Category Medicine

The Hood I Wore At Medical School Graduation

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There’s something undeniably powerful about donning a hood during a graduation ceremony, especially since it marks the culmination of years of hard work in a graduate or professional program. When you walk up to the center stage, hood draped across your shoulders, it’s like a visual representation of the dedication, sacrifices, and intellectual growth you’ve achieved. The hood symbolizes a kind of academic mastery—it’s a historical garment, evoking the traditions of scholars going back centuries. You can almost feel the weight of those who’ve come before you, standing on the shoulders of giants as you approach the moment when the degree is officially conferred.

As you take each step toward the stage, there’s an immense sense of pride. You’ve earned this. The hood feels like a badge of honor, a marker of your journey through intense learning, late nights, and possibly even moments of doubt. But all of that fades in the glow of the moment when your name is called, and you walk forward to receive your diploma. There’s a certain grace in the ceremony, too—the rhythm of the procession, the silence that fills the air, and the way the hood falls perfectly over your attire, a quiet but unmistakable signal that you’ve reached an academic pinnacle.

The most meaningful aspect of donning the hood for me at my medical school graduation ceremony was that I asked my mom to put it on me when I walked onto the stage to receive my diploma. My mother always believed in me, encouraged me, and was beaming with pride on the day that I graduated from medical school. I couldn’t imagine anyone else placing the esteemed hood across my shoulders.

A very special day in 2001 for me…

Another cool aspect is how the hood is often tied to your field of study through its color. Each color has a specific meaning, representing the different types of graduate studies or professional disciplines. For instance:

  • White often symbolizes a degree in Arts, Humanities, or Letters, evoking clarity, light, and knowledge.
  • Purple is typically associated with Law, representing authority and the prestige of the legal profession.
  • Green might be worn by those earning degrees in Medicine or Public Health, symbolizing healing and growth.
  • Red is often linked to Theology or Divinity, reflecting the historical connection to religious institutions.
  • Dark Blue or Navy signifies Philosophy, capturing the intellectual depth and complexity of the field.
  • Yellow or Gold can represent Science, linking the pursuit of knowledge with the brightness of discovery.
  • Silver Gray is a color worn by those in the field of Social Work or Library Science, representing service and support for the community.

The fact that each color is tied to a discipline makes the hood a visual and symbolic tribute to the unique paths that graduates have taken. It’s like wearing your field’s identity proudly for a moment before the real world asks you to put your knowledge to use. There’s an elegance in the subtlety of these colors, the way they convey a deep history while celebrating your own place within it.

The hood isn’t just an accessory—it’s a symbol of a journey and a transition, from student to professional, and from learner to expert. The way it fits, the way it feels on your shoulders, and the way it marks your success is incredibly meaningful. How did you feel about the moment of walking with your hood at your graduation?

What Is Silent Reflux?

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Laryngopharyngeal reflux (LPR), sometimes called “silent reflux,” is a condition in which stomach acid or other contents flow backward into the larynx (voice box) and pharynx (throat). Unlike gastroesophageal reflux disease (GERD), LPR often doesn’t cause the classic symptom of heartburn. Instead, it presents with a variety of upper airway and throat symptoms that can be subtle, confusing, and sometimes frightening.

Common Symptoms of LPR:

  • Chronic throat clearing
    A frequent need to clear the throat due to irritation caused by acid or digestive enzymes.
  • Persistent cough
    Especially at night or after eating, the cough may not respond to traditional treatments.
  • Hoarseness or voice changes
    Vocal cords can become inflamed or irritated, leading to a raspy or weak voice, especially in the morning.
  • Globus sensation
    A feeling of a lump, tightness, or something stuck in the throat, even when nothing is there.
  • Postnasal drip or excess mucus
    The body produces mucus in response to irritation, which can feel like it’s collecting in the back of the throat.
  • Difficulty swallowing (dysphagia)
    Swallowing may feel effortful or uncomfortable, and food may seem slow to move down the throat.
  • Sore throat or burning sensation in the throat
    Especially after eating or while lying down.
  • Ear pain or a sensation of fullness
    Acid can irritate the Eustachian tubes or nearby structures, leading to ear discomfort.

