On Compassion

Dov Michaeli

Posted 5/12/13 on The Doctor Weighs In

For Joel Klepper, who can do it all

My friend’s son, Joel Klepper, a student at the University of Oregon, sent his father a summary of a talk by the Dalai Lama at the university. I am not going to quote the whole report, brilliant as it is. But a few choice paragraphs illuminate the thought-provoking talk of this awe-inspiring religious leader. Here is the Dalai Lama on religion and compassion:

“He started by pointing out that all of the world’s major religions have compassion and love as their defining message, and pointed to the many people that all of the major religious traditions have produced who have used it as inspiration to devote their lives to compassion and the good of humanity. He was careful to differentiate between religion and religious institutions, saying it was the latter that was susceptible to corruption, and therefore it is the institutions that drive people away, but that generally that people don’t tend to have a problem with most core tenets, but that also as human understanding advances, it is critical that religion adapt itself, and not become mired in tradition or dogma when they clash with reality. Throughout, he was big on practicality and realism”.

The most surprising to me was the broad-mindedness of the leader of Tibetan Buddhism:

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Second Opinions: How Should You Choose?

Dov Michaeli

Posted 5/9/12 on The Doctor Weighs In

Incredulous Dov

I have frequently been asked to render judgment on another doctor’s diagnosis, or treatment plan. Other times I am asked anxiously: “should I get a second opinion”? The implicit assumption in this sort of questions is that “two heads are better than one.” Or stated more broadly, we put our faith in the “wisdom of the crowd,” whether the “crowd” is made up of two or two-thousand individuals.

I have to admit I’ve had some nagging doubts about this all-encompassing wisdom. For instance, wisdom of the crowd has been amply documented in estimation tasks (“how many people in this crowd?  What is your estimate of the completion date of the project?”). The reason this works is that it exploits the benefit of error cancellation; the outlier estimates on either side cancel out each other and we end up with the consensus opinion, that is closest to the truth. But how do you decide when the issue is not quantitative? Think of the virtually unanimous opinion of the White House crowd to go to war in Iraq. Where was the “wisdom” there? More interesting, we could drill deeper and ask why is it that the crowd reached such a wrong decision? Wisdom of the crowd was hailed as a source of near-magical creativity and unparalleled wisdom and forecast accuracy. Some of these attributions have proved to be unfounded. For instance, with respect to creative potential, groups that engage in brainstorming lag hopelessly behind the same number of individuals working alone. The key to benefiting from other minds is to know when to rely on the group and when to walk alone. Wouldn’t it be nice if we had some sort of an algorithm to guide us in making this decision?

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You Seem Distracted: The Effects of Loss

Dov Michaeli

Posted 5/2/12 on The Doctor Weighs In

Incredulous Dov

We all know the feeling; we experience something terribly unpleasant, such as loss in of a friend or a family member, betrayal by a spouse or a close friend, significant loss of money. Are your senses as sharp as normal, or are you distracted, having difficulty analyzing situations and making decisions?

You are not alone. Even animals show what on the surface seems to be poor decision-making. Shock an animal with an electric current and it will tend to cower in a corner, trying to avoid not only a repeat of the shock, but any potentially negative stimulus. This kind of behavior is not maladptive. In fact, it is adaptive. How so? Because in a dangerous environment there is no time for the brain to analyze situations and judge their degree of risk. The animal that reacts defensively and fast will survive. The one that lingers to assess the situation is likely to perish.

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Is Sugar Carcinogenic?

Dov Michaeli

Posted 4/30/12 on The Doctor Weighs In

Last Sunday on his show on CNN, Dr. Sanjay Gupta interviewed pediatrician, Dr. Robert Lustig, who made the assertion that sugar is toxic, and probably carcinogenic. This attention-grabbing statement had earned him a wide following on UTube. But is it true? Let’s examine the evidence.

How is sugar used in the cell?

Every cell in our body needs energy in order to survive and perform its functions. Our biochemistry has evolved over billions of years to extract energy from simple sugars, like glucose and fructose. I mentioned the evolutionary ancient-ness (is this a word?) for a reason. In the beginning (relax, I am not getting into the creation debate) the atmosphere was poor in oxygen. Yet cells had to extract energy from their nutrients. The solution? Extract energy from glucose without the participation of oxygen. This process is called anaerobic glycolysis, and even today, there are anaerobic bacteria that survive solely through glycolysis. This process nets a measly 2 ATP molecules (these are the molecules that store the energy necessary to drive chemical reactions in the cell), and two 3-carbon molecules of pyruvic acid.

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Vitamin E Supplements May be Hazardous to Bone Health

Dov Michaeli

Posted 4/2/12 on The Doctor Weighs In

Incredulous Dov

Vitamin E is a fat-soluble vitamin that has antioxidant properties. It is present in vegetable oils (safflower, sunflower, corn, soybean), nuts (almonds, peanuts, hazelnuts), sunflower seeds, and green leafy vegetables (spinach, broccoli). A balanced diet provides all the vitamin E you need, but most people take supplements of the vitamin, on the assumption that if a little is good, more is better. Is it really so? Let’s examine the evidence.

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Exercise, Diabetes, Cancer and Autophagy: A Fascinating Connection

Dov Michaeli

Posted 3/27/12 on The Doctor Weighs In

I can already see the yawn forming: exercise again? we know it; it’s good for you, it makes you feel better because of endorphins, it makes your cardiovascular function better because it strengthens your cardiac muscle and improves your circulatory system, and it may even protect you from cancer. But have you thought about what could be the common denominator to the beneficial effects of exercise? If you did, and came up with a blank, I don’t blame you. Until recently we didn’t have a good answer, but now the outlines of an answer are forming. So here goes.

The Amazing Journey of the Lowly Aspirin

Dov Michaeli

There are few stories in the annals of medicine that can rival the rise of aspirin from an obscure chemical to the status of something akin to a folk hero (well, at least among medical history buffs). And now it has attained new heights of media fame; every newspaper, news broadcast or blog worth its name has commented on the latest finding of its cancer-protective effect.

Who discovered aspirin?

Like everything else, all paths lead to the ancient Greeks.  Hippocrates, who lived in the 4th century B.C.E described a powder made from the bark and leaves of the willow tree to help heal headaches, pains and fevers. And there it lay for 23 centuries, unexplored and forgotten.

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