HIV and ID Observations

March 7th, 2022

How to Induce Rage in a Doctor

If you’re wondering how to make a doctor angry — really, really angry — read on. Because asking us to justify treatment decisions to insurance companies and their pharmacy benefit managers must rank right up there with the greatest tortures of practicing medicine in this country. Mind you, this isn’t just about my patient, or about […]

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February 22nd, 2022

A Personal Tribute to Dr. Paul Farmer — Who Made Everyone Feel Important

Paul Farmer’s unexpected death this weekend has all of us who knew him reeling. This just should not happen to someone so generous, so important, and so visionary about helping others — especially others who, due to being born in impoverished life circumstances, can’t help themselves. This is not fair at all. We’re heartbroken. The tributes will […]

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February 18th, 2022

A Return of Antiretroviral Rounds — What Regimen Would You Choose?

Years ago, back in the pre- and early internet days, one of the most popular features in the newsletter Journal Watch AIDS Clinical Care was something called Antiretroviral Rounds. We’d present a case, then have two expert discussants weigh in on what they would do. The link above is a case from ancient history — 1998! […]

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December 30th, 2021

Omicron and Reduced Severity of COVID-19 — Some Good News We Desperately Need

We’ve been burned so many times making predictions about COVID-19 that I should post this conspicuously by my computer: The famous pundit meant, of course, that “you don’t know anything” — we know his true intentions since he also said “Nobody goes there anymore. It’s too crowded.” The “know nothing” quotation is a reminder that COVID-19 is […]

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December 20th, 2021

Believe It or Not, We Already Have a Highly Effective Outpatient Antiviral Treatment for COVID-19

And that treatment is … (drum roll) … remdesivir. Yes, you heard me right. Remdesivir, the very same antiviral with a checkered history in COVID-19 clinical trials, with some studies showing efficacy (sort of), others not much of anything. What’s the truth here? For that, let’s turn to what gets my vote for the most unheralded highly favorable […]

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December 15th, 2021

Do We Need to Remind People that COVID-19 Is Truly Awful?

Last month, I read a deeply harrowing description of what it’s like to be hospitalized with severe COVID-19. I strongly urge you to read the full thread: https://twitter.com/CRStoli/status/1458600993621430272?s=20&t=km6XxJ5IDsQGQKsygjXfWg Something about the plain, direct language he uses to describe the patient experience hits home here like few other depictions I’ve read — it rings true in so […]

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November 23rd, 2021

Gratitude for 40 Years of Progress in HIV Care and Research

I was working with one of our outstanding senior ID fellows in clinic last week, and she presented the case she’d just seen, a 54-year-old man with HIV (certain details changed for confidentiality): Will is doing great on [fill in one-pill daily regimen], missing no doses. He’s having some difficulty with sleep (his wife says he […]

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November 12th, 2021

Time to Simplify the COVID-19 Vaccine Policy — Authorize a Booster Dose for Anyone Who Wants One

At this point in the post-vaccine era of the pandemic, we all know people who have had COVID-19 despite being fully vaccinated. Patients, coworkers, family, friends. The reason these breakthroughs are so common is now obvious — our initial vaccine strategies did not provide durable protection against infection. And recognition of this fact prompted the FDA […]

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October 31st, 2021

Interesting and Important Studies from IAS 2021 and IDWeek That Caught My Eye

As noted in my previous post, attending virtual meetings poses some serious challenges. The biggest obstacle:  trying to do one’s regular job while periodically checking in (or more likely not checking in) on the meeting. And while I might have been able to pull off some Really Rapid Reviews© after a few virtual meetings, not so […]

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October 1st, 2021

A Thank You to One of Our Best Patient-Teachers

Harvard Medical School and Brigham and Women’s Hospital lost one of their best teachers this week. No, it wasn’t a distinguished professor or astute clinician. It was one of my long-term patients, who had given himself selflessly to teach dozens of medical students, residents, and (especially) ID fellows over the nearly 30 years I’d known him. Let’s […]

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