Feeling Like You’re Drowning in Your Own Saliva

One of the more distressing and lesser-known symptoms of LPR is excessive saliva production (also called water brash), along with difficulty swallowing and a sensation of choking. This can feel as though saliva is pooling in the throat, leading to:

  • A sensation of choking on saliva
    Because the throat and swallowing reflexes may be disrupted by inflammation, even normal amounts of saliva can feel overwhelming.
  • Difficulty managing secretions
    Some people feel they can’t swallow quickly or completely enough, leading to a constant awareness of saliva in the mouth or throat.
  • Fear of aspiration
    The fear that the saliva or refluxate could “go down the wrong pipe” and enter the lungs, especially when lying down.
  • Shortness of breath or throat tightness
    These may be reflexive responses from the larynx trying to protect the airway, which can exacerbate the sensation of “drowning.”

Why This Happens

Stomach contents, including acid, pepsin, or bile, are not meant to come in contact with the sensitive tissues of the throat and larynx. Even a small amount of reflux reaching these areas can cause inflammation and nerve hypersensitivity. When this happens:

  • The muscles that control swallowing may become uncoordinated.
  • The throat may feel constricted.
  • The body’s natural response is to produce more mucus and saliva to soothe the tissues, which paradoxically makes the feeling of “drowning” worse.

What to Do

If you suspect you have LPR, especially if you’re experiencing this “drowning” sensation, it’s important to:

  • Consult an ENT or gastroenterologist
    They may perform a laryngoscopy or pH monitoring to confirm LPR.
  • Modify diet and lifestyle
    Avoid acidic, spicy, or fatty foods, eat smaller meals, and don’t lie down after eating. However, I will say that even a clean diet which follows these recommendations might not even make a difference at all. This has been the case for me.
  • Elevate the head of the bed
    This reduces nighttime reflux for some people. However, it won’t make any difference for other sufferers (like me).
  • Use supplements if needed
    These may include alginate-based therapies or other substances which create a physical “raft” to block off the backflow. Some physicians may recommend proton pump inhibitors (PPIs) or H2 blockers or allergy medications, but these medications might not have any effect on the condition.

While it’s not dangerous in most cases, the sensation of drowning in your own saliva due to LPR can feel alarming. The good news is that with proper diagnosis and treatment, symptoms can usually be well-managed and greatly improved.

The Five Keys To Optimal Brain Health (Repost)

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Sharpens-Your-Brain

By: Dr. Stacey Naito – Physician and IFBB Pro

Even if your genetics put you at risk for developing dementia, there are numerous lifestyle and behavior adjustments which you can make in order to protect brain function and fight dementia. The five keys listed below are proven to improve brain health and keep your mind vital and sharp for decades.

1. MOVE YOUR BODY

Scientific research has proven that overall physical health is closely linked to brain health. Regular exercise aids in the maintenance of a healthy weight range, normal cholesterol levels, while also optimizing blood flow throughout the body and the brain and supporting the growth of new brain cells.

The benefits of physical health stem not only from regular exercise, but also from other good health practices. Support your brain’s health by doing the following:

• Exercise at least 30 minutes daily to relieve stress.
• Make sure to get between seven to eight hours of sleep each night.
• Refrain from using tobacco.
• See your doctor regularly.
• Maintain a healthy weight.

2. YOU ARE WHAT YOU EAT

Research studies indicate that diets which are low in saturated fats and cholesterol, and rich in polyunsaturated omega-3 fatty acids and nutrients like lutein and vitamin E, may have a protective effect on brain cells and overall brain health.

