HIV and ID Observations

November 25th, 2019

Vaccine Defenders, U=U Holds Up, Zika Is Gone, and Other ID Things to Be Grateful For, 2019 Edition

An excellent episode of the Freakonomics podcast introduced me to the headwinds vs tailwinds asymmetry, and how we humans perceive life. It goes like this: We go for a walk, a run, or a bike ride, and the wind faces us dead-on, making the exercise a struggle. (In windy Boston, the wind is always in my face. Always […]

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November 18th, 2019

The Best Guide to HIV Drug Names — Yours for Free!

Earlier this month, I noted something that all of us ID/HIV specialists should readily concede — namely, that learning the names of the HIV drugs is fiendishly difficult. Afterwards, I heard from a few old-timers (that is, people like me). They acknowledged that we were lucky to experience the roll-out of these medications (and their convoluted […]

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November 3rd, 2019

Learning the Names of HIV Drugs Is Horribly Difficult — Here’s Why

Happens every time. We start teaching about HIV, and at first, everything is going great. Epidemiology, pathogenesis, diagnosis, clinical presentation. The students are right there with us. However, then we start covering treatment — and things immediately get tricky. Because no matter how engaged and brilliant they are, and no matter how scintillating we are, when the long […]

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October 27th, 2019

The Enduring Appeal of Live, Face-to-Face, Real-Time Continuing Medical Education

Around 15 years ago, after high-speed internet became a de facto part of work life and was rapidly becoming more widely available at home, I attended a meeting with other medical educators to decide what to do about our various post-graduate courses. The wisdom in the room was that most continuing medical education (CME) would soon […]

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September 15th, 2019

A Former Medical School Dean Invents a False Dichotomy in Curriculum Content, and Advises Physicians to Stay in Their Lane

Over on the editorial pages of the Wall Street Journal, a piece appeared last week with the following provocative title and subtitle: Take Two Aspirin and Call Me by My Pronouns At ‘woke’ medical schools, curricula are increasingly focused on social justice rather than treating illness. Dr. Stanley Goldfarb, former associate dean of curriculum at the […]

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August 25th, 2019

Save the Dates! International Scientific Conferences You Can’t Miss

On this beautiful summer Sunday, I’m sorting through a series of invitations to international scientific meetings. So many options. See, they really want me. And how do I know that my participation will be so important? Just look how personalized the greetings are — clearly intended for me and me alone. I’ve included actual screen shots of the […]

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August 18th, 2019

Choosing the Top Research Papers in HIV Medicine — and Recalling the Joy of Working with a Great ID Fellow

Way back in 2008 — the year I started writing here — I drafted an exceedingly long post listing the top published papers in HIV medicine. Oh how I tortured myself over that thing. How to define “Top”? Most cited? Most clinically important? Most rigorously scientific? Best written? After a while, I just abandoned the monstrosity. It still […]

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July 14th, 2019

The House of God Profiled Physician Burnout Long Before We Called It That — Should Aspiring Doctors Still Read It?

Many consider the novel The House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — […]

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July 7th, 2019

In Praise of Experienced ID Fellows — and a Dozen On-Service ID Learning Units

A few weeks ago, I cautioned ID fellows about underestimating their hospital’s interns and residents. My message — you were like them not so long ago; they didn’t suddenly all lose their brainpower when you graduated. This ungenerous opinion of house staff may be especially held by experienced fellows, as the accumulating workload of the year […]

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June 23rd, 2019

Advice to Incoming Subspecialty Fellows — Don’t Underestimate or Belittle Your Interns and Residents

Around a million years ago, early during the first year of my ID fellowship, a medical intern consulted me about an elderly patient with a urinary tract infection. Me:  Does she have a catheter? Intern: I don’t know. Me: Has she been admitted before with a UTI? Any cultures? Intern:  I think so — wait, I’m […]

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