Life Expectancy in the Elderly

Tweet Americans have a lower life expectancy than people in other developed countries. This lower longevity has been often used to disparage medical care in this country as being inferior to that of other similarly advanced nations.  Such an accusation is made acute by the high cost of American medical care – the highest in the…

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Statins For the Primary Prevention of Cardiovascular Disease

Tweet The use of statins (drugs which lower blood cholesterol) for the primary prevention of CV disease has been controversial since the drugs became available almost 30 years ago. Primary prevention is the prevention of a disease which the patient does not have, eg a stroke or a heart attack. Secondary prevention is the prevention…

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Shostakovich Violin Concerto #2 and Symphony # 7

Tweet Disc 6 of Valery Gergiev’s Shostakovich cycle contains the 2nd Violin Concerto and the Leningrad Symphony (#7). It was recorded in performance in February of 2014. The soloist was Alena Baeva. The violin concerto, written and first performed in 1967, was the last concerto composed by Shostakovich. It was dedicated, as was the 1st,…

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Daisy For President

Tweet Can a dog run for President of the United States? The answer is an unequivocal yes! Let me quote the Constitution: No person except a natural born citizen , or a citizen of the United States, at the time of the Adaption of this Constitution shall be eligible to the Office of President; neither…

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The Genetically Modified Organism in Your House

Tweet Vermont in a spasm of enlightenment has mandated that all genetically modified foods sold in the Green Mountain State be so labeled. According to numerous polls 90% of the population of the USA thinks this a good idea. This is the same concerned and informed group that by an 80% margin supports labeling food…

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Cosmosapiens – Book Review

Tweet Cosmosapiens by John Hands Subtitled Human Evolution from the Origin of the Universe, John Hands’ book attempts to explain the origin of the universe and our place in it; and he does so in less than 600 pages (about a quarter of a million words) including many tables and figures. Amazingly, except for a stumble…

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Verdi Chords

Tweet One of the most distinctive characteristics of Giuseppe Verdi’s operas is his use of chords to resolve or punctuate the moments of greatest emotional and dramatic tension as his story reaches a crisis point. This simple device would seem within the grasp of almost any composer, but Verdi’s use of it is unique. Below are…

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A Clinical Vignette About Medical Journals

Tweet A medical journal is supposed to be an unbiased and objective source of the latest and best medical information. Of course, since all journals (for now) are run by human beings the reality and the ideal are widely separated. Even so, you shouldn’t be able to tell the politics of the journal’s editor from its…

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The Doctors’ Loophole – Another Reason why this is Such a Wonderful Country

Tweet Forty million Americans have a combined $1.2 trillion in student debt. Since the last recession this is only type of consumer debt that hasn’t decreased. As these loans are mostly guaranteed by the government they keep accumulating. Whether going into debt to get a college education is a good idea is not my subject….

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Suicide in Doctors

Tweet One of the medical newsletters I receive describes the suicide of a 33 year old surgeon near the completion of his training. The sad story of this death was taken from an article that appeared in Time Magazine – Why The Toxic Treatment of Doctors Needs to Change. The authors of the piece are…

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Tutto Verdi: I Vespri Siciliani

Tweet I Vespri Siciliani is the least performed of Verdi’s mature works. It was written for the Paris Opéra to a French text by Eugène Scribe and Charles Duveyrier (Les vêpres siciliennes). While the opera is occasionally performed in its original French version, it is typically presented in its Italian translation. Verdi just sounds better…

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Vitamin D Treatment in Postmenopausal Women

Tweet A study just published in JAMA Internal Medicine examined the effects of placebo, low-dose cholecalciferol (Vitamin D3), and high-dose cholecalciferol on 1-year changes in total fractional calcium absorption, bone mineral density, Timed Up and Go and five sit-to-stand tests, and muscle mass in postmenopausal women with vitamin D insufficiency. This study was undertaken because “expert”…

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The Medical Record – Plus ça change, plus c’est la même chose

Tweet The medical record has been a problem ever since Hippocrates, in a moment of spite, invented it. Until the advent of the electronic record it had existed on paper and was stored in a variety of inaccessible locations by the Department of Medical Records, or by a similarly named entity. Once entombed in the…

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What Can You Do to Maintain Good Health?

Tweet The FDA just banned trans fat. The American Heart Association issued a statement that the move would prevent 20,000 heart attacks a year mirroring that made by the CDC. Where this number came from is a mystery. I suspect they made it up after a series of extrapolations from metabolic data to epidemiological conclusions…

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If You Are a Homicidal Maniac Press 1

Tweet Earlier today I called USAA. They’re my insurance company. I’ve been with them since before the big bang. Back then you could pick up the phone and a familiar voice would answer, “This is Phyllis at USAA.” And I would reply, “Hi, Phyllis, this is Neil. I got a new car; please change my coverage.”…

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Air and Romance

Tweet This site has been silent for the last month. I was on a trip on the Amazon River. I got as far as Manaus, Brazil and then came back out. A little later I’ll post some photos of the region, but my theme today is American Eagle. To get to most places east, north,…

