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 to the medical record…and a…
Who’s Afraid of Deskilling?
Many seasoned medical (and non-medical) hands are being wrung these days over dependence on AI sapping the clinical skills of trainees. It will, and that’s ok. But we do have a much bigger problem of medical education on our hands. The days began to fly now, and yet each one of them was stretched by renewed expectations and swollen with…
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, must have been pushing 60…
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 gym alone including a couple…
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 I think they can do…
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 from my own pediatric residency…
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 pretty strong hint from the…
Continuous Remote Care is the Future of Medicine
The industrial revolution began with the cloth weavers and only later transformed life for blacksmiths and longshoremen. Many people today work in textiles, manufacturing and shipping, but the way they work would bewilder their colleagues teleported from 1700. Technology vastly increased the amount of “stuff” one worker can produce, and society as a whole has reaped that benefit. Just so,…
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 pretty much the opposite –…
On Home Birth & Relative Risk
Home birth, its merits notwithstanding, may be a bigger risk to the baby than some parents would tolerate in other decisions. With many friends getting pregnant these days, one question I get a lot is some version of “We’ve heard a lot about home births. What do you think about them?” Remarkable new-ish research from Oregon helps explain why it’s…