The Anti-Medication Bias

[The patient interactions in this post are amalgams of hundreds of patient encounters over my career. They are not accurate depictions of any encounter with any single patient.] “I don't like taking medicines.” All physicians hear some form of this opinion very frequently. Even more frequently, patients don't state this view outright but rely on it to completely subvert their doctor’s plans. When I was new to practice such an utterance would shock and confuse me. “I don't want to...
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Nearing a Cure for Hepatitis C

In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis – liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis A and B. A new pathogen was hypothesized and called non-A-non-B h...
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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...
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