There are many shades of gray between opinion, theory, and fact, which can make it near impossible for healthcare consumers to navigate their choices. The principles of evidence-based medicine were designed to address this huge unmet need. It is the crowning achievement of a 300-year scientific pursuit that has resulted in dramatic increases in human life expectancy; responsible for lowering maternal and fetal mortality as well as a more than 30% decline in annual cancer mortality over the past 25 years. Celebrated for decades, it is now under assault with distrust, cynicism, and conspiratorial accusations by a shadow network of influencers that use pseudoscience and outright lies to enrich themselves while they prey upon the ill, the desperate, and the gullible. We begin our podcast examining ivermectin.

Horror movies are all the rage, so let’s get scared and grossed out on the podcast as we discuss the horror of parasitic infections. Parasites are organisms living in or on another organism to obtain nutrients, grow, and multiply, often in a state that directly or indirectly harms the host; and they are considered infectious diseases. Man-on-the-street polls often guess bacteria and viruses as parasites, yet neither are. Viruses aren’t even considered organisms because they lack cells and can’t independently reproduce. Three kingdoms produce human parasites: animal (like the tapeworm); fungi (like tinea that causes athletes’ foot and jock itch); and protozoa (like the plasmodium transmitted through the bite of the anopheles mosquito causing malaria). Prepare for a cringe-worthy discussion on parasites.

In my 16 years of hosting a two-hour, call-in radio talk show, I’ve learned that as much as I enjoy my conversations with guests who share their unique medical backgrounds, information, and insights with the audience, I enjoy my conversations with the callers even more. Sometimes the conversations with a caller that meander without specific destination or purpose are the most compelling. One such conversation is the topic of today’s podcast.

Mother’s Day traces its roots back to ancient spring festivals honoring maternal goddesses of Greek mythology. The clearest modern precedent is the early Christian festival known as Mothering Sunday. Anna Jarvis campaigned tirelessly for a national holiday to honor mothers, culminating in President Woodrow Wilson signing a bill in 1914 designating the second Sunday in May as Mother’s Day. Interestingly, after the holiday was established, Anna Jarvis grew deeply disappointed by its extreme commercialization and spent the latter half of her life actively campaigning to rescind the holiday from the calendar. Dr. L. Joy Baker, an obstetrician, joined Dr. Feinberg in conversation this past Mother’s Day to discuss motherhood.

Managing a long-term illness is an ongoing process of adaptation, daily management, and resilience. It is a marathon, not a sprint; a journey, not a destination. It challenges the all-too-American notion of fixing the problem, and instead focuses on living well while managing the problem. It requires acknowledging that setbacks are part of the process and not personal failures. Chronic illness management involves adapting to new symptoms, changing treatments, and shifting limitations, making it an ever-winding road rather than a straight line to recovery. Instead of viewing medication or lifestyle changes as temporary measures, this approach treats them as long-term tools for maintaining functionality and quality of life. Viewing it as a journey allows for the psychological process of moving through phases like anger and denial toward a place of acceptance. But it is a journey with many inflection points that often invoke the refrain: now what?

In his farewell address as president on January 17, 1961, Eisenhower warned his countrymen of what he called "the military-industrial complex," a huge and permanent armaments industry that had acquired great political and economic power. He was concerned about the possible conflict between public and private interests in the crucial area of national defense. The past decade has seen the rise of another kind of federal/private "industrial complex" with an equally great potential for influence on public policy. What has been called the "medical-industrial complex" is a large and growing network of government agencies and huge corporations engaged in the business of supplying healthcare services to patients for a profit. The perception or reality of a medical-industrial complex weighs heavily on the way the average healthcare consumer thinks and interacts with the system.

In the 19th century, Chinese railroad laborers brought a host of traditional medicines to our shores, among which was the oil of the Chinese water snake to treat inflammation and arthritis. An American, Clark Stanley, commercialized the concept of boiling rattlesnakes and skimming the fat off the top. It proved to be a lucrative business, likely because it worked. The fatty oil was rich in omega-3 fatty acids, which we now know have a powerful anti-inflammatory effect. By the late 1800s, the newly self-proclaimed “rattlesnake king” popularized his remedy by putting on medicine shows in which he would kill a live snake to prove the product authentic. But demand, greed, and copycats resulted in products with little or no snake oil. The US government, emboldened by the 1906 Food and Drug Act, found Stanley’s cure-all to be useless, popularizing the term “snake oil salesman” as a synonym for quackery. Today, we continue to see companies promising single products that can cure diverse, complex illnesses, and using testimonials and anecdotes rather than scientific proof. Social media often serves as a platform for modern day, virtual medicine shows, which has resulted in a multi-billion dollar industry. It’s led by charismatic, fast-talking, influencers whose health recommendations are followed by nearly half of the adults in this country. On this episode, we talk about contemporary snake oil and more.

You know them, you’ve seen them, you may even use them. They’re WMD-wearable medical devices like the FitBit, the Apple Watch, and the Aura ring, and the one-inch square discs affixed on people’s upper arms monitoring blood glucose or delivering medication. These are examples of an expanding array of wearable and implantable medical devices or BioMEMSs (biomedical microelectromechanical systems) that have transformed modern healthcare. These wearables enable non-invasive, real-time monitoring of heart rate, heart rhythm, blood pressure, sleep, blood glucose, and blood oxygen saturation. Implantable BioMEMS range from continuous glucose monitoring and insulin delivery to intraocular pressure monitoring. Other uses include programmable drug delivery for antibiotics, neuro-modulation for chronic pain and Parkinson’s disease, and the list goes on.