Brain-healthy dietary changes:

• Opt for healthy fats which are found in olive oil and fatty fish like salmon. Avoid saturated and trans fats.
• Consume a diet which incorporates milk, eggs, vegetable oils, nuts, whole grains, and dark leafy greens like spinach, all of which are rich in vitamin E. Vitamin E is an important nutrient which supports brain health. If you can’t get vitamin E from foods, you can take it in supplement form.
• Eat plenty of fresh fruits and vegetables, aiming for nine fist-sized servings each day. Select colorful fruits like cranberries, blueberries and tomatoes which are packed with powerful anti-inflammatory compounds known as polyphenols. Keep the skin on fruits and vegetables to maximize their nutritional benefits.
• Add lutein. Lutein is a potent antioxidant which is critical for eye and brain health. Foods which are rich in lutein include spinach, kale, turnip greens, collard greens, egg yolks, corn, and peas. You can also take lutein in supplement form.

3. EXERCISE YOUR BRAIN

Extensive research has proven that the brain continues to learn new skills and information throughout life, and benefits from frequent intellectual stimulation. Make sure to pursue new activities, education and games to challenge your mind. Read books to elevate your knowledge base.

How to stimulate your brain:

• Engage in regular sessions of a mental activity you enjoy, such as reading, word games such as crossword puzzles, or learning a foreign language.
• Get into a daily habit of learning a new word or fact.
• Master a new skill or subject each year.
• Manage stress and balance your energy by meditating. Meditation may help to reduce stress and body inflammation by soothing the vagus nerve, an important nerve which controls the body’s immune response.

4. NURTURE RELATIONSHIPS

Though we know that relationships with family and friends are key factors in a person’s happiness, regular social interaction promotes the formation of new brain cells and aids in brain repair. One study revealed that men and women who had the most social interaction had less than half the rate of memory loss as those who were the least socially involved. By visiting friends and family and being involved in community activities, you will protect brain health.

Social brain boosters:

• Spend time with your family and friends regularly, and make them a priority.
• Volunteer for an organization which surrounds a cause which you are passionate about.
• Work for as long as you can, and for as long as you feel motivated to do so.
• Join clubs and become involved in religious or spiritual activities which resonate with you.

5. BALANCE YOUR NEUROTRANSMITTERS

Brain function relies on important molecules known as neurotransmitters. Neurotransmitter levels affect mood, behavior, cognitive function, social function, digestion, sleep, weight regulation, and many other processes.

The problem with current society is that the vast majority of people have overly stimulated sympathetic nervous systems, which over time can drain the body of serotonin. The excitatory part of the nervous system dominates once the inhibitory neurotransmitters are depleted, resulting in anxiety and an inability to “wind down”. Eventually, even the excitatory neurotransmitters such as serotonin, epinephrine, norepinephrine and GABA are also depleted, and severe depression or chronic fatigue usually develop.

Conventional drugs cannot replenish these neurotransmitters, and in fact, tend to cause depletion of the neurotransmitters. This is the reason why some depression medications do not work on some individuals. The good news is that supplementation with amino acids can help to replenish deficient neurotransmitters.

How To Nourish Neurotransmitters:

• Eat a healthy diet. Neurotransmitter imbalance is aggravated by poor diet. Diets high in protein supply the brain with the amino acids it needs to replenish neurotransmitter levels.
• Consume branched chain amino acids to ensure a rich supply of neurotransmitter precursors.

REFERENCES
Neurotransmitter Assessment Brings Light to Management of Psychiatric Problems
Monday, 15 August 2005 00:59By Erik L. Goldman | Editor in Chief – Vol. 6, No. 3. Fall, 2005

Chronic Pain Sufferers Can Use This Holistic Guide For Active Living

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Article written by Karen Weeks (https://elderwellness.net/)

Photo via Pexels

Living with chronic pain doesn’t mean putting life on hold. Innovative strategies and supportive resources are available that empower individuals to lead fulfilling lives despite persistent discomfort. By tapping into specialized care and community support, people with chronic pain can reclaim their daily activities and joy. In this article, presented by Dr. Stacey Naito, we’ll go over several things you can do to live an active life even with chronic pain.

