America’s Doctor

From Julia Belluz’s portrait of Dr. Oz in Vox, now apparently America’s most famous and most trusted physician:

This setback didn’t slow down Oz in his study of alternative medicine — or his embrace of fame. In the early 2000s, he worked with a reiki healer named Raven Keyes. She told me recently, “My reiki master is the archangel Gabriel. All I have to do is ask Gabriel to activate all the angels, and everybody’s angels come to life.” In the operating room, she said, she’d perch on a stool behind the anesthesiologist and transfer her good energy. “I’m connecting with the divine light within me and allowing myself to absorb the divine light in myself so it expands outward.”

Dr. Oz embodies the tension between personal freedom and professional responsibility. If one-way communication via a television or radio show doesn’t qualify as medical advice or constitute a physician-patient relationship, then how do we define it? Because anecdotes are apparently not uncommon about people who trust Oz via TV more than their actual physicians:

One reported that her dad had a heart attack and five stents placed in his heart, which required him to take aspirin and Plavix to prevent blood clots. “He was watching Dr. Oz, who said Plavix was not necessary, so he stopped taking it. About a month later, he had another massive [heart attack] and coded and had to be shocked back to life.” She continued: “My dad admitted to following Dr. Oz’s advice and not asking his own cardiologist.”

When a personality like Oz speaks about health and is a physician, he or she is essentially doling out medical advice. But right now, we wouldn’t even consider holding them accountable. Oz doesn’t even need to disclose his COIs when it comes to fat busting green coffee bean extract or other natural miracles.

The Radical Humaneness of Norway’s Halden Prison

Ragnar Kristoffersen, an anthropologist who trains Norway’s correctional officers, quoted in a fascinating NYTimes piece about a different kind of maximum security prison:

He leaned back in his chair and went on. “We like to think that treating inmates nicely, humanely, is good for the rehabilitation. And I’m not arguing against it. I’m saying two things. There are poor evidence saying that treating people nicely will keep them from committing new crimes. Very poor evidence.”

He paused. “But then again, my second point would be,” he said, “if you treat people badly, it’s a reflection on yourself.”

Explanations for the 2015-2016 Official Step 1 Practice Questions

The NBME just released the updated 2015 sample questions this past month, and there are no new questions in this iteration (at least in the downloadable pdf version). In fact, six questions have been removed (two from each section), which was done to reflect the decrease in total Step 1 test items starting May 11 from 322 to 308.

I’ve made a note of which questions were removed from the 2014-15 set. Therefore, at this time, my explanations for the 2014-15 set are still current. The question order is the same, but the numbering is off a bit.

If an updated set with new questions is eventually released, the explanations will appear below as they have in prior years.

Block 1

#20 and #29 from 2014-15 were removed.

Block 2

#74 and #85 from 2014-15 were removed.

Block 3

#98 and #130 from 2014-15 were removed.

 

Again, the still current 2014-15 explanations can be found here.

A neurosurgeon’s final message

Paul Kalinithi, writing to his infant daughter in his last op-ed before succumbing to lung cancer:

That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.

It’s a rare thing for us to write to the ones we love before we go, let alone to share such poignancy in order to touch others as well. We don’t write meaningfully to each other very much anymore, especially when it counts most. We could do better.