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Molecules to Medicine

Molecules to Medicine


Demystifying drug development, clinical research, medicine, and the role ethics plays
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Welcome to Molecules to Medicine!


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I’m Dr. Judy Stone, an infectious diseases physician and author. I love helping people understand issues and look at things from a different perspective. I hope I can offer you some different insights—bridging the gap between basic science and your medicine chest—as I am still a practicing physician, as well as having had broad clinical research experience. I’m interested in developing new medicines and treatments, as well as in caring for patients—and in explaining these topics for you.

Why read my blog, Molecules to Medicine?

Being both a clinician and from having experienced research from a variety of angles, I offer a unique perspective—a view from the trenches. I have participated in clinical trials since college and have been a patient in a clinical research center. I conducted bench and clinical research during my infectious disease fellowship, for which I designed and oversaw my first clinical trial (with mentoring, of course). I wrote a how-to handbook on clinical research, Conducting Clinical Research: A Practical Guide… In all, I have had over 25 years experience in conducting clinical trials and even more caring for my patients.

My medical training was a bit rocky, as I followed the adage, “Question authority.” I was always in trouble for asking provocative questions or looking at things in an unorthodox fashion…I still do, as you will soon see in my column.

{City of Cumberland, http://www.ci.cumberland....When I was recruited to practice in rural Cumberland, Maryland, there was no infectious disease specialist on the eastern side of the Appalachian Mountains within almost 150 miles. I wanted to practice in such an underserved area.

Infectious diseases, a specialty that spans all ages of patients and that involves being a sleuth and puzzling things out, immediately captivated me. I chose infectious diseases as my niche, initially thinking that this would be a relatively cheery and gratifying specialty—that I would be able to sprinkle antibiotics on patients and have them rapidly recover from their grave illnesses. Instead, the specialty has increasingly evolved to caring for critically ill patients, many of whom are immunocompromised by cancer, organ transplantation, kidney failure, or trauma or by treatments for these conditions. Additionally, we are seeing the rapid emergence of “superbugs,” bacteria that are resistant to most, if not all, antibiotics. And we rely all too frequently on high-tech solutions rather than listening, sleuthing, and hands-on caring.

Old postcards and a magnifying glass.As a consultant physician, I am asked by primary care physicians to step in and help solve problems when a patient is not responding as expected, or appears to have an unusual problem. I take a careful, often more detailed history (I have the luxury of more time), review piles of lab results and prior medications (many fevers are due to medicines, not infection), and try to place all these pieces in context. Infectious disease practice is a bit like playing Sherlock Holmes—relying on observation, studying, deduction, and explanation.

Since I started practice, discovery of new infectious diseases occurs regularly—AIDS was not recognized when I started, let alone Hanta, Legionnaires, SARS, or many others. With each discovery, attempts to develop effective therapies soon follow.

As medicine has evolved, so have my interests. For example, having become fascinated by tropical diseases, I’ve spent short periods of time studying and teaching in Peru, Thailand, and India—something I hope to be able to do more of. I have also become increasingly interested in health disparities, social justice issues, and ethics. I hope you’ll join me as we explore a variety of territories. I hope that reading these posts will encourage your will to learn, to engage and, above all, to work for the forces of good.

Fine points

If there are topics you hope to see me cover, please let me know—I welcome your input as to what you would like us to discuss in this column.

Comments

Disagreeing with my positions is fine, but I do have the expectation that you will be civilized and constructive in comments. If not, comments will be deleted. Also, please remember that I still take care of patients and they are, of course, my priority. So there might be a delay before your comment is moderated and posted.

Addendum:

Some material in my posts, largely those on the basics of clinical research, will be adapted from my book, Conducting Clinical Research: A Practical Guide for Physicians, Nurses, Study Coordinators, and Investigators.

Credits

Thank you to the Scientific American community for welcoming me into your family. I am honored. Thanks, too, to Michelle Banks (@artologica) for capturing my blog’s persona so warmly in the banner she created.

Molecules to Medicine blog banner © Michele Banks

City of Cumberland {http://www.ci.cumberland.md.us} (Photo credit: Wikipedia)

Old postcards and a magnifying glass. (Photo credit: Wikipedia)

Judy Stone About the Author: Judy Stone, MD is an infectious disease specialist, experienced in conducting clinical research. She is the author of Conducting Clinical Research, the essential guide to the topic. She survived 25 years in solo practice in rural Cumberland, Maryland, and is now broadening her horizons. She particularly loves writing about ethical issues, and tilting at windmills in her advocacy for social justice. As part of her overall desire to save the world when she grows up, she has become especially interested in neglected tropical diseases. When not slaving over hot patients, she can be found playing with photography, friends’ dogs, or in her garden. Follow on Twitter @drjudystone or on her website. Follow on Twitter @drjudystone.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. aidel 10:34 am 05/14/2012

    SciAm is lucky to have you! Thank you for joining the network. I look forward to reading your posts!

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  2. 2. Bora Zivkovic 10:46 am 05/14/2012

    Welcome to the family!

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  3. 3. EricMJohnson 12:16 pm 05/14/2012

    Welcome Judy! It’s wonderful to have you as part of the network. Your background and travels are certain to be a welcome edition to SciAm! I look forward to reading more.

    Link to this
  4. 4. JEBulletin 2:41 pm 05/14/2012

    Will you address the gut biome?

    Link to this
  5. 5. sunspot 8:42 pm 05/14/2012

    Judy Stone,
    After 45 years as a working scientist, I tend to be pretty unforgiving of attacks on religious scientists. So when your earlier post attacked Catholic Hospitals, ignoring all the good that they have done, it seemed fair to call it slanted and deceptive. And to be constructive, I even gave point by point refutations.

