David Auerbach
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Articles by David Auerbach
The AI revolution will devour Apple John Ternus' empire is folding
Ternus, the new Apple CEO, speaking on Wednesday. (Benjamin Fanjoy/Getty) aiAppleBig techiPhones Prefer us on Google The physical mobile phone seems to have stagnated. Take the next iPhone, which new Apple CEO John Ternus has just unveiled. Featuring a folding screen and incrementally improved processing, that might excite Apple’s legions of fans, even if they have to pay $2,000 for the privilege.
How to rethink old breast implants as your body ages
Not long ago, a woman came into my office with breast implants that were forty-one years old. The implants were older than I am. As a plastic surgeon who specializes in breast and body procedures, that is the longest I have personally seen implants last. And honestly, my first reaction was probably the same reaction most people would have: disbelief. Forty-one years is an incredibly long time for any medical device to remain in place.
Cross Browser vs Cross Platform Testing: Challenges in Real Projects
Cross-browser and cross-platform testing get lumped together constantly which creates real problems. Many teams consider if they have tested it in Chrome, it was sufficient for browser and platform coverage. It is not, because I found that out the hard way on a checkout flow that broke exclusively on Windows Firefox in production. We had full browser coverage on macOS. Nobody had thought to combine OS and browser variables deliberately.
The tragic reality of pregnancy-associated breast cancer
This photo shows one of my patients’ children. (I am sharing the photo with the family’s consent.) Can you guess the secret behind this photo? Let me tell you about the background. The difficult diagnosis of pregnancy-associated breast cancer Mrs. U was in her first trimester of pregnancy when she discovered a lump in her right breast. Work-up revealed that it was a highly aggressive form of breast cancer known as triple-negative breast cancer.
Navigating dense breast tissue and breast cancer screening guidelines
“Pathology confirms invasive ductal carcinoma.” I had said those words to patients many times before. This time, they were said to me. For years, I had been the voice on the other end of that call, gently guiding patients through one of the hardest moments of their lives. I knew how to say the words. I knew how to explain the diagnosis. I knew how to help women process what came next. But that day, I was not the physician. I was the patient.
When the doctor becomes the patient: a breast cancer journey
At 62, I unwittingly became a cliché: the physician who makes a poor patient. The hard lump in my right breast, directly inferior to the nipple at the 6 o’clock position, shocked and shook me in the middle of a long August night when it first poked me as I tossed and turned my way through a bout of insomnia.
Breast cancer and the daughter who gave everything
I had been trying to write this story for a long time. The topic is so heavy that it took a great deal of courage and emotional strength to finally put it into words. This story is not about a patient; rather, it is about a caregiver. I met Mrs. N. in 2020. She travelled from Gujranwala to Islamabad (a distance of 223 kilometers) to begin her treatment. Mrs. N. was in her late 50s and used a wheelchair. She was accompanied by her daughter, who was around 25 years old and wore a strict veil.
Racial disparities in pancreatic cancer screening cost Black lives [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Internal medicine physician Earl Stewart, Jr. discusses his article “Pancreatic cancer racial disparities.” Earl examines the devastating pattern of pancreatic cancer claiming Black cultural icons like John Lewis and Aretha Franklin while the medical establishment fails to implement race-specific screening guidelines.
a doctor's guide to TRT safety
A man in his late 40s sits down in my office and says, “Doctor, I think my testosterone is low.” Sometimes he is already holding lab results. Sometimes he is coming from a gym forum, a friend’s recommendation, or a late-night Google search. But almost always, the story sounds familiar: lower sex drive, fewer morning erections, weaker erections, fatigue, brain fog, mood changes, and that stubborn belly fat that seems to arrive overnight.
The quiet bravery of breast cancer screening
There is a stillness in the waiting room, not exactly silence, but a quiet that settles over chairs, minds diverted elsewhere. Here, women sit in chairs with their thoughts floating in opposing directions, pretending to read magazines, while their minds wander hallways they would rather not travel. My name is called softly, and my heart skips a beat, the time has come. I follow the routine, changing from street clothes into bare arms and a borrowed gown that never seems to fit properly.
How new pancreatic cancer laser therapy works
Researchers at Sichuan University in China have developed a laser therapy that selectively kills pancreatic ductal adenocarcinoma (PDAC) tumors while preserving the surrounding healthy tissue. The technology, built around a 6.1-micron laser, takes advantage of the characteristic collagen fingerprint within PDAC tumors to focus the laser energy where it is needed the most.
Alcohol, dairy, and breast cancer risk
Delta Airlines has been raising money for the Breast Cancer Research Foundation by selling cocktails and rosé on board flights for 20 years. This month, it’s Une Femme Sparkling Rosé. Delta also serves gouda and cheddar slices, along with chicken salad sandwiches topped with queso. Have a drink or two, snack on cheese, and feel good about sending money for research, a party for a cause.
