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

Introduction

The Centers for Medicare & Medicaid Services (CMS) announced last month that it will begin recovering payments from all Medicare providers and suppliers who requested and received COVID-19 Accelerated and Advanced Payments (CAAPs) from CMS during the COVID Public Health Emergency (PHE). Those repayments could have begun as early as March 30, 2021, depending upon the one-year anniversary of when the provider received the first CAAP installment payment.

Background

CAAPs is not a new concept. The existing Accelerated and Advanced Payments Program, sometimes referred to as only AAPP to distinguish it from the CAAP-COVID program has existed for quite some time.Read more

2020 was a long year, and the pandemic is not over yet. On the bright side, we can learn a lot from what has happened. Even early on in this experience, sleep researchers were busy evaluating the effects on our sleep with new studies, or altering ongoing studies to see the effect that this disruption of our daily routine has had on our sleep. The annual Sleep Medicine conference that is held in June was postponed to August to allow time to adjust to the virtual platform. Even by then, there was a wealth of information starting to emerge.

Rebecca Robillard, PhD, reviewed her survey of 5,525 Canadian participants aged 16-95, who reported sleep difficulties that increased from 36% before the outbreak to 51% after the outbreak, although approximately 6% of people reported sleeping better.… Read more

“Oh, the Noise! Oh, the Noise! Noise! Noise! Noise!”
– Dr. Seuss, “How the Grinch Stole Christmas,” 1957

“Before the Industrial Revolution, the principle sources of noise were thunder, church bells, and cannon fire.”

New York Times, Jan. 1, 2021

We are surrounded by noise. Noise can rob us of sleep; it can hinder our ability to concentrate; it also can affect our hearing. I first became aware of noise-induced hearing loss when I was in the Air Force. One day, one of the enlisted men who was assigned to the base carpentry shop came to see me because of hearing loss.… Read more

My father, a salesman, liked to tell this joke to his customers: 

At the inauguration of a U.S. president, a man in the audience turns to the man next to him and starts a conversation: 

“You see the man up there?”

“Yes, that’s the next president.”

“Well, he is my son!”

“You must be very proud”

“Well course, I am, his brother is A DOCTOR!”

My mother took a more somber view of my accomplishment. She was born in Vienna in the 1930s, and her hope for a career in medicine ended as a consequence of World War II. Instead, she passed on her passion for medicine to myself who became a psychiatrist and my brother who entered neurology.Read more

Sometimes in the pediatric ophthalmology clinic, things just don’t go my way. While we all love our patients, some of them can be a little (OK, a lot) more draining than others: the uncooperative 6-year-old who could read the smallest line of the eye chart in 10 seconds last time, but decides to stubbornly dig in his heels and make me beg for every Snellen letter over 15 agonizingly slow and oppositionally defiant minutes. Next door is the 4-year-old with supposed low tone who suddenly has more strength (and appendages) than John Cena when I try to put eyedrops in. Should it really take four of us to put eyedrops in this kiddo?Read more

As I write this, one quarter of U.S. adults have been fully vaccinated, while half have had at least one dose. If the vaccines offer us significant protection against the assorted variants in world circulation, there is hope that we may entertain a gradual return to pre-pandemic life once the vast majority of the population has been fully vaccinated. Here in the United States, debates about re-opening businesses and schools still rage, but a pervasive sense of “giving up” also is in the air.

“We’re tired of being under restrictions, and some people are vaccinated, and other people don’t care, so let’s just reopen,” is the rallying cry.Read more

February 14, years ago, my wife and I made an early exit from a Heinz Hall Pops Concert. We wanted to beat the crowd to the parking garage elevators. I was wearing only a sport coat and tie with my stethoscope still in my pocket as I had made a late exit from the office and deferred dinner. 

We succeeded and stepped into one of the elevators as it left with only the two of us. As the door opened on a top floor, my wife saw a man from the adjacent elevator collapse in the exit area. I stepped out and saw he was not moving.… Read more

Clinical and public health guidance related to COVID-19 has evolved over the last year. The Allegheny County Health Department provides the following frequently asked questions (FAQs) for physicians on common clinical and public health COVID-19 scenarios.

What is the difference between isolation and quarantine?

Isolation separates people with an infection (e.g., COVID-19) from people who have not been diagnosed with the infection, while quarantine separates and restricts the movement of people who were exposed to COVID-19 but are not yet experiencing signs or symptoms of the infection.

What is a close contact?

For COVID-19, a close contact is anyone who was within 6 feet of an infected person for a total of 15 minutes or more.Read more