Archives for July 2007

MedBlogs Grand Rounds 3:42

Aetiology: Grand Rounds 3.42

Welcome to Aetiology and this week’s edition of Grand Rounds. It’s my pleasure to host this carnival for a second time, and I greatly appreciate all of you who sent along submissions for today’s round-up.


The downside to all the rain in North Texas is the humidity. It’s now modestly warm but wet as a bath towel. Walking outside is like putting on a wet blanket.

Inside the house we now have a nice (if temporary) commercial dehumidifier. It collected 4 gallons on the first 6 hours, indoors, and that’s with the AC on. Did I mention it’s 11:33PM and it’s 83 tonight?

It may be time for a permanent dehumidifier. This is a test to see if it makes a difference.

How wet is it in North Texas?

This wet:

Photo credit: Aunt Sue


Photo credit: Aunt Sue

Jane Galt is ticked off at Sony

You would be too!  Read her tale of crummy Sony VAIO customer service.

Mechanical Carrion and a Tomcat

An F-14 Tomcat.  It’s kind of hard to watch.

Oh, and just mute the 30 second entitlement propaganda at the beginning.

Update: the video linked above is now gone.  Probably just as well; I’d rather remember it flying.

Reality of Weighting

I have a friend who auditioned for the TV show Biggest Loser, but wasn’t selected.  In the best traditions of making lemonaid form the lemons, she formed an online blog / collaboration of similarly non-chosen people who want to lose weight as a support group.  I asked her a few months ago if I could blog about it, and the answer then was that it was early yet, let’s see how thing go.

Here’s how it’s going:

…And together, we’ve lost over 560 lbs in the past 15 weeks!!!  And we’re getting a little attention for it.  The last week or so we have been getting greater than 1000 hits per day.  Our “leader” told me yesterday that a national magazine is interested in doing a story about us.  Plus we have a couple nationally known trainers chatting with and advising us.

I think it’s terrific, and should you have an interest in joining, or just reading about their adventure, look here: Reality of Weighting.

We need a ruling here

Should I call in sick today?

Photo credit: Aerospace Genius

45 Muslim doctors planned US Terror raids

Before you get too anxious, I’m pretty sure this is three years old, and got sexed up a bit due to the recent terror strikes in Great Britain by physicians. group of 45 Muslim doctors threatened to use car bombs and rocket grenades in terrorist attacks in the United States during discussions on an extremist internet chat site.

Police found details of the discussions on a site run by one of a three-strong “cyber-terrorist” gang.

They were discovered at the home of Younis Tsouli, 23, Woolwich Crown Court in south-east London heard.

One message read: “We are 45 doctors and we are determined to undertake jihad and take the battle inside America.

“The first target which will be penetrated by nine brothers is the naval base which gives shelter to the ship Kennedy.” This is thought to have been a reference to the USS John F Kennedy, which is often at Mayport Naval Base in Jacksonville, Florida.

The message discussed targets at the base, adding: “These are clubs for naked women which are opposite the First and Third units.”

It also referred to using six Chevrolet GT vehicles and three fishing boats and blowing up petrol tanks with rocket propelled grenades.

Investigators have found no link between the Tsouli chat room and the group of doctors and medics currently in custody over attempted car bomb attacks in London and Glasgow.

However, sources said it was “definitely spooky” that the use of doctors for terrorist purposes was being discussed in jihadi terrorist circles up to three years ago.

So, this was in an internet chat room run by would-be jihadists who would actually rather steal credit card numbers and defraud banks.  While it bears investigation, I’m not going to start sweating just yet.


Thanks to reader ‘Medic’ for the tip!

Standard Patients, and learning to be a doctor

Physical examination is both taught and learned in medical school.  Most schools now use non-patients (paid volunteers, and there’s an oxymoron for you) to introduce the mechanics of examination to students.  As with all other things there’s a range of innate competence, and that’s the subject of a piece in Slate from yesterday:

Current events, news, politics, culture, and more from Slate MagazineOver the course of three days recently, I had 23 head-to-toe physicals from 23 second-year students at the Georgetown School of Medicine. I was the first person these would-be doctors had ever fully examined on their own. Some were shaking so violently when they approached me with their otoscopes—the pointed device for looking in the ear—that I feared an imminent lobotomy. Some were certain about the location of my organs, but were stymied by the mechanics of my hospital gown and drape. And a few were so polished and confident that they could be dropped midseason into Grey’s Anatomy.

It’s very well written and amusing, please give it a read.  Also, she has a Q&A about the article at the bottom of this page.

