Some studies that I like to quote

Wow! Very nice.

Dr Seuss Does Malaria « Contagions


This Malaria map was illustrated by Theodor Seuss Geisel, better known as Dr. Seuss, during World War II to educate young GIs. According to the Naval Department Library, this map was printed on the back of a Newsmap (two sided poster) that showed the five war fronts in 1943: Russia, Italy, “air offensive”, southwest Pacific and Burma.

via Dr Seuss Does Malaria « Contagions.

Excellent primer on Malaria (and Ann!).

via @doctorgrumpy @docgrumpy on Twitter

…and that’s when I shot wine from my nose…

I was having my occasional glass of red wine with dinner (it’s AMA approved, and possibly cardioprotective, plus, I like it), having a conversation with my grandson, who’s 10ish.  (I don’t now his exact age; I’m not one of Those grandparents, and to be fair, I wasn’t one of those parents, either).

Just to have some fun with him, because I figured he’d think it was silly, I decided to start spelling some words when chatting with my wife at the table.  As in “I think if I s p e l l some words h e won’t be a b l e to understand what w e are saying”.

“I can’t keep up, you spell too fast” was not the response I thought I’d get and …see title.

Fun having family visit.  I need to help him with his spelling, though.

A Cartoon Guide to Becoming a Doctor: The med student gunner: profile

A Cartoon Guide to Becoming a Doctor: The med student gunner: profile.

Nice one…

via Doc_Rob on twitter…

2010 ACEP Scientific Assembly: I’m in

The 2010 American College of Emergency Physicians’ Scientific Assembly is in Las Vegas this year.

I’ve registered, bought plane tickets and have a marker on a box under a bridge (but very near the convention site, so I’m good).

So, time for you EP’s to get in there and register, and, I’m going to blog it (unless ACEP gets a court order preventing it (they weren’t interested in me blogging for their house blog, so only time will tell…)).

Oh, as a service to my three ACEP readers I plan to get enough freebie pens from the exibitors to give one to each of you when I meet you.

Yeah, I’m a giver.  Or a re-gifter.  Whatever.

Vaginal Bleeding Algorithm for the ED

Via ER Stories, a reminder of the flow chart every EM resident is taught…


Nicely done…

HT: MovinMeat

Do not text while driving

Seems very simple: concentrate on what you’re doing, and you lessen (but not eliminate) the risk of car crash.  How much higher is the risk of accidents from texting?  Twenty Three times, that’s how much (VTTI, .pdf).

That’s just not worth the risk.

Unfortunately, apparently it’s hard to resist…


Hey, Remember That Patient You Saw… « The Central Line

Hey, Remember That Patient You Saw… « The Central Line

Hahaha… A visual depiction of what six simple words do to an Emergency Physician.

Nice one, Graham.

Zippy the Lobster travels to the Bahamas

I was pleased to be Zippy’s caretaker when we went to the Bahamas for a medical conference (background on Zippy Here).

I’ve made a pictorial essay on the travels and travails of Zippy the Lobster:


Also, recall what Zippy’s trying to do, raise awareness (and coff money coff) for childrens’ brain cancer research.  So, if you feel the urge, go over there and give a little.

Growing our own…

This was sent by one of our nurses (and a frequent commenter) with her title “Growing our own Nurses”.


When she originally showed it to me, she said this is how to treat doctors: the pacifier does the trick.

I’m not saying she’s wrong…

Fish Pedicure Is Now an Outlaw in Texas – Medgadget

Fish Pedicure Is Now an Outlaw in Texas – Medgadget –
We have terrible news to report. “Fish pedicures” or “doctor fish” procedures that we reported on back in August, have now been banned in at least two states. Washington and Texas are unhappy with the communal insertions of stinky feet into aquariums primarily for sanitary reasons.

While I was not in the target market for this, I’m a little surprised.

GruntDoc: bringing the tough news.  via Medgadget.

Caption Contest: We have a winner!

I asked you to give me a caption to this photo, and we have a winner:

Joel Goldberg, MD Grand Rapids, MI

“North Carolina Prescription Drug Plan” by Doc

Honorable Mentions:

SkyDaddy with “I can haz oxygen?”

Warriorpear with “Doc, I had to smoke 400 packs in order to get enough points for my Winston Med Case… man, but was it worth it?!”

Ian Furst with “More doctors choose Winston”

Doc gets to place the unwanted coveted “Caption Contest Winner” logo on his blog.


You delivered, BTW: 47 comments (not all were captions, but they’re all welcome).  Thanks for playing.  We’ll have another one when I have a suitable picture.

Naughty Radiology Tech

Well, I learn something new every day from blogging. Thanks to TBTAM for the wart therapy tip: pregnancy can cure warts? I’m not sure if I’m THAT desperate yet. And what would I say to my child – yeah, daddy and I didn’t really want to have a kid, we just wanted to cure our plantar wart? Lol.

Here’s an ER themed cartoon for you trauma folks. Enjoy!

