Over the five years that I have been writing Perspectives and/or Editorials for the Bulletin, I often have been asked by physician friends from where I get my ideas for my columns. My long medical career, that spans nearly 60 years (including medical school), has allowed me to see the many aspects of our profession. In some columns, I shared events in which I participated (gorilla barium enema1); in others, I indulged my urge to comment on things that I thought needed to be changed. And on occasion, another Editorial or Perspective will stimulate me to express my opinion(s) on the subject (Mentoring2).

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I graduated high school in 1962 and spent my youth in mid-century America in the 1950s. I went to the Catholic grammar school in a neighborhood on the southside of Chicago, a middle-class neighborhood that saw generations of the same families raising their families, something akin to a small town in the larger city of Chicago.    

The historical event that had the most significant influence on my education and choice of career was not the election of our Camelot President Kennedy, nor the advent of rock ‘n’ roll. Rather, it was the launching of Sputnik by the Soviet Union. This unthinkable accomplishment by a hostile foreign power shook the pastor of our church to his core.

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Since the dawn of time, once humans acquired the gift of speech, they have felt the need to name everything and everyone in their immediate world. While doing research for an Osher course I am teaching on ancient historians, I learned that the Romans used three names for most people. The first was the praenomen (first name), the second was the gens (family name), and the third was the cognomen (common name) by which the individual was called. The cognomen was based on either some physical characteristic or on some momentous deed, such as a military victory. Thus, the famous Julius Caesar’s full name was Gaius (praenomen) Julius (of the Julian family) Caesar (“fine head of hair”).… Read more

As we enter a new era of the COVID-19 pandemic, the benefits of a vaccine booster at this time remain uncertain. The mRNA vaccines (Pfizer and Moderna) usually result in creating high antibody titers for at least six months in immunocompetent hosts. After that, it appears that the antibody titer may start to wane. However, it remains unclear if these titers directly correlate with protection, since other aspects of the immune system also are stimulated by these vaccines. In those who have underlying immunosuppression, including transplant recipients and cancer patients undergoing chemotherapy, the antibody response is often less robust. Because of their relatively poor antibody response, the FDA recently approved an additional booster vaccine dose for individuals with solid organ transplants or equivalent immunosuppressed status. … Read more

The federal No Surprises Act (the Act), which was signed into law Dec. 27, 2020, as part of the Consolidated Appropriations Act of 2021, ensured that all Americans had protection from surprise medical billing/balance billing when using out-of-network providers or facilities under certain circumstances. On July 1, 2021, the Biden administration released a series of regulations to implement the Act, which includes rules from the U.S. Departments of Health and Human Services, Treasury, Labor and the Office of Personnel Management (the Rules). The Rules are categorized as an “interim final rule with comment period,” meaning that they are mostly final, but some adjustments may be made based on comments submitted by stakeholders.… Read more

“The dress code is at least business casual. Make sure that your earrings aren’t too big, and your makeup is not too loud.” These were the instructions I received from a young production assistant during a mandatory audio-visual check. I was presenting as an expert at a virtual national medical conference – and I was taken aback by these details. I politely thanked the representative, and proceeded back to my day of patient encounters and virtual meetings.

Patients and colleagues comment to me frequently on my clothing; to my great relief, it is mostly complimentary. I take careful note of the fact that people not only notice my sartorial choices, but feel the need or desire to comment on them as well.… Read more

As we emerge from the worst pandemic in a century, businesses and employers are struggling with issues involving the rapidly developed vaccines that have begun to sharply curb the spread of COVID-19. These vaccines, offered by Moderna, Pfizer and Johnson & Johnson, have been granted emergency use authorizations (EUAs) from the Food and Drug Administration and full unrestricted approval is anticipated in the coming months. As of June 4, 2021, 54.7% of Pennsylvanians age 18 older have been fully vaccinated, and the AMA reports that 96% of practicing doctors in the United States are vaccinated. 

Still, there are many who have not received the vaccine for a variety of reasons – legitimate medical contraindications; religious objections; unavailability of vaccines in disadvantaged communities; or fear spread through misinformation.… Read more

When I was a child, my summers were spent in a magical land by the sea in the care of my grandmother and uncle. At that time, the city was known as Bombay, and we lived in a flat in a seaside suburb of Old Bombay. The sun beat down hard on the stone and concrete buildings from the early hours of the morning, and it was far too hot to venture out during most of the day. During the monsoon, the rains poured down relentlessly for days on end, pausing briefly now and then for a day or so of oppressively humid but sunny respite before the faucet reopened.… Read more

Last summer, in the throes of pandemic angst, I asked my good friend (an endocrinologist who radiates calm, love and compassion) how she was keeping her sanity and balance. Her answer astonished me because it was unexpected – I always pictured her as more of a town mouse rather than a country mouse, like myself.

“We’ve been hiking!” Every weekend, she and her family had been exploring the great outdoors as long as the weather cooperated. She excitedly told me of exploring Ohiopyle and various state parks with her family and bubblemates, and of the profound peace and joy it had brought her. … Read more


In a moment of cynical excess a few months ago, I speculated that Shakespeare and Dr. Seuss would be the next victims of the cancellation/bowdlerizing culture.

Then, like millions of parents and grandparents worldwide, I was shocked and disappointed when Dr. Seuss Enterprises announced that it would cease publication of six of his picture books because of depictions it now deems “hurtful and wrong.”

Geisel was not a physician, but added “doctor” to his middle name as his pen name and was a prominent figure on the Dartmouth campus as an undergraduate. (Full disclosure: my de facto godfather was his classmate, and I am a graduate of Dartmouth College and of its medical school.)… Read more