A New Hope

7-day average of daily LA County COVID-19 cases and deaths calculated on Sundays
How’s it going in Los Angeles with the pandemic? The numbers in LA are absolutely dreadful. Daily new cases, hospitalizations, and deaths are at all-time highs. The current case numbers make the mountain of cases this summer look like a molehill. In July I worried that a COVID death rate in the 40s per day would make COVID a contender for the leading killer in LA...

Think Local, Act Local

Monday, April 27, 2020

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

If you’re reading this, I assume you’ve already been recruited into one of the several armed motorcycle gangs that scours the city’s ruins for canned food. I know finding a generator to recharge your laptop isn’t easy so I’ll keep this short. Oh, wait. That’s the first paragraph of the post I’m writing for June. Where’s my end of April post? Oh, here. Let’s start over. ...

Testing, Testing Part 2

Can you feel it, now that spring has come? That it's time to live in the scattered sun.

Waiting for the sun. Waiting for the sun. Waiting for the sun. Waiting for the sun.

This is the strangest life I've ever known. -- Waiting for the Sun, The Doors

[I’m writing this on Friday, April 17. Everything in this post might be false in a few days, and conditions might be different in places oth...

Largest Study Ever Finds No Link Between MMR Vaccine and Autism

The rash on the skin of a measles patient. Photo credit: CDC/Dr. Heinz F. Eichenwald

“A lie will go round the world while truth is pulling its boots on.” -- C. H. Spurgeon

In 1998 Andrew Wakefield, a British gastroenterologist, published a study in The Lancet reporting on 12 (remember that number) children with developmental delay, 8 of whom were diagnosed with autism within 4 weeks of receiving the MMR (measles, mumps, rubella) vaccine. The study proposed a link between the MMR vaccine and autism. Other researchers were unable to reproduce ...

What Vitamin D and Fish Oil Have to do with Cancer and Heart Disease

About half of U.S. adults take some sort of nutritional supplement. (My wife and I are in the other half.) Many supplements have a crucial specific function (vitamin C, for example, is the best and only treatment for scurvy) but their benefits to the general population are unproven. Vitamin D is frequently prescribed to prevent and treat osteoporosis. It is critical in calcium metabolism and in bone health. Some observational studies have found lower rates of death from cancer and cardiov...

In Healthy Older Patients Aspirin Doesn’t Help

Aspirin tablets. Photo credit: Ragesoss / Wikimedia Commons
Before we delve into this month’s news about aspirin, let’s briefly review what we think we know. Aspirin is life-saving therapy during a heart attack. In patients who have had a stroke or a heart attack in the past, daily low dose aspirin can prevent a second stroke or heart attack. Ditto in patients who have had bypass surgery or angioplasty or those who have chronic angina (chest pain caused by narrowing of coronary arteries), daily low dose aspirin prevents heart attacks in them too. ...

Heart Stents Don’t Decrease Chest Pain

“The first principle is that you must not fool yourself – and you are the easiest person to fool.” -- Richard Feynman

This month brought more bad news for coronary artery stents. To understand how far coronary stents have fallen, we have to understand what we’ve been using them for. But first I should explain that coronary stents are life-saving treatments during a heart attack. That has been well established and is not changed by anything in this post. T...

Medications Are Not the First Choice of Treatment for Low Back Pain

Low back pain is very common. The vast majority of people reading this sentence have had low back pain at some time in their lives. It is one of the most common reasons for physician visits in the U.S. and results in an estimated $100 billion in annual costs. Given the very high prevalence of low back pain, you would think that we would already have noninvasive treatments that are proven to be safe and effective. You’d be wrong. Recently the American College of Physicians (ACP) reviewed e...