General Medicine Knowledge

A Cranberry question highlight our ways of knowing…

Technology has changed things in so many ways.

When I was Will’s age (12) there were no remote controls, a rotor which turned our antenna on the roof for better TV reception of the 4 channels and no cell phones, heck-there were rotary dial phones.
Information was less accessible as well. There was a building on Main Street called the library. Paper 3×5 cards told you where books were located. Really, this is true.
In college, my first semester Gen/Ed course was entitled “Ways of Knowing.” This was before the internet revolution and google.
Even in medical school, we looked things up in the library in bounded heavy books. Requirements included, getting dressed, shoes, coat, nickels for copy machine and often your car.
This week in the office a patient who required the blood thinner warfarin, complained to me that she was told not to eat cranberries. She loves cranberries. “I want to have cranberries at Thanksgiving.”
Hmm, the brain goes into action.
“Verbatim memory:” Cranberries are featured at Rainbow Blossom and Whole Foods. They must be good. I know Staci eats them. That’s good as well. They have anti-oxidants and are red (not white-white things are bad to eat).
“Gist Memory:” The big picture thinking is someone told her not to eat cranberries while taking warfarin. Must be a reason. Also, it’s well known that fellow fruit, grapefruit, has important interactions with medicines.
What to do in 2009? Say, to the patient, “Standby.” Swing around to the computer in the exam room, click on the google icon and enter “cranberries and warfarin.” Voila! In less than one minute, I read that the flavanoids in cranberries MAY, inhibit the important CYP450/CYP2C9 enzyme system in the liver. This is the same enzyme system that metabolizes warfarin and thus, cranberries may increase the blood thinning effect. It is a potential interaction only and numerous studies since the first case report show no significant effects. All in 45 seconds.
I tell the patient that occasional cranberry ingestion is ok. She is delighted.
My verbatim memory is enhanced. Does one wonder how modern day information availability affects modern day learning. Will doesn’t have to go to the library. Is this good or bad? Does it help “gist” (big picture) knowing. I’m not sure but it sure is cool.

3 replies on “A Cranberry question highlight our ways of knowing…”

Thanks for this post! Michael takes that med, and I love cranberries. I will make sure to make lots, but make sure he eats them in moderation. Add cranberries to the list with dark leafy greens!
Marcia Seiler

I'm not sure they have the same immediate impact as those leafy greens but everything in moderation or at least until you get your INR regulated.

Here's another no-go for launch –

Mucinex DM and Cranergy drink with B-Vitamins. I'm pretty sure I'm in SVT, or maybe even afib. AND I had a Halls cough drop earlier. Bad news bears.

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