Aggravated DocSurg: Waiting & watching for Jon

We were invincible. Packed into Jon’s pale yellow Olds Cutlass, the car I’d always wanted, careening down the road between our high school and its “sister” all-girls school, we’d sing along with whatever was playing on the oversized speakers garishly mounted in the back. More exactly, we’d usually be screaming along with the music, which was loud enough to rouse more than a few nearby drivers from their afternoon daydreams.

We were on our way to……take a typing class.

via Aggravated DocSurg: Waiting & watching for Jon..

It goes sideways after that.

Excellent post.

Dr. Wes: The Wren

Dr. Wes: The Wren.

A beautifully done blog post. Recommended.

A laryngectomy shakes this physician to the core

As an infectious diseases physician with a special interest in head and neck infections, I had extensive experience in otolaryngological illnesses. However, when I was exposed to new, different, and challenging experiences as a neck cancer patient, I had to deal with these as a patient — not as a physician. I endured the consequences of radiation, repeated surgeries, and prolonged hospitalizations. I confronted medical errors in my care, discrimination following loss of my vocal cords, and the hardships of regaining my ability to speak.

via A laryngectomy shakes this physician to the core.

I could not be that brave.

Definitely worth the read.

Why I don’t blog much anymore, and why I won’t stop

I don’t, and it’s not because I don’t appreciate the eleven of you. I do, it’s just that life, and blogging, evolve.

Here are my thoughts on why I don’t blog much anymore:

Technology changes. I Twitter more now than I blog. (@gruntdoc if you’re interested). What I twitter is occasionally snarky and completely useless and nonmemorable, so it’s not blogging, it’s just (sorta)-social media in action. Facebook is where people keep track of each other, and I’m engaging there, somewhat. I still prefer blogs.

My role in my Emergency Medicine group has changed. I’m now one of three ‘officers’ (I’m the Secretary, and no I don’t file or take dictation), but with a little more responsibility comes the awareness that people higher up than me are interested in what I think, and vice-versa. I’d hate for anyone to believe my blog is representative of my thinking (it’s not, the blog is better). Low expectations are better than high, in some circles.

I’ve said it. Frankly I’ve written 20 blog posts that I get halfway through and realize “I’ve said this before”, and that’s that. I’ll only rant about the same thing (excluding parasites) about three times, then it’s Done. Repetition isn’t fun to read on blogs, and I’ve spared you. Welcome. (Many bloggers have had this realization and had the decency to quit. Color me indecent).

I’m established. Yeah: stale, but present. There’s one continuous medblog I know of older than mine, and with that comes a sense of being, of not having to write to get attention. To be fair, stale isn’t what I aim for, but it’s what you get when you don’t push, and I’m not pushing. No argument. Also, not an excuse.

Parasites. There are ever-changing ways to screw docs, they’ll find them, and I’m less and less interested in handing them a blog post they can use against me. And, as I hate them, not worth the effort to rail at them. Doing so diminishes me, and certainly doesn’t elevate them. So, heck with that.

Commenting on the work of others is probably my best input/output option. Yeah, it’s sometimes lazy, but I think sometimes i have an interesting take on the blog/news of the moment. (YMMV).

A ton of my blog-peers, and blog-children, have packed it in. Nobody’s claimed blog-grandchild, and I understand that. It’s the blog version of an old-folks home sometimes, with the whipper-snappers causing problems and getting on the porch. No offense, but I haven’t added a blog to the blog-roll in probably a year. I don’t think blogging is dead, but it’s entirely possible it’s passed me by. Time will tell.

Shifting hobbies. I like projectile-oriented things, spend a lot of time (and the same dollars) on this hobby, and fearit’s not something people on this blog really dig. I don’t want to go all-shooting, but it’d be hard to stop if I started. So, restraint. For now.

Snootiness. Yes, me. I feel I’m setting a disapproving example in not blogging when others blog. About politics,  especially. Political hackery turns the seemingly most-eloquent, genius med blogger into a raving idiot, and not in a good way (either way). The disconnect between politics and the gentle practice of medicine is vast, and I choose to lead by Not Playing. True, I’ve lead in a direction nobody is interested in following, but I feel that it’s still worth the lack of effort. Someday my genius will be recognized. I hope.

