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Regarding a Fine Gentleman

Regarding a fine gentleman


I just returned home from a sad but necessary event which was memorial services for my Uncle George who died a week ago.


He had  been diagnosed with untreatable cancer earlier this year.


It was just a week before he died that I drove to visit him and my aunt Rita. At that time,  My senior cousin Jack rode along with me and it was a great trip overall considering the purpose.


At George’s memorial yesterday I spoke briefly to the  audience about my first recollection of George and my recent visit with Him. Generally I am quite glib , but it emotion made it difficult to speak as I wanted.


When I was preparing for the travel to see him two weeks ago, I thought about what was my earliest recollection of George.


When I last visited with George I told him this story

"I pondered , what was my first memory of You?

When I was very young I was excited to have my first stay-over at someone else’s home, and guess who it was?  Your house!.

(George and Rita had a daughter  a couple years older than me and a son who was close to the same age as me.)

 After a busy day it was time for sleep, but not for me. Your home was on the side of a hill that overlooked the local airport. At night the beacon light of the airport shined continually onto the widows of the bedrooms, red then green then red again, all night long.


Although You were all asleep, I was not because I disliked the lightshow.


Cousin Tony was sleeping soundly as I walked out of the room to go into your bedroom. You and Rita were both sleeping soundly.


I pushed on your arm until you awakened and asked me what I wanted.


I told you that I did not like that red and green light shining in the window and that I wanted to go back to my home.


You got up, dressed and kindly drove me back to my house with no complaints. It was then, I knew that You were a good man and you have been a good uncle to me my whole life”


At that point both George and I had both had happy tears and a man-hug ensued.


George then told me that the airport beacon light was changed in 1956 and did not shine in their windows after that time, so I could not have been older than three years old at that time.


Only George would know such detail information.


For my entire life George was a positive male role model in my life and was always a good uncle to me. He was artistic and creative, highly organized and thoughtful.


I never saw him lose his temper! He was a history enthusiast and kept a great curiosity about how things worked, especially how nature worked.


Please visit the website which my Remarkable Uncle George created and share my Uncle’s view of the world


I will miss him very much and know impermanence is one of the facts of our existence.


Seeing my family and my cousins who all seemed to have aged more than me (until I looked in the mirror) reminded me again of how life is precious and limited.


So, please take time to be aware and engaged in your life. Choose to enjoy every day as it comes. Chose wellness no matter what your health issues, do not define yourself through pain and suffering, but rather by creating happiness for yourself and the people in your sphere of influence.


Enjoy the now, for it is all that we have.


Sam Wise MD









Physicians Declaration of Independence

Recently I was sent a linkage to a WSJ article referencing a Physician declaration of independence by Daniel Croviotto MD.

I acknowledge his frustrations expressed within the article , but find the declaratives as imprecise.


Richard Amerling MD has a more defined Physicians Declaration of Independence published here


Check them out and please support direct private practice healthcare and wellness.


If you are unhappy about healthcare , join people who want to do something about it.


Join AAPS  , visit Healthy.CoOp , Talk about cash pay healthcare and don't give the broken system any money.


Get Activated and Support Healthy.CoOp upcoming crowd-funding !


PO Box 82321

Las Vegas, NV 89180-2321



Thanks !





Why Grandfather/ Grandmother might need a spinal tap

A problem often mischaracterized or “Why Grandfather/ Grandmother might need a spinal tap”

I want to highlight a problem that is very often overlooked or misinterpreted.

When a person over 60 years old begins to forget things and gets dulled intellectually there is an increasing frequency that they are given the diagnosis of “probable early Alzheimer’s disease”.

Interestingly, they are now often started on an assortment of quite expensive medications or a “study protocol” by the neurologist. Usually there is no improvement in function with the medications but the family is shamed into continuing them to the benefit of the pharmaceutical industry. Such medications may even make matters worse by adding undesirable side effects.

