CDC Report Finds ADHD Diagnosis, Treatment in Children and Adolescents Continue
to Rise

It's just a matter of degree. Shouldn't the government simply put Prozac and amphetamines into the water supplies? Historically, one of the selling points of Coke was the coke in the mix.

The latest very large study says it's not really possible: Fat and healthy is a myth, new study says.

Medical risks associated with being overweight include breast cancer and several other cancers, cardiovascular disease, arthritis (esp. knee), diabetes (obviously) along with other insulin-resistance-related metabolic syndromes and carbohydrate-craving, non-alcoholic liver disease, pancreatitis, stroke, hypertension, gall bladder disease, sleep apnea, and many more fun problems.

Yes, Obamacare's insurance standards cover quackery: Obamacare and the New Age quacks

In a short piece discussing shyness vs. Social Anxiety Disorder, Dr. Kristy Dalrymple has this to say (my bolds):

A “disorder” is a socially constructed label that describes a set of symptoms occurring together and its associated behaviors, not a real entity with etiological homogeneity.  Labeling emotional problems “disordered” assumes that happiness is the natural homeostatic state, and distressing emotional states are abnormal and need to be changed.  A diagnostic label can help improve communication and understand maladaptive behaviors; if that label is reified, however, it can lead to assumptions that the etiology, course, and treatment response are known. Proponents of the diagnostic psychiatric nomenclature have acknowledged the dangers of over-pathologizing normal experiences of living (such as fear) by way of diagnostic labeling.

That's what I've been saying for years, but she says it better.

Ethical Questions Science Can’t Answer

I am not sure what science has to do with ethics, or what they mean by science. Everything is called "science" now - political science, social science, etc.

Also interesting:  Male And Female Brains Have Different Gene Expression

Sex 'Addiction' Isn't Just a Guy Thing

Well, for starters there is no such thing; just people with varying degrees of self-respect, dignity, and self-control. Humans are apes, after all.

Via Instapundit, an Antioch student who does whoredom on the side

A sex object, and proud of it

Girl-on-girl catfights

It's not exactly news.

In my view, of course not. Science cannot even answer science questions but can only offer up their best theories du jour. Just ask Feynman. That's what he always said. Science is a method of pursuit, rarely gives us permanent facts.

About Sam Harris’ Claim That Science Can Answer Moral Questions

It depends. As Freud knew, memory is distorted by our choice of defensive narrative of the moment. One of the many fascinating things about Psychoanalysis is to see how memories change over time.

How Many of Your Memories Are Fake?

In Psychiatry, rightly or wrongly, we are able to work in the world of psychic reality rather than courtroom facts 99.9% of the time.

It has become a big business: Addiction Treatment With a Dark Side - In Demand in Clinics and on the Street, ‘Bupe’ Can Be a Savior or a Menace

It's an opiate agonist/antagonist. Apparently it's a mild high. I know a doc who prescribes it. He is all about $.

My bias tends to be in favor of sobriety and standing up and facing life and oneself directly, but those things are difficult for everybody. In the UK, however, certified addicts can pick up their heroin etc at the docs' office on the way to work. The NHS figures it's cheaper than rehab. Of course, the NHS also considers death cheaper than cancer treatments.

This article explains nothing: Why Teenagers Are So Impulsive, but it's a good example of the nonsense that is coming from brain imaging.

The article spins the imaging data to be about crime. It's not about crime, it's just about the young male brain as compared to the female. It's not a bug, it's a feature. Young male humans are designed to defend the tribe, to kill food, and to be willing to die doing those things, but no brain scan can explain that.  Vive la difference.

His first death, third year of medical school

I recall my first deaths in medical school, in the ER. Two ambulances, family of four after a parking lot accident. The cool efficiency of the ER senior resident doing five-second triage: the 7 year -old - "Dead."  The ten year-old - "Dead."  The Mom - "Dead." The dad, blue but not grey like the others - "Breathing. Get him in a room and let's work on him. Tube here now, chest tube, EKG, crash cart, IV. Get a surgeon down here. Let's go, team."

In just a couple of minutes the unconscious Dad was intubated, had an emergency chest tube, IV, monitor, etc., survived.

People ask me, as a Physician, whether or how I would reform healthcare. (What they mean, it turns out, is not to reform medical care but to change how medical insurance works. Nobody really wants medical care in the US to change because it is the best and most caring in the world, by far, thanks to our free choices, national prosperity, brains, and freedom in general.)

It's become clear to me that people are divided into two basic camps on medical insurance: those who want to insure cheaply against major expense and those who want what amounts to pre-paid medical care. In any event, it is stunning to me that 85% of Americans were content with their medical care situation pre-Obamacare so I'm not sure that represented any crisis requiring massive Federal intervention and control.

As someone whose bias is against government getting involved further in our lives, if I were King here's what I would do about medical insurance - free it up:

1. I'd permit medical insurors to create national markets for insurance, like MLS does with real estate. They would be happy to do so were they free to do that.

2. I'd make medical insurance portable across state lines, and detach it from employment. If any employer wants to chip in, or if a union contract requires a business to chip in, fine. They could offer vouchers as a benefit, if they want to.

