A Second Vaccine against Pneumonia Recommended for Seniors

If you're over 65, there’s a new vaccine you should know about. But before I explain the vaccine, let me introduce you to the bacterium that the vaccine protects you from. The little blue ovals in the above picture are Streptococcus pneumoniae bacteria. You might have guessed by its name that S. pneumoniae is a leading cause of pneumonia, and you'd be right. Pneumonia is an infection of the lungs, usually manifested by fever, productive cough, and shortness of breath. Pn...

Sorting Out the Different Flu Vaccines

The best way to avoid the flu is spending the months from fall until spring in a solitary bunker, communicating with other people only electronically. The second best way is getting the flu vaccine. The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for everyone over 6 months who doesn't have a specific contraindication to it. Because of the increasing number of different flu vaccines that are now available, this post highlights the three most commonly used fl...

Why Ebola is not a Major Threat in the US

I have written twice this year (links below) about the increasingly severe Ebola outbreak in West Africa. The news in West Africa is still mostly bad. Over 7,000 have become ill and over 3,300 have died. This is by far the worst Ebola outbreak ever. This week marked another first, the first Ebola patient diagnosed in the US. This news is likely making many of my regular readers wonder “Should I freak out?” This is a reasonable question, and I will attempt to answer it. But first, let’s go...

All Ashkenazi Jewish Women Should be Tested for BRCA

Mutations in two genes called BRCA1 and BRCA2 greatly increase the risk of breast and ovarian cancer. Last year I wrote about Angelina Jolie’s discovery that she carries a harmful BRCA1 mutation and her decision to have preventive double mastectomy. In the general population mutations in these genes are quite rare, but among Ashkenazi Jews these mutations are much more prevalent. One in 40 Ashkenazi Jews carries a mutat...

Suicide Contagion in the Age of Social Media


In every life we have some trouble When you worry you make it double Don’t worry. Be happy.

It will soon pass, whatever it is. Don’t worry. Be happy. -- Bobby McFerrin

Much has already been written in reaction to Robin Williams’s untimely death, about his incandescent talent, his prolific career, his decency and kindness, his addiction and his mental illness. His death robbed his fans of many more years of his genius and...

Return of the Spirochete


"Example is the school of mankind, and they will learn at no other." – Edmund Burke

Syphilis has been around at least since Europeans arrived in the Western Hemisphere. It’s a sexually transmitted disease caused by Treponema pallidum, a member of a group of corkscrew-shaped bacteria called spirochetes. Sometimes it causes no symptoms at all, but typically it initially causes a painless sore on the mouth or genitals. Later it can cause a rash. Untrea...

There Has Never Been a Better Time to Have Diabetes

The danger of diabetes is not only the immediate risk of very high blood sugar. Diabetes also has many dreaded long-term complications. (In this post I am referring to both type 1 and type 2 diabetes mellitus. For an explanation of the differences between these two very different diseases see the first half of this post.) Diabetes greatly increases the risk of stroke, heart attack, and amputation. In the US it is the leadin...

What We Don’t Know About Eating Fat

Most humans have spent most of human history nearly starving to death. So it’s no surprise that we spend a lot of time thinking about food. And it’s no surprise that food has acquired cultural, social, and religious significance in almost every society. Because food is so important, and because it’s nearly impossible for us not to ascribe powerful effects to anything important to us, every society imbues special health properties to various foods. From believing that some foods are aphrod...

The New Uncertainty about Mammograms

“I’d like to be tested for every kind of cancer.” All primary care doctors have heard this request. Our answer is an explanation that we can’t. Understanding this explanation is important before we get to the most recent study about mammograms. We don’t test for all kinds of cancers for an important reason. The outcome of most cancers don’t depend on when they are diagnosed. This may come as a surprise to many, since we’ve all heard the message of the importance of ear...