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New Medical Memoir: Training in the Urban Trenches of Bellevue Hospital

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There is a Santa Claus

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Annals of Int Med: The Death of a Clinician-Educator

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There is a Santa Claus

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Miguel de Cervantes, Author of Don Quixote

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Acute Wiiitis Reported in NEJM

Clinical Cases Exercise Literature Rheumatology

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Human psychology: Why do we have equivalents of bogeyman in so many countries around the world?

Bogeyman (also spelled bogieman, boogeyman, or boogie man) is a common allusion to a mythical creature in many cultures used by adults to frighten children into good behavior. This monster has no specific appearance, and conceptions about it can vary drastically from household to household within the same community. Parents may tell their children that if they misbehave, the bogeyman will get them. Bogeymen may target a specific mischief—for instance, a bogeyman that punishes children who suck their thumbs—or general misbehavior, depending on what purpose needs serving. Source: Wikipedia. Examples - by country - listed in alphabetical order: Afghanistan – Bala or Newanay Mama, which means "The Monster or Crazy person", is used to scare children when they don't want to sleep or when they don't want to take their medicine. Albania – There are two similar creatures that are used to frighten children. In the South (Vlore area), there is Katallani, that means "t...

Dermatologists are at their best at 10 years of experience - and AI is getting closer in competency

A recent study in JAMA Dermatology provides a realistic view of AI versus human performance in diagnosing skin cancer. Key finding: AI surpassed dermatologists with <3 years of experience, matched those with 3–10 years, but remained inferior to experts with >10 years of experience. The Study Researchers tested modern AI models (including foundation models) against 652 physicians on 1,117 realistic dermatology cases with clinical and dermoscopic images. Top AI accuracy: 72% Humans by experience: <3 years: ~68% 3–10 years: ~72% 10 years: 74.2% (highest overall) Why Experience Still Wins Seasoned dermatologists integrate subtle clinical context, patient history, and rare presentations that current AI struggles with. AI excels as a supportive tool - especially helpful for novices, triage, education, and areas with limited specialist access - but does not yet replace expert judgment. Takeaways Patients: Prioritize experienced specialists for concerning skin lesions. AI may improve ...

The evolutionary advantage of having hair

Apparently, when our ancestors moved from the trees to the ground in the African savanna, they needed to shed their body hair so they can get cool and they needed to develop hair on their head to keep their brain cool. Hair also plays a critical importance in sharing to the other members of the species our age and physical condition. https://www.wsj.com/science/biology/human-hair-evolution-brain-sun-protection-9f109694?st=HQ5gjr&reflink=article_copyURL_share

The two current heavyweight world boxing champions both have PhDs, believe or not

Believe or not, but the two current heavyweight world boxing champions both have PhDs... The two researchers are the Ukrainian heavyweight boxers and brothers Wladimir and Vitali Klitschko. Wladimir Klitschko, called "Dr. Steel Hammer"(born 25 March 1976, Semipalatinsk, Kazakhstan), currently holds the IBF, WBO, IBO and Ring Magazine world heavyweight titles. His older brother, Vitali Klitschko, is the current WBC world heavyweight champion. In the summer of 1996, Klitschko finished Pereyaslav-Khmelnitsky Pedagogical Institute (Ukraine) and was accepted in the postgraduate study program of Kiev University. On 18 January 2001 in a conference hall of Kiev University of physical science and sports, Klitschko presented his doctoral dissertation and was awarded a Ph.D. in Sports Science. Klitschko speaks four languages: Ukrainian, Russian, German and English. Image source: Wikipedia , GNU Free Documentation License. Vitali Klitschko, called "Dr. Ironfist", (born 19 July ...

How Seasonal Allergies May Trigger Anxiety and Depression - A Possible Link

A new study by our team was published in The Journal of Allergy and Clinical Immunology and revealed a striking seasonal connection between allergies and mental health. We analyzed Google search trends in the U.S. from 2020 to 2025 and found that peaks in searches for “allergies” (especially allergic rhinitis) consistently lined up with increased searches for “depression” and “anxiety.” These mental health search spikes occurred during the classic allergy seasons — spring (March–May) and fall (September–November) — often rising at the same time or within a few weeks after allergy symptoms surged. There are at least two likely mechanisms: - Sleep disruption caused by nasal congestion, sneezing, and itchy eyes - Systemic inflammation from allergy-related cytokines that can affect brain function and mood Even in 2020, when the COVID-19 pandemic added extra stress, the allergy-anxiety pattern was clearly visible. Bottom line for patients and doctors: Allergies aren’t just annoying — they...

