Medblogs Grand Rounds 7, Here!

Welcome to Medblogs Grand Rounds, a weekly rotating compendium of posts by the medically minded. Here you’ll find writings from many different perspectives about medicine, patients, and thoughts about the medical parts of comic books (really).

Thus far the hosts have had somewhat varying organizations for the submitted posts, and I will continue that trend, by posting a little snippet, to whet the appetite for more.

We begin with the most topical topic, that of Mrs. Elizabeth Edwards, wife of Senator and presidential candidate John Edwards, being diagnosed with breast cancer (from CNN). Via Kevin MD, a review of the most common type of breast cancer:

Prognosis for women with early stage disease would vary according to tumor size and spread. The 5-year survival rates for lymph nodes negative, 1-3 positive, and >4 positive are as follows:

And follow with three remote-from-the-bedside opinions about the cause of Yasser Arafat‘s non-fatal, reversible, but maybe-a-little-fatal affliction. All three (Dr. Rangel, MedPundit and CodeBlueBlog) agree the underlying cause is liver insufficiency/failure, though CodeBlueBlog has a hypothesis as to why he took a sudden turn for the worse, just as he was making Monty Python noises about “getting better”:

I think the final diagnosis is going to be Hepatitis and iatrogenicide.

For what it’s worth, I think he had an intracranial hemorrhage (stroke) due to his announced thrombocytopenia (low platelets). We will probably never know.

Next up are a pair of reviews about a thought-provoking New York Times article about two interns, by Jonathan Wilde of Catallarchy

Lifestyle considerations do not necessarily lead to undedicated doctors. There are incentives in both directions.

and Bard Parker of Cut to Cure:

Medicine has always attracted a wide spectrum of individuals, from the lazy and disaffected to the deeply committed. Even draconian scheduling policies may not change basic personality traits, or the kind of doctors that interns grow up to be.

Obesity and its flip side are both debilitating. From Interested Participant, we hear that

According to the United Nations World Food Program, virtually every country on the entire continent of Africa is malnourished…(m)eanwhile, in Sun City, South Africa, the First African Obesity Conference recently concluded with the determination that obesity is “completely out of control.”

and find that starvation is linked to behavioral problems, per Mental Notes‘ Dr. James Baker:

If you let a toddler become malnourished, you increase his chances of behavior problems throughout childhood, according to this research in the American Journal of Psychiatry.

Politics raises its unusually medical head, with medical post-election commentary from Dr. Rangel which is a rich linkfest of its own, and from Matthew Holt’s The Health Care Blog:

I don’t think that we are going to see any serious expansion of Medicaid to cover the working poor, and the defeat of Prop 72 in California augurs poorly for any expansion of employment based insurance.

Keeping an open mind it important, per Dr. Centor of DB’s Medical Rants

Physicians err when they do not think. We must keep an open mind. I like to recall Peter Falk?s Columbo routine – you know the one where he is leaving the room, pauses and turns, and says, ?You know, something is bothering me ??

especially when your transgendered patient requests a mammogram

As I began to conclude a rather disjointed visit, she looked at me with concern. ?Shouldn?t I be getting a mammogram, doctor??

from The Examining Room of Dr. Charles.

Cancer is the unifying theme of the next four posts. The Cheerful Oncologist wishes to share about some of the less worthy in medicine

Although it sounds as hideous as it is strange, I have worked with several doctors who have such a nihilistic attitude toward the treatment of cancer that they harbor prejudice and ill will against their own patients fighting the disease.

while Dr. Emer of Paralell Universes has some science to back up a cheerful attitude, followed by his anecdotal evidence

In practice, I have always observed that there is a world of difference between an OPTIMISTIC sick patient and a GLOOMY sick patient. The optimistic patient has always recovered more favorably and faster than his depressed counterpart.

a finding echoed by Hospice Blog, that patients on hospice live longer

…these things boil down to one common point. Hospice patients live longer because they have someone who caring for them. Simple, but true.

and the story of an individual with a bad cancer and an excellent attitude, from Geena at CodeBlog

Yet he still wants to get out of bed. He goes from bed to chair several times a day and has even managed to manage his own wires for himself. Unfortunately, every time he exerts the amount of energy necessary to move from bed to chair, it takes him quite a long time to catch his breath again.

And now, for something completely different: A review of the recently released comic book Strange issue #2, focusing on the medical aspects of the comic, from Family Practitioner Scott at Polite Dissent

Strange #2 was much better than the first issue. The story and art were improved (though not as good as Lee and Ditko?s original), and the medical aspect was better thought out. My only major medical gripes were a couple of typos due to poor editing. There were some smaller nit-picks too, of course.

Lastly, a Fool Physician and his Money are soon parted, via Symtym

I’m always intrigued by the propensity of “professionals” to be so easily pandered and duped. No doubt x?lan offered a special decoder ring and had a secret handshake for all those “special” meetings ?

Just a rule of thumb, the word pyramid when used with “funding” or “financial” is never a good thing! (as in Pyramidal Funding Systems)

MedRants is hosting next week, and get your submissions in early! Many thanks to Nick at Blogborygmi for getting the whole thing started!


  1. Charlie (Colorado) says:

    Woo! Good pickup!

    For what it’s worth, I think he had an intracranial hemorrhage (stroke) due to his announced thrombocytopenia (low platelets). We will probably never know.

    Via Drudge:

    Palestinian leader Yasser Arafat is still alive and efforts are being made by his French doctors to stop the haemorrhaging of his brain, negotiations minister Saeb Erakat told reporters.

  2. Arafat could very well be an alcoholic and has now developed end-stage alcoholic fulminant liver failure after many years of chronic active cirrhosis.. This could explain also the sudden jaundice, the “gastric problem” (?gastritis or ulcers due to alcohol?), the thrombocytopenia, the cerebral hemorrhage. Also his viral illness could have been a trigger tipping him over to end-stage liver diease – surely you can’t rule out hepatitis A, B, or C nor any hepatotoxin neither.

    Remember when he was holed up in his building several months ago with the Israeli’s threatening to take him out? That could have been a time when he might have been drinking heavily to calm himself.

    I think if the diagnosis was a type of cancer like metastatic pancreatic, hepatic CA, or cholangioCA, this would have been more easily found – either with serum markers and/or abdominal CTs. If the diagnosis were carcinoma, there would be much less secrecy about it also. The big mystery about his diagnosis makes the diagnosis either of two things: either Arafat was poisoned with a hepatotoxin (and the pro-Israelis are trying to avoid making him a martyr), or Arafat is an alcoholic (and the pro-Arafat faction is trying to hush this story up).

    Also, why weren’t there any calls for liver transplants as soon as he took ill? He’s too old to receive a liver, but with his clout I’d think some young suicide-bomber would be willing to give him his liver.

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