Posts tagged: grand rounds

“Grand Rounds” Dr.A. Show Wrap-up

Hello! Above is the video post I did as a wrap-up for last night’s Doctor Anonymous Show in true Dr.A. fashion, except Dr. A. did his before I got to do mine! However, I still did it, because, as Wilford Brimley would say: “It’s the right thing to do.” haha

Thanks again to my star-studded panel: Ramona Bates of Suture for a Living, Mother Jones, RN of Nurse Ratched’s Place, Val Jones of Getting Better with Dr. Val, and Bongi of Other Things Amanzi. I am still in awe that these A-list bloggers all took 90+ minutes out of their Thursday to spend with me.  Awesome.

Also thanks to Vijay of Scanman’s Notes for calling in all the way from India; you made it a cross-contiental event x2!

Whether  you were there or missed the show, go the link above so you can listen to the archive, download it to your computer/music player, whatever you like.

Grand Rounds 5:11 – Death and Transfiguration

todverk-scoretitle.png

Welcome to Grand Rounds! I am privileged to be your host for this week’s edition of the best posts of the medical blogosphere. As in the previous two times I’ve hosted, I will integrate music into this edition, but unlike before, I will focus on one piece of music: Tod und Verklärung (Death and Transfiguration) by the German composer Richard Strauss. I said when asking for contributions that adherence to a theme was not necessary; moreover no single theme could really encompass the excellent variety the medblogosphere has to offer. Since this musical selection is quite long–over 20 minutes at least–I have decided to present only excerpts so as to tell the basic story as we go along, placing musical interludes in the list of posts. Hopefully I still keep to the spirit of the piece while not detracting too much from the excellent contributions.

Death and Transfiguration is a “tone poem,” literally, a musical literary depiction. In this case, it is of a dying artist on his deathbed in his last moments, and what is experienced up to, including and after death. A patient in a bed knowing it can be the end is certainly scared, and perhaps even confused. Mother Jones of Nurse Ratched’s Place learned how to comfort a confused, hospitalized elderly woman in a very significant way in the early years of her career. In another mental health story of an elderly lady, Sara at My Sad Alter Ego appropriately rails against a fellow clinician pointing out that depression does not equal lack of competence.

The patient lies in his bed, breathing heavily, his heartbeat marked by syncopated triplet rhythms in both the strings and timpani. Falling sighs contrast against a flute and clarinet asking a wordless question in unison. There is not yet struggle, but there is certainly no peace.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

HEALTH POLICY AND BUSINESS:

The near-code-blue status of primary care has received so much press recently, but in the end what has been done? What needs to be done? DrRich of The Covert Rationing Blog has some excellent insights and advice.

Dr. Val shares her insights at the dubious practice of Fecal Transplants (yes, you read that correctly) at her site, Getting Better with Dr. Val.

Mike Cadogan of The 28 Hour Diet shares his feelings on the general trend towards open peer review in scientific and medical publishing. I think he’s spot on.

Another spot-on editorial, and a shocking discovery for me, was Ramona Bates of Suture for a Living on the subject of medical method patents and the dubious practice of legally patenting something as ephemeral as a surgical technique. Is, say, a left-handed version of one safe from infringement?

Medical costs are skyrocketing, and since many of us are involved on the patient-end of healthcare, it’s sometimes alarming to read and be reminded that not all providers may act in the best interest of the patient, as a sobering post by InsureBlog indicates.

Violence in the ED is a disturbing and increasing problem, particularly in urban settings, as Marjan Siadat of Detroit Receiving writes.

Giving addicts sterile needles and a safe place to inject may seem like enabling on the surface, but Sam Solomon of Canadian Medicine shares there are quite a few good reasons to do so.

Suddenly he is startled awake with agony, struggling. The low strings groan with his pain. Driving rhythms, piercing brass motifs indicate his torment. The timpani, once quietly beating a halting rhythm, now pounds forcefully as though his heart will leap out of his chest. Relief is temporarily granted as he sighs back, exhausted.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

DISCOVERY AND LEARNING:

Jolie Bookspan of The Fitness Fixer in her post 14,000 Miles On a Bike reminds us that most intervertebral disc problems happen over time, and so too over time, they can also be repaired sensibly without invasive intervention.

How to Cope With Pain gives tips on how to be a “Computer Athlete” by showing sensible ergonomic suggestions.

Medicine for the Outdoors’ Paul Auerbach with a post entitled Sawyer Water Filter shows how a simple micron filter attachment to an ordinary bucket allows a pure gravity-enabled water filtration system that makes water from almost any source potable. It’s truly amazing, elegant technology.

Walter Jessen of Highlight Health shares remarkable new research indicating we might be closer to unraveling the genetic basis of autism. Not surprisingly, vaccines are not mentioned in the article. ;)

Ves Dimov at Clinical Cases and Images Blog is one of the pioneering physicians using Twitter to share conference proceedings in real-time, as he did at the Annual Meeting of American College of Allergy, Asthma & Immunology. Likewise, Twitter can also be used for USMLE Step 1 board preparation. Med students, this is an invaluable resource, since now First Aid can quiz you!

