Dr. Maller’s Blog

The topic du jour this week has been the emergence of a new influenza strain in Mexico. Initially it was reported to be “part pig, part bird, part human” and as it seemed to coincide with the visit of our Boy President and his 500-person entourage to Mexico City, my paranoia meter went bonkers. Such a chimera virus sounded like the product of an evil lab somewhere, perhaps a trial terrorist run.

Now the hysteria has abated and we have a more rational basis for assessing the threat. This is a new H1N1 strain, an Influenza A virus primarily associated with swine contact (not eating pork). The outbreak in Mexico has caused some deaths, and cases have been identified in several states here as well as countries around the world. Overall though, the severity of this strain seems ordinary. It seemed odd that the source was Mexico as flu strains usually come out of Asia, but there is evidence that this outbreak began with a visit to Mexico of a citizen of Bangladesh who was quite ill on arrival.

This is not a harbinger of a 1918-like scourge that killed tens of millions of people in the wake of World War I. It seems more like the 1976 strain that struck Fort Dix NJ and led to the emergency production of a new vaccine which forty million Americans received. It was apparent by the fall that the “epidemic” had not materialized but the program went ahead as government programs usually do. The fallout was about a thousand cases of the paralytic condition Guillain-Barré syndrome, and a widespread antagonism toward vaccine mandates that carries over to this day.

Influenza is a true menace; it kills 36,000 of us in an average year, and the present choice of vaccines will not protect against the new strain. So far we can be hopeful that by fall an effective vaccine will be available and that the Virus Formerly Known as Swine Flu will prove to be manageable. Antiviral drugs are of some help (TamiFlu or Relenza) but their use in kids is problematic because of side effects, and the best they do is shorten the illness, not cure it.

Since influenza is seasonal, we won’t hear much for a few months about this. Schools and public venues should stay open and I hope folks won’t flock to emergency rooms with minor symptoms. But there is some precedent for new flu strains to appear mild at first, then return after summer with a vengeance. (One of the great mysteries of influenza is where it hides for six months, only to reappear, often in the same communities.)

Stay tuned, but enjoy the nice weather.

An old favorite smidgen of poetry went lost during one of my office moves, but most parents know it:
Children’s faces looking up
Holding wonder like a cup…”
Last week I had a cute little patient show up in an Alice Blue gown. I asked what the occasion was and her Mom said she always dresses like that (she’s 3 and a half). I grabbed my Polaroid (yes they still make them) and took two quick shots, one for her and one for me. The wonder in her eyes was priceless as she saw her [...] Continue Reading…

Chatting with a young pediatrician recently I remarked on seeing about 350 cases of spinal meningitis in my one year as an infectious disease fellow at LA County/USC. She was amazed; she had never seen ONE!

Such is the march of progress over one’s career in medicine. Most cases of bacterial meningitis are caused by Hemophilus influenzae Type b, commonly called “H flu” or “Hib.” One of my attending physicians at Columbia-Presbyterian in New York during my residency was Dr. Hattie Alexander, who pretty much owned “H flu”, having done much of the early work on it. Since its name [...] Continue Reading…

Tomorrow is the 200th birthday of two of the most famous men who ever lived - Abraham Lincoln and Charles Darwin. And no one can be that famous for so long without being controversial.

President Lincoln is revered for saving the Union, at least outside Dixie. But he suspended habeas corpus, swept away states’ rights, and went through a bunch of mediocre generals before finding a winner. Slavery, that abomination which still goes on today in many parts of the world, would eventually have disappeared as it had in England, but eradicating it was a noble cause.

I believe Darwin is [...] Continue Reading…

A favorite motto of mine is “Illegitimi Non Carborundum”. It appears on my cell phone when I activate it. It also adorns an archway at New York University, probably put there in the 19th century. I was an ace in Latin in high school, and that translates to “Don’t Let the Bastards Wear You Down” despite some folks denying it really means that.

The climate in the country is decidedly worrisome in general, and downright apocalyptic in the world of medicine. Congress is passing a near-trillion-dollar “stimulus” bill that will put our nation further in debt as far as the [...] Continue Reading…

So your baby’s a year old or so and doesn’t need formula any more. What are your options?

First of all, let’s talk delivery systems. Since my patients often breast-feed for a long time, they may be unfamiliar with the bottle or even with formula. Taking Baby off the bottle may be a challenge, but the sooner you do it the better, for several reasons. Using a bottle after a 12-15 months is unnecessary, and may cause major problems such as tooth decay and ear infections. “Nursing bottle mouth” is more than a cosmetic issue; it can ruin the [...] Continue Reading…

Perhaps it’s unfair to blame Gucci for my seven-month absence from my blog, but you see every time I’d try to write she’d sit on my lap or the keyboard and I just couldn’t do a thing. Pretty lame, eh?

Truthfully it’s been a rough year, probably for many of you as well. But it took a reprimand from one of my moms and a few quiet hours on an airplane a few weeks ago to get my writing itch going again.

My 42d anniversary in my Van Nuys practice just passed. A cynic might say I’ve not had 42 years’ [...] Continue Reading…

The change in drug store shelves has come about rather suddenly, leaving folks asking why and what now.

Lots of people depended on Sudafed (pseudoephedrine) for congestion and were puzzled when it went behind the counter. We can thank our entrepreneurial drug makers for that, since it is the base from which crystal meth is made.

With uncharacteristic haste and certitude, the FDA then banned decongestants and cough preparations for children less than two. Now all compounds intended for children 2-4 years are to be re-labeled and restricted. There is talk of the ban being raised to six or even [...] Continue Reading…

There wasn’t supposed to be a dog in my life. Then I unexpectedly found out what I’d been missing when Gucci arrived five months ago, a one-pound black hairball stuffed in my wife’s neckline. All the years of resistance and rationale melted when she saw that starburst white face, the little nose and round eyes of a cartoon dog, and the ears of an Ewok. Now she’s fully grown but less than five pounds and will forever look like a puppy.

She is a “designer breed”, a purposely mixed mating between a teacup Maltese and a Pomeranian. My stepdaughter acquired [...] Continue Reading…

I’ve been waiting two months for an inspiration to resume blogging (nice not to have deadlines) but today is Memorial Day and the fire is lit.

George Will published a great column yesterday called “The Last Doughboy” in which he paid tribute to our last surviving WWI soldier, who is a spry 107 and not only served in France with over 4 million other Americans but spent most of WWII in a Japanese prison camp, having been a civilian contractor in Manila on December 7, 1941.

Our nation is at war but I wonder where we’d be without the thousands [...] Continue Reading…