A Country Doctor Reads: March 30, 2019

A No-Pain Gene Mutation – NYT

Last week I wrote about whether pain is a sensation or an emotion. This week, there was a story across multiple platforms about Jo Cameron, a 71 year old woman who has felt almost no pain in her lifetime, including from burns, arthritis and several surgeries. She also scored zero on standardized anxiety questionnaires and doesn’t recall ever feeling depressed. Her two gene mutations responsible for this have been mapped now and may open doors to new approaches to treating chronic pain. And, of course, this discovery supports the notion that physical and emotional pain are, really, all the same.



Is it a Crime to Underestimate How Long a Patient Will Live? – WSJ

The Wall Street Journal has an interesting piece about a court battle involving a hospice and home health agency whose patients seemed to live longer than the certifying doctors predicted. Was it fraud, and should the doctors get penalized? In a funny twist, the prosecution’s expert witness physician contradicted himself in some cases he happened to review twice: One time he agreed the patient qualified for hospice because they had six months or less to live, yet another time he thought they would live much longer. The article concludes:

“The antidote is not to pretend that subjective decisions in a hospital room become objective facts in a courtroom. 

Some medical judgments can be false. But the government is trying to create a standard that is far too broad. Professional disagreement should not be illegal.”



FREE: Important Articles – JAMA

So many journals, even single articles (including some of my links, I would think) are expensive to access. JAMA has one free section, called JAMA Network Open Access.

For example, the current issue has an article on how opioid prescribing has changed in each state over the past several years.


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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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