Complications is a new blog by an orthopedist. Welcome!

A long time ago a common requirement for an ortho residency was “bottom 10% of your class and able to bench your own weight”. Now it’s top quarter, but strength still counts for something.

His jokes are funnier.

Don’t read indignantly from your performance evaluation, unless you want the listners to secretly agree – with the bad parts.

Eject! Eject! Eject!: 1.0 INTRODUCTION

From Bill Whittle, How to make an Ideal American.

I had Adult Beverage coming through my nasal passages at one point reading this.

It’s that good!

ACEP.org, EM Today: Vasopressin for Asystole?
I’m always suspicious when a drug that’s been around for a while turns out to have previously undiscovered powers. Such is the case with vasopressin:

The January 8 issue of the New England Journal of Medicine includes an article suggesting that vasopressin may be superior to epinephrine for patients in asystolic cardiac arrest (Wenzel et al for the European Resuscitation Council Vasopressor During Cardiopulmonary Resuscitation Study Group: “A Comparison of Vasopressin and Epinephrine for Out-of-Hospital Cardiopulmonary Resuscitation,” NEJM 2004;350:105-113.)

An accompanying editorial grabbed the attention of the popular press with the statement that the study’s findings “should be translated into a new standard of care without delay.”

Not so fast, says ACEP in the above linked article. This definitely warrants more study, but is far from standard of care.

And, let’s not forget that when you wind up in aysytole, the game’s usually over anyway.

Overlawyered: Update: Texas lawyers raced to beat damages limit

… The equivalent of four years of medical liability lawsuits were dumped on Harris County courts in the first nine months of [last] year — prior to the effective date of the medical liability limits. This pattern of flooding the courts was repeated statewide. All of the cases have to be defended, and all are governed under the old law, which imposes no cap.”

But it’s not about the money, nooooo……

CNN.com – Two women in plot to poison one’s husband – Jan. 9, 2004

So, allegedly these two geniuses decided to poison the husband of one of them. So far, pretty boring stuff.

The part that jumps out at me is that they made ricin, a very powerful biologic weapon, from a recipe they got on the internet.

That’s not good news, because on reading the rest of the article it’s pretty clear that these two have not cornered the market on intelligence or cunning. If people this stupid can make ricin, anyone can.

Sleep tight!

Medpundit: Anthrax

Dr. Smythe over at Medpundit, the best ‘Medical Blog’ around, has been following the Anthrax immunization court actions. In case you missed it, the immunizations were stopped by a judge about 2 weeks ago, then the same judge has allowed them to restart. She has gotten an email from someone who, apparently, either hasn’t done their homework or is trying to spin the argument.

This is one of those issues that engenders so much emotion in its opponents that their few legitimate concerns get buried in a sea of claims that are either false or deliberately misleading enough to completely turn me off. Your mileage may differ, but I don’t get it.

For the record, this is the first immunization series in the military that was command driven: this wasn’t the medical departments’ idea, this was the line command saying that the troops need this vaccine. I left the service just as this vaccine was coming on line, and missed it. I’d get it if I were in.

Family Medicine Notes: January 09, 2004 Archives

He’s got a nice post about how different professions speak their own languages. I agree, but I think that docs in particular might be worse about using ‘doctor’ language with patients when regular words would be less technically correct but much more understandable.

So, what’s the dumbest thing your doctor has said to you?

via Tales of Hoffman

Long-Term Coffee Consumption Significantly Reduces Type 2 Diabetes Risk: Harvard School of Public Health

The researchers also found that for men, those who drank more than six cups of caffeinated coffee per day reduced their risk for type 2 diabetes by more than 50 percent compared to men in the study who didn?t drink coffee. Among the women, those who drank six or more cups per day reduced the risk of type 2 diabetes by nearly 30 percent. These effects were not accounted for by lifestyle factors such as smoking, exercise, or obesity. Decaffeinated coffee was also beneficial, but its effects were weaker than regular coffee.

Drink up!

via Slashdot

Spirit of America is the funnel for donations to the 1st Marine Division, which is going back to Iraq.

They’re collecting money to help win hearts and minds. If this interests you, follow the link and donate (it interested me).

The Marines are usually thought of as the least intellectual service, but this, and their decision to wear their green camo instead of the desert uniforms, strikes me as very smart.

what Chris Muir was talking about in today’s installment of his excellent cartoon Day by Day (think conservative Doonesbury, but with talent). I digress.

Godwin’s Law.

I get it now.

Update: Mr. Muir comments.

The Doctor Factor (washingtonpost.com)
Several have held forth about this recent screed in the Washington Post. I have read it several times and have not been filled with warmth or compassion for the writer.

The man is a doctor. This is the least-examined chapter of his career. But suddenly it all makes sense: Where else but in medicine do you find men and women who never admit a mistake? Who talk more than they listen, and feel entitled to withhold crucial information? Whose lack of tact in matters of life and death might disqualify them for any other field?

Uh, journalism?

Try this exercise: watch a televised piece, or read an article about something you know pretty well, and find all the areas where the reporter left things out, or glossed over big parts, to get to the story they want to tell. Or, just recall the last 20 times you’ve watched some televised fool stick a microphone in the families’ face and ask “..and how do you feel (about this horrible tragedy)”, which in a just world would be followed by a beating.

I have met some really incredible jerks in my practice of medicine, and have to deal with a few nearly every day. Many, many more are friendly both to colleagues and their patients. It’s human nature to recall the unpleasant one out of the sea of thousands, it’s pettyness to paint everyone based on the worst of any group.

The author here has engaged in some pettyness of her own, slamming doctors. It’s fun, and easy to do. Doesn’t make it right, though.

And, question to Andrew Sullivan: How is medicine an “undemocratic profession”? It’s democracy in action: people who are highly motivated and smart with good grades get into medical school. Those who apply themselves get the best residencies, then get to work 80 hour weeks for years to learn a profession, which requires constant education and recertification. All this to be Doctor in the most regulated profession on earth. The vast majority laws which I must practice under are written by people who don’t practice medicine, enforced by non-physicians and openly reported on. That’s democracy.

:: doctorgrosz dot com ::

At least one office doc has a patient who worries about such things.

Star Telegram | 01/03/2004 | LIVING LARGE IN TEXAS is how it’s titled in the online version of the Fort Worth Star Telegram, but the print version headline was better (the title for this post).

We’re number 6 in the nation, according to Men’s Health Magazine, which is where I go for my epidemiologic research. Dallas was number 3, and Arlington was number 8.

I don’t put a lot of stock in this sort of thing, but we do have our fair share of heavy hitters here.

Really I just posted it because I liked the title. Oh, and for the record, the Fort Worth Star Telegram is a pretty good fishwrap for straight reporting, just remember the rule on their editorial advice: always do the opposite of their recommendations. You’ll be glad that you did.

OK, I have never worn a flight suit, and would look like Mr. Bib if I did. However, for those who know the answer the question:

Why aren’t flight suits camouflage colored?

All that I’ve seen are OD green, Navy blue, or Khaki (all Army as near as I can tell), no doubt a requirement from way back when they were first ordered, and probably the Nomex could only be made mono-color. That was then, this is now.

It seems camo is getting more and more complicated and effective, but the usual flight suit is still OD green. Seems to me that they should be camo, so that when they decide to stroll on the deck they have a better chance of hiding.

It’s always possible that they exist and I haven’t seen them (or they’re a huge secret), but it seems odd. If the Chinese can send a man into space, we can make camo flight suits.

Can anyone enlighten me?