungry enough. Forcing children to eat who do not want to only makes them fatter, not healthier.

What should parents do, then? Rather than concentrating on the amount of food children eat, focus instead on the quality of the food they are eating. Providing healthy food options will make for healthy kids. Let the kids decide how much to eat.

The study was published in the October 27 edition of the New England Journal of Medicine.


Katrina #2

Since Katrina, it has been convincingly shown that most of the flooding that occurred in the New Orleans area was not a result of the storm surge overtopping the levees. It was a result of levee failure.

With that knowledge, it it great to see that the Louisiana legislature has determined that absolutely nothing needs to be done. Whew! I was really afraid someone might take seriously the crazy idea that the levee management system should be overhauled, creating a new superdistrict that would make levee planning more efficient and consistent across parish lines.

Thank God the courageous powers-that-be had the backbone to stick up to that rascal Senator Walter Boasso, who has the nerve to put common interest in front of political patronage. Once again the legislature and the governor have bravely defended the good ol' boy networks who really got it done for us in the last storm.

This weekend, when I am out watering my lawn in sunny, beautiful St. Bernard Parish, I'll keep those goodfellas in mind.


Katrina #1

As some of you may realize, I lost my home and medical practice in Louisiana to Hurricane Katrina. Today is the first of what I expect will be a long series of articles on the subject.

I cannot say that I was deeply traumatized by Katrina. I have a medical degree and so was able to simply pull up stakes and move 100 miles further inland, then set up shop again. Even my financial setback was only slight. For me, Katrina was like being awakened in the middle of the night and dragged out of my house. Everything I had was left at home as it was, and by the time I returned, it had washed away. It was dreamlike, in the sense that everything that appeared absolutely permanent suddenly disappeared.

I am not a Buddhist, but I have always been partial to the Buddhist view of life as impermanent. Buddhism teaches that everything, absolutely everything, in our lives is temporary, and for us to assume anything is unchanging is foolish and a prescription for unhappiness. There is a foolhardiness in humans that compels them to acquire things, and then to act disappointed when these things slip away from them, as if such things can never happen.

Whatever we have, what ever we will ever have, is on loan to us. Eventually it will be taken away, if only at the moment of death. Katrina was like an early death for me. But in a way, it was luckier than death, because with this experience I have not lost anything that I cannot be happy without (my wife, children, health, and mind are still with me) and I can learn from the experience. Who else has the good fortune to learn from the experience of death?

The Flu Epidemic

There has been a lot of recent concern about the possibility of a flu epidemic in the United States. Many people have pointed back to the great Spanish flu epidemic of 1918, which swept through Europe and the United States, killing possibly 50 million people. We have not had a worldwide flu epidemic in over 30 years, so we are overdue.

The most important public health measure is to innoculate all the children. Why? Because studies of the flu in Japan and Texas have demonstated fairly convincingly that the flu virus is typically passed through communities by children. It is the elderly who typically die of the flu, but it is children who usually spread it.

If you have kids, especially kids in school or daycare, get them immunized. It is more important that kids get the shots than their parents. Adults typically have a 60% response rate to the flu shot (that is, 60% of adults who get the shot will become resistant to the flu), while kids have a 90% response rate. Thus, if your kids or grandkids get the shot, you will probably be better protected than if you get it yourself.

Bring your kids to their doctor.


Petting Zoos

The latest bit of medical nonsense is the elimination of petting zoos. It seems that a few cases of E.coli intestinal infections have been traced to contact children have had with animals, expecially goats, in petting zoos. This infection can lead to a very rare condition called hemolytic uremia, which causes permanent kidney failure. There is at least one documented case of a child who ended up on dialysis as a result of contact with zoo animals.

Although this is being treated as a new issue by the media, it is not. It has been known for decades that children can acquire many different infections from animals. Some infectious disease experts have suggested that children should not have pets because of this risk.

It all seems excessive. Yes, there is maybe a 100,000-to-one chance that your child could catch E. coli from a zoo goat. But the average child's chances of drowning in a swimming pool or being killed in a car accident is much greater, and no one is considering banning swimming pools or automobiles. Children need to be around animals. Contact with animals helps kids to learn and understand other living things. Touching animals, which was a given a century ago when most kids grew up on farms, is now only an occasional experience for many kids.

Everything a child does involves a small risk. The only way to avoid all risk is to chain kids to their beds and never let them out. But this is not what life is all about. We have a responsibility to protect our kids from unneccessary risks. We have an equal responsibility, though, to push our children out into the world so they can learn and grow, and this means taking a little risk from time to time.

If we fear every threat, no matter how distant, we shelter our kids, and teach them excessive caution and fear. Is fear the lesson you want your kids to learn?