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But as my time for blogging has gone down, my reading and writing has actually gone up, just for a different reason.In science, unlike politics, there is value in saying, “I don’t know,” or “We don’t really know, but it might be this,” or “Actually, what I believed last year is no longer likely correct.” Once you actually embrace this notion—that you can’t know everything, that facts have a half-life, and that humility is a blessing more than a curse when it comes to trying to understand the natural laws of our universe—you become obsessed with research. Other times a patient asks a question to which I I know the answer, but a day later I realize the answer I gave them was based on my last reading of the literature, which on that given topic was circa 2007. Do PPIs really increase the risk of Alzheimer’s disease?My “work” obligations, even with the huge reduction I deliberately made in exercise time, made it too difficult for me to keep up. Today, my practice employs a team of research analysts who are not just exceptionally bright and voracious consumers of literature, but also people who are so naturally curious (arguably the one skill I can’t really teach) that when you give them a problem, it’s just a matter of time until our collective knowledge on the topic will be increased.The list of “To read” papers on my desktop was becoming an eyesore. Over the past year the volume of reports we’ve created—both in response to patient questions and our more elaborate proactive research agenda—has been impressive, though largely underused. We’ve even created an internal helpdesk to moderate, organize, prioritize, and keep track of our work.With more and more papers published by the minute, just how much noise is generated in the current landscape?Our conservative calculations show that, “these go to eleven.” To be sure, there’s still a formidable amount of information and knowledge waiting to be plucked from the literature. In 2015 I came to the realization that I was slipping.

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Bob Kaplan, our head analyst, is a really amazing guy, and not just because he’s done more pullups than pretty much any one on earth, though that helps.What started as a weekly email to a handful of friends grew into a substantially longer list of friends, then friends of friends, and quickly expanded to complete strangers.By late 2011, I decided to start putting my emails into long format and posting them as blogs.Once the book is out, we’ll also publish the “outtakes” (i.e., the stuff the publisher felt was too dense for the book).

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And—eventually—what I really hope will come of all this is something that so many of you have been asking of me for years: an online forum where patients and doctors can find each other.

To really learn something requires contemplation and thinking—even as the reader—and over time this leads to new insights, which is one of the most rewarding experiences I have come to know.

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