Sensible Medicine
MAY 2, 2025
One of the many great things about being a general internist is the exposure to the wondrous diversity of humanity. I am a better person for having brief, but intense, visits with some 50 people every week. These people grew up all over the world and have worked in every imaginable field. I see people barely scraping by financially and people with unimaginable wealth.
Sensible Medicine
APRIL 30, 2025
The most common question we get asked is: is there a course on how to become better at critically reading medical research. Well, now there is! This is the first of 9 videos that we recorded as part of a course on clinical appraisal, and there will be many more to come. We call our class: How Not to Get Fooled by the Medical Literature. These are topics that each of us teaches separately, but, here, for the first time, we teach them together, and the whole is more than the sum of the parts.
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Sensible Medicine
APRIL 28, 2025
The picture below shows how a treatment can make patients better. I see four ways. The drug/procedure may work biologically. The Voltaire effect relates to his quote saying that the art of medicine consists of amusing the patient while nature cures the disease. AKA: natural history. Placebo effects can also contribute. I will show you an elegant experiment demonstrating how positive energy and words can add to improvement.
Sensible Medicine
APRIL 21, 2025
For me, transcatheter aortic valve implantation (TAVI) approaches a miracle. My brain thinks: how in the world does a doctor place a valve in the aorta, then into the stenotic valve, squish the calcified old valve and land a new one. Watching the procedure on x ray does not do the miracle justice. Miracle number one is the valve stays in place. Miracle number two is that the debris-traveling-north does not cause stroke in every patient.
Sensible Medicine
APRIL 14, 2025
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.
Sensible Medicine
APRIL 10, 2025
I’ve already gotten pretty bored reading about AI in medicine. So many of the articles cover the same ground, either breathlessly celebrating AI’s promise or bemoaning the brave new world on the horizon. This article from Dr. Mendoza made me feel embarrassed that I have not even considered this angle. Adam Cifu This Substack is reader-supported.
Sensible Medicine
APRIL 9, 2025
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 neurosurge
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