I am dismayed that often those newly diagnosed as demented are not even given proper testing before this diagnosis and treatment are given. Most often there has been a cursory history and exam, which surprisingly often includes electro diagnostic testing such as, nerve conductions, EEG and evoked potential studies (none of which is definitive or actually helpful to diagnose dementia but are good income for the neurologist(s) involved).

I am still surprised that the diagnosis of Alzheimer’s disease is often reached without having done any imaging of the brain whatsoever.

It is very important that a proper history, physical exam and testing be done because there is no cure for Alzheimer’s dementia but there are many other conditions which can be improved or cured by early, proper intervention.

Remember that many correctable medical conditions can cause reduced mental function. A good example is severe thyroid disease may cause significant cognitive impairment and can be likewise significantly improved by corrective treatment. Be sure thyroid testing is done as part of a thorough medical evaluation.

What is Hydrocephalus anyway? Our brains make the spinal fluid  and normally it flows from a cavern (ventricle) in the center of each side of our brain to the base of our brain where the two channels combine. Then the spinal fluid flows out of our head into the neck and down the spinal canal where it is absorbed. The production and absorption of spinal fluid should be in balance.

There are two age groups that have the most hydrocephalus, infants and people over 60 years old. It is possible but very uncommon in the people of in-between ages.

Hydrocephalus (water on the brain) is the reason that the pediatrician measures around the baby’s head. In infants the bones of the skull are soft and not yet stuck together along the edges so if there is poor drainage of the brain fluid, the head gets bigger as the fluid accumulates. Placement of a drain in the ventricles of the brain to bring the excess fluid under the skin down the neck to the abdominal cavity can save the infant from brain damage and intellectual retardation. Hydrocephalus is then mostly forgotten about past the infant stage.

Once the skull is hardened and fused into a solid shell to protect the brain, excess water in the brain cannot be determined by measuring the outside of the head since it will not increase in size. If there is too much water in the brain of an adult, brain damage can result.

The second peak occurrence of hydrocephalus is in adults over 50, increasing by each further decade of age. The triad of symptoms for adult hydrocephalus consists of: cognitive changes; bladder incontinence’ and impaired gait.

Cognitive changes such as poor memory, somnolence, irritability, wandering, reduced hygiene, apathy or blunted affect may be seen with adult hydrocephalus.

Bladder incontinence is a classic symptom of hydrocephalus.

Gait disturbances in hydrocephalus may look like alcohol abuse. Frequent falling, difficulty getting up from sitting and generalized clumsiness are common with adult hydrocephalus.

It is important that a brain scan be performed to see if the internal spaces (ventricles) of the brain are enlarged (ventriculomegaly).

However, there are some variations of hydrocephalus, which may not make the ventricles look significantly enlarged! That is why it is very important to move to the next step in diagnosis and have a large volume spinal tap done. Under fluoroscopy, a needle is inserted into the spinal canal and 40 to 60 cc of spinal fluid is taken out. If the person has hydrocephalus, there usually is a significant improvement in alertness and generalized function! This improvement in function may last for a few hours up to a few weeks in duration. Once the diagnosis of hydrocephalus is confirmed the affected adult can have a Ventricular peritoneal shunt placed by the neurosurgeon.

Placing a VP shunt for hydrocephalus is one of the most successful surgeries that neurosurgeons perform. When hydrocephalus is the problem, a shunting can bring back the parent from the progressive brain fog to improved functioning.  It is often a remarkable improvement in function, which improves life for the patient and the family who care about them.

The failure to properly diagnose adult hydrocephalus is a tragedy that can be averted.

A large volume spinal tap followed by careful observation for the effects is the most physiologic and reliable testing for hydrocephalus in adults.

Be Well and be sure to think about water on the brain when grandparents are showing the triple symptoms of mental status changes, impaired bladder control and impaired gait.

Sam Wise MD

AskDrWise.Com  ©


Selling acetaminophen poison over the counter

New Thoughts about some old medicines


One of the curious societal  circumstances is that poisonous drugs are allowed to be sold over the counter in an unregulated fashion and nontoxic ones are restricted. I don't understand why this is so, only that it is so.