PT for Movement and Pain Relief

Collaborating with a skilled physical therapist is pivotal in effectively managing chronic pain. These professionals develop tailored exercise regimens that address your specific pain points and mobility issues, whether they stem from joint pain, muscle stiffness, or injuries. Through gentle, targeted exercises, physical therapists work to strengthen your muscles, enhance flexibility, and improve overall mobility. 

Seek Out a Skilled Chiropractor 

Many things can contribute to chronic pain, but car accidents are one of the most common causes. Chiropractic care, especially from a car accident chiropractor, can significantly alleviate pain from back and neck injuries such as whiplash, herniated disks, and other accident-related conditions. These specialists focus on spine and joint alignment to help restore function and relieve tension. Treatment duration varies widely, from just a few sessions to ongoing care, based on the injury’s severity and your recovery progress. 

Pace Yourself 

Mastering the art of pacing is essential for managing chronic pain effectively. It involves balancing activity to avoid overexertion, which can exacerbate pain, and underactivity, which can lead to muscle weakening. By breaking tasks into smaller segments and taking regular breaks, you can conserve energy and avoid pain triggers. Prioritizing essential activities and learning to delegate or refuse less critical tasks also helps manage physical strain and mental stress, supporting a more comfortable and fulfilling lifestyle.

Access Pain Management Workshops 

Attending pain management workshops offered by clinics, hospitals, and organizations can provide comprehensive support and education on managing chronic pain. These workshops cover a variety of pain management strategies, from dietary tips to reduce inflammation to exercise routines and cognitive-behavioral techniques for mental coping. You can also look for telehealth services that will help you manage pain from the comfort of your own home.

Build a Supportive Community

Building connections with others who understand the challenges of living with chronic pain can significantly reduce feelings of isolation. Support groups, whether online or in person, offer a platform to share experiences, tips, and personal milestones, providing both emotional and practical support. These communities can help diminish loneliness and foster a positive, motivated mindset. Engaging with others facing similar struggles can also offer fresh perspectives and encouragement, making the pain management journey less daunting.

Track and Understand Your Pain

Regularly tracking your pain can play a crucial role in managing it effectively. Various apps are available to help monitor pain levels, triggers, and the effectiveness of different treatments, providing valuable data for you and your healthcare provider. This ongoing record helps identify patterns and tailor treatments more accurately, enhancing your ability to make informed decisions about your daily activities. Effective pain tracking also improves communication with your healthcare team, ensuring you receive optimal care tailored to your needs.

Alternative Therapies for Relief

Exploring alternative therapies can complement traditional treatments and offer additional relief from chronic pain. Techniques like acupuncture, which uses fine needles to stimulate specific body points, and massage therapy, which relaxes tight muscles and improves circulation, tap into the body’s natural healing mechanisms. These methods not only help in reducing tension and promoting pain relief but also enhance overall well-being and mobility.

Managing chronic pain effectively requires more than just enduring discomfort—it involves actively seeking solutions and support systems that enhance quality of life. With the right approaches and resources, individuals can navigate their challenges more confidently and with greater ease. This journey is about continuous learning and adaptation, enabling people to not only manage but thrive despite chronic pain. 

What Is Laryngopharyngeal Reflux?

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Laryngopharyngeal reflux (LPR), also known as silent reflux, is a condition where stomach acid and digestive enzymes flow back into the larynx (voice box) and pharynx (throat), causing irritation and discomfort. Unlike gastroesophageal reflux disease (GERD), which primarily affects the esophagus, LPR often doesn’t present with classic heartburn symptoms. Instead, it can manifest with a range of symptoms affecting the throat and voice.

