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October 4, 2005

Grand Rounds Vol 2 Issue 2

Grand Rounds

Volume 2 Issue 2

Case Studies

Subcutaneous Emphysema, by GruntDoc. Wow.

Buy That Man a Wheelbarrow, by Dr Bard Parker. Still haven't made his blogroll, but I have to admit Dr Parker serves up some of the meatiest posts in the blogosphere, with a particular emphasis on case studies (students like me love case studies, particularly surgical case studies). So here's his most recent, a wicked hernia. [An editor's pick, not submitted by the author.]

Disaster Response, Part II, by me. I was the team leader for twenty Texas A&M medical students at a special needs shelter in College Station during Rita. The first draft was written within 24 hours of turning over to the next crew.

Clinical Correlations

Applying Single-Disease Guidelines to Patients with Multiple Diseases by Dr James Gaulte of Retired Doc's Thoughts. Dr Gaulte is a graduate of the Tulane School of Medicine and did his residency at Charity Hospital.

Doctors Telling Bad News and How to Tell Bad News by Dr Maurice Bernstein at Bioethics Discussion. Starting from a post by Dr Greg P at Information is Free, Dr Bernstein expands on the topic of giving bad news.

News and Commentary

The Nobel Prize in Medicine goes to Barry J Marshall and J Robin Warren for their association of helicobacter pylori to stomach ulcers, from DB's Medical Rants.

The Liar's Brain, by Dr Emer. Dr Emer comments on an original article from the British Journal of Psychiatry on structural differences in the brains of pathological liars. PS: Gruntdoc also commented on this article.

BBC Invents New Germ: the E. coli "virus", also* by GruntDoc. Comments are short, but I think both of GruntDoc's BBC links raise a much larger issue: the BBC is substantially rewriting articles after going to press?! Journalists are supposed to get it right. Period. What is going on at the BBC that they allow anything short of retractions, which involve an admission of error?

Where Should Donations Go?, by Elisa Camahort of HealthyConcerns. Ms Camahort provides two alternative ways to dispose of excess monies generated by a charitable campaign. What other alternatives can you think of? How would they play out? I'm particularly interested as I added a donation button to my blog.

Drug Approved to Help Alcoholics Also Effective Against Tinnitus by Joseph at Corpus Callosum. The title is introduction enough.

Harvesting Brains Without Consent. Ironman, of Political Calculations, provides a synopsis of this case against the King County Medical Examiner's Office, which sold brains of mentally ill patients to a research foundation in Maryland.

I Will Name My Anger Scowly McGrimace And He Wrote This, Not Me, by the Jerry at the Cosmic Watercooler. Jerry takes issue with Morley Safer's softball treatment of Robert Oxnam's new book.

Group Doctor Visits: on the rise? from Hospital Impact. The blogger reviews group therapy, particularly for Kaiser Permanente's obstetric patients.

Stealing Endoscopes and Colonoscopes, by the Interested Participant. Who steals colonoscopes? Funny I should know this, but an essentially identical device is used for diagnostics on turbine engines and other equipment with very high, very fast internal rotating forces (pumps, engines, etc).

Clowns in the OR, by Aggravated DocSurg. Uh, yeah.

Late Addition

National Depression Screening Day is 6 October. Thanks to Dr Serani for this notice.

Perspective

Within These Hands, by the Cheerful Oncologist. Compare this to They Sent Me Here, by Dr Danielle Ofri, editor of the Bellevue Literary Review.

Running Through My Mind, by Shrinkette. Editor's pick, not submitted by author.

The Ghost of Influenza Season Future, by Dr Charles. Dr Charles' fictional piece has the feel of The Minority Report, except this is possible. As we saw with Katrina, horrific scenarios need this sort of thinking before they happen. Loaded with facts and, at the bottom, helpful references.

Identifying a Pill by Dr Mic Agbayani. How many times has this refrain been repeated? No matter, it bears repeating again. Rather than a possible horrific scenario, this one plays out, surely, millions of times every day.

Becoming a patient by Jen SN. An editor's selection, not submitted by the author.

There's a Reason They Call Nature a Mother by Josh Cohen of Multiple Mentality. Josh continues to his weight-loss struggle while recording his observations, almost as though he is leaving breadcrumbs for himself and others.

"When You Look Up", by Geena at Codeblog. Geena's submission is, in her words "a silly little post". Well, maybe, but nerdy students like me actually go study up on spinal traction after reading.

Teaching Compassion, by the Red State Moron. Some of Harvard's material mentioned in the article is now posted (free) at the New England Journal of Medicine.

Behind the Mask by the Difficult Patient. DP continues to struggle with her most distressing physician encounter.

