For Subcutaneous Use Only

If you were asked to name the best-selling medication in the United States last year, what would your guess be?  Not the most prescribed drug, but the medication with the most revenue, mind you.  I know what you are thinking — it must be a cardiac drug, due to the prevalence of heart disease.  Lipitor?  Close, but that would be the lifetime sales king ($141 billion).  Maybe a diabetic drug?  There are obese people with diabetes everywhere.  No, wait, an opioid — that has been in the news all over the place in the last year.  Well, the answer is not exactly clear cut, depending on what source you quote.  However, it does appear that between July 2013 and June 2014 the best-selling medication in this country was aripiprazole (Abilify), with sales of $7.2 billion, and the most prescribed medication was levothyroxine (Synthroid), with 22.6 million prescriptions written.

Who's Afraid of the Boogeyman?

Toothpaste grenades.  Bombs in iPads?  Exploding clothing!  How scared I am.  Not the typical Dr. Seuss rhyme we grew up reading.  U.S. officials announced on Tuesday, Sept. 23, that one of the reasons for the recent bombing on Islamic State (ISIS) and Khorasan Group member locations in Syria and Iraq was because of intelligence that indicated these groups had obtained materials for improvised explosive devices (IEDs) that could be concealed in handheld devices such as smart phones and tablets as well as clothing dipped in explosive material.  These could then be used in coordinated, multiple “lone wolf” attacks.  See the story on CNN.

It's Not Your Fault

“He used to put a wrench, a stick, and a belt on the table, and just say, ’Choose.’ ”

Mama Said Knock You Out

Not since Mike Tyson was destroying opponents in the ring in the 1980s has a left hook ignited discussion like what has occurred this week with Ray Rice, the suspended Baltimore Ravens football player.  Domestic violence is the topic, even if the video of Mr. Rice punching his fiancée, Janay (Palmer) Rice, who is now his wife, in an Atlantic City elevator happened back in February.  Like many domestic assault cases, Ms. Palmer declined to testify against her significant other, and charges were dropped.  See the article in The New York Times.

The Fetus is the Parent of the Child

As summer winds down and the seasons begin to change again, a new child will enter this world in the next few weeks.  My office manager will give birth soon, and while we may consider the notion that knowledge and ideas begin the day we are born, research has proposed that even in the womb, a developing fetus is learning things that will affect his/her own future and parents as well.  Most healthcare clinicians, and even the general public, understand how prenatal exposure to chemicals such as alcohol, nicotine and drugs will negatively affect the developing fetus.  See the article in Pediatrics.

Ice Ice Baby

Unless you have been living under a glacier recently, you likely have seen, read or heard about someone who has done the ALS Ice Bucket Challenge.  It was a simple request started in New England in July 2014 by Pete Frates, the former captain of the Boston College Eagles baseball team in 2007: dump some ice water on your head or donate $100 to fight amyotrophic lateral sclerosis (ALS).  Pete was diagnosed with ALS in 2012 at the young age of 27, and his “ice bucket challenge” to friends and family was a way to help increase awareness and advocacy.

Family Physician to the Bereaved

As the unfortunate events unfolded in Ferguson, Missouri, over the past 10 days after a police officer shot and killed 18-year-old Michael Brown on August 9, much of the controversy centered on the lack of transparency of the investigation as to the events of the shooting.  The St. Louis County medical examiner had not released the results of the original autopsy as of August 17, which is the date when the Brown family’s privately hired forensic pathologist, Dr. Michael Baden, released details of his examination.  Dr. Baden was the former chief medical examiner for New York City and had examined the autopsy results of President John F. Kennedy and the Reverend Martin Luther King Jr.  Dr. Baden felt that his results showed that the unarmed Michael Brown was shot four times in the right arm and twice in the head.

Carpe Diem

As many of us reflect on the recent death of Robin Williams, the gifted comedian, actor, husband and father of three, much of the focus in the media this week has been on the issues of depression, substance abuse, addiction and suicide.  It was refreshing to hear some of the commentators talk about depression as a “brain disease” and not use the term “mental illness” as much as might be expected.

The Right to Bear Arms, Part 2

On June 2, 2011, Republican Florida Gov. Rick Scott signed into law House Bill 155, The Privacy of Firearms Owners Act, which in the state of Florida would, according to the National Rifle Association, “stop pediatricians from invading privacy rights of gun owners and bringing anti-gun politics into medical examining rooms.”  The American Academy of Pediatrics and the Florida Pediatric Society urged Gov. Scott to veto HB 155 to no avail. The penalty for asking a patient about gun ownership? A $500 fine and loss of medical licensure.

The Right to Bear Arms

It is one experience to talk about Second Amendment rights, mental health issues and gun ownership.  It is another experience completely to hold for the first time a loaded gun, a Taurus .357-magnum with six bullets and no safety lock, in your father’s home, knowing that in the middle of the night your father, who has dementia, might mistake his wife getting up to feed the dog as an intruder, and then the problems really begin.  I had this experience two weeks ago, and as physicians, we know that we have, hopefully, been trained to make the right decision in tough situations.  Making that correct decision is often much tougher than expected.

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