Sensible Medicine Newsletter

Articles

Ask Us Anything: Chapter 2

2 days ago | sensible-med.com | Adam Cifu |Vinay Prasad |John Mandrola

In the coming weeks Vinay, John, and I (Adam) will be getting together in person. We are meeting to work on what we think will be some really valuable Sensible Medicine content. Since we will have some time together, we thought it would be a good time to gather some more questions to answer. Same rules as last time: the comments are open to all paid subscribers to pose questions. Ask anything and we promise to take a swing at any and all questions. Photo Credit: Ilkka Kärkkäinen
What We've Learned From Sensible Medicine

4 days ago | sensible-med.com | Adam Cifu |Vinay Prasad |John Mandrola

It is hard to believe that we are coming up to the third anniversary of Sensible Medicine, well into toddlerhood. None us could have predicted that the site would last this long or be this successful (93,000 subscribers!!!!). The three of us are getting ready to meet up in person for the first time and we thrilled to see what the future will bring. We have some exciting plans. Three years seems a reasonable milestone to call for some reflection.
What if it were the other way around: Universities were overwhelmingly conservative and shut down liberal ideas & faculty for years

5 days ago | sensible-med.com | Vinay Prasad

As the Trump administration exerts maximal pressure on universities and medical centers to comply with its’ demands: eliminate masking on campuses, eliminate DEI, follow merit based admission policies, etc, many have strong feelings, and these divide along political lines. In fact, let’s start with a poll:Now, I am curious how you would feel if the shoe were on the other foot.
Tech Bros Require Regular Relooks at the Seminal Evidence in Coronary Artery Disease

1 week ago | sensible-med.com | John Mandrola

Not every week, but most weeks I read social media posts about getting your heart checked. It could be lifesaving. The pleas often start with a coronary artery calcium scan—which could then lead to a coronary angiogram with possible stent placement. It’s a compelling story. Heart disease is a leading killer. Sudden cardiac death or massive heart attack can be the first symptom. So if you find a widow-maker-type blockage, you can have it fixed, and disaster is averted.
Are medical journals balanced?

1 week ago | sensible-med.com | Vinay Prasad

On Sensible Medicine, we publish disagreement. Adam and I have disagreed on many issues, including masking and whether doctors should disclose their mental health ailments. We published essays by people supportive of and critical of Robert Kennedy Jr. When I praised the indirect cuts to the NIH, we published and essay defending those (excessive ;) ) indirects. We even published an administrator’s response to my popular essay in defense of medical personnel who directly care for patients.
Adam Cifu, Churnalist

1 week ago | sensible-med.com | Adam Cifu

I liked my previous post on why I don’t think the shingles vaccine (actually our previous shingles vaccine, Zostavax, rather than the present one, Shingrix) does not prevent dementia, despite a Nature article and coverage pretty much everywhere to the contrary. I stand by my conclusions. However, a couple of astute readers, one in the comments and one email, called me out for a bit of an unintentional sleight of hand in the math. It was unintentional, but I want to set the record straight.
Post Herpetic Churnalism

1 week ago | sensible-med.com | Adam Cifu

There I was, enjoying a Wednesday morning clinic session, when my phone vibrated with a notification from the New York Times. I looked down, wondering what disaster was afflicting the stock market, our country, or the planet, when instead I see: Shingles Vaccine Can Decrease Risk of Dementia, Study Finds. Instead of being annoyed, I had a couple of pleasant thoughts:1. Great, this must be a piece of churnalism that I can write about on Sensible Medicine. 2.
I learned about medicine from that: aboard the La Rabida Children's hospital

2 weeks ago | sensible-med.com | Vinay Prasad

In the Spring of 2008, I was stationed aboard the La Rabida Children's hospital. The hospital was perched on a peninsula that jut into Lake Michigan on Chicago's South Side. Outside all the windows spilled tranquil blue water. We could have been in the Pacific. The patients were a mix of kids who were hospitalized for a treatable conditions, like diabetic keto acidosis, as well as those who were incurable, like a cute 2 year old boy with a brain stem tumor that grew relentlessly after neurosurgery.
I've been wrong about treating pleural effusion for 25 years

2 weeks ago | sensible-med.com | John Mandrola

Patients who present with acute fluid accumulation and congestion due to heart failure often develop something called a pleural effusion. The fluid is not in the lung, but around the lung. It compresses the lung, creating shortness of breath, chest pressure, and other symptoms. We call such a fluid accumulation extra-vascular because it is not inside the blood vessels. Rather, it is in a separate space outside of the lungs.
A Call for Parentalism in Medicine

2 weeks ago | sensible-med.com | Adam Cifu

VB is an 88-year-old woman. She had remained vigorous into her mid ‘80s, biking and playing pickle-ball with younger friends. She was admitted to the hospital with an MI. She had come to the emergency room with five days of chest pain. There were ST elevations across all the precordial leads and signs of heart failure on physical exam. Troponin level was 500 and declining. VB went directly to the cardiac catheterization laboratory.