Making knowledge (with sidenote on healthy living)

I think one of the coolest, more interesting parts of medicine is that new knowledge is being created every day. Objective, evidence-based science has created amazing therapies and helped so many lives. I've also started to realize how much of what we know about medicine and therapies is so subjective. I think this will be one of the unexpected philosophical benefits of being a physician -engaging with the subjectivity of knowledge and clinical decision-making and evidence-based medicine. I will be continually confronted with the job of evaluating whether a study design was sufficient to say that the outcomes is true, what could have been designed better, and what limitations there are to our evidence-base.

I bring up this point because of a lecture I attended today by Donald Abrams, MD, an oncologist who works for the UCSF Integrative Medicine OSHER Institute. He quoted someone who said that "the degree of evidence should be directly proportional to the potential of harm". My response to that is -who gets to decide what the potential of harm actually is? When we're talking about soy, Vitamin D3, omega-3s and cancer treatment -I think we need actually rigorous studies, not just 6 month studies of 25 women to understand how these things interact with treatments before we say "yah go ahead and take vitamin D3 supplements during chemotherapy, can't hurt".

My last point (for if you want to enjoy your time now, later, and be a 95 year old sprite, sharp great grandma)...Everything in moderation. (Even McDonalds, ice cream, and BBQ ribs) If you're going to change anything about your lifestyle here are 2 fundamental rules of thumb:

1. BE LEAN. Perferably by making the outdoors a part of your life! Run, bike, walk, ski, swim, rollerblade, hike, kayak! You'll be trimmer and enjoy life more, I guarantee it!

2. EAT PLANTS. Unless you're a SF health nut, you and I both know neither of us are eating 5 servings of vegetables a day. Eat way more vegetables than you currently do. This will take years to get used to if its not typical for you, I know because I've been trying to do it for over a year! It's tough! It's a learned taste! But give it a shot!