Symptoms

The symptoms of LPR can vary but often include:

  • Chronic cough: A persistent cough that doesn’t seem to go away.
  • Hoarseness or voice changes: Difficulty with voice, or a raspy voice.
  • Sore throat: A feeling of irritation or discomfort in the throat.
  • Lump in the throat: A sensation of something stuck in the throat, often described as “globus sensation.”
  • Post-nasal drip: Mucus dripping down the back of the throat, which can be a result of irritation.
  • Throat clearing: Frequent clearing of the throat to relieve irritation.

Less commonly, LPR can cause symptoms like sore ears, dental erosion, or a dry throat.

I am very familiar with LPR because I have been struggling with the condition since 2021. It is a persistent, annoying, and at times frightening condition which is quite resistant to treatment. I have a lump of mucus in the back of my throat the majority of the time, and this lump grows and starts to drain within a minute after eating most meals. I must frequently clear my throat to rid it of the mucus, and when the condition is particularly severe, my voice becomes raspy. The other thing I experience is very severe coughing which at times is so violent that I end up vomiting. It’s a horrible condition to have.

Diagnosis

Diagnosing LPR can be challenging because its symptoms often overlap with other conditions, such as allergies or infections. The diagnostic process typically involves:

  1. Medical History and Symptom Review: A healthcare provider will take a detailed history of symptoms and may inquire about diet, lifestyle, and other health conditions.
  2. Laryngoscopy: A procedure where a flexible tube with a camera (laryngoscope) is inserted through the nose or mouth to visualize the larynx and pharynx. This can help identify signs of acid damage or inflammation.
  3. 24-Hour pH Monitoring: This involves placing a small probe in the esophagus or throat to measure the amount of acid reflux over a 24-hour period. This can help confirm the diagnosis of LPR by documenting acid exposure.
  4. Esophageal Manometry: Sometimes used to assess how well the esophagus is functioning, though it’s less commonly needed for LPR diagnosis.
  5. Empirical Treatment Trial: In some cases, doctors might start treatment based on symptoms and response to medication as a way to confirm the diagnosis if other tests are inconclusive.

Treatment Options

Treatment for LPR often involves a combination of lifestyle changes, dietary adjustments, and medications:

  1. Lifestyle Modifications:
    • Elevate the Head of the Bed: Sleeping with the head of the bed raised can help reduce nighttime symptoms. *NOTE: I do not personally find this to be helpful at all.
    • Avoid Eating Late: Try not to eat within 2-3 hours of bedtime to reduce nighttime reflux.
    • Maintain a Healthy Weight: Excess weight can increase abdominal pressure and contribute to reflux.
    • Quit Smoking: Smoking can irritate the esophagus and throat, worsening symptoms.
  2. Dietary Changes:
    • Avoid Trigger Foods: Common triggers include acidic foods (like tomatoes and citrus), spicy foods, caffeine, chocolate, and fatty foods.
    • Eat Smaller Meals: Larger meals can increase pressure on the lower esophageal sphincter, leading to reflux.
  3. Medications:
    • Proton Pump Inhibitors (PPIs): These reduce stomach acid production and are often effective in treating LPR. *NOTE: Please be aware that I am not a fan of this treatment method.
    • H2-Receptor Antagonists: These medications also reduce acid production but are typically less potent than PPIs. *NOTE: Please be aware that I am not a fan of this treatment method.
    • Antacids: Can provide short-term relief by neutralizing stomach acid. *NOTE: Please be aware that I am not a fan of this treatment method.
    • Alginate-Based Medications: These form a protective barrier on top of the stomach contents to prevent reflux.
  4. Surgery: In severe cases where lifestyle and medication don’t help, surgical options like fundoplication (a procedure to wrap the top of the stomach around the lower esophagus) might be considered to prevent acid reflux.

Managing LPR often requires a comprehensive approach, including lifestyle and dietary changes combined with appropriate medical treatments. Regular follow-up with a healthcare provider is crucial to monitor the condition and adjust treatment as needed.

