Welcome to Billy's Blog

How does one start a blog, anyway? (Other than begin by writing on January 1?)

I suppose I should just jump in feet-first. "Billy Rubin's Blog" is going to be my attempt to offer thoughts on medicine, commerce and politics and how they all work, or fail to work, together. If that sounds a bit too vague, here are some particulars that interest me and I think are worthy of comment:

1. Have you noticed all the TV commercials for drugs? And that these commercials frequently have, not humans, but inanimate objects prancing around extolling the virtues of their elixirs--cheerful water balloons, satisfied water pipes, dancing livers & spleens, emboldened lung cells watching clots of mucus scurrying for cover? I am interested not only in the abundance of pop advertisement of pharmaceuticals, but in how so many of these advertisements look the same.

2. Why do so many people fear dying from avian influenza, when they are orders of magnitude more likely to die from good old-fashioned routine human influenza? About two years ago when there were a few dozen cases of avian flu, I was asked constantly at parties & other gatherings whether people should stock Tamiflu in case there was an outbreak of avian flu in the US. I wondered why they weren't talking about stocking up supplies for nuclear war, for all the good it would have done.

3. Similarly, why do so many people fear dying from MRSA (methicillin-resistant staphylococcus aureus) when they're much more likely to die of a heart attack--and they can usually decrease their risk of dying from heart attack but often do not do so? I work in infectious disease, and MRSA is genuinely scary. That said, your average person--let's call him "Joe, The Plumber," shall we?--is pretty much going to die of a heart attack or cancer; every other cause is a footnote. Yet MRSA grabs the headlines and scares the be-jeepers out of people, including friends of mine whom I would otherwise consider to be well-informed and thoughtful. I got an e-mail from a friend once who asked me about her kids risk of MRSA after the kid scraped her knee after falling from her bike. I replied that she was more likely to die in an auto accident on a routine trip to the supermarket than she was of developing a serious staph infection. But nobody ever bothers to think about the fact that putting one's kid in a car (or putting oneself in a car, for that matter) is putting them in mortal danger. True, it's not that dangerous, but we all recognize that a fatal car crash is a risk, right? Yet MRSA is what keeps people up at night.

4. Will global warming lead to the spread of tropical diseases? This is more than just a sci-fi consideration: scientists are talking about it in professional meetings. In my own field of arboviral hemorrhagic fevers, one of the gurus has come out publicly against this kind of rhetoric. As far as I can tell, it's not because he doesn't believe that global warming theoretically could induce such a spread of disease, but I'll have to flesh that out further in a separate entry.

These are the kind of subjects that interest me, and I'd like to think that I bring some sort of expertise to the subject: I work as an infectious disease doc, doing research on mosquito-borne viruses like dengue. I also work at a local hospital as a part-part time internist and sometime ID consultant, so I see medicine from both the big University Hospital and Local Community Hospital perspectives. I love both, and wouldn't trade either right now for anything. Hopefully my employers will be down with that.

I don't promise to keep this blog strictly focused on medicine. Lots of things interest me, things ranging from the NBA to jazz to English 14th century history to beer brewing (and consumption!) to other scientific topics. So you (and indeed I hope there is a "you") will forgive me in advance for the occasional departure in topic. But I do promise to keep the focus on the one subject where I have a mild amount of authority, and hopefully something interesting to say.

As to the title, suffice it to say that my name is not Billy Rubin. Call it a little medical humor. I figure that some of my writing will include some pointed critiques of our medical system, but I will endeavor not to be too bilious.

--br