Clinical Cases and Images – Blog

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The medical blogs community reminds me of the hospital structure. It is very interesting to see that the medical blogosphere has spread well beyond the limits of doctors and nurses as authors (click on the diagram to see this week’s authors according to job/topic description). Grand Rounds is a snapshot of the best posts and shows the wide variety of medical blogs. It takes us all to make the miracle of healing happen everyday.

Quite a well done presentation, one that’s going to be remarkably hard to follow.

Speaking of which, Medblogs Grand Rounds is here next week! See the left sidebar for how to submit your posts.

Today, while cycling, I reminded myself that I’m a terrifically competitive person. This was my first time back in the saddle in about two months, and before starting I said to myself, about twenty times, ‘this is for completion only’. That means I wasn’t pushing for times, or speed, just for completion.

Then good intentions got squashed by my inner demon, competitiveness. It nearly always wins over good intentions.

They Called Me Gunner. I (and one commenter to this site) wore this appellation in medical school, and it was deserved. A medical school gunner is one of those hyper-competitive people who really wants to be at the top of the class. I’ve seen other definitions that includes sabotaging others, and there’s a different name for those people, and it rhymes with stick-bed. Time has made me a little more selective about the competition thing, but it’s still in there.

Back to the ride. I was only about 6 miles into it, a beautiful ride on a very popular bike trail on a nice day, so there were a lot of cycllists (and angry loners, too). I was loafing, I’ll admit it, admiring the blackened terrain from a recent grass fire, and then I noticed a cyclist behind me, about 150 feet.

‘Click’ went the switch, and suddenly it became very important for me to Not Be Passed. Now, I’m not going to block or do something stick-bedded, but if I can push harder and keep the same or bigger interval, I’ll do that. And I did, with a series of cyclists who appeared seemingly out of nowhere. It struck me, pedaling with a gastroc cramp, how sometimes that little competitive thing can work against the good intentions.

And it was a good ride, too.

Gunner. Heh.

Sean Gleeson : Dean’s Song

Apropos of nothing whatsoever, the link takes you to a duet featuring Howard Dean and Supreme Court Nominee Sam Alito. Oh, and it’s set to the Dean Martin, Sammy Davis tune, “Sam’s Song”.

It’s not JibJab, but it’s pretty funny.

via InstaPundit

As an Emergency Room doctor I’m quite used to the completely chaotic, barely-organized environment, and while it’s not a really comforting place for me to be I handle it was well as any other (I think). However, the high-speed, get-things-done-now pace sometimes can lead to some bad habits, and one of them has recently risen to the level of Formal Irritant: interruptions while speaking.

We all need to communicate, and we all need to get things done quickly for any type of efficiency to happen. I truly get that, and operate that way myself. But, because you want to have a question answered in the shortest amount of time doesn’t mean you get to interrupt me while I’m trying to communicate with someone else. That’s called Being Rude, and well mannered people don’t do it.

Yes, please interrupt me to tell me the patient in bed 6 is coding, thanks! But, don’t interrupt me in the middle of a sentence with anyone else to ask “Is this patient’s admission full or obs?” “Can bed 3 have a box lunch?” I realize I talk a little too much, but my time is as valuable as yours, and when interrupted I have to start over, thereby taking more time (and it’s less efficient, and we’re back to the rude thing, again).

I see this throughout my ED, certainly not just with me. It’s ubiquitous. I probably interrupt people, too, but since it’s been annoying me I’m making an effort to not interrupt without real cause (like the lady in bed 6). I don’t expect anyone to wait through the Gettysburg address, but there are natural pauses in conversations when questions aren’t completely disruptive, can we all try to wait for that?

There, I feel better now.

…and a new address!

Just wanted to let everyone know that’s I’ve moved blogs to my new blog called Doctor
which can be found at: http://www.internalmedicinedoctor.blogspot.com/

Please update your blogroll, I would very much appreciate it.

And he’s got a fun header graphic:

Make sure you update your blogrolls.

2005 Medical Weblog Awards: Polls Are Open! – Medgadget – www.medgadget.com

Welcome to the voting phase of the 2005 Medical Weblog Awards!

Please exercise your right and vote now for your favorite weblog in the following six categories:

• Best Medical Weblog
• Best New Medical Weblog (established in 2005)
• Best Literary Medical Weblog
• Best Clinical Weblog
• Best Health Policies/Ethics Weblog
• Best Medical Technologies/Informatics Weblog

 Polls close "at midnight on Sunday, January 15, 2005 (PST)", so don’t wait too long!

Random Acts Of Reality :: Main Page

The honour of hosting the first Grand Rounds of 2006 has fallen to me. Well…. actually the evil minds behind it got me drunk first. When I said ‘yes’ I thought I was agreeing to another round of drinks.
Grand Rounds consists of mainly medical bloggers sending the links of their best post of the week to some poor sucker who has to collate them all and post them on their own blog. It’s a great way to be introduced to some of the excellent blogs out there. Unfortunately in this case you are going to be directed to much more interesting people than me – so please promise to come back here when you are finished…

From across the pond!

From the Texas Medical Association:

Measles Health Alert

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Three cases of measles have been identified in Houston. Prior to diagnosis, but during the period of communicability, the infected individuals visited several health care facilities in the Houston area. The sites visited between Dec. 4 and Dec. 12 include: Texas Children’s Hospital, a doctors’ office at 2500 Tanglewilde, St. Luke’s Minor Emergency (San Felipe), Kelsey-Seybold Clinic (Holcombe), and a doctor’s office at Texas Medical Center.

The incubation period for measles is generally 14 days from exposure to rash, however it can range from 7 to 18 days. Measles is highly communicable with greater than 90% secondary attack rate among susceptible persons. When considering your practice policies in cases of rash illness, remember that transmission has been documented to occur in waiting room settings with exposures occurring up to 2 hours after the infectious patient’s visit. Cases may transmit virus from 4 days prior to 4 days following rash onset.

With measles occurring in the state, the diagnosis should be considered with any febrile rash illness. Please report upon suspicion any possible measles cases to your local or regional health department. Health departments will assist with specific testing and shipment of specimens.

Sincerely,

Col. W.S. “Chip” Riggins Jr., MD, MPH
Chair, Council on Public Health

The real story here is how a patient with the number one infectious disease in the world visited 5 different doctors (including a Childrens’ Hospital) and it wasn’t picked up. This story doesn’t say how it was finally diagnosed. Oh, and why this child hadn’t had their MMR, which is (usually) protective against said virus.

CDC Page on Measles