One of the oldest medicines in use is aspirin. Salicylic acid was initially extracted from willow bark ( from latin salix=willow tree) and subsequently made synthetically.

It is a phenolic phytohormone which acts throughout the plant to induce defensive responses in the plant to pathogens. Volatile methyl-salicylate is naturally produced by the willow when stressed and will induce a similar response in nearby plants when they are exposed to the vapours.

Willow was used as a herbal remedy for fevers, pain, acne and arthritis. It has an assortment of side effects like urticaria ( rash) deafness, metabolic acidosis and Reyes syndrome.

Continuing applications of Salicylic acid are for acne, as a treatment of dandruff and for dissolving calluses as an exfoliative (removes dead skin).

salicyic acid








In 1897 the Bayer company modified Salicylate by acetylation and "Aspirin" (acetylsalicylic acid ) was born. This was aggressively marketed by Bayer even though it had been first synthesized by the French chemist Gerhardt in 1853.

It was better tolerated that the simple salicylate compound and had additional effects. It is estimated that currently 40,000 tonnes are consumed annually!

(PS: as partial reparations extracted from Germany after WWI Bayer's patents were invalidated by seizure and dispersed to the conquerors . Aspirin was one of those patents)

acetylsalycyic acid







Bayer laboratories was a busy place and one of the things they were working on in 1865 was a synthetic blue dye to replace the expensive and uncommon plant derived blue indigo dyes.

These indigo dyes were rare and expensive enough to be called "blue gold" in ancient India. The natural dyes are a metabolite of the ring/cyclic amino acid Tryptophan, made by the specific fermentation of certain plants in big piles by the Indians to create the blue color.














The destructive distillation of indigo in 1826 produced aniline, a toxic ring compound related to phenol and benzene. This chemical is used for many chemical reactions including the production of polyurethanes and many dyes in the "colourant industry".

A cheap and reliable aniline purple dye was made accidentally by 18 yr old William Henry Perkin in england who was attempting to make quinine in chemistry class. Because He was a student and not employed by a chemical firm, he was able to patent the compound and build a fortune in the dye works.

Later variations of this compound were used for "ditto" machines to print those fragrant blue copies that many of us remember. It was probably carcinogenic too!












While experimenting with aniline, the bayer company made a white powder from coal- tar derived aniline which they called phenacetin or acetanilide.

Since it was colorless and not useful as a dye, they wondered what they could do with it to make money........ So they gave it to sick people!

It would block fever and people who took it would have less pain complaints but a significant number of them would unfortunately turn blue and die. The compound is a general metabolic poison and will often induce methemoglobinemia or even wide spread acute hemolysis.


Despite those little problems it was widely marketed as APC (aspirin-phenacetin-caffiene) until being withdrawn from the market in 1983 because of cancer causing and kidney killing effects (renal papillary necrosis). If that doesn't kill you right away , it caused cancer of the kidneys and urological tract (likely other cancers as well).








A metabolite of phenacetin was observed, then synthesized and has been independently marketed since 1887, it is called acetaminophen or paracetamol or APAP or Tylenol. It is the first direct metabolite of phenacetin  in people.









It was mixed with various other compounds most notably with codeine to limit the "abuse " of codeine and make those who took too much codeine ill! (curiously codeine and the other narcotics are notably NON_TOXIC in comparison to acetaminophen).

How does such a regulatory mind work that would add a poison to a non-toxic medicine purposely to make people sick?

For discussion, codeine is a natural narcotic chemical derived from the poppy. Other natural narcotics are morphine and theobaine . Morphine was isolated from the poppy in 1804 and it's structure as a complex polycyclic was not defined till much later.

Chemically Modified semi-synthetic) narcotics in common use today are hydrocodone and oxycodone. When they are mixed with acetaminophen/APAP they are called lortab or percocet respectively.


These are very common medications and amount to huge $ in the "pharmaceutical " trade.


