November 23rd, 2023

Giving Thanks — This Time to You, Readers of This Thing

Louie with his favorite dessert plates

Most years around this time I post some ID-related things to be grateful for — a research advance, a nice shift in epidemiology showing fewer people are sick and more are living longer, a new drug approval we’ve been eagerly awaiting. That kind of thing.

Last year, for example, it was gratitude that mpox had come under control (fingers crossed). That dolutegravir and bictegravir were holding up just fine. That Covid-19 finally seemed to be trending toward true endemicity (second pair of fingers crossed). And a quick comment about a certain social media site that remained a “wonderful and entertaining place to learn”, chaos at the top notwithstanding (yeesh, still holding out hope).

This year, I’m doing something different.

I’m going to thank you, whoever’s out there reading this thing, for sticking with it all these years. I’m truly grateful for your emails, your comments, your feedback, our chats at professional meetings, but most especially, for your eyes just reading this. Face it, if no one were reading these posts, I highly doubt the fine people at NEJM Journal Watch would continue supporting it. So thank you so much, and keep reading!

(Actually, if no one were reading it, I’d probably be writing something somewhere anyway — that’s how I’m wired — but you know what I mean.)

At this year’s IDWeek, at the Medical Education Community of Practice meeting, I met Dr. Priya Kodiyanplakkal, an ID doctor from New York. In the pre-meeting chat, she gave me the greatest compliment I could imagine about this blog, one she later kindly posted in this convention center lobby photo:

What she said is exactly what I’m trying to do — to convey what it’s like practicing clinical ID, the “everyday realities of being an ID physician” for all of us out there doing it.

And while I can’t know exactly who the readers are, I know from the numbers that it’s not just ID docs — it’s a much larger group of healthcare providers, people who find ID interesting, or enjoy my takes on broader issues of clinical practice (e.g., rants against fax machines, ABIM recertification, CME requirements), or just want to see the latest photo of Louie.

(My wife Carolyn purchased those dessert plates from a store which had them on sale in a remainder bin. Can you believe it?)

But whoever you are, I do know that we’ve built a remarkably nice, smart, and civil community. At one of our editor’s excellent suggestions, we have a moderated comments section, meaning we review the comments before posting. With few exceptions most of them are thoughtful and not at all nasty — it’s uncommon that we have to ding one for breaking the site’s rules. A rarity for internet communication!

Speaking of the editors, thank you also to the three of them, who take turns reviewing each post before it appears, scanning for typos, unclear prose, and unauthorized material. They’ll probably not be happy with me that this one went up without their approval, but this is a national holiday, after all — don’t want to bother them. Plus, I can guarantee that I hold all the rights to that photo at the top.

So after starting writing here in 2008, and 877 posts later, I’m still at it — thanks to all of you readers.

Hey — you can still buy these plates on eBay, in case you’re wondering. Happy Thanksgiving, everyone!

16 Responses to “Giving Thanks — This Time to You, Readers of This Thing”

  1. Meg Noyes DNP, RN says:

    Thankful to Dr James Maguire at the Brigham for identifying staph capre, a goat virus, rarely seen, infecting my hip replacement of 8 yrs. He postulated that it may be one of the multitude a staph that only recently identified. ID Docs rule!

  2. Nelun de silva says:

    I am one of your faceless and nameless readers who looks forward to your weekly ID Observations which can be read and enjoyed without a subscription. Most NEJM articles now require subscriptions which is somewhat difficult for a retired clinical microbiologist in the developing part of the globe. I am thrilled to read your observations which are pertinent, and explicit but laced with humour which makes them so readable . Hope to see many many more of your ID observations in the future. All the best for 2024.

  3. Gurudutt Nayak says:

    Thank you Dr Sax for writing these posts for 15 years! I am not an ID Doc but NEJM is one of those journals one cannot ignore as a healthcare professional. Through Journal Watch I got introduced to your blog and it gives me a break from all the ‘core science’ & dive into something ‘hatke’ (different in Hindi :)). Please keep writing!

  4. Shishir Gokhale says:

    I joined this wonderful group quite late. I am enjoying and learning a lot from each post and comment.

    But I think I have missed a lot of what was posted before I joined few years ago. I would be very happy if we could have access to all the old posts compiled at one place. It is not possible to read all posts at one go, infact we would rather visit and revisit some posts and savor and learn from those observations.

    Have a wonderful year ahead.

  5. Stephen Bickel, MD says:

    Dr. Sax, Thanks so much for eloquently sharing your insights and human experiences in clinical medicine with us week after week–you are an inspiration and role example to us all–plus you make learning fun!