Don’t Call Them ‘Private Parts’

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I wanted to share this brilliantly written article by Dr. Rachel S. Rubin, who demystifies the talk surrounding genitalia and sexual health. Hopefully readers will find some encouragement in the language and the wonderful explanations of reproductive physiology and anatomy, and will better understand conditions such as erectile dysfunction. For those of you who would like to check out the original post on Medscape.com, here is the link:

https://www.mdedge.com/familymedicine/article/265321/womens-health/dont-call-them-private-parts?ecd=WNL_FAM_231008_mdedge

By Rachel S. Rubin, MD

Today, I’d like to talk about private parts. You know: the genitals, down there.

I hate all of that. I really wish that we can get to a place where we can talk about genitals and sexual health the same way we do about high blood pressure and diabetes. In fact, when a new patient comes in and they get a new diagnosis of diabetes, you spend time explaining to them how their pancreas works. I don’t remember all the details because I’m a urologist. But you explain the details of diabetes, how it works, why therapy is important, and how it’s very important for quality of life.

I would like us to take that same understanding of anatomy and physiology and use it to explain to patients how their sexual health works because when they understand it, they then have the tools to make it better. I say to patients, “You have to know what parts you have in order to figure out how they drive, right?” We want them to drive better.

Let me give you an example. Many men come to see me with complaints of erectile dysfunction. They refuse to take sildenafil and tadalafil (Viagra and Cialis), saying, “Oh my gosh, those are magic pills. I won’t be a man if take them.” We all know that doesn’t make any sense. I explain to them how their penis works: “Your penis is a muscle. The muscle does two things. It contracts and it relaxes, just like your bicep. It’s just that your penis muscle is smooth muscle, which means it responds to fight or flight. It’s on the autonomic nervous system.”

I explain that if the muscle of the penis is relaxed, it fills with blood and expands. It gets big and hard, and it traps the blood. But when the muscles of the penis are contracted, when they are tight, it squeezes out all the blood, like squeezing out a sponge. So the important thing to do if you want to have good erections is to get the muscles to relax. Relaxed muscle increases erections. I get them to understand that sildenafil and tadalafil are phosphodiesterase 5 inhibitors: smooth-muscle relaxants. Instead of saying, “I need to take Viagra or Cialis because I’m broken,” it’s, “Oh hey honey, I need to take my muscle relaxants because my muscles aren’t working the way that they used to.”

In the future, I’ll go into what happens in erectile dysfunction. We’ll go into what can happen with erectile dysfunction and the many reasons why it happens. It’s getting them to understand that if we get the muscles to relax, you will have better erections. This is how the penis works. It’s why the medicine works. The patients will actually try the therapy and they’ll feel so much better about it. They’ll say, “Oh my gosh, this makes so much sense.” They work on their mental muscles to get the muscles of the penis to relax. Understanding anatomy and physiology helps them understand the treatments, which leads to better outcomes.

How about the female side? If a woman comes to see me reporting that she can’t have an orgasm, part of it is education and understanding the anatomy and physiology. The clitoris and the penis are exactly the same thing. The head of the clitoris and the head of the penis are the same. The clitoris has legs that go all the way down to the butt bone. So everyone is sitting on their genitals right now. The butt bones connect to the bottom of the clitoris or the bottom of the penis. They each have legs called crura. When you get patients to understand where their anatomy is and how it functions, they will then understand how to maximize their quality of life.

The clitoris has smooth muscle just like the penis. When that smooth muscle relaxes, it gorges with blood. When you stimulate it, it can lead to orgasm for most people. But, wait a minute. The clitoris is not inside the vagina. It’s outside. It’s behind the labia majora. If you follow the labia minora up, you get to the head of the clitoris. If patients understand that, they then will understand that penetration is not the way the majority of people orgasm.

I love pictures. I show everyone pictures in my office. They help patients to understand why vibration or outside stimulation on the vulva will allow orgasm to happen. And so instead of patients coming in saying, “I’m broken, I can’t orgasm from penetration,” or, “Dr. Rubin, I’m broken because I can’t get erections,” getting them to understand the anatomy and physiology helps them understand the treatment.