It also reminded me of my ‘standard patient’ (We didn’t call them that, but I can’t remember the actual term).  The one thing I do recall was the proctor in the room smiling the entire time, and his feedback was “you didn’t test his reflexes, and you don’t have to say thank you after each and every test”.  I said thank you about 200 times in roughly 15 minutes.  Seriously.  Overly polite under stress then, I suppose.

Thanks to Mrs. Yoffe and all her Human Guinea Pig colleagues, for helping make real doctors out of medical students.

100 MPH Prius

Not 100 Miles Per Gallon, 100 Miles Per Hour. No, I didn’t try it, but it’s official:

LOS ANGELES (Reuters) – The 24-year-old son of former Vice President Al Gore was arrested for drug possession on Wednesday after he was stopped for speeding in his hybrid Toyota Prius, a sheriff’s official said.

Al Gore III — whose father is a leading advocate of policies to fight global warming — was driving his environmentally friendly car at about 100 miles per hour on a freeway south of Los Angeles when he was pulled over by an Orange County sheriff’s deputy at about 2:15 a.m.

I wonder how environmentally friendly a Prius is at 100 MPH?

Thanks to Mr. Gore for giving the Prius a sportier reputation. The rest of it, including his arrest, is too bad. It stinks to be related to the rich and famous.

Hat tip to reader Jim for pointing this out.

“This is my doctor…

..and he’s very good looking”…

Occasionally I get to care for patients who have lost their vision late in life, usually due to macular degeneration, and for some reason the vast majority are female. They will nearly always early in their evaluation, tell me this:

“Doctor, I’m sorry, but I’m blind (from Macular Degeneration)” to which I reply “That’s too bad, because I’m very good looking”. They always chuckle, and then we move on with whatever problem brought them to the ED. (The three readers who actually are aware of my appearance are under no obligation to defend my visage. I’m in my forties, and resemble Ren more than Brad Pitt. I’m okay with who I am. The truth is in the rest of the story).

Some time will pass, the patients’ workup will be finished, and I’ll go back to see my sight-impaired patient. After I say hello, this almost always happens: the patient will say, out of the blue: “This is my doctor, who is very good looking”. The patients’ friends all wonder if there is another doctor in the room, or chuckle pleasantly, but the tension is gone, and we have a pleasant conversation about their problem and their care.

I like caring for people, and sometimes wonder if appearances get in the way. If my late in life blind patients are any indication, the answer is yes.

Happy Independence Day


Have a safe and Happy July the 4th!

Photo originally used two years ago

Welcome to Intern Year : PANDA BEAR, MD

Welcome to Intern Year : PANDA BEAR, MD

(Gentle readers, I present the following which is mostly written in Marine-speak. You have nothing to fear and yet, if you have a weak constituion or are easily upset I implore you to skip this article, perhaps using the time saved to peruse the latest Peanuts comic strip in the newspaper or anything else that is similarly non-threatening.-PB)

Heh.  Nice.

MedBlogs Grand Rounds 3:41

over my med body! » Happy July 3rd Grand Rounds!
Happy July 3rd Grand Rounds!

It’s a special, more patriotic version of Grand Rounds this week (now with 50% more love for America!)

New York Times on HIPAA

Keeping Patients’ Details Private, Even From Kin – New York Times

Seriously, what did they expect? A hundreds+ page law by lawyers for lawyers, about medicine, with the threat of major fines, loss of billing abilities, and they wonder why healthcare workers have become close-mouthed? (The executive summary runs 11 18 pages, if that tells you anything).

Read this article, and wonder: their fix for over-caution?

Senator Edward M. Kennedy, Democrat of Massachusetts, a sponsor of the original insurance portability law, was dismayed by the “bizarre hodgepodge” of regulations layered onto it, several staff members said, and by the department’s failure to provide “adequate guidance on what is and is not barred by the law.” To that end, Mr. Kennedy, along with Senator Patrick M. Leahy, Democrat of Vermont, plans to introduce legislation creating an office within the Department of Health and Human Services dedicated to interpreting and enforcing medical privacy.

I’m reassured already, and feel this extra layer of scrutiny is just what we need in the trenches to feel better and just trust that our on the spot judgment won’t lead to protracted guilty-until-proven-innocent government investigation.

(An amusing aside: when I had a wireless internet connection the company put the router in a box and padlocked it. This was inside my house. I asked why, and was told, ‘we do a lot of work with the Healthcare industry, and you’re a doc, so we want to make sure there’s no HIPAA violations. I kid you not. HIPAA paranoia isn’t just healthcare workers.)

If they were serious, they’d re-write this abomination to cover actual, major and intentional lapses in privacy, keep the Healthcare Portability provisions that started this, and junk the rest. It hasn’t helped.