Transforming patient fear into understanding through clear communication [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Counselor and certified coach Mary Remón and oncologist Tiffany Troso-Sandoval discuss their article, “Clear communication is kind patient care.” They explore the common scenario of patients leaving the office more confused and anxious than when they arrived, overwhelmed by medical jargon and frightening online research.
a survivor's story
I found a lump at age 32, just four months after a clear clinical breast exam. No family history. No genetic markers. I noticed the golf-ball-sized mass one day while putting on my bra. It turned out to be stage 3C, with spread to 14 lymph nodes, as advanced as it gets without being terminal. I went through a year of aggressive treatments: bilateral mastectomy, chemo, radiation, reconstruction, and hormone therapy.
Breast cancer in teenagers is rare but real
When people think about breast cancer, they picture middle-aged or older women. The pink ribbons, awareness campaigns, and even clinical guidelines overwhelmingly focus on adults. What’s almost never discussed is that, though rare, breast cancer can occur in teenagers. And when it does, the diagnosis is often delayed, with consequences that change a young life forever. Breast cancer in adolescents is extremely uncommon, accounting for less than 1 percent of all breast cancer cases.
Rethinking real estate
Ownership, complexity, and the coming wealth transfer. Over the next 20 years, real estate ownership will be fundamentally redefined. As the largest intergenerational wealth transfer in history unfolds, an estimated at $90 trillion globally¹of property owners, investors, and heirs will face a radically more complex and digitised landscape.
High-risk pregnancy: Who should manage your care?
An excerpt from Understanding High-Risk Pregnancy: A Patient’s Guide to Prenatal Complications. What is a high-risk pregnancy? You may find it strange that there is no single accepted definition of what constitutes a high-risk pregnancy. Probably more than half of women will have at least one risk factor that could be an issue, but for most of these women it will minimally affect their pregnancy care or the outcome.
Drug giants face suit over hidden cancer risks
Bridgett Brown, a resident of California, developed breast cancer from using brand-name and generic versions of the antipsychotics Risperdal (risperidone) and Zyprexa (olanzapine) says a new lawsuit from the Wisner Baum law firm.
The human case for preserving the nipple after mastectomy
You can live without a nipple, but what if you don’t have to? Historically, this specialized region of the breast—known as the nipple-areolar complex—was one of the most vital aspects of human anatomy, providing not only nutrition but also immunologic safety for the infant via breastfeeding. The nipple deserves our respect; without it, human society would not exist.
The ethical crossroads of medicine and legislation
Previously, I wrote about politicians regulating medical practice. I support regulations that protect individual or public health. However, when these laws are not evidence-based, misguided or frivolous, and potentially harmful, as occurred when 16 state legislatures permitted over-the-counter sale of ivermectin, they are unacceptable.
How drug companies profit by inventing diseases
Funding from direct-to-consumer (DTC) “ask your doctor” drug ads has captured news media outlets and all but blocked important health stories like these. Read on. 1. “Hormone replacement therapy” (HRT) is back.
Why the U.S. Preventive Services Task Force is essential to saving lives
You may have noticed the Supreme Court announced several crucial rulings on controversial topics. Buried in most coverage was a note that the Court upheld the legality of the U.S. Preventive Services Task Force (USPSTF). Most folks have no clue what the USPSTF is or does. To people like me, it is crucial to advancing the early detection and prevention of cancer in the United States. For now, we can be grateful that the Task Force is “safe” from immediate elimination.
The critical role of nurse practitioners in colorectal cancer screening
Colorectal cancer (CRC) is the second-deadliest cancer in the U.S.; however, screening rates remain too low due to a combination of lack of awareness, patient fear, and health care system barriers. Many patients don’t realize they are at risk because early-stage CRC has no symptoms, making screening the only way to detect and prevent disease progression.
Summer’s dark side: How not to dim your fun
It’s all fun and games until your health becomes one big puzzle to solve, and little do many people know what risks and hazards might surround us during our favorite summertime activities. I learned this personally after what should have been an innocent business trip turned into a year-and-a-half nightmare for me after contaminated water made me sick. I contracted bacteria that led to a secondary chronic inflammatory breast disease.
Unraveling the mystery behind one of the most dangerous pregnancy complications: preeclampsia
When reviewing poor maternal health outcomes in the U.S., it is clear we cannot keep doing the same thing and expect to make pregnancy safe and healthy for all. A new approach is needed that harnesses the power of molecular advances to bring precision medicine to pregnancy health. Preeclampsia, one of the most dangerous complications in pregnancy, is a disorder of high blood pressure that has eluded the ability to effectively predict who will develop the condition.