As we go forward, I’ll talk more about anatomy and physiology and how to increase the sexual health of our patients. For now though, please stop calling them private parts. Please use your understanding of anatomy and physiology to educate your patients to have better sexual health and higher quality of life. You may be the only clinician to ever do so, and it will make their life so much better.

Dr. Rubin is an assistant clinical professor, department of urology, at Georgetown University, Washington. She reported conflicts of interest with Sprout, Maternal Medical, Absorption Pharmaceuticals, GlaxoSmithKline, and Endo.

Should Nurse Practitioners Be Called Doctors?

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For this post, I am starting it off by copying and pasting an article by Art Caplan, who is from the Division of Medical Ethics at the NYU Grossman School of Medicine. In this transcript, he discusses a lawsuit which three nurse practitioners filed in California. For those of you who would like to see the original post as well as the video, please click here.

Three NP’s With Doctorates Sue to Use ‘Doctor’ Title”; Ethicist Disagrees

Arthur L. Caplan, PhD

August 08, 2023

Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at the NYU Grossman School of Medicine. A lawsuit has been filed in California by three nurses. The nurses are arguing that because they have PhDs in clinically related fields of nursing and healthcare, they ought to be able to use the term “doctor” as a sign of respect for the work that they did to get a PhD.

That’s no insignificant amount of work. I have a PhD in a different area, but I know the kind of labor that it takes to complete that kind of a degree. I have no doubt that there are many advanced skills associated with having a PhD in one of those nursing areas that benefit patients.

The nurses say that California law, which currently restricts the use of the term “doctor” to MDs or DOs, ought to be expanded to recognize their PhD work. I don’t agree with this even though I certainly have nothing but respect for the work that nurses do, whether they have PhDs or not.

It seems to me that patients really come to hospitals, clinics, and healthcare settings distinguishing, if you will, between doctors (MDs and DOs) and nurses. They may have their ideas about what each of them do, and they may be wrong about what each of them do. I think the road to gaining respect for the work, the contributions, and even the importance of what nurses do is not to start to broaden the use of the term “doctor.”

Part of the reason I worry about that is that it’s a slippery slope. There may be others coming in who want to use that term. Some PhDs in bioethics may start to say, “Well, I’ve done a large amount of work in healthcare-related fields. Maybe I’d like to have that term used for me.” People in some of the more life science–oriented fields may do the same.

I don’t think heading down that road is the way to go. Instead, I would suggest that we try very hard to honor and recognize the work that all healthcare professionals do, including physical therapists, social workers, chaplains, doctors, nurses, lab technicians, and radiation technicians. When I have been in the hospital, I deeply respect all the work that those folks are trying to do to help me.

I don’t use the term “doctor” so much as the only person who’s worthy of respect or the only person who’s in charge. I use it just to distinguish between the set of skills, responsibilities, data collection, recommendation of therapy, and so on that, in my own head, correspond to different roles that people are doing.

Do nurses deserve more respect when they complete the difficult path to a PhD? Absolutely. My argument is simple. Let’s teach everyone who goes to the hospital. Let’s teach our students to respect everybody’s work, to respect the roles and professionalism that everybody tries to bring to the care of patients.

I don’t think having a battle over who really gets to use the word “doctor” is the best path forward because it still may lead to confusion. I think the path forward is learning to respect what all parties contribute in the care of patients.

I’m Art Caplan at the Division of Medical Ethics at NYU’s Grossman School of Medicine. Thanks for watching.

Now for my two cents…

I am in complete agreement with Art Caplan, and see absolutely no reason why these nurses who have PhD’s feel that they have the right to use the title of ‘doctor’ (due to the PhD designation and NOT MD or DO) and potentially confuse their patients. I firmly believe that unless someone who works in healthcare actually obtained an MD or a DO, that the individual has no right to insist on being referred to as ‘doctor’. If the title of ‘doctor’ is so important to someone who is interested in working in healthcare, then I suggest that the person attend and complete medical school and residency training just like I and countless others did. We put in the work, and we earned the doctor title.