So what is the problem You may ask? Despite increasing irrefutable data about the toxicity of acetaminophen , it is still being taken like candy over the counter. It is in many witches-brew compounds and is an adulterant in narcotic prescriptions (such as percocet, tylenol- codiene , and lortab).


Acetaminophen is a leading cause of liver disease in the world through acute and chronic mechanisms! Acetaminophen associated Kidney disease is well known and the increase in cancers of all types is highly suspect. There is evidence that Alzheimer's disease is linked with intake of acetaminophen .

Taking tylenol with narcotics is particularly bad because the less poisonous / more natural narcotics are better suited to our metabolism and get preferential attention by our liver cytochrome p450 enzymes.

When this happens, acetaminophen is shunted to a secondary pathway of N-hydroxylation to form the toxic alkylating metabolite NAPQI which irreversibly attacks glutathione and other important compounds in our bodies ( like our DNA and critical proteins).

Some people have metabolisms which preferentially produce NAPQI from acetaminophen even without having any competing compounds like the narcotics present.

Having even the smallest amount of alcohol in your system when taking acetaminophen is equally toxic. Because the  liver metabolism prioritizes natural chemicals like alcohol  and pushes un-natural chemicals like acetaminophen to N-hydroxylations pathways it is imperative to Avoid having any acetaminophen intake with alcohol.

NAPQI metabolism










When the increasing incidence of cancers of all types are noted, the wide spread ingestion of acetaminophen is very concerning. I would like to see acetaminophen banned in all forms.

Just recently, A new "black box warning" has been put on acetaminophen products stating that it may cause liver failure. It should say "does and will cause liver failure".

Tylenol is particularly poisonous to Cats! Even with very small amounts they have untreatable hemolysis (rupturing of the red blood cells) with methemoglobinemia , kidney failure , turn blue and suffocate/asphyxiate. Snakes are poisoned just like cats. Dogs suffer liver damage.

Use of acetaminophen to poison brown tree snakes in Guam has recently resurfaced  but the article entirely leaves out the facts about acetaminophen toxicity in people. They neglected to mention that acetaminophen is also poisonous to fish, birds, mammals, cats, dogs and essentially all animals . Any cat which eats the dead mouse full of acetaminophen will die too.

Acetaminophen overdose is a major problem and is associated with irreversible liver damage leading to liver failure and then death over a 2 to 3 day period, There is only limited treatment possible for acetaminophen overdose and no cure for the liver failure.

I ask: " Why has  poisonous acetaminophen not been removed from the market ?"

You know the answer............ big $$$$ to be lost by reduced direct sales and profits made due to the causative indirect disease  .

Consider that world production of acetaminophen/paracetamol is estimated at 145,000 tonnes (metric tons) or 319,670,280 lbs or 290,000,000,000  tablets of 500 milligram dosage.

So, please avoid taking acetaminophen in any form.

Ask to have narcotic analgesics in their pure form without added poisonous APAP. Take an aspirin instead, but only now and then and never give one to your cat because it will poison them almost the same as APAP.

Choose to avoid poisonous acetaminophen in any and all forms!

Be Well

Sam Wise MD



Carbohydrate Overload and Unintended Consequences

An Article by DR Wise:


Carbohydrate Overload and Unintended Consequences


With the arrival of this New Year I had decided that I was too heavy and there needed to be some changes.  So, starting January 1,2012 I began eating differently. As a physician, I have counseled many people for weight reduction and activity programs. Now I needed to follow the same advice.

Basically, there are excessive amounts of carbohydrates in our modern American diet. Too much carbohydrate intake causes elevated blood sugar, which stimulates the release of insulin. The insulin causes the body metabolism to switch over to fat building from fat burning.

By converting the sugar to fat, body mass increases in an unhealthy way, especially if there is no periodic famine to clear out the larder. In a culture of periodic feast vs famine, being able to save extra calories as body fat  getting ready to survive the next famine might be an adaptive advantage if the feasting stops, but is certainly not healthy if the feasting  continues.