A Wart And The “Keys To The Kingdom”

As many of my close followers know, I’m “in between blogs” at the moment. My new website has not launched yet, so I’ve asked a few close friends if I could guest-blog at their sites until further notice. Dear Grunt Doc actually offered me a password and authority to post directly to his blog. Now that’s trusting! I mean, I could fill up his site with LOLcats posts if I wanted.

A few blog-hijacking fantasies later, I decided to ask myself – “What sort of content would be appropriate to contribute to an Emergency Medicine blog?” The answer, of course, is “real photos of anything gross.”

And as luck would have it, I do have a nice photo of something gross (albeit mildly so). Even better, it’s my own grossness so there’s no HIPAA violation looming. What is it? Well, it’s the sadistic work of a dermatologist. (By the way, dermatologists have the best photo galleries of really gory conditions).

Let me explain.

You know how every once in a while in life you think, “Gee, this is a really bad idea” but then you go ahead with it anyway? That happened to me 7 years ago. I had accompanied a friend to a hair salon in Rochester, New York. And since the process of having her hair colored would take about 2 hours, I figured I’d find something to amuse myself. The salon offered manicures and pedicures. So I opted for a pedicure.

A little voice inside me said, “Is it hygienic to do a pedicure in a plastic tub with tools that don’t look as if they’ve been sterilized?” But then I figured, “it’ll be fine.”

A few weeks later I noticed a plantar wart on the heel of my foot. “Crap. I guess I’ll just go and have my PCP freeze it off.” Sounds easy enough – but 7 years later I have to tell you that this wart virus is still alive and kicking. Here’s what I’ve hit it with:

Liquid nitrogen Q month x 24 months, salicylic acid pads QD x 12 months, duct tape, OTC wart spray, podofilox topical solution, aldara cream (costs $500/3 month supply), bleomycin injection (that’s the chemo that can cause pulmonary fibrosis), and now blistering acid solution.

I had the “blistering acid” applied yesterday. And it’s 4:30 am and I was awoken by a sharp pain in my foot. So I got up and saw – you guessed it – blood blisters on the bottom of my foot. Yum! Not to be outdone by Paul Levy, I snapped a photo for Grunt Doc’s blog, feeling very satisfied with my contribution.

Here it is:

What on earth is the moral of this story? Ladies (and a few gents), if you have any doubt about the hygiene practices of your local nail salon – do NOT override your instincts. Just remember my story, and how I discovered the virus that will survive a nuclear war. If this series of blistering acid treatments doesn’t do the trick, I’m coming to GD’s ER for a wide excisional biopsy. God bless EMTALA.

P.S. If the injury site begins to look really gross, I’ll snap you another photo!

What a junk comment looks like: A Warning to Comment Trolls

This blog was just graced with an awesome comment, and I didn’t want anyone to miss it.

The piercing insight into the post, the added information for us all to share, the affirmation of the central thesis, the rebuttal of other less well-thought-out details, it is, in fact, the best blog comment eveah:

New comment on your post #2783 “Tundra Medicine Dreams: Moving. Ugh.”
Author : David Zahaluk, MD (IP: ,
E-mail : Zahaluk@

URI    :
Whois  :
Great job!  We physicians need to keep connected and you have moved the conversation forward.  But why are there so few blogs concerning the business of running a practice?  That’s why I started my blog at  I hope I live up to the high standards you have set.
David Zahaluk, MD
Founder MIP Practice PerformanceYou can see all comments on this post here:

Oh, wait, that’s not what it was, at all.  It was shameless self promotion from someone too lazy to write and ask for a link (which I usually do), and so clueless he thinks dumping this stinking fish in my comments was both warranted and acceptable.  Doofus.
Every blogger gets this kinda junk, and I will typically delete it and and the idiot, but I’m tired of it.
So, Kudos to you, David Zahaluk, MD!  Yours is a message constrained by neither decency nor taste, and now you get the full, front-page treatment you knew you deserved all along, but were too shy/arrogant/presumptuous to ask for!  Congratulations!
(In his defense, he probably thought this was an abandoned blog given my recent posting frequency, making this more of a cynical, take-advantage-of-a-dead-blog for a Google rank / Technorati page rank thing.)
Holy Crap!  It’s a gift that keeps on giving!  While composing this, I got the following update comment:
Whois  :
Sorry, I misquoted my blog address.  It’s actually for those who share my interest in practice building.



So, not just all of the above, but an incompetent linker, to boot.  Wow.  When I though it couldn’t get better…

(Yes, I’m aware of the irony that this will give the comment dumper more attention than he’d get otherwise, but it’s worth it for the satisfaction of getting this off my chest.  And, yes, I went ahead and banned him anyway).

Holy Crap2! The link takes you to some admin page, so I’ve had to modify it somewhat to assuage my conscience. Check his ‘blog’ link, though, so you won’t miss the credit card spam there since August 17th (I have a screen cap).