Strength Training For The Blood Pressure Win

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Copyright: nomadsoul1

A recent study involving close to 16,000 subjects which was published in the British Journal of Sports Medicine determined that strength training exercises like planks and squats were more effective than other forms of exercise in reducing blood pressure. This flies in the face of previous recommendations by cardiologists, which focused on cardiovascular aerobic exercise. To be fair to the study, the reductions in blood pressure from strength training exercises, were minor, averaging 8.24 mm Hg for systolic blood pressure readings, and 4 mm Hg for diastolic readings, but the reductions were indeed greater than aerobic exercise such as running, which reduced pressures by 4.49 mm Hg and 2.53 mm Hg on average. However, the study did point out that various forms of exercise were proven to be beneficial with respect to lowing blood pressure.

There’s No Such Thing As Blue Eyes

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Portrait of a beautiful little girl with blue eyes. Close-up.

© pixander, 123RF Free Images

Please check out this interesting article which was posted on the American Academy of Ophthalmology website, explaining the science behind eye color. I have copied and pasted it here so that you can easily read it.

By Dan T. Gudgel

Reviewed By Ivan R Schwab, MD, FACS

Jun. 16, 2023

Brown and hazel eyes get their color from melanin, the same pigment that colors your skin. The more melanin in the eye, the darker your eye color will appear. But blue eyes don’t have any blue pigment in them. Blue eyes get their color the same way water and the sky get their blue color. They scatter light so that more blue light reflects back out.

How do eyes get their color?

Eye color depends on the iris, the colored part of the eye. It’s a structure that contains muscle and other kinds of cells. You can see the iris in action when it squeezes or relaxes to let in more or less light through the pupil. The iris is made up of two layers. For almost everyone — even people with blue eyes — the back layer (called the pigment epithelium) has brown pigment in it.The front layer of the iris (called the stroma) can make eyes appear brown, hazel, blue or green. 

  • People with blue eyes have no pigment at all in this front layer, causing the fibers to scatter and absorb some of the longer wavelengths of light that come in. More blue light gets back out and the eyes appear to be blue.
  • For people with green or hazel eyes, one or both of the layers of the iris contains light brown pigment. The light brown pigment interacts with the blue light and the eye can look green or speckled.
  • Many people have variations in the color of their irises, often with one color near the pupil and another at the edge. This variation happens when different parts of the iris have different amounts of pigment in them.

Is there a way to predict a baby’s eye color?

The genetics of eye color are very complicated. You can’t predict a child’s eye color just from looking at the parents’ eyes. Even parents who have the same color eyes as each other could have a child with different colored irises.

Babies often do not have much pigment in their irises when they are born. This is why their eyes can look very blue. More pigment accumulates in the iris over the first few months of a child’s life and blue eyes can become less blue or even turn completely brown. For most children, eye color stops changing after the first year, but for some kids the color can continue to change for several more years.

Genetic research has shown that blue eyes probably only appeared in the last 6,000 to 10,000 years. Before then, everyone had brown eyes. Blue eyes have probably spread through the population just because some people like how they look and chose to have children with blue-eyed people.

Why do some eyes change colors in different lighting?

People with hazel or green eyes might notice that their eye color changes depending on surrounding light. Green and hazel eyes are a mixture of pigment color and color from scattered light, so they can look different in different lighting conditions.

Since blue eyes get their color from the light that’s coming in and being reflected back out, they also can appear as different colors depending on the lighting conditions. 

What is the rarest eye color?

The Academy surveyed more than 2,000 Americans to determine what color eyes they have. Below are the results of that 2014 Harris Poll survey, weighted to reflect the United States population at that time:

  • 45% have brown eyes
  • 27% have blue eyes
  • 18% have hazel eyes
  • 9% have green eyes
  • 1% have eyes a color not listed above