3. I'd demand that insurors insure everybody who wants to buy some, creating high-risk pools just as they do for auto insurance if needed.

4. I would permit the freedom to sell any kind or style of medical insurance people might want with whatever sort of coverage they want to buy. Or not to buy, if they want. It's a free country, and people are free to be foolish or to trust in the benevolence of others.

5. Regarding Medicare and Medicaid, I would fold them together somehow as means-tested charities for the poor, run by states or municipalities.

(As an off-topic aside, let me tell you the problems with many government-paid Medicaid patients and charity patients: they miss appointments, they are not appreciative and treat you like a servant, they will not make morning appointments, they resist advice, their fees do not pay the rent so docs have to limit their numbers - and they are prone to lawsuits against you. I know about this, because I do around 10-15% charity work in my office as my form of tithing, volunteer one day/week in a charity clinic, and teach for free 1/2 day/week. Just another greedy doc. )

Addendum: A reader asks about tort reform. Good question. God knows how much of medical expenses are CYA by docs and hospitals. The reality is that medical care is an art, and that any medical decision can be challenged or questioned if somebody wants to sue their doc.

What would you do if you ran the world?

In the Western world, the things that Public Health was invented to address are basically complete. From The disease of ‘public health’ - We are in the midst of an epidemic of lifestyle moralism:

Since the 1970s, however, the World Health Organisation has defined health as ‘a state of complete physical, mental and social well-being’ and demands ‘Health for All’.

Good grief. I suppose that will ensure steady work for the public health people forever.

In a related piece, The Radical Case for Bloomberg's 'Nanny' State

Not especially, unless you are calorie-deprived in the Third World. Definitely not "good for you" if you're on a diet, and fruit juices and dried fruits are the worst:

"Eat more fruits and vegetables.”

If I had a dime for every time I heard that recommendation, I’d be a rich man today.

The 1 Boring Old Man mentioned the book Big Data.

A review of the book comments:

Academic Mayer-Schönberger and editor Cukier consider big data the new ability to crunch vast collections of information, analyze it instantly, and draw conclusions from it. Big data is about predictions: math applied to large quantities of data in order to infer probabilities. Because big data allows us to analyze far more data, we will move beyond expecting exactness and can no longer be fixated on causation. The authors state, The correlations may not tell us precisely why something is happening, but they alert us that it is happening.

Data is not knowledge.

Just for starters, eggs are good for you. More at that link.

It's wonderful that Americans have the luxury of getting neurotic about what to buy at the supermarket and about what to eat. As I do, they advocate low-to-no-carb diets for weight control. It's Physiology 101.

An author at Slate thinks Americans should consider imitating the Dutch approach - or non-approach - to marriage. Of course, our lower classes already have, but I don't know how you run a complicated and nurturing family life that way, to imbue a family heritage and family values.

I mean, who hands out the candy while hubbie is taking the kids out trick or treating?

The Dutch Don’t Care About Marriage -Americans can learn a lot from their indifference:

As a popular view, this laissez-faire approach accommodates the vicissitudes of the heart, the changing nature of love, the great variety of forms attachments take in real life. It acknowledges that things change, and to exit a relationship with kids is less violent somehow, less publicly absolute, than to exit a marriage. A bit of tolerance, of bemusement, of compassion or imagination is built into the system.

Very bemusing indeed. The "vicissitudes of the heart"? Are we in high school?  Why grow up, if you don't have to? The government will raise your kids, Julia.

So some Dutch women just want to "follow their hearts." I'll assume that means plenty of romance and sex with lots of guys, like monkeys. But are Dutch men real men?  Is life a serious enterprise, or just a lark before your well-deserved and government-paid euthanasia?

For difficult patients who need more than outpatient treatment or short-stay stabilization. Over the years, I have found Gould Farm to be very helpful to patients: Gould Farm.

Good, highly-dedicated people work there.

The government offers me a $40,000 check to go on electronic medical records. I won't do it. Who would open up to me if I did?

For the same reason, I keep minimal notes anyway and just enough to refresh my memory. From  The
Electronic-Medical-Records Wreck -Doctors have their own Obamacare nightmare to deal with:

 As I’ve mentioned previously, my own primary-care physician in Colorado Springs quit her regular practice and converted to “concierge care” because of the EMR imposition. Dr. Henry Smith, a Pennsylvania pulmonary doctor, also walked away. “Faced with the implementation costs and skyrocketing overhead in general,” he told me, “I finally threw in the towel and closed my practice.” He said, “As EMRs proliferate, and increased Medicare scrutiny looms, medical documentation is evolving from its original goal of recording what actually was going on with a patient, and what the provider was actually thinking, to sterile boilerplate documents designed to justify the highest billing codes.”

Many docs today are spending more time on computer screens than they are with patients.

If $300,000 buys you a statistical chance of living a few more days with a terminal cancer, would you take it? Would you take it even if Medicare paid for it - which it probably would?

