Hacking the QTc

The QT interval—a measure of the duration of the overlapping action potentials from two billion ventricular muscle cells—has fascinated physiologists since the dawn of electocardiography.  Too long or too short, it can be a harbinger of ventricular arrhythmias and sudden death. Sensitive to electrolytes, drugs, and autonomic tone, susceptible to congenital ionic channel mutations, difficult to… Continue reading Hacking the QTc

Cutting Down on Coffee

This morning as I write this, there is on my desk a steaming hot cup of fake coffee. The ingredients are roasted barley, roasted malt barley, roasted chicory, and roasted rye. This is the sort of stuff people drank as a coffee substitute during wartime rationing. It smells odd. It is hot and black and… Continue reading Cutting Down on Coffee

The Death of Dr. Shock

The call came from one of my attendings at night during my cardiology fellowship. It had a touch of the black humor that medical persons don’t like to admit bubbles up to the surface from time to time. “You know Dr. Shock, the guy on TV? He’s being transferred. He’s having a big infarct and… Continue reading The Death of Dr. Shock

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Categorized as Medicine, TV

George Mines and the Impermanence of Knowledge

It was a chilly Fall morning in Montreal. A Saturday, the campus of McGill University was quiet. Students, not much different in 1914 from those of today, were sleeping off their Friday night activities. A cleaning woman entered the Physiology Laboratory to dust the glassware and wash the floors. As she turned a corner she… Continue reading George Mines and the Impermanence of Knowledge

The Smartphone is an Essential Medical Instrument

The storage capacity of the human mind is amazing. One estimate of the size of the brain’s “RAM” is as high as  2.5 petabytes (a million gigabytes). The number is based on the total number of neurons in the brain and the total number of possible connections per neuron. I suspect it is an overestimate,… Continue reading The Smartphone is an Essential Medical Instrument

Do No Harm

Cardiac neuroses are often iatrogenic in origin. A well-meaning but careless comment by a physician can change a person’s sense of well-being in an instant. The effect can be permanent and devastating. Many clinicians who complain about overly anxious patients don’t appreciate their own role in the genesis of this problem. Our words matter. They… Continue reading Do No Harm

Massive Heart Attacks

Carrie Fisher’s sad, premature death is an occasion to reflect upon the poor job the news media does in reporting medical news. The initial report from TMZ had the headline “Carrie Fisher Massive Heart Attack on Plane.” If one equates “heart attack” to the more precise medical term “myocardial infarction,” as is usually done, then this… Continue reading Massive Heart Attacks