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Salt and More Salt

Tweet The August 14, 2014 issue of the New England Journal of Medicine contains three papers on salt intake and health. The third of these is so layered with assumptions that I won’t discuss it. I have previously written about recommendations for optimum dietary intake of salt. In 2011 the American Society of Nephrology endorsed…

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Ecco Il Mondo

Tweet ‘Ecco il mondo’ is sung by Mefistofele in Act 2 Scene 2 of Boito’s opera. Last March I presented 11 recordings of basses singing the same character’s first act aria – ‘Son lo spirito che nega’. Below are 11 versions of ‘Ecco il mondo’. The words in Italian and an English translation are presented…

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Mammography Screening in Switzerland

Tweet The May 22, 2014 issue of the New England Journal of Medicine has a perspective piece that is even more instructive than its authors and the journal’s editors realized: ‘Abolishing Mammography Screening Programs? A View from the Swiss Medical Board’. It describes the process that the Swiss used to evaluate the scientific foundation for…

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Son Lo Spirito Che Nega

www.youtube.com/watch?v=JPvj4V2OcUo

Tweet This aria, from the 1st act of Boito’s Mefistofele, captures the essence of Goethe’s Mephisto. Of course, the opera is one of many musical works based on Goethe’s monumental play. Mefistofele is the spirit that denies. The words to ‘Son lo spirito che nega’ are below in Italian and English. Every great bass (or…

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A Serious Bird

Tweet BOISE, Idaho — Albertson’s LLC said Monday that it has agreed to acquire The United Family, a privately owned chain of 50 supermarkets based in Lubbock, Texas, operating under three banners. Supermarket News Sept 9, 2013 This is really very simple, but I’ll do my best to make it complex. Groucho is a Yellow-Naped…

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No Second Acts in American Confectionary?

Tweet OK so the world has been going steadily downhill for last 5774 years. The trouble began with food which will eventually be my focus. But first a few disjointed musings. Most of our problems result from misdirected attempts to make things better. There are few Iagos in the world. This (the desire to do…

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Earl’s Oil – Photographs

Tweet On Friday March 8 my friend Earl allowed me and another friend to accompany him as he made his daily rounds. Earl is an oilman. He started in the business when he was 17. He’s a lean and taciturn West Texan except when he sees an oil well – then he recites the well’s…

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Doing Nothing – New Revised Edition

Tweet A new Edition of Doing Nothing has been released. It can be purchased at Amazon as either a paperback book or in a Kindle edition. Go here for more details. Below is a new review of the novel: Kurtzman, Neil DOING NOTHING CreateSpace (708 pp.) $23.35 Paperback $9.99 e-book January 6, 2012 ISBN: 978-1461096535 Kurtzman’s…

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Second Law of Thermodynamics Held Unconstitutional

Tweet A deeply divided Supreme Court, in a 5-4 decision, held the Second Law of Thermodynamics to be unconstitutional. In a decision released Monday the 4th of July, the first time the court has ever met on the nation’s birthday, the court ruled that the law violated the due process section of the 5th amendment. The case (ACLU v….

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Una partita a poker

http://il.youtube.com/watch?v=nZEXtTcdltE]

Tweet Talk to any theater person and he’ll tell you that the second act curtain should descend on the show’s strongest scene. Nobody was better at ending the second act than Giacomo Puccini. With the premiere of the Met’s revival La Fanciulla del West less than a month away, I thought I’d present a few versions of the opera’s second act finale. This the scene where…

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More Uncertainty about Cholesterol and Cardiovascular Disease

Cholesterol and lipid metabolism used to simple. There was good (HDL) cholesterol and bad (LDL) cholesterol. Eat a diet low in cholesterol and fat and your blood vessels will be as open as a new straw. On the basis of very little solid scientific information a litany of assumptions was issued by both the medical…

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Statin Therapy in the Elderly and Quality vs Cost

The JAMA published a study online which examines the Effect of Statin Treatment vs Usual Care on Primary CV Prevention Among Older Adults. The full paper is below as a pdf file. I’ve written about the overuse of this type of cholesterol lowering drugs in the primary prevention of cardiovascular disease several  times. Primary prevention…

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Depuis le Jour

Gustave Charpentier (1860-1956) is remembered, to the extent that he is remembered at all, as the composer of Louise – 1900.  The opera enjoyed some success in the first half of the 20th century; it received 52 performances at the Met between 1921 and 1949. I saw a single performance of it a long time ago…

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Doing Nothing Doing Nothing: "Doing Nothing by Dr. Neil Kurtzman takes us through the education of Richard Grollman, from his first day of medical school through his last day as chief resident on the medical service of a busy city hospital. Through his experiences, the reader is taken through a wonderful journey as we see the highs and lows of his life during his “education.” One is taken through the trials of medical school and the challenges faced during residency. This story examines the human side and art of medicine. This is a wonderful book that would be appreciated by most people, but would be greatly enjoyed by physicians who can certainly relate to Richard. It is reasonably priced and very well written. It is very difficult to put down. I would recommend this book without hesitation." - JASON LIFSHUTZ, M.D. › More ...

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