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We are continuing on the theme of “normal” versus “abnormal” in medicine today. It turns out that there is clever medical lexicon to describe the insatiable urge to make all lab results and other findings normal in critical care medicine: Euboxia is the state whereby all boxes on a pathology […]

The Trojan horse of sepsis bundles

“All is for the best in this best of all possible worlds” – Dr. Pangloss in Voltaire’s Candide Whether septic shock provides a defense to the host is an open question – one that is increasingly relevant to emergency and critical care. Even if certain features of sepsis represent host […]

Lessons from the ADRENAL trial

The ADRENAL trial is the recently published, and influential, randomized controlled trial of hydrocortisone in patients with sepsis. There are two lessons to be learned from the ADRENAL trial. Lesson #1. The first is a small lesson. Should we be using steroids in sepsis? Answer: no. This was a big […]

The New Normal – Podcast #3

This is the EvolutionMedicine ‘cast #3, entitled The New Normal, for Wednesday July 13th. This podcast is based on a presentation I gave at last year’s ISEMPH 2015 conference. I actually recorded this audio two weeks ago. That is why it is mis-identified  as podcast #1. It is indeed ‘cast […]

Do as much nothing as possible

Never more timely from Samuel Shem’s 1978 classic, the House of God, Fat Man’s Rule #13: The delivery of good medical care is to do as much nothing as possible As we have covered on this site, many examples of aggressive treatments aimed at fixing abnormal results have proved useless […]