March 2021

Bookshelves

• Tweet by David Perell of photos of friends’ bookcases. Some awesome images, and tons of cool ideas on what book to read next.

New Discoveries

• Apparently archeology still has plenty of discoveries to make. Check out this list of the top 10 from last year. I think my two favorite are “Polynesians meet Native Americans around A.D. 1150” and “Discovery of the tomb of Romulus beneath the Roman Forum’s Senate House.” 

Chill Music

• It’s always cool to find a Greatest Hits album by someone you have never even listened to. Edgar Meyer’s hits album is so good, another instrumental, so you can relax, read, work, or operate to it. Great stuff.

Cookies

• Trader Joe’s started carrying some new cookies called Partake. The main flour is buckwheat, which is technically a seed rather than a grain. Claimed to have lower blood sugar spikes, buckwheat also has fiber, protein, manganese, copper, magnesium, iron, and phosphorus. 

Mustafa Kemal Atatürk

• Very interesting 20th century world leader. The Turkish Parliament granted him the surname Atatürk in 1934, which means “Father of the Turks”, in recognition of the role he played in building the modern Turkish Republic.
• From Wikipedia: Atatürk initiated a rigorous program of political, economic, and cultural reforms with the ultimate aim of building a modern, progressive and secular nation-state. He made primary education free and compulsory, opening thousands of new schools all over the country. He also introduced the Latin-based Turkish alphabet, replacing the old Ottoman Turkish alphabet. Turkish women received equal civil and political rights during Atatürk’s presidency. In particular, women were given voting rights in local elections on 3 April 1930 and a few years later, in 1934, full universal suffrage. Thanks Dan for the recommendation. 

Writing

• For any writers out there, check out this brief essay by Paul Graham, American computer scientist, essayist, entrepreneur, venture capitalist, author, and cofounder of the startup accelerator and seed capital firm Y Combinator. This essay is loaded with pearls:

– Make claims “as strong as possible without being false.” Vulnerability: If you stated something as strongly as possible without making it false, all someone has to do is exaggerate slightly what you said and it becomes false. 
– “Precision and correctness are opposing forces.” You can’t ensure every idea you have is good, but can ensure every one you publish is. “With essay writing, publication bias is the way to go.” 
– When reading back through your work, look for sticking points like briars that catch your sleeve, these should be deleted. 
– Essayists have advantage over journalists – no deadline. 
– If you don’t learn anything from writing an essay, don’t publish it. Paradox: Confidence helps you to be humble. If you are an expert and you learn something new on a topic, it is safe to say the reader will also not have known it. 
– Importance + novelty + correctness + strength is the recipe. 
– How many essays are left to write? “Nearly all of them are left to write.” 

Bernard Lown

• Bernard Lown was a very accomplished cardiologist who died on February 16th, 2021. I highly recommend his book Lost Art of Healing. It contains pearls such as if the patient can point to the area of chest pain with one finger, it isn’t ischemia, and every patient who has a heart attack has some major emotional or life stress at the time. 
• Check out this Medscape article by Louisville doctor John Mandrola. Here is an excerpt: 

I have no idea how he got an uncontrolled study published in the New England Journal of Medicine. But in 1981, before disease-modifying drugs like statins were discovered, his group published 5-year follow-up data on more than 200 patients who had profound ischemia on treadmill testing. They reported very low mortality rates, with only 1% of patients receiving coronary artery bypass surgery. They concluded that CAD did not confer a poor prognosis, medical management was successful, and revascularization was rarely needed. I remind you that the recent ISCHEMIA trial enrolled only patients with significant ischemia on stress testing and found that an early invasive strategy did not lead to reductions in death. And before ISCHEMIA, there were COURAGE and BARI-2D. Lown could not have been more correct. I’ve often heard people attribute the lack of benefit from revascularization in stable CAD to the benefits of modern medical therapy. Okay. But how do your account for Lown’s success in 1981? 

My theory: it was the intense caring. Lown believed that to help people with heart disease you had to be intertwined in their life. His book The Lost Art of Healing details anecdotes that would sound foreign to modern clinicians, who spend most of their time looking at a computer during the typical 20-minute encounter. 

At the bedside, Lown would sit down at the same level as the patient, listen attentively, and take the time to explain the true nature of atherosclerosis. He railed against fearful phrases, such as “heart failure,” “widow-maker,” and “time bomb in your chest.” Lown despised the use of fear to gain a patient’s adherence; better to build trust with reasoned explanations. He felt words could both heal and harm. Building trust and removing fear were especially useful in 1981, when the only heart disease–modifying therapies were exercise, diet, and stress reduction. A person with a time bomb in their chest is surely not going to exercise or feel less stress. His approach resonates with me because of its relevance to the electrophysiology clinic. Patients with arrhythmia often come in with intense fear. You can almost feel the relief when you simply explain the nature of the problem. Education cannot be overstated as an intervention.

Quotes

“In your struggle for justice, let your oppressor know that you are not attempting to defeat or humiliate him, or even pay him back for injustices that he has heaped upon you. Let him know that you are merely seeking justice for him as well as yourself.”
– Martin Luther King, Jr.

“The Thinking Brain is objective and factual. The Feeling Brain is subjective and relative. And no matter what we do, we can never translate one form of knowledge into the other. This is the real problem of hope. It’s rare that we don’t understand intellectually how to cut back on carbs, or wake up earlier, or stop smoking. It’s that somewhere inside our Feeling Brain, we have decided that we don’t deserve to do those things, that we are unworthy of doing them. And that’s why we feel so bad about them…Put another way, the problem isn’t that we don’t know how not to get punched in the face. The problem is that, at some point, likely a long time ago, we got punched in face, and instead of punching back, we decided we deserved it.”
– Mark Manson

Martin Huecker, MD, is co-editor in chief of the free, open access Journal of Wellness. He is an Associate Professor and Research Director in the Department of Emergency Medicine (EM) at the University of Louisville. He is a member of Phi Beta Kappa, and the Alpha Omega Alpha medical honor society. Dr. Huecker graduated from UofL’s EM Residency Program and (Chief Resident in 2011). He works full time seeing patients and teaching residents in the UofL Emergency Department. His diverse research interests include substance use, accidental hypothermia, and healthcare professional wellness. Dr. Huecker is also a Certified Lifestyle Medicine Physician (DipABLM). He loves books, (cold) trail runs, dogs, and coffee. His wife is an OB/GYN and they have 4 children with cool names.