When there is free access to food, especially carbohydrates, obesity occurs. The availability of carbohydrates/ sugars year round is not a natural circumstance in the world. Our metabolism is not suited for it. Many of the food crops we gorge upon are  the result of mankind selecting mutant plants  in a process we call “farming”.

Did you know that many of our food crops cannot replicate on their own and continue to exist only because we plant them?

The most notable of these is our favorite mutant plant, corn. A field of corn will not grow by itself if left untended. Corn must be dried, separated and planted by humans in order to grow.

Our fascination with corn includes food chemistry so that massive amounts of “corn syrup” and corn sugar / dextrose are derived every year. Once these products are available, we feel compelled to use them in whatever manner we can to honor the mutant corn plant, our photosynthesizing Frankenstein.

Corn products have been put into everything possible to make more money off of our Frankenstein plant. Did You know that gypsum wall board is made with cornstarch mixed into the plaster as a “pregelled” texture enhancing material  and that the paper is stuck to wall board by cornstarch adhesive?

I know where black mold gets it’s nutrients so it can  grow in our homes and poison us. Yes, it is fed by our favorite mutant plant, corn.

We have even gone so far as to incorporate foreign genetic material into corn to make it toxic to bugs which would dare harm our creation. Monsanto added genes to corn to kill bugs trying to eat corn, most notably the corn borers.

Guess what has happened now? The corn boring pests have mutated / been selected to be resistant to the toxins now in corn plants.

Another unintended consequence of this Pandora’s box of meddling with Mother Nature is the incorporation of the genetics for systemic toxins into other unintended bystander plants.

Monsanto in their arrogant genius never understood that the genes for toxicity would be freely incorporated by other food crops like wheat or strawberries or fruit trees. Now these plants make poisonous pollen which is unhealthy for bees.

Now that this toxic genie has been released, bees are dying in “colony collapse”, threatening the natural plants that need bees to pollinate. Many of our other food crops also need bees to pollinate them; this includes alfalfa and other forage for our livestock. How is that for scary?

So getting back to my spare tire, I realized that I had been eating mostly carbohydrate laden, convenient, but highly unnatural, junk food. So I dusted off my Dr Atkin’s diet book and cut out carbohydrates.

After the first three days of metabolic pandemonium, I felt much better not being on the sugar/insulin rollercoaster. I feel more energetic, less hungry and more alert. In a month I lost 19 pounds and plan to lose another 20 pounds.

I am now eating food easily recognizable as food, without additives and chemicals. I have resumed cooking but have changed what I am cooking so as to avoid/minimize sugars /carbohydrates.

I know that the Joslin clinic was very wrong by teaching physicians to treat hyperglycemia with unnaturally high dosages of insulin rather that teach people to not eat all these toxic carbohydrates. I believe they had an interest in selling insulin to treat diabetes, not in preventing the cause of diabetes, which is excessive dietary carbohydrates.

So please reduce your dietary intake of sugars and carbohydrates to the minimum. Go on the caveman diet and get healthy. Buy Dr Atkin’s book , liberate all those stored calories and follow  a diet suited for your metabolism.



Use Your Brain and get healthy


Sam Wise MD



Drug Resistant Bacteria

An Article Written by Dr. Wise

Drug Resistant Bacteria

One of the current questions patients ask Me quite often today Is "What about bacteria which are resistant to antibiotics?"

The media is loaded with scary stories about such bacteria these days, seemingly looking for who is to blame. I know who is to blame.

Firstly what are the concerns? Much has been raised about methacillin resistant staph aureus (MRSA) and vancomycin resistant enterococcus (VRE). By reading those sensational  articles It would  seem that these new superbugs have been purposely  created by hospitals and purposely given to the hapless for unknown malicious reasons. Rather than review actuality, hysteriae have been set forth on our country.

Nothing much has been said about multi-drug resistant tuberculosis bacteria or entero-pathogenic E Coli (EEC) which have become increasingly common.

