I showed a patient her brain tumor

…the other day. She’s a terrifically nice lady, and has been diagnosed with a tumor about 2 months before.

She became my patient after she tripped and fell, and needed a head CT. When I was closing her wound, she said “I keep asking to see it, but nobody will show it to me”.

My last act that shift was to unplug all her monitors and put her in a wheelchair for the ride to the monitor. We had a nice talk about where it was, and that we were going to admit her due to the increasing edema. She was very happy to finally get to see it.

I wonder if I’d want to see mine?

Cross posted at the Lingual Nerve, an odd collection of medically minded, group bloggers.

Apologies

My typical post-vacation busyness, combined with a new computer, have conspired to keep me from commenting on the vast nothing I find interesting right now.

No doubt I’ll be stirred to post tonight, but for now, nada.

Back from vacation

We’re back, and had a terrific time. I’m so re-energized I need a vacation to rest up from the vacation I just had.

For those of you with kids, you’ll recognise this look:
travels with a pre-teen

More to follow.

Vacation / Best Of

My gift to you is that I’m taking a vacation, so all those wasted hours refreshing to see if I’ve posted yet can be used to a more productive purpose, but only for a week. I’ll be back early next week.

My amends for my absence is that I’ve gone through the archives and have linked some of the ‘better’ stuff you may have missed / forgotten. I’ve been meaning to do this for a while, and this is my chance / excuse.

In reverse calendar order:
Why GruntDoc?
Consults and Pain
my DSL Horror Story
LCPL Anthony Sledd, USMC
Bird Strike
Organ Donation
Ladies Save C-5
Go to the ER
Who makes the ED run? The Secretaries
Liberia Marine Malaria: Inexcusable
Stanford sets new policy for med students
Liberian Marine Malaria Results
The Twelve Sexual Diseases of Christmas
My favorite Dilbert cartoon
Word to the Wise
So, you want the Navy to pay for your Med School
New Feature: Guess the Diagnosis

Back next week, see you then!

Happy Birthday, Doggies!

dogtulosba, ink. – soapiate of the masses mentions that Today is the 229th Birthday of the US Army.

Thanks for your service, proud Army Veterans, and Happy Birthday!

Bush parachutes for 80th birthday

CNN.com – Bush parachutes for 80th birthday – Jun 13, 2004

Given that my interactions with those in their 80′s is usually very bad (octogenarians don’t come to the ER for laughs), I’m very happy that Mr. Bush has the health and willpower (and connections) to do this. His message is good, too: don’t just sit there, do something!

The video from CNN is also very nice.

Graduation Day

My son Bob graduates from UCLA at the end of the week, and we’re using the opportunity to introduce my grandson (about 4 1/2) to the Wonders of Disneyland.

Bob’s degree is in Philosophy. I have nothing against philosophy, and think that it’s a good choice for him, given his advanced degree choice, Law. He’s gotten into a good (he tells us) law school, so things are working out.

However, his degree amuses me. What is the application for that degree? For me, it’s an invitation to humor.
[Read more...]

Alcohol Report

Fron CNN: Report: Alcohol abuse up, but fewer alcoholics.

This gives me a chance to tell one of my favorite doctor jokes:

Q: Who is an alcoholic?
A: Someone who drinks more than their doctor.

Don’t write me letters, I know alcoholism is terrible, etc. etc.

Friday Night Lights

There’s a trailer out for the movie about Friday Night football in West Texas.

Yahoo Movie Page for Friday Night Lights.

It’s opening in October. It may well be the first opening day movie I’ve ever seen.

Took my daughter to her riding lesson today

Of course, it’s pouring rain, so the drive was very wet, but uneventful.

I got home about 10 minutes later, and the phone’s ringing. “Dad, can you come and pick me up? It’s the wrong day”.

My wife leaves for ONE DAY and I cannot keep things straight. Geez.

Listeriosis Health Advisory

This was sent last week to Texas docs, a warning to be on the lookout for another listeriosis outbreak (not a Listerene outbreak, which would be a good thing).

The Texas Department of Health (TDH) has received reports of listeriosis cases that occurred recently in residents of four counties in South Texas, North Texas, and the Texas Gulf Coast. The five cases had illness onset dates in February, April, and May of this year. Genetic analyses of isolates from three of the patients indicate identical strains of Listeria monocytogenes for two patients and a similar strain for the third patient. The infections have resulted in one adult death, one fetal miscarriage, one premature delivery, and two other serious illnesses. Consumption of queso fresco within the incubation period for listeriosis was reported in four of the five cases; the source(s) of these cheeses is not yet known.

In addition, the Centers for Disease Control and Prevention (CDC) has received reports of recent listeriosis cases in four other states. Two of these cases had the identical or nearly identical strain of L. monocytogenes as the two identical strain cases in Texas; one of the patients with an as-yet unidentified genetic strain of L. monocytogenes reported consumption of queso fresco.

I had no idea what “queso fresco” was, and there’s no explanation in the advisory. Fortunately, the Food Dictionary does know:

queso fresco
[KAY-soh FRAY-skoh]
A white, slightly salty, fresh Mexican cheese with a texture similar to that of FARMER CHEESE. Queso fresco is available in cottage cheese-style tubs in Latin markets and many supermarkets. Also called queso blanco.

So, throw out your queso fresco, and get some new cheese. And some Listerene, too.

CDC info about Listeriosis

Ark

For those in the DFW area, I’m considering building an Ark. Anyone want to help?

Enough with the rain. Bring on the heat and oppressive humidity of summer.

Serendipity vs. Luck

A few days ago I was comparing notes with a colleague, and we both related unexpected findings from tests, findings which significantly altered the course of treatment for these two patients.

Serendipity came to mind as a description: serendipity \sehr-uhn-DIP-uh-tee\, noun:
The faculty or phenomenon of making fortunate accidental discoveries.

Luck also came to mind: luck n.
The chance happening of fortunate or adverse events; fortune: They met one day out of pure luck.
Good fortune or prosperity; success: We wish you luck.
One’s personal fate or lot: It was just my luck to win a trip I couldn’t take.

I suppose the biggest difference is that you cannot have bad serendipity.

My case was a fellow with a hernia I was CTing and found renal cell CA, a potentially curable problem that usually goes undiagnosed until it’s too late. My colleagues’ case was a fellow with a femur fracture from being thrown off a bull. Absoultely benign abdominal exam. The EP’s quote was “I wimped out” and ordered a CT, which found a subcapsular splenic hematoma (bleeding around the spleen, but inside its protective capsule – at least for a while).

This stuff makes me want to just CT people at triage.

edited for spelling

My Reagan Memories

Others have said it better, and I am not maudlin enough to try to express how I feel about his Presidency, and his passing. I do, however, remember where I was when he was shot.

I was a senior in High School, and my government class (lead by the same government teacher who would later perform my marriage) went to Federal Court to ‘see how government works’. The case was modestly interesting: the Govt. wanted to take all the loot from a salvaged ship, after a private company had done all the work to find it and bring it up. I digress.

We were in court for about 2 hours when the Federal Marshall started going to the Judge every 3 minutes or so. After the third such visit, he said “President Reagan has been shot. As the Order of Succession includes Federal Judges, I have to leave now”. And he did! Court is adjourned, and we went back to class.

I have read so many good tributes to the man, I just want to second them all. I’d be glad to be half the man he was, someday.

What’s on my locker?

Well, this is. It was put there by one of the scribes after an evening of seeing patients and going to the coffee machine.
On my locker
The hand-written addition is by a fellow physician, reading ‘And it was Good, but God said “Limit yourself to 3 cups an hour”.’