the Natural Condition

The Swiss Federal Commission for HIV/AIDS recently released a public statement, indicating that there is no plausible threat of sexual transmission of HIV for HIV+ persons undergoing antiretroviral therapy. Of course, there are several caveats to this rather consequential statement. For example, the person must receive active physician-supervised antiretroviral therapy, and must demonstrate low levels of virus in the blood consistent with an effective therapy for at least six months (viral load less than 40 copies/ml). Most importantly, the individual must not have an STI (sexually transmitted infection), which would exclude patients with AIDS from this zero-risk group.

This is a promising piece of news that may allow HIV+ people to lead more normal lives. However, do recall that the good news only benefits patients who have access to the expensive antiretroviral regimens. In poor countries, only 1 in 4 people has such access.¹

References: (1)

A startling map of obesity in America, and how is has increased exponentially in the last 20 years:

CNN’s Map of Obesity in America

Epidemiologists set the bar for obesity at a BMI of 30. BMI stands for “body mass index,” and it is a measure of divergence from optimal weight. To calculate a BMI value, you divide an individual’s weight (kg) by the square of their height (m²).⁽¹⁾ To put a BMI of 30 into perspective, a 5′5″ female would weigh 180lbs, and a 5′10″ male would weigh 209lbs. I gave the average heights for adult men and women in the US, but, in fact, the BMI calculation is independent of sex, body frame, musculature, etc. It is, therefore, a rather crude metric for estimating obesity rates, as the only determining factors are height and weight. I.e., you could be super jacked, but have a BMI that technically places you in the overweight range.⁽²⁾ However, as the ratio of jacked:fat in America is approximately 0.0001, BMI is probably a reasonable indicator of America’s waistline, when averaged over a population.

Well enough about BMI. The bottom line is that America is getting extraordinarily fat, and the obesity epidemic is spreading Read the rest of this entry »

I was at an interview for medical school a few weeks ago, and was asked the question:

What do you think is the greatest problem facing healthcare today?

In the following paragraphs I outline the gist of my response, and some embellishments on the topic.

While I was in college, I can remember attending a lecture by the former United States Surgeon General Dr. C. Everett Koop. While Dr. Koop is best known for his monumental work in enhancing public awareness about the dangers of cigarette smoking (indeed, he is the one responsible for the warning labels prominently displayed on all packs of smokes), he actually spent most of his career pioneering the field of pediatric surgery at the Children’s Hospital of Philadelphia. He is a most distinguished graduate of Dartmouth College (class of 1937), and, more interestingly for the non-Dartmouth readers, he was interviewed on the Ali-G show, so clearly he merits profound respect.

At the time of this lecture, Dr. Koop was almost 90 years old. I was expecting to hear a speech from a elderly man whose wisdom would be sadly muffled by his frailty. It turned out that he still spoke with a loud and penetrating voice Read the rest of this entry »