Your Face Might Know More About Your Health Than You Think: Mass General FAHR-Face AI Pattern Recognition Model

A new study published this week in Lancet Digital Health is getting a lot of attention for a simple, slightly unsettling claim: a single photograph of your face could help predict biological age and, in cancer patients, risk of dying. I went back to the original paper, not just the headlines, because the details matter. A very old idea This is not a new observation. Around 400 B.C., in the Book of Prognostics, Hippocrates described what he called the face of impending death — what we now call facies Hippocratica: "a sharp nose, hollow eyes, collapsed temples; the ears cold, contracted, and their lobes turned out; the skin about the forehead being rough, distended, and parched; the color of the whole face being green, black, livid, or leaden." For 2,400 years, doctors have been taught to look at the face to judge if someone is failing. What is new is trying to make that look quantitative, consistent, and scalable with AI. What they actually built The team at Mass General Brigh...

About Us

British Medical Journal Editorials, How Web 2.0 is changing medicine, Dean Giustini BMJ 2006;333:1283-1284 (23 December) "One of the best blogs in medicine is Ves Dimov's Clinical Cases and Images - Blog. It contains a rich collection of "presurfed" material for busy clinicians and features interactivity and timely discussion. Dimov is also a supporter of medical librarian bloggers. Why waste time fumbling with search engines when you can consult this blog for timely updates? As well as case discussions, Ves provides links to today's medical headlines from Reuters and clinical images via a dynamic, free photo sharing tool called Flickr. One of his slide presentations "Web 2.0 in medicine" is available on Slideshare (itself a fantastic new 2.0 tool). Clinical Cases and Images is a virtual laboratory for doctors and medical librarians interested in Web 2.0." The blog web site was founded by: Ves Dimov, M.D. Dr. Dimov is an Allergist/Immuno...

How to give a talk/present a lecture - by MIT/Patrick Winston

Some goods points in the video below. Quality = f (K P t) -- explained at beginning: Patrick Winston's How to Speak talk has been an MIT tradition for over 40 years. Offered every January, the talk is intended to improve your speaking ability in critical situations by teaching you a few heuristic rules. 00:16 - Introduction 03:11 - Rules of Engagement 04:15 - How to Start 05:38 - Four Sample Heuristics 10:17 - The Tools: Time and Place 13:24 - The Tools: Boards, Props, and Slides 36:30 - Informing: Promise, Inspiration, How To Think 41:30 - Persuading: Oral Exams, Job Talks, Getting Famous 53:06 - How to Stop: Final Slide, Final Words 56:35 - Final Words: Joke, Thank You, Examples

1 in 4 cases of severe depression may be a body-clock problem

A new study from the University of Sydney's Brain and Mind Centre is getting a lot of attention this week. The paper: Tonini et al. Clinical and genetic correlates of a circadian subtype of depression in the Australian Genetics of Depression Study. British Journal of Psychiatry, Oct 21 2026. DOI: 10.1192/bjp.2026.10798 What they did: Analyzed 11,380 adults with severe, recurrent depression from the Australian Genetics of Depression Study. How they defined it: Need 3 of 6 features — seasonality, being a definite night owl, delayed sleep midpoint, 2+ hours social jet lag between work/free days, sleeping much more when depressed, and severe morning tiredness. Result: 2,604 people, 23%, fit this "circadian depression" profile. Why it matters: Earlier onset, more episodes, more suicidality, more hypomanic and psychotic-like features Worse response to SSRIs (OR 0.88) and SNRIs (OR 0.89) and more side effects Distinct genetics : higher polygenic risk for ADHD, depression, anxiet...

AI Discrepancy: Patients Ask AI for Diagnosis. Doctors Use It for Treatment.

JAMA analyzed 271 million real clinical queries from 952,008 US clinicians on OpenEvidence (Jan 2024 - June 2026). 51.9% of queries were for clinical decision-making, particularly treatment and management (33.1%), while diagnosis was only 13.9%. Who's actually using it? Career stage is the biggest driver: <10 years from med school: 24.3% of workforce, 61.8% of queries — ratio 2.54 Residents/fellows: 14.8% of workforce, 27.2% of queries — ratio 1.84 20+ years out: 53% of workforce, only 16.5% of queries — ratio 0.31 An "inversion of expertise" — trainees are more fluent than attendings. 90% monthly retention by 2026. This is habit, not experimentation. Specialty: Highest: Oncology/Hematology (2.00), Internal Medicine (1.88), Family Medicine (1.80) Lowest: Ophthalmology (0.23), Radiology (0.24), Orthopedics (0.24), Anesthesiology (0.37) Fast-moving, cognitive fields lead. Procedural fields lag. Intensity: NPs and PAs: 44.5 queries per active user-month vs Physicians...

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