I’ve only seen scurvy once. I was in training at Barnes Hospital in St. Louis, and a homeless man was admitted with weakness, muscle and bone pain, bleeding gums, and shortness of breath. It turned out that his diet consisted solely of hotdogs (no condiments) and Coke. It’s a good thing he came to tertiary care hospital, because scurvy is so rare now that many physicians wouldn’t even consider it in their diagnosis.
I will admit, though, that I’ve been watching a friend of my son for years, expecting to see my second case of scurvy. This friend only eats white rice. Well, he also eats white bread, and a few other things, but only bland things. I thought he would grow out of it but he still hasn’t, and he’s teenager.
I’ve been puzzled about his dietary habits, but I just read something that might explain this.
In The Medical Detective, Roueché describes a baker who suddenly developed a similar problem. The baker, named Rudy, had a perfectly normal sense of smell and taste until one day, he came down with a cold. Then suddenly, his smell and taste perception changed (and persisted). He couldn’t handle the smell in his pizza bakery any more. The ripe tomatoes smelled rotten. The entire kitchen smelled like burnt plastic. Continue reading “Can You Taste with Your Kidneys? Can You See with Your Blood Vessels?”
My best friend was diagnosed with gout recently. I told him to stop ingesting fructose immediately.
Only twenty five years ago, when I was in training, gout looked like it was like a disease on its way to extinction, sort of like tuberculosis. We were taught it used to be common hundreds of years ago but that it was pretty rare. Sure, I had a few patients with gout in my clinic with gout but I would see a case once every couple of months at most.
Now, it’s exploded in frequency.
Gout is very, very bad. Not only because it is excruciatingly painful. (In some patients, you can’t even let a gouty big toe brush against tissue paper without unbearable pain. It’s one of the few things that may rival childbirth in the intensity of pain.) And not only because it is a major risk factor for heart disease. Not only because it causes heart disease. No, it’s very bad because your risk of dying goes up by 25% if you have gout. Continue reading “Gout and Cardiovascular Disease”
Ed Thorpe is the mathematician who wrote “Beat the Dealer.” In that book, he detailed his invention of card counting. He proved for the first time that it was possible to beat the Las Vegas casinos in blackjack, something that was believed to be impossible. He also invented the Black-Scholes equation several years before Black and Scholes (and in fact Black and Scholes directed credited Thorpe’s writing for inspiring them), which resulted in a Nobel Prize. Except he didn’t share in the Prize because he used the equation to make millions of dollars on Wall Street rather than publishing it. But that’s another story.
Thorpe writes about the time he was asked to dinner with Warren Buffett. Ralph Gerard, the dean of UC Irvine, where Ed was a professor of mathematics, was thinking about moving his money from Buffett to Ed. Warren was secretly assessing Ed’s bona fides.
Ed passed muster when he correctly answered Warren’s question about the oddly numbered dice. This is a curious phenomenon. Let’s say you have three dice. The first die A is numbered 3,3,3,3,3,3. The second die is numbered 6,5,2,2,2,2. The third die C is numbered 4,4,4,4,1,1.
If you roll the dice, then most of the time, die A will beat B, B will beat C, and… C will beat A. Continue reading “Metas, Or, Biology is Non-Transitive”
Let’s talk about what happened when Europeans first tried to settle North America. They failed and never came back. The entire Eastern seaboard was covered Native American farms and there was hardly a fertile spot left. And the Native Americans overwhelmed the settlers and drove them out.
I am, of course, talking about the Vikings who tried to settle Newfoundland and failed.
Continue reading “Hand of God or A Viral Shockwave?”
We were taught in medical school that the bladder was sterile. That’s because urine is sterile. So naturally, so is the bladder, right?
Wrong. It turns out that there are numerous organisms in the bladder, and that probiotics that might change the microbiome in the bladder may enhance effectiveness of chemotherapy for bladder cancer.
The reason we thought bladder was sterile is Continue reading “If You Can’t Culture It, It Doesn’t Exist”
“Drug Development: When Scientists Try to Build Things”
In 1968, Gunther Stent, a prominent biologist and part of the “band” that included Watson and Crick, wrote a famous paper, subsequently followed by a book. In it, he bemoaned the fact that everything there was to know about molecular biology had already been discovered. That there was to be no more Continue reading “Terra Incognita of Science”
When Xerox launched model 914, the first real copier in history, they didn’t know if it would be a success or a miserable failure. Before then, no one copied anything, mainly because it would take hours to days to make a single copy of a single page of a document, and it was horrendously expensive. In short, there was no market for copiers. The initial estimates were that the entire market may be a few million dollars. Continue reading “Reductionism and Redundancy”