    For this response, and related comments about the article’s emotional content, the blog editor said that I was simply being religious (not true), and I would be banned if I continued to express the opinions that I felt were civilized, and that balanced your post with an equally emotional content.

    My questions to you: 1. Can you define “civilized and constructive” in this context? 2. If you feel that you must make powerfully emotional arguments, shouldn’t your readers be allowed to respond in kind? If you can “take it” as hard as you “give it”, I welcome you to the network.

    Link to this
  6. 6. Judy Stone in reply to Judy Stone 12:26 pm 05/15/2012

    Sunspot:

    I think that you missed the focus of my post, When Religion Collides with Medical Care: Who Decides What Is Right for You?

    Catholic institutions do provide valuable aid to many—that is not in question, nor was it the focus of the discussion in the original post.
    The work of Catholic “women religious” with the poor, the weak, the sick and the downtrodden, often at great personal sacrifice and in dangerous environments throughout the years, for example, has been most notable.

    The criticism is specifically regarding the strings that come with that aid. In my post, I simply raised the question of whether or not religiously-affiliated medical institutions should be receiving public, taxpayer money to facilitate the imposition of their beliefs on others. In my opinion, it is inappropriate for anyone’s religious beliefs to be used to deny care to someone who doesn’t share that belief, using public monies to do so. I am certain that there are persons who will disagree with me on that position, and I respect their right to disagree with me, but do expect them to express their disagreements through rational arguments, rather than through diatribes.

    In my opinion, it is also disingenuous that many religious institutions operate in secret and won’t disclose the terms of hospital acquisitions until deals are “fait accomplis,” nor tell the public what their institutional restrictions are in advance, thereby giving those patients the option to seek alternative institutions for their care, that are compatible with their own beliefs, if available.

    This was the crux of my argument:
    “If religious organizations want to impose their beliefs on others who do not share them, should they be receiving public monies—our monies—to deny care that we need and deserve? Should their “conscience” trump yours? Who should decide what care is right for you?”

    You ask, “Can you define “civilized and constructive” in this context?”

    Your previous comments were not constructive, specifically, phrases like “Big Lies,” “biased rant,” “your biggest lie.” Your attacking my pain over circumstances surrounding my mother’s death as “Chutzpah” was foul and particularly uncivilized and unworthy, to my mind, of anyone who considers him-or-herself to be an ethical person.

    Constructive commentary might have been simple counterpoints with less emotional overlay…, “I disagree with you because…” or “Have you considered …”

    You ask, “…shouldn’t your readers be allowed to respond in kind?”

    Brief, specific responses that are on target are welcome. Those that are wildly digressing and which employ perjorative terminology are not.

    I subscribe to BlogHer’s definition of “unacceptable content as “anything included or linked that is:
    · Being used to abuse, harass, stalk or threaten a person or persons
    · Libelous, defamatory, knowingly false or misrepresents another person
    · Infringes upon any copyright, trademark, trade secret or patent of any third party. (If you quote or excerpt someone’s content, it is your responsibility to provide proper attribution to the original author. For a clear definition of proper attribution and fair use, please see The Electronic Frontier Foundation’s Legal Guide for Bloggers at this URL: http://www.eff.org/bloggers/lg
    · Violates any obligation of confidentiality
    · Violates the privacy, publicity, moral or any other right of any third party
    · Contains editorial content that has been commissioned and paid for by a third party, (either cash or goods in barter), and/or contains paid advertising links and/or SPAM or “Stupid Pointless Annoying Messages.” For BlogHer’s purposes, we define SPAM as anything that qualifies as nonsense unrelated to the discussion, either in comments on a blog or in our forums. This nonsense may take classic forms (e.g., simple links to unrelated content that are often advertising or e-commerce), or more insidious forms.
    BlogHer’s co-founders and staff define and determine what is “unacceptable content” on a case-by-case basis-and our definitions are not limited to this list. We reserve the right to change these standards at any time with no notice. We also reserve the right to remove links to any content at any time.”

    Or, as my friend Liz Ditz succinctly says, “My house, my rules.”

    Link to this
  7. 7. BigInScience 12:32 pm 05/15/2012

    Hi Judy. Congratulations on such a long and successful career in medicine. I discontinued my medical studies my senior year of medical school (partly due to a family member’s terminal illness), but I know how rigid medicine can be- at times I felt like a star shaped block being squeezed into a square peg! Like you I was probably a tad too nonconforming and nontraditional at times (although I think this was typically in my patient’s best interest). In any event, I wrote about my experiences here if you’d like to read: http://biginscience.com/home/2012/3/25/what-are-you-thinking-leaving-medical-school.html
    Congratulations again and I look forward to future posts!

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  8. 8. Judy Stone in reply to Judy Stone 1:49 pm 05/15/2012

    I’m not sure yet. For now, I’d suggest you follow Jonathan A. Eisen over at Phylogenomics or news from the Human Microbiome Project. Thanks for the suggestion!

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  9. 9. Judy Stone in reply to Judy Stone 3:10 pm 05/15/2012

    Thanks, Brian. I can certainly relate to your story, as well. It was a long, tough haul. While tempting at times, I was too stubborn to quit. And, despite the stresses and heartache at times, it has also been a very gratifying career. I love helping people…and solving their puzzles. Best of luck.

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  10. 10. Glendon Mellow 10:19 pm 05/19/2012

    Yay! Welcome Judy, can’t wait to read more! Blog banner looks sweet!

    Link to this

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