Dr. Maller’s Blog

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 a Yorki-poo at the same time and they often play together. How wonderful to have a puppy who is gentle, quiet yet full of spirit, and hypoallergenic! She is in my office most days and many of you know her personally.

She was born three days after my latest grandchild, my seventh, but unlike them she isn’t hours away by car or plane but here in my life, my space, my heart. I’ve had to re-learn what new parents all experience: the unconditional love and hard work, the reading of subtle sounds and body language, the moments of pure joy and the anxiety of vaccinations, injuries (one trip to the emergency room already), the challenge of toilet-training, vet’s bills, and above all the responsibility of caring for a little package of life so totally dependent on you. A friend said recently after meeting her that a dog is the only animal that prefers the company of another species to its own.

Parents often ask about dogs and children. Generally it’s best to wait until all the kids are 6 or more. That’s because younger children may abuse the dog, won’t help care for it, and you have enough to do already! However, these days people often have pets before kids and that’s manageable too. Cats are more of a problem because they cause more allergies and infections and tend to get jealous of babies whereas dogs usually are protective. It is true that a dog’s mouth is cleaner than a human’s; I’m glad because Gucci would have licked me to death by now.

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…

Somewhere in his adolescence my oldest started referring to his sister and brothers as Sibling Units. Perhaps he preferred to think of them as having been created in a high-tech factory rather than in the regular way. Anyway over the course of a long career as a pediatrician, father and grandfather I’ve developed certain generalizations about the birth order of children. I believe it was Mark Twain who said “All generalizations are false including this one”, so this is far from a scientific tract.

Sibling Unit #1 tends to be the most successful, most pleasing to adults, most neurotic, and [...] Continue Reading…

Most of you will be surprised to learn that doctors in California went on strike about 32 years ago, seeing only emergencies for several days. That got the attention of the so-called public servants in Sacramento and they passed an emergency malpractice reform package called AB 1xx. The best feature was a cap of $250,000 on pain and suffering, or non-economic damages. This allowed insurance companies to plan for future risks and kept some of them from leaving the state. Many key states such as Florida have no such law, and certain fields of medicine such as obstetrics and [...] Continue Reading…

Ricky is 19 months old and doesn’t like me. Oh, he’s friendly enough if he has his clothes on and his parents are holding him at a safe distance. He babbles and delights his audience of the moment, but when I have to do my doctorly stuff he gives me as much as I can handle.

Some people would say he has no business being here. For one thing he came through two life-threatening heart surgeries very early in life. And then there’s that “extra” thing, a 47th chromosome that marks him as a Down’s Syndrome child with a [...] Continue Reading…

Rubeola, a.k.a. red measles, has been targeted for eradication by the WHO but that goal has proved elusive. My first opinion blog. “Science vs. Truth” discussed some of the reasons why.

A recent CDC bulletin shows the good news and the bad about this ancient scourge. An athletic competition in Pennsylvania drew 265,000 participants and spectators from eight foreign countries and all parts of the USA. A 12-year-old Japanese boy was incubating measles when he arrived in PA after several changes of planes. His team and the Taiwanese shared transportation.

The good news: only six more cases of measles could [...] Continue Reading…

“It” was a baseball field, but rather than an Iowa corn field, this one was on the grounds of the venerable Philadelphia General Hospital (built by Ben Franklin) where I took my internship.

Medical graduates must serve at least a year of training before being eligible to practice medicine. The internship no longer exists as such, perhaps because the memo about the Emancipation Proclamation finally got to the powers that be. As was typical of the time, I worked 90-plus-hour weeks for $100 a month. It had been $59 the year before but some interns’ wives marched to City [...] Continue Reading…

My wife loves to regale new patients with my resumé, including announcing that I am an epidemiologist (or was, actually). Folks sound impressed but I suspect they’d be hard-pressed to define what that means. I’m glad you asked.

CDC in Atlanta, originally created to combat malaria, had by the early 50’s become the world’s top communicable disease command post. In order to put trained investigators at the scene of outbreaks and research facilities they came up with an elite group called the Epidemic Intelligence Service (EIS) which took about two dozen physicians, veterinarians and statisticians yearly, trained them and assigned [...] Continue Reading…

Ever notice that everyone describes his cough as “bad”? This post is a somewhat tongue-in-cheek defense of the lowly cough (except for those who cough in theaters, which should be a hanging offense.)

Why do we cough? To clear our airway of bothersome stuff: pollen, bacteria, viruses, toxins and the cellular reaction to them, collectively known as mucus. If not for the cough reflex our lungs would be like vacuum-cleaner bags.

When do we cough? The timing can indicate the cause. Exercising, especially in dry windy weather triggers an asthmatic cough in many people. Breathing via the nose helps humidify [...] Continue Reading…

The scene was grim but familiar. A gurney arrived on the floor carrying a motionless young man. The attendant casually remarked, “Just another drug overdose; he’s DOA” (dead on arrival). I was in my infectious disease fellowship at Los Angeles County/USC Medical Center.

The patient was a 14-year-old black boy. He had been brought to the Emergency Department by police ambulance. He was admitted because the ED doesn’t like to handle deaths. We had no history. His mother came along soon afterward, and when the cause of death was suggested to her she became outraged. “My boy didn’t do [...] Continue Reading…