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A new Barron’s report describes more than 100 cases of suspected methanol poisoning in and around São Paulo, including at least one confirmed death. From upscale bars to beachfront kiosks, Brazilians are suddenly wary of what’s in their glass. The culprit is methanol, a chemical cousin of ethanol that’s cheap, hard to detect, and dangerously toxic. Here's the science behind the poisoning.

If you ever drank grape Kool-Aid or sucked on a grape Jolly Rancher, you’ve already met methyl anthranilate – the reason your childhood smelled like “purple.” This same molecule moonlights as a bird repellent, a fireworks perfume, and a bathroom surprise. Chemistry doesn’t get weirder, or grapier, than this.

Anuses are like martinis. Some like 'em dry and some don't. And in the bathroom, a similar debate continues. Hardly a day goes by when the bidet vs. toilet paper war fails to rear its ugly head. This is only one more reason why ACSH – flush with newsworthy articles – is the place to go to learn about this and similarly vital issues. Buckle up.

Tattoos
Photographing Art
The Legacy of Neutron Jack Welch

Once we became aware of our mortality, we wanted to know when death was upon us. While we have forsaken predictions by chicken bones or auguries, today we attempt the same predictive magic. That's at least at the population level, using new chicken bones like our co-morbidities or a frailty index. It should be no surprise that we have enlisted our latest oracle: A.I.

Those buildings we call supermarkets are laid out to encourage us to buy. It is not a coincidence that magazines and candy are displayed at the register, nor the fact that the food you really want is in the back, so you have to transverse the whole store to find it. Are our online purchases, without that physical organization, the same? Short answer: no.

What is our most important organ? Every time there was a new lecturer in medical school, they began by pointing out why their organ of interest was the most important. After all:

Evidently, more and more of us are abandoning Dr. Google and seeking medical advice ... from Dr. TikTok. Highly caffeinated drinks will no longer be the go-to lift. That's because we now have adrenal cocktails developed to treat the mythical disease of adrenal fatigue. PT Barnum strikes again.

Doctors use “diagnostic” labels to describe a condition or constellation of symptoms and signs before determining treatment or rendering a prognosis. Diagnostic criteria generally remain static and serve as a collective reference point for the medical world. Not so for the diagnosis of “excited delirium.”  Not only has the meaning of “excited delirium” morphed over time, but the legal community has conscripted it for non-medical purposes, like defending claims of excessive force by police officers. Recently, the medical community rejected this use and “revoked” the diagnosis. Who benefits?

Can being one with nature harm nature?
For Climate Change - Having your meat and eating it too.
“VUCA stands for Volatility, Uncertainty, Complexity and Ambiguity.
Advice from a bad mother

Everyone is using, embedding – or about to use and embed – Artificial Intelligence in their work. I am not so concerned about the imminent arrival of SkyNet; those bits and pieces are already in place. What concerns me more is that A.I., already a misnomer, will increasingly become real stupidity and hurt patients along the way.

We know the beat of our heart varies over time, increasing with exertion and slowing with rest or meditation. But, stable as those variations may appear, they vary even within those intervals. Dr. George Lundberg, former long-time editor of JAMA, muses about those variations – termed heart rate variability – and what they might tell us.

Ten thousand steps for exercise and health, much like ten thousand hours to become an “expert,” are magic quantifications passed down without clear origins. Some researchers sought some scientific clarity.

I remember answering patients’ questions in the office (or on the phone later when the fog of what I had told them had dissipated) and there were other “concerns.” Today, more and more doctor-patient discourse is digital and comes at a cost, both financial and medical.

In this radio conversation, Lars Larson and I discuss his concerns about the testing and approval process for new drugs and medical procedures in the United States.

In this conversation on "CBS Eye on the World," John Batchelor and I discuss the development of a universal vaccine to prevent COVID-19. John has received multiple COVID-19 vaccinations and was curious about the concept of a universal vaccine that would protect against all – even future – variants of the virus.

We know stress can be dangerous, although treatment is not lacking. Pharmaceuticals abound, and more are in development. But reports are emerging that drugs may be addictive, they don’t work well in mild or moderate cases, and it's hard to wean off them. What’s a patient to do?

The perils of Thanksgiving! Hellish traffic, Aunt Gertrude's bunions, and a whole bunch of toxic chemicals. We are all doomed.

Much published science and the "knowledge" resulting from it is likely wrong and sends researchers chasing false leads. Without research integrity, we don’t know what we know, so it is incumbent on the scientific community to find solutions.

The Fourth Turning and Complexity
Can a medication change our brain’s anatomy?
Are colonoscopies helpful?
Can the value of chicken soup be quantified?

The pandemic’s successful expansion of pharmacists’ scope of practice to include vaccinations has given some people the idea that pharmacists can fill other gaps in primary care, like prescribing medications for our greatest comorbidity, high blood pressure, or hypertension. A new, deeply flawed analysis of the economic benefits suggests savings of money and lives.

On November 11th, America honors and celebrates our veterans. November 11th was originally Armistice Day to commemorate the cease-fire of the Great War, World War I, that took place at the eleventh hour of the eleventh day of the eleventh month.
I know many veterans personally. Lots of family and friends served. Most honorably left their military service unharmed. Some left the service with deep wounds and scars. And some did not make it back alive. On Veterans Day, we thank them all for their service.

The uptake of the current COVID vaccine is running at about 7% of the U.S. population. Pfizer is taking a significant write-off. After the pandemic, our trust in vaccinations has reached a nadir. It's a far cry from our behavior concerning smallpox in 1947 when, over eight days, over 4 million New Yorkers were vaccinated. Or compared to 1961, when 90% of the at-risk population got vaccinated against polio.

Last year, Congress passed the Mainstreaming Addiction Treatment (MAT) Act, seeking to expand access to buprenorphine, a proven treatment for opioid use disorder. However, a recent proposal by the Drug Enforcement Administration threatens to undermine Congress' intention. Now, some members of Congress appear ready to push back.

While largely ineffective medications for the treatment of Alzheimer’s Disease have gotten a great deal of press, an “orphan” disease – sickle cell disease – is in a similar situation. It is a devastating disease, and there seems to be a gene treatment on the horizon, one that comes with risks and benefits. How do patients calculate what to do?