Screams and disconnections

I started reading the two bestsellers by Johann Hari (Chasing the Scream and Lost Connections, about the war on drugs and about the modern epidemic of depression, respectively) after hearing him on Sam Harris’s Waking Up podcast.  They’re powerful and well-written books, though reading them can be quite upsetting, as they both deal with issues that have profoundly affected my life.

As may be obvious to anyone who’s read this blog much, I’ve had a lifelong struggle with depression, which is often quite severe.  I say lifelong; it really began in my early teens, and I think in my case it may be more endogenous than reactive.  Thus, I might be a slight outlier in Hari’s thesis on the illness (but I haven’t finished the books yet, so I may be wrong in this).  Nevertheless, Hari’s point about missing connections and support is one that resonates with me. Continue reading “Screams and disconnections”

It’s unreasonable to expect “cures” for most diseases

I often encounter Facebook memes denouncing pharmaceutical companies with words to the effect of: “Big Pharma isn’t interested in making cures, they’re interested in making customers,” as if this were some deep insight into a grave moral failing on the part of the entire industry.  Now, I’m quite sure that there are perverse incentives and inappropriate goals scattered throughout the medical industry in general, from the level of the individual physician, to pharmaceutical manufacturers, to the insurance industry, and everywhere else in the healthcare field.  There’s little doubt that these injustices and inefficiencies gum up the works for everyone, making healthcare overall worse than it might otherwise be.  But simply to complain about the fact that most medications don’t “cure” our many modern ailments is to confess a misunderstanding of the nature of biology and medical treatment. Continue reading “It’s unreasonable to expect “cures” for most diseases”

Diabetes For Beginners – Part 2

First published on robertelessar.com on February 23, 2012

Welcome to Part 2 of my “freshman lecture” on Diabetes.

Now we get to Type 2 Diabetes Mellitus. Interestingly enough, although this is “Type 2”, it is in fact by far the Number 1 form of Diabetes numerically, with 90 to 95% of Diabetics falling into Type 2…and that number is likely, if anything, to become larger. Continue reading “Diabetes For Beginners – Part 2”

Diabetes For Beginners – Part 1

Diabetes is an illness of which I suspect almost all adults in America are aware. I also suspect that most people know that it has something to do with high blood sugar and that having high blood sugar is a bad thing. Still, I imagine there are a fair few people out there who haven’t really got a lot more understanding of it than that—including some people who have the disease—because they haven’t really had it explained to them in terms they can follow. After all, doctors—of which I am one—don’t often take the time necessary to make sure that their patients fully understand the ins and outs of a disease process. Partly this is because, when one understands something on a very complex level, it seems like it’s going to take serious effort to explain it to someone who doesn’t have the same educational background. However, I think this is a failure of imagination and a bit of mental laziness on our part as doctors. The Nobel-Prize-winning physicist Richard Feynman used to prepare “freshman lectures” about physics subjects when laypeople asked him about topics they didn’t understand. If he found that he couldn’t prepare one, he recognized that failure as an indication that the subject wasn’t well-enough understood! Continue reading “Diabetes For Beginners – Part 1”