pediatricly home
Health, Tech, Cents
Hippocrates would have recognized the practice of medicine I studied. That will not be true of my children’s generation. We live in interesting times.
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CDS is Dead. Long Live CDS.
AI has made clinical decision support (CDS), the great dream of my line of work, obsolete. We should invest our time clearing out its detritus to make way for the robots. CDS – The Once Great Dream Codified into informatics parlance in 2001 but drawing on concepts from long before medicine was computerized, CDS was…
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When Will AI Destroy Humanity? Or Maybe Cure Cancer? Or…Both?
For all the Croesian sums going to AI data centers these days, some fear superhuman robots are right around the corner. They are not. But they are already here. Machines. Smash a man to 89 atoms if they got him caught. Rule the world today.— Mr Bloom in Aeolus, Ulysses by James Joyce, 1920 Joyce…
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The Data Tsunami
In just the modest span of my career, the volume of medical data has exploded. Well intentioned folks in my line of work call this “bloat” and worry over cajoling humans to stem the tide. We never will. Fortunately, AI will save us from ourselves. “…it will be necessary to develop a more organized approach…
Artificial Ranch Intelligence
Practical tips for my fellow city slickers taking up home on the range. Don’t be caught with all hat and no cattle.
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Raising Chickens 101
Being an old farm boy myself, chickens coming home to roost never did make me sad; they’ve always made me glad.— Malcolm X I was pretty well sold on getting chickens as soon as we decided to move to the ranch. Finding one with a great chicken coop sealed the deal. It’s been awesome (and…
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Well Water 101
To unpathed waters, to undreamed shores.— Camilo, Twelfth Night IV, 4. Shakespeare Before taking up the ranch life, I lived in a world in which I turned a faucet, water came out and I didn’t give the rest much thought. (Well, except for earthquake risk but more on that in a moment.) Now on the…
Lies & Statistics
Even with best intentions, they can be hard to tell apart, especially, unfortunately, in medicine.
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The TCOM & Reverend Bayes
Transcutaneous CO2 monitors (TCOM) have been a breakthrough technology for neonatal medicine. I can remember the days without them when we faced the unsavory choice between poking the baby for a blood gas or flying blind. In the last few years, however, I have seen them used more & more – occasionally in circumstances where…
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The Priest of Sepsis
Bayes’ theorem applied to neonatal sepsis diagnosis The Man of the Cloth Late nights in our neonatal intensive care unit, I am often asked to evaluate a baby with potential symptoms of sepsis. In small babies especially, those potential symptoms are incredibly broad, so the evaluations are always hard. Usually the request comes with a…
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Observational Studies in Nutrition are a Waste of Time
Observational studies in nutrition are a waste of time. Their results should be ignored. An article in a Lancet sub-journal this month suggested that both very high and very low carbohydrate diets shorten life spans. That may seem odd to casual followers of nutrition science after an article in the Lancet mothership last year said…
Stories
Proof, hopefully, I’m not entirely robot.
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Clogs to Clogs
My hospital needed some utility upgrades. The final step was repaving the parking lot. So yesterday, going from my office to the hospital ward, I passed giant asphalt paving trucks with their crew scurrying among them. As is typical where we live, they spoke in Mexican Spanish. What struck me was how old they looked,…
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Your Name, Tancredi
I have no complaints about my name, but it is very common. It was near the top of most popular boys’ names for quite a few years when I was born before falling out of fashion (and, as these things tend to, lately starting to resurge). There must be a dozen other Michaels at my…
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Back from the Brink
Slate blue and utterly motionless, I thought for sure our baby was dead. By an extraordinary coincidence, I had been at that moment in the middle of a lesson on neonatal resuscitation with Jacaranda’s first batch of very talented nurses to receive pediatric specialty training. I was dedicating my project time, on a 4-month leave…