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Grand Rounds is up at Suture for a Living. Plastic surgeon Dr. Ramona Bates has included posts that cover many different subjects, some light, some serious. Stop by and have a look.

DSM lists two principal “illnesses” under the heading Eating Disorders: anorexia nervosa and bulimia. Anorexia Nervosa means chronic and pernicious fasting even though food is readily available. “Anorexia” is Greek for lack of appetite. “Nervosa” is Greek for nervous. Bulimia means recurrent episodes of binge eating followed by self-induced vomiting or other methods of purging. “Bulimia” is Greek for “the hunger of an ox.” Neither anorexia nor bulimia is an illness in any correct sense of the word. But my concern today is not with either of these issues, but rather with common, everyday overeating. ...

Babies are born selfish. Not only has the newborn no consideration for others, he isn’t even aware of others. For the newborn, the universe is him/herself. Babies are born bad-tempered. When their needs are not immediately met, they cry. If they are still not met, they scream, turn red, and thrash their arms and legs. This is raw, unmitigated anger. Babies are born rude and ill-mannered. They vomit and urinate on other people’s clothes. They defecate in inappropriate places. They spit and drool. They grab people’s hair and poke their fingers in people’s eyes. ...

Every society in every generation makes errors. Some of the errors are minor. Some are major. One of the great errors of the 20th century was this: we accepted the spurious notion that a wide range of life’s problems were in fact illnesses. This spurious notion was initiated with good intentions – to provide shelter and humanitarian care for a relatively small number of individuals whose plight was truly dreadful. But then the concept of mental illness took off, fuelled largely by the efforts of psychiatrists to legitimize their status as “real” doctors. ...

Grand Rounds is up at Highlight Health. The theme is The Impact of Healthcare Reform, and Walter Jessen has included posts that cover many different perspectives on this timely subject. Stop by and have a look.

We’ve known for years that drug companies give gifts to physicians. The gifts have taken many forms – pens, vacations, meals, free samples, etc… Physicians always insisted that these gifts didn’t influence their prescribing practice – that they always prescribed strictly in the best interests of their clients. Two trends have been exposed in recent years which demonstrate just how depraved this hand-in-glove relationship has become. Firstly, the “thought leader” ruse. Here’s how it works. A drug rep, usually an attractive young, perfectly groomed female, approaches a physician, usually male, and tells the physician that he has been identified as a thought leader in his area, and that they would like to recruit him to give presentations to groups of physicians and other healthcare workers. The physician, of course, will be paid generously for his time. He says “sure,” and the dance begins. The drug rep arranges the “training” sessions. The drug company provides the script and the refreshments. The mark – I mean the physician – delivers the script, in which the merits of the drug company’s product are lauded to the detriment of competitors. At the end of the session, the physician receives a check and goes away contented. Over the next few months more such sessions will be organized and the physician begins to think of his “speech” checks as regular income. He will also receive “coaching” from the drug rep if his presentation seems to lack the kind of conviction that the drug company feels warranted. (After all, they are paying the piper). ...

The human brain is a pattern-seeking machine. Because of his brain, man strives to understand the world around him and uses this understanding to improve his lot. The brain looks for patterns and explanations. Our ancestors, for instance, discovered that certain rocks, through processing in certain ways, could be shaped to make sharp tools which they used to great advantage. Later it was discovered that other rocks when heated in certain ways produced iron. And so on. ...

The notion of learning disorders gained momentum during the 50’s and 60’s, when it began to be appreciated in professional circles that there were a small number of individuals who, although quite bright, seemed to experience inordinate difficulty learning to read. They juxtaposed letters or did not seem to readily “see” the patterns of letters in words, and the term “dyslexia” was used to describe this condition, which was relatively rare in school-aged children. ...

Unhinged, by Daniel Carlat, MD Dr. Carlat is a psychiatrist who has written something of an exposé of the abuses that reside within the psychiatric profession. Many of his chapters echo topics that have been addressed frequently on this blog. Dr. Carlat still clings to the notion that problem behaviors can be accurately conceptualized as illnesses, but he does criticize the proliferation of “diagnoses” and the application of these “diagnoses” to increasing numbers of individuals. ...

This post was edited and updated on June 29 2014, to include additional thoughts. . . . . . . . . . . . . . . . . A Rational Policy on Drugs and Alcohol In my last post I argued against government prohibitions against drugs and alcohol. My position is that substances such as cocaine, heroin, methamphetamines, etc., should be legal in the same way that alcohol and tobacco are today. I believe, however, that the distribution and marketing of these substances should be brought under direct government control. All of the commonly abused addictive substances are dangerous, and they have taken - and continue to take - an enormous toll on society. This cost includes lives, health, lost opportunities, money and general suffering and anguish. But it’s difficult to put old heads on young shoulders, and it seems that each generation - indeed each individual - has to learn these lessons anew. I don’t believe we can ever eradicate substance abuse entirely. ...