When did you ever see a report about penicillin resistant bacteria? The last one I remember seeing was when I was in training as a medical technologist in the 1970's.

Remember that wild and crazy guy named Darwin who sailed in a boat called the beagle to some lost islands somewhere off the coast of south america to study the animals which had been trapped as individual populations on those rockpiles to change over time into distinctly different forms? His famous study of finches and  iguanas is masterful in it's scientific importance. Basically, over  time there is the survival of those forms best  suited for a specific environment. The faster the generation time, the quicker the selection process is evident. Populations of Tortoises take a longer time to adapt than quickly replicating forms like fruit flies. Even faster adaptation can occur with fast dividing lifeforms like bacteriae. It doesn't take long to exterminate the weak germs and select out the strong (resistant ) ones. Had Darwin known more about his future discovery at the time of his voyage ,He would have collected bacterial specimens also.

Tuberculosis is a bacteria which grows relatively slowly but is fairly resistant (like the sloth of the germ world). Typically , treatment with antibiotics is recommended for extended periods of time (12 months) in order to have a "curative" effect. The problem is that within a relatively short time after starting the medications to treat TB, the afflicted will feel better, move away and stop taking the antibiotics. This selects out the bacteria which are not killed by the antibiotics and they grow to cause more  infections in other exposed persons. The result of this selection are strains of tuberculosis which are almost impossible to treat. This is a major world health problem that is not properly addressed.

EEC is a major problem, driven by greed and improper livestock practices. When cattle are crowded into unnaturally confined spaces such as feedlots to be fattened up for market, they get stressed and get severe diarrhea called the scours. This makes the cattle fail to fatten up, lose weight or even die. This causes the feedlot to lose money. The answer by the industry was to load the feed up with antibiotics to prevent the scours and increase weight gain. The bovine e-coli then can become resistant to all the antibiotics given. Soon they are resistant to all know oral antibiotic families. When bacteria from the cattle's intestines get onto the meat products because of unsanitary slaughter the product is tons of hamburger full of dangerous bacteria. When that hamburger is handled non-hygeincally the cooks get sick and if not adequately cooked, those who eat the product often die.

Proper feedlot management can essentially prevent the scours without using antibiotic feeds and produce healthy fattened cattle, but not as fast . Proper slaughter techniques can minimize bacterial contamination of the meat, but is slower and less profitable. Bulk grinding of meat trimmings can produce prodigious volumes of inoculated burgers.

Greed , greed, and more greed.

Estimates of prevalence for VRE and MRSA in the united states  is roughly %50 of the population! So, if you went to the mall and cultured 100 people in a row, 1/2 of them would have MRSA . Out of that same 100 people, 1/2 would have VRE . I have no idea what percentage  of those 100 would have both, but it is known that bacteria are often very friendly to one another (even EEC to MRSA) and freely exchange genetic material called plasmids which contain drug resistance coding. That is the mechanism by which most of these resistances have spread in our population. We all have staphylococcus and enterococcus bacteria , and resistance development  is inevitable with sufficient drug exposure.

Why are there no more reports about penicillin resistant bacteria? It is because essentially all bacteria in our bodies have become resistant to penicillin since it was discovered by Alexander Fleming on September 3rd 1928. After that date , antibiotic production and distribution has reached humongous industrial proportions. Just look at the ads on TV for a clue.

We could blame it all on the father of antibiotics but please don't. Instead, why not Ask for rational policy on antibiotic usage in all areas of application from feedlots to clinics to hospitals? Please Don't take antibiotics unneeded. Have cultures taken to assure proper selection of antibiotics and effective completion of treatment. Be certain to finish your course of antibiotic treatment  properly , how many partial bottles are sitting in your medicine cabinet?

Remember that we live because of a delicate balance between that which is within and that which is outside of us all. Very Few live in a bubble.  Neglecting the rules of our ecology will result in unintended, negative consequence.

Use your brain first and Stay Healthy !


Sam Wise  MD