Correspondence

Another writer questions JAMA’s Scientific Integrity, by Dr R W Donnell. Dr Donnel comments on one Dr Hanson's comment on another author's comment on a JAMA article. [Ed: Dig deep on this one and you'll find Regulation, a publication the Cato Institute, the neo-conservative think tank.]

Blogger of Gloom and Doom by David Williams. Mr Williams offers planning advise to people looking at retirement.

A Little Criticism Directed Orac's Way by Orac at Respectful Insolence. Orac slogs through the hinterlands of logic searching for lost souls to invite to the hearth of science. In this post he does battle with some of his more vocal critics. Pay attention - he discusses a few clinical biases that caregivers do need to gaurd against in their own practices.

Communication

Ed: A quirky category where these all seemed to fit.

Communication Skills by MSSPNexus.

Why Connect Medical Devices, by Tim Gee. Inspired by a reader, the connectologist struggles with the fundamental problem in medical technology: so what's this data good for? [Ed: this also comes up in the military, particularly in the tech heavy Navy's combat information centers aboard ships where shoot-don't-shoot decisions are made without ever seeing the attacker. Life-and-death decisions are intimately tied to the information the decision-maker has at the time. Anything that enters that relationship between the decision-maker and their information is bound to be caught up in the painful struggle).

Make the Largest Encyclopedia in the World Better, by Clinical Cases. If you haven't actually contributed to the Wikipedia yet, it's a win-win: you get to share what you know; we get to learn.

Book Reviews

Jill Quadagno's One Nation, Uninsured, by Dr Stern of Insureblog.

Editor's Picks

Paul Starr's The Social Transfomation of American Medicine. This is a must read for the health insurance debate; it won the Pulitzer Prize in 1984 and remains highly relevant. Nothing has taken it's place.

Edward Tufte's The Visual Display of Quantitative Information. A visually stunning book, Tufte's work will make you a better presenter, a better communicator. One of Amazon's 100 best non-fiction books of the 20th century.

George Lakoff's Don't Think of an Elephant!. It's much shorter than his seminal (and less partisan) Metaphors We Live By. If you want to understand politics, you've got to read one of his books.

Nota Bene

The Pulmonary Roundtable is loaded with case studies.

Assassins, by the first year Texas A&M medical students. What a novel use of a blog [Ed: Cheryl got me].

Insert Clever Title Here by a New Orleans family doc and the wife of a classmate.

Liveblogging Katrina Relief in New Orleans, by Enoch Choi at Medmusings. Dr Choi is being housed in Kenner, a bit west of the city, and working — where, I'm not exactly sure.

Push Fluids, by three MDs, is notable because it's still here, having survived the shift of the three authors from students to MDs, and the incumbent moving around the country.

Kent Bottles Interviews Intueri's Maria. Possibly the best new addition to the medical blogosphere interviews one of the best.

End Matter

Finally, this is from Dr Gary McCord, a radiologist and the dean of student affairs at Texas A&M. I'll save the details for another post, but I will never be able to repay the debt of gratitude I owe the Aggies.

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The waiting room for our Pediatrics clinic where I trained was a large open area. Kids played in the middle and the parents sat around the periphery with the secretary's desk at one end. This day it became quickly evident that one 8 year old was terrorizing all of the other kids while waiting to be seen. Periodically, Johnny's mom would get up, attempt to remain calm, and quietly talk in his ear, telling him to calm down. Little Johnny got louder and louder over time, and his mom got more and more embarrassed, but seemed unable to help him gain control. After 10 minutes of this, he pushed another child to the floor. Mom bolted over to where he was and exploded. She picked up Johnny by the shoulders, carried him over to the secretary's desk, and slammed him down into a sitting position on top of the desk. She proceeded to read him the riot act, while the whole waiting room got very quiet, all eyes fixated on what this kid might do next.

After her diatribe, and having been slammed down on top of the desk, Johnny announced in a voice that all could hear, "Now you've gone and done it! You went and smashed both my balls!"

Mom was mortified. Some of the other parents started snickering, while others shook their heads as if to say, "But for the grace of God go I..."

Then Johnny hopped off the desk, reached into his back pockets, and plucked out a smashed ping pong ball from each.

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Next week's Grand Rounds will be hosted by Doulicia

Posted by Niels Olson at October 4, 2005 12:01 AM

Comments

Posted by: jeff at October 4, 2005 6:28 AM

Posted by: Tim Gee at October 4, 2005 11:47 AM

Posted by: R. W. Donnell at October 4, 2005 2:16 PM

Posted by: hgstern at October 4, 2005 6:57 PM