Practicing primary care medicine resembles the off-and-on activity of the game of baseball.  The routine of annual check ups and minor problems can suddenly be interrupted by the discovery of urgent, life-threatening conditions like pneumonia, pulmonary emboli, and coronary artery disease.  As internist Danielle Ofri writes, “In contrast to specialists who have their diseases cut out for them—cardiologists get patients with heart problems, pulmonologists get patients with lung problems—the general practitioner has the far more challenging task of sifting out serious illness from the vast sea of aches and pains that afflict the human race.  And this is what we fear, that one of these hundreds of patients will indeed harbor some grave illness and that we will miss it.”

But preventing, detecting, and treating serious health conditions are not the only tasks that matter.  It’s also worthwhile and satisfying to effectively address the minor annoyances that afflict people.  Accordingly, I thought I’d share some pearls an esteemed dermatology colleague shared with me yesterday about brittle fingernails.  This occurs when superficial grooves in the nails lead them to split.  To treat this problem he recommends an over the counter Biotin 3 mg pill daily, applying moisturizer to the nails regularly, and avoiding excessive water exposure to the nails.  If this is not effective, there is also a new, expensive product called Nuvail that can be applied to fingernails to prevent friction on the nail surface and protect against the effects of moisture.