Archives for May 2007


In my practice of Emergency Medicine I see a lot of people, and consequently a lot of feet.  Some people bring me their feet as their problem, and that’s what I’m there for.  No biggie.

Some are reticent to remove their shoes: these are the ones that have foot problems, usually amazingly advanced cases of foot fungus.  This isn’t surprising given our societies’ wearing plastic shoes (sneakers) that don’t / won’t breathe.  So, I’ll spend no small amount of time explaining how the problem begins with warm, dark and wet, and how getting the feet out of the shoes was the best thing to do.  Then, it never ceases to amaze me that people I’ve just spent significant time discussing the need to dry out their feet and get them out of their shoes are the ones who are back in them the second I leave the room.  I hope beyond hope they go home and air the dogs out, and that they go and get some shoes that’ll breathe.

Additionally, I’ve stopped wearing shoe covers during my shifts.  Though I wear mesh-topped shoes, I noted my own feet needed some ‘airing out’, and have changed my ways.  I now wear them when I suspect I’ll need them, but not just because I’m at work.

MedBlogs Grand Rounds 3:35

? grand rounds. Emergency Department

For this weeks Grand Rounds I threw down a challenge for writers to submit a post that they were particularly proud of. As you will soon see, there are some truly gifted writers amongst us; recording the narrative of their experiences as they bump up against the medical humanity.
Each link is followed by a brief preface by its author. ( And in Grunt Docs case, I’m talking brevity approaching singularity!)

Do not rush these readings. They are in no particular order. But it is my careful consideration that each and every one has its own particular elegance well worthy of your time. Enjoy.

Hmm, had I known, I’d have been more verbose if not more eloquent.

Kevin, MD does an interview

On eDrugSearch: eDrugSearch Blog ? Blog Archive ? Five questions with Kevin, M.D.

Happy Birthday Dad!


Happy Birthday, Dad, from all of us.

Prius gets 65.9 MPG?

Wow: 65.9 MPG | KnoxViews

via Instapundit.

Fun on Vacations

My brother (the Aerospace Genius) and his family are apparently having quite a time on vacation:

Oh, here’s the story, and yes.

Life around the house

While I’m self-censoring on patients, and since that’s the medicine I actually do, I’ll substitute some posts about other things, like life around the house.

Last month I found this photo on the desktop, and while my initial reaction was dread (my wife has taken apart the mower that doesn’t run), the next thought was ‘at least she’s taken photos so we stand a chance to get it back together’.

Yes, we got it back together, but it still won’t run.  Fortunately, we got it used, and, well, it’s deceased.  Oh, I could spend a lot of time overhauling it, but it’s surplus, so there you go.


Also recently we went out to dinner, and when leaving we picked up mints from the bowl.  As I was leaving I looked down before unwrapping, and found I’d gotten something I’d never seen before: half-a-mint!  Yes, the wrapping was perfect, so this was a factory quality-control miss.

Oh, and it tasted just like it should.

Online Healthcare MBA’s

Does anyone out there have experience with one, good or bad?

I’m considering obtaining a Healthcare MBA as a diversification measure; I know little about business and I’m my own corporation, for goodness sakes.  Beside that, the glamour of wearing the bodily fluids of others is slowly fading, and I find that while I can do all the shifts the body clock is getting less forgiving about my circadian rhythm being a punchline.

I’ve considered Law School (for one reason, so I’ll finally know everything there is to know about medicine), but cannot get motivated for it.  I can see myself (in the distant future) being a consultant, and the knowledge of an MBA would be a decided advantage, not to mention the credentials.

So, I’m looking for the good and the bad anyone has to offer.

Blog Traffic Bump from Dead Tree Publications; also, Black Wednesday, and a message to Flea and Fat Doctor

Yeah, the title got added onto as I wrote.


This blog has been written up in the two big EM newspapers, in the Dallas Morning News, and most lately in the Annals of Emergency Medicine.  After the first couple I watched the sitemeter like a hawk, expecting the counter to go spinning.


Now I always hope these articles will at least bring some fresh eyes to the site, but again sitemeter reports my desires are denied.  Nobody reads a print publication and then goes online, at least to look for EM blogging.  (I’ll suppose that if I posted porn or on inflammatory politics that’d change, but you have to motivate new readers, and EM blogging isn’t it).  It’s easy online to click and follow a link, which helps most bloggers (which comes at a price: it’s also easy not to follow the links).

So, don’t think your paper’s write-up will make you famous, or need a better web host.


On a different note, the Black Wednesday blog-bugout has made me review every one of my posts and caused me to unpublish about 5, simply out of a desire to stay as far from the edge of the trouble-cliff as possible.  All the posts removed had to do with patient interactions, and they were fully anonymized and absolutely no patient was in any danger of having their identity discovered, but I found them less interesting in retrospect, and little to be gained by leaving them up.  Nobody will miss them (in fact, I’ll bet nobody can tell me which are gone, because they were all that forgettable).  (Like the ones I left up).

I understand why Flea’s blog got axed; I thought it was terrifically brave or astonishingly foolhardy to blog about an upcoming / current trial, and think he’ll be back after his current trouble runs its course.  Though I have taken plenty of exception to his ED bashing, I still enjoy his writing (and we were winning him over on the ED front toward the end).

I don’t get Fat Doctor’s signing off, unless there’s a lot more behind the story than was written (and there usually is, but it’s not clear in this case).  She was upset that “Someone in my department printed out my blog and showed it to my boss. He tells me he didn’t read it and won’t interfere in what I do with my own time as long as I do a good job at work.” (via Kevin, as even that’s gone from her site now).  If that’s what scared her off from blogging, why?  The boss knows and doesn’t care, expressly, and just because some idiot who can run a printer copied your blog in a failed attempt to cause you problems, you shouldn’t quit!  In fact, you won!  The only way the troublemaker wins is for you to stop the blogging you obviously enjoy, which is a loss to us all.

So, both of you, shake it off and please come back when you’re ready.

Change of Shift 1:24

Nurse Ratched’s Place: Change of Shift: Volume 1, Number 24

Cat Save in Britan

Random Acts Of Reality :: The Only Time You Will See A Picture Of One Of My Patients
Enjoy a happy ending.

Disneyworld Series by James Lileks

Yes, my blogging dry spell continues.  I have nothing interesting or original to say (and I’ve tried, alas there are now a bunch of half-finished posts even I’m not interested in reading), but I’ve been reading others’ blogs.

One I’m particularly enjoying is the first two parts of a four-part series by a professional wordsmith, James Lileks.  I’ve always liked his writing generally, but combine a writer I enjoy with a subject we can both agree is pretty interesting (the Disney vacation experience) and it’s true entertainment.  He’s obviously never been before, and after reading these, he and his family will be back, like me and mine.

Here’s links to days 1 and 2.

MedBlogs Grand Rounds 3:34

Our weekly Grand Rounds is up: Medical Humanities Blog: Grand Rounds (Vol 3, No. 34)

Next weeks’ is a little different, at ImpactED Nurse. It’s not a theme, so much as a ‘send me your best

It’s my birthday

so I’m taking it off.

See y’all tomorrow.

Prius Mileage EPA Change

I buy a Prius, and what happens? Reality: Hybrid Cars’ Fantasy Mileage Ratings Drive Into the Sunset –

Good news: I’m not a horribly inefficient driver; bad news, 48/45/46 aren’t even close to what’s on my window sticker. The EPA decided to test more like people drive (speeding, etc), but with the 2008 model year.

Oh, and tank #2: 44 MPG by the calculator, 46.8 by the car computer. Hmmm.