Aging. As I become more mature I’m letting things go I didn’t before. The realization that some things are temporary, and those that aren’t don’t usually matter have made me (a little) more tolerant of folderol and foolishness. And get off my lawn.

Why I don’t plan to stop:

I’m a blogger. Yeah, not an auspicious beginning, but an actual description of an organism. (Or, to be fair in describing a blogger, an onansim, but I digress). That likes to blog.

I’m too lazy to quit. I’ve goofed on this before, but really, why quit (more than) now?  The world will miss me when I’m gone (I mutter this to myself continuously).

Blind squirrels, etc. Nuts are my especitalty…

I like all eleven of you.

Thanks for coming around now and again. I promise you…nothing, but when the Spirit moves, I shall keep blogging.

 

 

Texas budget crunch could delay M.D. program in Fort Worth | Texas Legislature | News fr…

AUSTIN — A proposal to add an M.D. program to the medical school in Fort Worth could be delayed because of state budget woes, lawmakers and local officials said Thursday.The possible setback for the M.D. school — which would be at the University of North Texas Health Science Center at Fort Worth — was just part of the grim news that confronted scores of Tarrant County officials as they spread out in the state Capitol to lobby for local priorities.

via Texas budget crunch could delay M.D. program in Fort Worth | Texas Legislature | News fr….

Interesting.

Dr. Wes

I stumbled across Klout.com recently, thanks to an tweet by the well-respected web strategist and industry analyst at the Altimeter Group, Jeremiah Owyang. Needless to say, it’s not a place doctors venture much.

So I looked into the scores and characteristics of a few physician bloggers. The results were interesting.

via Dr. Wes.

Indeed they were. Go, read.

Thought Leader. I’ve never been accused of that before.

Doc Rob: Unplugging

I have made a very big decision: I am going to unplug myself from the internet world for a while.  That means that I am hanging up my blogging for now.

via Unplugging.

I’m not going to swipe any more of his post, go have a read.

He’s been a good, prolific blogger with smart thoughts expounded in an entertaining way.

I speak for many that I hope he returns with his humor and voice intact, but even if he doesn’t we’re the better for having had him for this long.

Thanks, Dr. Rob, and enjoy the Llamas.

Joint Commission – Anti-Safety in Action | WhiteCoat’s Call Room

“Severe pain can trigger suicide in hospital ERs” the headline reads. If they’re still calling it an “ER” you already know they’re clueless.

Since 1995, there have been 827 reports of patient suicides in the United States. Of those, about 14% are in non-behavioral health units, making a total of about 116 non-psychiatric inpatient suicides in 15 years.  That’s about 8 inpatient suicides per year out of 198 million inpatient days per year (644 inpatient days per 1000 population in US x 307 million US population) for a total chance of an inpatient committing suicide on any given day of … 1 in 24.75 million.  Now I admit that the numbers may be off by one in a couple million or so because reporting suicides is voluntary for hospitals, so not all suicides get reported.

via Joint Commission – Anti-Safety in Action | WhiteCoat’s Call Room.

Again, I went into medicine as I understood there would be little math.  Others are good at it, and thanks to White Coat for doing the heavy lifting.

Read his post, and enjoy the probably well-intentioned silliness.

And, marvel at what happens to every organization that outlasts its original mandate: it eventually has to keep ‘doing something’ to make all its parts relevant.  Unfortunately, what it does makes it more irrelevant than had they done nothing.

It must take a lot of fortitude to do nothing when that’s what is the right thing to do in these realms…which is why it seldom happens, if ever.

Darvocet is banned, Primatene mist still available

FDA is therefore illogical. At best.

Dr. Arafiles arrested – Winkler County

Jailed and bailed as the person who sent he the link says…

KERMIT The ongoing saga of the whistle-blowing Winkler County nurses took a turn for the karmic Tuesday with the arrest of Dr. Rolando G. Arafiles on charges of retaliation and misuse of official information. Both are third-degree felonies.

Arafiles left the Winkler County Jail on a personal recognizance bond and had his passport revoked, CBS 7 reported. (Arafiles is a native of the Philippines).