Why what doctors say matters more than you think [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Physician Scott Abramson discusses his article “How doctors’ words can make or break patient care.” Scott shares two compelling scenarios illustrating the profound impact of a physician’s communication. He recounts a family conference where a doctor’s use of medical jargon like “lesion” completely obscured the diagnosis of cancer for a concerned family, highlighting the barrier that medical language can create.
Elon Musk was destined to fail
12 hours ago In an extraordinary Oval Office meeting, Trump pressed Cyril Ramaphosa on widely discredited claims of a white genocide in South Africa. In an extraordinary Oval Office meeting, Trump pressed Cyril Ramaphosa on widely discredited claims of a white genocide in South Africa.
Big reckoning for Big Tech? EU’s fines on Meta, Apple won’t change bad behavior Original
A Meta logo is pictured at a trade fair in Hannover Messe, in Hanover, Germany, April 22, 2024. REUTERS And just like that, the European Union’s massive fines on Apple and Meta ensured that competition would reign and the monolithic tech companies that structure our lives would never have such power again. Or perhaps not. Remember when the United States government went after Microsoft for having a Windows and Office monopoly and now they don’t anymore? No?
Breast cancer was never supposed to be part of my story
She was pale, underweight, fifty years old and scared. Mrs. G was a breast cancer patient on the oncology unit whom I met by chance, as she appeared on my patient census list that morning. As I walked into her room, I noticed the fragrant flowers, the cards scattered about her hospital tray, and the numerous pictures of her friends and family that attempted to bring her peace and comfort. But she looked uncomfortable. Her port located on the upper part of her chest was red and angry.
DAVID AUERBACH: Let’s fight climate change with organic and sanitation waste
In Summary In East African cities like Nairobi, 1.5 million tonnes of organic and sanitation waste go untreated each year. “We must remember that our actions today shape a cleaner, greener world for generations to come.” David Auerbach, the co-founder of the Sanergy Collaborative/HANDOUT The Sanergy Collaborative is now officially registered and verified under Verra’s Verified Carbon Standard for its methane avoidance carbon credits (Project ID: 4015).
What’s going on with left-sided breast cancer: a curious phenomenon
In clinical research, chart review is nearly as familiar as daily functions like walking or breathing. My days are full of identifying missing variables, finding them in the electronic medical records, then documenting them in my meticulously organized data sheets. However, during these chart reviews, my mind tries to find a way to break out of autopilot by looking for trends in the data.
From surviving to thriving: a new era in breast cancer care
Breast cancer recovery is about more than survival—it’s about reclaiming a vibrant, fulfilling life. Instead of focusing solely on survivorship, we need to embrace what I call “livingship”: the journey of truly thriving after treatment. This approach focuses on ensuring patients not only survive but thrive in their cancer-free lives.
Texas’ Medicaid expansion: a lifesaving solution ignored
Most Texas politicians balk at even discussing Medicaid expansion. They fear the wrath of state leadership and the threat of being primaried by someone further to the right. The expansion of Medicaid to the full extent permitted by the Affordable Care Act (ACA) is both an ethical and financial imperative.
Medicaid in non-expansion states: Explaining the indefensible
Over the years, as members of the Health and Public Policy Committee (HPPC) of the Texas chapter of the American College of Physicians (ACP), we have focused on advocacy for what we believe is the most important health policy issue in our state, Medicaid expansion under provisions of the Affordable Care Act (ACA). Our efforts, and the work of many others, have had no discernable impact on state policy.
What You Own When You Own a Passive REIT Index?
By David Auerbach, Managing Director, Armada ETF Advisors. Armada is a REIT-specialized Asset Manager offering differentiated REIT funds to sophisticated investors. "REIT stands for Real Estate Investment Trust, so you might be forgiven for assuming that something called a REIT would provide you with exposure to Real Estate." REIT stands for Real Estate Investment Trust, so you might be forgiven for assuming that something called a REIT would provide you with exposure to Real Estate.
David B. Auerbach
David B. Auerbach Global computer collapse is a chilling look at what's to come When CrowdStrike CEO (soon to be ex-CEO) George Kurtz said Friday morning that “this is not a security incident or cyber attack,” you should not have been reassured.
The Property Chronicle - Real estate, alternative real assets and other diversions
Over 200 US REITs and homebuilders have reported first-quarter earnings results over the past four weeks, providing critical information on the state of the commercial and residential real estate industry. A microcosm of the past two years across REIT world, interest rate movements dictated the narrative and stock performance, overshadowing what was ultimately a relatively solid earnings season for the sector.