Cancer chemotherapy is a big business: The Cancer Drug Racket:

What is sobering about this booming business is that, as a group of oncologists wrote earlier this year, "most anti-cancer drugs provide minor survival benefits, if at all." They often (but not always) reduce the size of inoperable tumors, but they rarely eradicate the disease. For relatively uncommon malignancies like testicular cancer, some forms of leukemia, and lymphoma, drugs effectively cure the disease; for the common "solid tumor" cancers (lung, breast, colon, prostate, and so on), which account for the vast majority of annual cases, drugs buy some time-precious time, to be sure, but time usually measured in weeks and months rather than years. And even though many of the newer drugs are less toxic, they often still have to be given with older drugs whose side effects include nausea, hair loss, fatigue, and decreasing blood counts. One anti-cancer drug produces a skin rash so severe and disturbing, according to Saltz, that some patients have been asked by employers not to come to work.

I have referred to the DSM as an obsessional disorder. This author approaches it as a dystopian novel, and I do agree with some of his sentiments.

He says, about this "novel," that "A mad person is like a faulty machine."  What he doesn't quite mention is that, in the DSM, essentially everybody has at least one DSM disorder. That satisfies insurance companies, which is the main point in the end.

When government gets involved in things, those things become politicized. Same thing goes for medical care. The death panels are meant to be a buffer against popular clamorings, but they won't work.

When it comes to medical care, nutrition, vitamins, exercise, etc, the loudest quacks and cranks tend to prevail:  The Quackish Cult of Alternative Medicine - Dr. Paul Offit's battle against charlatanism

Is there quackery in non-alternative medicine? Sure, but it is mostly unintentional quackery. Docs tend to cling to the most recent information they have read, but most of it proves, in time, to be in error:  Trouble at the lab - Scientists like to think of science as self-correcting. To an alarming degree, it is no.

Best to go with a conservative physician who has a good dose of skepticism and common sense.

We posted about Tarte Tatin last week, and there is no need to post more about Apple Pie because everybody makes it the way their Mom did. Here are more favorite apple desserts, all quick and easy to make (except for the Apple Tart), and all as American as Sarah Palin (except for the Apple Tart):

Apple Brown Betty (a classic American colonial dessert - a "betty" is a pudding)

Apple Cobbler (I think it's better with a few cranberries added)

Apple Crisp (a Dr. Bliss standard, with ice cream)

Apple Dumpling

Baked Apples

Apple Tart

Apple Pan Dowdy

I also like to make Apple Pancakes for breakfast. I just throw thin slices into the batter. A good pancake combo is some apple and a handful of cranberries. (Every fall I throw a dozen or so bags of cranberries in the freezer. They seem to last 10 months easily without any deterioration.)

Our Editor tells me his family refers to all of these apple desserts generically as "Upside-down Apple Town Dowdy Betty Bow Wow," and reminds our readers that, in Yankeeland, Apple Pie is traditionally for breakfast, not for dessert.

The change in medical care. I refuse to term it "health care," since health needs no care other than one's own reasonably-sensible and attentive but not health-obsessed life, combined with the main factor - luck. From a commenter at Allahpundit:

Perhaps the concept of ‘insurance’ isn’t the right one for health care?

I always liked the comparison that was trying to be made with car insurance…

Yet for there to be an equivalent your car insurance would have to cover:
- maintenance tune-ups, including oil and filter changes
- the cost of repairs for any reason
- a price break per gallon of gas
- an annual detailing
- the cost of tires
- a new muffler annually
- and never, ever raising the cost of your insurance no matter how many accidents you were in, how many tickets you got… anything

Imagine what car insurance would be like if we modeled that on health insurance coverage and you get an idea why health insurance coverage is so high. And why get fuel efficient vehicles if you are getting the gas subsidized? Or bother with the maintenance if you’ll get a brand new engine if you forgot about it? And the cost of such insurance would be… lower than what you have now?

The number of shades of maroon that went into trying to make this entire ‘insurance’ concept work for one’s health is plain nuts. It isn’t ‘insurance’ if you are going to use it constantly… you want something else.

Perhaps a clue.

Health insurance used to be an executive ‘perk’ because it was TOO EXPENSIVE to provide for everyone in the workforce. Businesses got a price break for it to entice people who would not normally come to work to do so during WWII. The war ended. The subsidy via the tax code did not. Strangely enough before this misbegotten idea got infested into the tax code and people’s minds, individuals did not drop over dead in the street and did work out payment schedules WITH hospitals and physicians. Amazingly that worked and there was a strong system of charitable hospitals and care givers to pick up the slack. Then government got involved and screwed it up.

Government is all about money. Government's expertise is perverse incentives. The Obama-thing, like the previous Hillary-thing, is not technically insurance. It's just pre-paid medical costs, spread across populations and subsidized, or not, by income and with bureaucrats deciding what you can get paid on it.

That's not an entirely insane idea, except that whenever government gets involved with things outside their Constitutional mandate, things turn out wrong and over-controlling by the standards of a free country. Always.

I do not believe that most Americans want every detail of their lives politicized. I think they want to be left alone, but maybe I am old-fashioned.

Child Behaviour: Not In Their Genes?