Arafiles arrest results from the criminal investigation of nurses Anne Mitchell and Vicki Galle.

They were fired from Winkler County Memorial Hospital and were indicted and arrested by local authorities in 2009 in connection with misuse of official information after they sent an anonymous letter to the Texas Medical Board with examples of 10 patients they believed Arafiles had not properly treated.

Arafiles’ criminal charges come from the Texas Attorney General’s Office. In the arrest warrant affidavit, Arafiles is accused of giving patient information to Winkler County Sheriff Robert Roberts, Arafiles’ friend and also a patient, so that Roberts could investigate the source of the anonymous accusations against him. After determining the patients themselves hadn’t made the complaints, Roberts identified Galle and Mitchell as the whistleblowers, setting into motion all future events that brought national attention to the small community.

via Winkler doctor arrested | arafiles, winkler, county – Local News – Odessa American Online.

I had hoped this wasn’t over.

Captain Atopic : Degranulated: Full Time.

Sunday, December 19, 2010 by Captain Atopic

So this is it; During the course of this wee blog, I had several ideas about how to wrap it up- the range from just disappearing to a protracted series of farewell posts.

Like a long list of medstudent bloggers, I’m pulling the pin now that I’m finished. My aim with Degranulated was to blog weekly until graduation, and, well, that’s where I am.

via Captain Atopic : Degranulated: Full Time..

It was a good ride.  I predict Captain Atopic will return, though in the Residency form.  And if not, we still got the free entertainment.

Thanks, Captain Atopic!

Mom | The Blog That Ate Manhattan

We tried, Mom. We tried so hard.

via Mom | The Blog That Ate Manhattan.

A Beautiful, Loving Tribute.  I mourn your loss.

Movin’ Meat: Market Economics in Action

… All of a sudden, we started seeing large numbers of herion users, many of them “novice” injectors, still using their veins. Most of them were pretty frank that they had only recently started using heroin, and few of them had any record of ER visits for drugs in the past. So, amateur economist that I am, I started systematically asking the heroin users how long they had been using, whether and what they had used before, and why they changed. …

via Movin’ Meat: Market Economics in Action.

Excellent post about economics in action, as seen by an Emergency Medicine physician.

Nice one.

FWIW, Fort Worth is mostly a cocaine town, with a smattering of meth and black tar heroin only once or twice a year.  AFAIK, our Rx drug problem is hydrocodone (sorry about that word, spam filter, you’re about to get a pounding).  I think Oxycodone and its ilk being Schedule II in Texas, requiring different State prescription pads, has kept that class abuse down (some).

Interview with Dr. Flea « ScienceRoll

Interview with Dr. Flea « ScienceRoll.

Interesting interview with Flea, an early medblogger and the definition of beware what you blog.  Read the interview for the lowdown on that…

He’s wrong about not blogging anonymously.  I think he means not to blog like you’re anonymous, which is a different thing…

Anyway, good for Berci for getting the interview!

AMA Policy on Social Media

New AMA Policy Helps Guide Physicians’ Use of Social Media

For immediate release:
Nov. 8, 2010

SAN DIEGO – Millions of Americans use social networks and blogs to communicate, but when those users are physicians, challenges to the patient-physician relationship can arise. New policy adopted today by the American Medical Association (AMA) aims at  helping physicians to maintain a positive online presence and preserve the integrity of the patient-physician relationship.

It’s not surprising there is some guidance on social media from the AMA.  I suppose the only surprise is that it took this long.

Follow the link above to read the policy, which I find remarkably reasonable.  I have some litle heartburn about this one:

(e) When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.

Plenty of thoughtful people disagree with things I’ve written (and a few unthoughtful folks disagree with everything), but I’m not a fan of giving AMA blessing to harass. 

Yes, there’s some things written out there I’m not a big fan of.  I take it as a sign of strength that we can disagree but not make a federal case of it.

And, for you aspiring to get into a professional school, f) is not just for practicing physicians:

(f) Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.

You’d have to go a long way to damage the medical profession, but it takes one facebook post to damage yours.  “Dude, I was so wasted when I…” doesn’t instill confidence in you or your judgement.  Just putting that out there.

So, rare kudos from me for the ever-shrinking AMA.