  6. Heather Wray says:

    While ID is about as far from my specialty as you can get while still working in clinical medicine (anesthesiology), I really enjoy your columns, even if most of the drug names make my brain hurt.

    I think it’s at least partly because of all the diseases there are, the one thing we can all be quite sure we will get multiple times during our lifetime is an infection. It’s great to know that there are people out there like you who are doing there best to keep them at bay (I have visions of ID doctors like Roman gladiators, with net and trident).

    Love Louie’s plate – but, beautiful dog though he is, I’m not sure I’d like to see him staring up at me as I finish my slice of pumpkin pie!


    Thanks Paul for your wisdom insights and especially your humor all in the context of
    My favorite medical blog…Hope you can sustain this for at least a few more years!

  8. Ira Dunkel says:

    I am another non-infectious disease physician (pediatric neuro-oncology) who is a long-term and appreciative reader.

  9. Dr. Susan Lasch says:

    I have enjoyed your columns for many years, too. I am an Ob/Gyn. Keep writing! Thanks for introducing me to Olive and Mabel during the dark days of Covid.

  10. Loretta S says:

    I’m one of those non-ID people who have been reading this blog for over a decade. And I’m still excited to see an email announcing a new post! That’s a tribute to Paul’s great writing, sense of humor, and ability to engage people outside the ID field. (Although yes, the drug names make my brain hurt sometimes, too!) The photos of Louie are an added bonus. 🙂 My nursing students have all heard of Dr. Paul Sax, too, because sometimes something Paul said comes up in one of my lectures. At which time I remind them that ID docs take the BEST histories!

    Thank you for this blog, Paul.

  11. Deborah Foley says:

    Dr. Sax, I’ve been thankful for your insights since discovering your blog via Journal Watch from its inception. Then I was medical director of employee health for 4000 employees at a community hospital and ID presented the most challenging problems I addressed. You were my especially valued consultant and colleague. Now I am retired but your insights kept me sane through Covid. You may not appreciate how many colleagues far from Boston and not exclusively ID docs, look to you for expertise. Thank you! Deborah (Chicago)

  12. HUGO FIGUEROA says:

    Thanks Dr. Sax for your wisdom and humor for 15 years. I´m a General Physician and still missing “Physician First Watch”. Thank you! Hugo (Chiloé Island)

  13. Rogerio Luz Coelho Neto says:

    Another hail from Brazil, I am a Family Physician and have extensively used your comments in residency training for more than 10 years now … Loved your “Favorite antibiotics” at (other site, here is de doi so I am academically correct so much I printed it and it is one of the handouts I give out at the very first week of the residency.

    My favorite stuff learned from Sax:
    – Dolutegravir was approved and became mainstream
    – Sulfametoxazol/Trimetoprim is an awesome antibiotic
    – Azithromycin is a no-no in almost everything important except STI’s

    Hope to learn a lot more in the years to come.

    Happy hollidays and a jolly new year

  14. Alice Cole says:

    Thank you so much for your work. Your thoughtful columns mean a great deal to me. I am a certified nurse-midwife, but I worked for years in a county health department treating STIs. The realities of being dedicated practitioner transcend titles and areas of expertise. ID docs deal with pregnant people and all practitioners deal with infection in their patients. Lines intersect and roles mesh, all of the time. You are an inspiration to me, and I send many of your columns to my daughter who is a PA and my son who is a PT student…and I have an undergraduate degree in English Literature, and I love your writing!

  15. Anne S says:

    I began reading your blog when I was writing the antimicrobial chapter of Australian Medicines Handbook. I found it most helpful and I’ve continued to read it since I retired as it’s so interesting and informative.
    I hope to continue reading my antimicrobial fix for years to come.

  16. Howard says:

    Dear Dr. Sax,

    To state the obvious, just wanted to say thank you for being you. Being trained in the dark ages (quite likely before approximately half of your DNA was in your mom and certainly before your DNA could have existed in your father) as an engineer, physician, pathologist, (AP/CP, Ob/Gyn Path); sometimes one forgets that medicine alleges to be based in science yet remains an art.

    You are a gifted artist, not only are you able to dissect, practice, and succinctly highlight the ongoing evolution of our understanding of infectious diseases– you are able to communicate eloquently so that a simple-minded person, like me has a better appreciation of our tools and limitations in the care of those impacted by infectious diseases.

    The past couple of years have been a great opportunity for infectious disease experts to shine and you are a great light!



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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

Learn more about HIV and ID Observations.