Nancy Brown of Teen Health 411 shares tips on teen oral health that may not be obvious.

Robin from Survive the Journey shares some new research that indicates Cushing’s Disease has a higher prevalence than common wisdom indicates.

At Sharp Brains, Dr. Rabiner talks about a quantitative EEG method for screening ADHD as opposed to observational/behavioral methods. The improvement of this new method is astounding and shows great promise.

PERSONAL STORIES:

Dinah from Shrink Rap talks about how simple medical jargon can be taken the wrong way by patients who don’t have the context clinicians do.

Christine at Corn Allergic shares a story where a conscientious nurse made a simple blood draw less of an anxiety-producing event (and not for the needle, either) by both being resourceful and non-judgmental.

Our patient begins a reverie, remembering his youth. theme. The strings’ rhythms drive forward, so full of exuberance they’re practically tripping over themselves. He must be thinking of a past love, unable to contain the rush of his passion, emotionally climbing higher and higher — until the brass for the first time fully states the “Ideal” theme in the piece (1:44). This represents his soul, the totality of his being, his essence. He has found himself through this 6 note theme, and having done so, can finally move on, secure in himself and who he is, ready to face whatever fate is to come with pride and dignity.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Cris Cuthbertson from Scalpel’s Edge shares a personal letter spelling out her point of view on the differences between non-MD researchers and physician-scientists. (she also has great tips on preparing medical presentations)

Doctor Anonymous shares his thoughts as part of yesterday’s official observance of World AIDS Day. It is, as he pointed out, the 20th anniversary of the event, and we have made incredible strides in that time.

Bongi at Other Things Amanzi shares a story from his past about not looking down at people on your way up–they just might do the same to you when it’s their turn!

And finally–TRANSFORMATION:

Barbara Kivowitz In Sickness and In Health shares how Gratitude Can Change You. Read how there is transformational power in giving thanks in a tangible way.

ADHD isn’t a disorder, it’s a personality type. That’s what Dr. Rob of Musings of a Distractible Mind writes in “The Doctor is Distracted.” ADD/ADHD confers its own strengths and weaknesses, and just like everyone else, each individual has their own unique aptitudes. The key is adapting and transforming “liability” into leverage.

In Reflections in a Head Mirror, Bruce Campbell shares a beautiful story about how love transforms perceptions, making the previously impossible possible.

Jacqueline at Laika’s MedLibLog really took off with the theme, so I’m saving this for last. She writes a very thorough review of a symposium on fear focusing mainly on a speech by an Israeli lecturer showing many neurological elements in fear processing and response. Post-traumatic stress disorder is featured prominently as an example of how extreme fear eventually can transform a person into someone else. She offers another German composer, J.S. Bach, to accompany her piece as well.

Finally we arrive at the end of our patient’s mortal journey: a pause, another short, violent struggle, and after his last agonal breaths, death arrives (0:52). However, no sooner than the tam-tam signals this event than the harp, low strings, brass, and winds indicate the soul’s release, loosed from his mortal coil, floating finally free. Sumptuous, almost agonizing pedal points stretch out like harmonic taffy as the “Ideal” theme transforms, grows and is passed around the entire orchestra. A final victorious flourish at our triumphant final key of C major (6:06) and our fully transfigured soul now rests quietly in peace.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

One may be wondering why I chose this rather heavy musical topic. For one, it fits in with a healthcare theme. Death and end-of-life issues are ever-present challenges in healthcare. Paul Levy just spearheaded a blog cause on this very issue. Facing our mortality isn’t easy for anyone. However, the main reason I chose it is because, metaphorically, it represents what I’ve gone through this last year. I decided not to tie in my own story along the way so as not to detract further from the contributors, but regular readers and friends know about the limbo status of my scholastic endeavors, unforeseeable health issues that took me out of commission for 9 months, and a divorce forced upon me in the middle of it all. One can allow dreams, relationships, etc. to simply die, or be transformed in the crucible of experience into something new. I hear Strauss and it reminds me I must do the latter. I have to believe this–like the musically idealized portrayal–is how things will turn out eventually. I invite those not already readers to join me in searching for my “C major chord,” speed bumps and all, and I’ll be there to share yours.

Finally, I do want to offer a small dedication to those that lost their lives in the tragedy in Mumbai last week. I think this post is an appropriate place to offer that, even though the topic was already conceived when the horror of those events unfolded. May the souls of the departed as well as the families and friends that mourn them find peace.

Thank you for reading! I hope that beauty and catharsis was found in spite of a weighty topic. I also want to thank Dr. Val and Colin Son for their work on keeping Grand Rounds what is is and giving me the honor to host once again. One of the things that makes Grand Rounds special is the variety of hosting topics and personalities one gets each week. So with that, I pass the baton to next week’s host, Sharp Brains. I look forward to their edition. Cheers and good health to all!