LUCID/STILL, by OCEANS AND
Includes unlimited streaming via the free Bandcamp app, plus high-quality download in MP3, FLAC and more. Purchasable with gift card TIM BERNE ALTO SAXOPHONE HANK ROBERTS CELLO AURORA NEALAND ACCORDION AND VOICE released April 5, 2024 RECORDED LIVE BY BOB HOFFNAR AND MAX LORENZEN MIXED BY BOB HOFFNAR OCTOBER 25TH AT THE DRAYLEN MASON STUDIO KMFA RADIO CONCERT PRESENTED BY PEDRO MORENO/EPISTROPHY ARTS MASTERED BY DAVID TORN DESIGN ACCOMPLICE STEVE BYRAM COORDINATION JASON TORS
Projecting the Future Registered Nurse Workforce After the COVID-19 Pandemic
Key Points Question Has the current and projected number of registered nurses (RNs) in the US changed after the COVID-19 pandemic? Findings This study found that after a substantial drop during the pandemic, the nursing workforce recovered in 2022 and 2023, and the future size is now expected to reach 4.56 million in 2035, similar to what had been forecast prior to the pandemic.
Is STEM Education Broken?
After decades of discourse about the humanities in crisis, some progress has finally been made: We’ve moved on to STEM in crisis. The sociologist John D.
9 New Books on Why the Future Ain’t What It Used to Be
Among his many memorable (and hilarious) quotes, famed New York Yankees catcher Yogi Berra once exclaimed, “The future ain’t what it used to be.” And when it comes to advances in big data and artificial intelligence, he couldn’t be more right. New, world-changing technology is emerging all the time, so to find out what life will look like in the not-so-distant future, check out the nine eye-opening reads below.
ChatGPT and the Decline of Accuracy
Maybe the most surprising thing about ChatGPT and other LLMs like Google’s Bard and Microsoft’s Bing Chat (formerly Sydney) is that they’re out there in the wild. Taking a step back, look at the situation: we have some of the biggest tech titans on earth producing and promoting LLM-based chatbots that regularly give misinformation, contradict themselves, and produce incoherent nonsense. Amazingly enough, they also frequently produce coherent truths and accurate information.
Survive the Future with These 5 New Books
Those worried about the future have no shortage of reasons to be concerned. Will it be the economy that pushes the world toward dystopia? The climate? Runaway digital technologies? Much remains uncertain, but one thing is clear: To survive the future, we have to know what could be coming. With that goal in mind, we recommend that every future-focused reader check out the five excellent books below.
The Digital Forces Commandeering Human Life – - Reema Jadeja-Reed
The journey from the TCP/IP, the original Internet protocol suite designed by the US Department of Defense, to Tim Berners-Lee’s Word Wide Web has seen the Internet develop beyond an information exchange in cyberspace to permeate all spheres of life. As an academic researching the cyber domain in the 2010s, I was greatly bemused by the epoch. Ambiguity prevailed among us with the primary debate being: which parts of the electromagnetic spectrum count as cyber.
The Property Chronicle - Real estate, alternative real assets and other diversions
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A new book explains how global digital networks accumulate data and turn into uncontrollable systems
The growth of biotech arises from the increasing miniaturisation of digital devices, networked and otherwise. MIT researchers have designed a computer in a pill, a nanocomputer that monitors stomach temperatures after swelling up in size once in the stomach. In time, we will have such devices constantly monitoring our bodies, catching threats and changes before we are physically aware of them.
ChatGPT Does Not Hallucinate
ChatGPT spreads one lie more than any other, and that lie is that it understands what it’s saying. We assume anyone using language has a grasp on some pretty fundamental concepts, like the difference between real and imaginary and the difference between truth and falsehood. Even parrots know what’s real (even if they can’t actually express it in language). But ChatGPT doesn’t.
ChatGPT Doesn't Understand What It Says
I’ve compared AI to the “intelligent” horse Clever Hans before—a supercharged Clever Hans that is so uncannily good at simulating uniquely human behavior in unprecedented ways that we’re intuitively baffled when it falls down. Here’s what to remember: ChatGPT doesn’t understand what it’s saying. Remind yourself of this no matter how convinced you may feel to the contrary.
Comparing ambulatory commercial spending in Rhode Island and Massachusetts, 2016-2019
Abstract Objective To evaluate trends and drivers of commercial ambulatory spending and price variation. Data Sources and Study Setting Commercial claims data from the Massachusetts and Rhode Island All-Payer Claims Databases from 2016 to 2019. Study Design Observational study of spending in major ambulatory care settings.
“Meganets,” the melodramatic new excuse for giving up against digital oppression without a fight
A session at the World Economic Forum’s 2023 summit in Switzerland posed the question “Are you ready for brain transparency?” In a brief animated video, a woman’s brainwaves are monitored via work-issued earbuds, maximizing her health and productivity. When she gets to the office the next day, however, the cheery panopticon takes a darker turn: A co-worker is arrested for wire fraud, and the government has subpoenaed the whole team’s brainwave records to search for accomplices.
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