Video Post: Hosting Dr. Anonymous show Dec 4th

Links:
The Dr. Anonymous Show on BlogTalkRadio (this Thursday at 9pmEST)
Grand Rounds 5:11 – Death and Transfiguration

Update 03December: Confirmed panelists are Ramona Bates, Mother Jones, Val Jones, and Bongi (schedule permitting). It’s a star-studded event, ladies and gentlemen! Even Dr. A. is jealous! hehe

GR: Don’t forget your submissions!!

Just a reminder about the Grand Rounds submission timeframe ending this evening! If you haven’t given me a post and want to be included, time’s running out!  I might consider a post later than the posted time today, but tomorrow will be too late so don’t delay!

Grand Rounds 5:11 here on Dec 2 and Happy Thanksgiving!

Happy Thanksgiving to everyone!! I realized just a bit ago that I neglected to have a “ready” post to formally accept submissions for the upcoming edition of Grand Rounds next Tuesday, December 2nd.  I apologize profusely, and can only offer as my excuse the craziness of two family birthdays, Thanksgiving, and all the family coming and going that occurs during this time.  Mea culpa!

Before I continue, make sure you go see the excellent current edition at Canadian Medicine, featuring last week’s content.  If you submitted a piece that wasn’t included in Dr. Solomon’s edition, re-send to me for consideration.

Please have all articles submitted to me no later than 18:00CST/17:00EST Sunday, November 30th (00:00UTC Monday December 1st) for inclusion by sending an email to enrico -[at]- mexicomedstudent.com. Please put “Grand Rounds” in the subject, and in the body text include the URL and a sentence or two of summary. That summary is important because not everyone’s URL is descriptive, and when I have a table of URLs, etc. when planning the edition, a blurb really helps. 

I do have a tentative theme in mind but don’t want to reveal too much (and want some flexibility to change it ;) ) but these words should be applicable: renewal, metamorphosis, change, transformation. That should be enigmatic enough for everyone. :)  Do not feel constrained by these, however. There is no judgment about whether to include or not based on any theme; each article is reviewed on its own merit. 

Thank you for your cooperation, and I look forward to reading everyone’s entries!  Good health to all, and for those traveling here in the US this holiday season, be safe.

Election Edition Grand Rounds

Grand Rounds, the Election Edition is up at Nurse Ratched’s Place. Go check out the best of the medical blogosphere.  Although these posts have already been vetted and voted upon, YOU can still vote in the BIG election if you haven’t already.  Exercise your right or don’t complain later!

Nurse Ratched Kicks Grand Rounds Oldskool

Nurse Ratched’s Place is the home of this week’s Grand Rounds, the best collection of recent posts from the medical blogosphere.  I loved the use of retro (I mean retro) photos showing how far medicine has come and how quackery still hasn’t changed much.  (my magentic bracelet hasn’t come in now that I think about it… heh)

Go check it out! Oh and happy ‘Diez y seis de septiembre‘, Mexican indepdendence day.  Unlike cinco de mayo which is all but ignored unless you live in Puebla, this holiday is the most important for the nation–their 4th of July, if you will. But it’s hard to make a beer/liquor campaign here in the US with such a long name.  Still, some people try like this group in Austin try to do it anyway and keep the true tradition alive.  I’m going to go do my part to celebrate *cough* *cough* later this afternoon on the other side of the border and hope Dept. of Homeland Security is gullible kind enough to let me back in. ;)

Grand Rounds 4:44, #200

Who better than Gruntdoc, one of the medblogosphere’s oldest (and I mean that as in “stately” and “learned” hehe) and most respected bloggers, to host the 200th anniversary edition of Grand Rounds! Is it flashy? Is it full of Web 2.0, AJAX-y, or Flash animation goodness?  Hell no, cuz that’s just not the way Gruntdoc rolls. Short, sweet and to the point–we need editions like these just as much as the envelope-pushing ones, and if I do say so myself, completely apropos for the nostalgia of the first ever 6-peat host.

Congrats from a fellow proud Texan!

Be Master of Your Grand Rounds Domain

I know I haven’ t been good about posting GR updates, but there’s no time like the present with The Blog That Ate Manhattan (TBTAM)’s Seinfeld edition of this week’s best of the medical blogosphere. Check it out!

Grand Rounds 4:33

Sorry for the late posting, but my friend Ramona Bates at Suture for a Living is hosting this week’s Grand Rounds, and in true “better late than never”-fashion, I ask that you go check it out for the best of the medical blogosphere this week. Dr. Bates is a plastic surgeon from Arkansas, and this week’s edition features some really nice local and state pictures. Check it out!

(and I’m doing better but was offline for too long–the nerve of various places and family members not to have WiFi!! Can you imagine?! ;) Updates soon once I get re-situated)

WordPress Theme Design