Grand Rounds XXX

Welcome to this week’s edition of Grand Rounds! Despite the fact that I have been ill this past week and weekend (I still am ill, as a matter of fact), I still managed to write and publish this, the 30th weekly installment of Grand Rounds, for all of you to read and enjoy! I created categories for each topic so you could more easily find your way around. You will also notice that some stories could easily have been included in several different categories; in that case, my choice for placing the story was made primarily based on how many submissions already existed in each category.


Rites of Passage:


The process of getting into medical school can be daunting, requiring long years of study and preparation before the hopeful candidate even applies to med school, and then there’s that rite of passage, the Medical College Admissions Test (MCAT). For some people, just saying the name aloud makes their heart skip a beat. This report comes from a premed student, TheSquire, who just took the April MCAT.

How soon we forget those early days when we struggled to learn basic skills, such as taking a patient’s blood pressure, but the author of Top Of My Head takes us back in time by describing a few moments in her classroom with her students, who were learning how to take an accurate blood pressure reading.


Medical Practice:


Kevin, MD discusses Red Sox manager, Terry Francona’s hospitalization after he experienced mysterious chest pains and his subsequent diagnosis of a virally-caused myocarditis or pericarditis.

Journal Club comments about the most recent biventricular pacemaker study published in the New England Journal of Medicine (NEJM). This blog entry includes a link to the original article and to an editorial about the procedure that also appears in the same issue of NEJM.

If a particular health care market is rapidly expanding, that means more money and personnel will be invested into it, right? Not necessarily, especially when you consider the expense of mammography. This story is part II in a series written by CodeBlueBlog.

Science writer Gina Kolata’s recent NY Times piece, The Body Heretic: It Scorns Our Efforts prompted RCentor to write this response, Working on the Probability Edge, where he concludes that Kolata is too fatalistic, that even though we cannot change things, [..] we can certainly improve our odds.


Mental Health:


Dr. Sanity is a psychiatrist who wrote this interesting three-part essay, “Narcissism and Society”. This series will certainly give you and your colleagues something interesting to talk about as you hang around the water cooler. All three parts are linked from an introductory prologue.

This double-feature essay, Electroconvulsive Therapy and Bestiality, by Dr. Maria is an interesting look at modern electroconvulsive therapy, which is nothing like what they showed us in One Flew Over the Cuckoo’s Nest. This essay ends with a story of an animal lover whose fondness for his dog was threatening his marriage.

This essay, A Swamp Plant & A Cactus is written by a loving parent who is dealing with not one, but two, sons who suffer from a variety of mental and physical illnesses. Despite the similarities of their disorders, her sons’ disorders are manifested in opposite ways, so she compares them to a swamp plant and a cactus.


Medical Science:


And now, for the best news of the week, Chocolate Stops Cancer. This, according to a story published recently in Science Daily, is due to a natural ingredient found in chocolate, pentameric procyanidin (pentamer), that apparently has cancer-fighting properties. The reaction of various special interests will be interesting, says Interested Participant.

Red State Moron returned from a medical conference recently where he attended a lecture about elective Cesarean deliveries. In his article, The Obstetric Buffet, he compares the advantages and risks to mothers from vaginal births versus Cesarean deliveries.

MedGadget, a blog that investigates emerging medical technologies, in this essay, Nanoscience Meets Cochlear Implant, draws our attention to a report about a cochlear implant that might stimulate regrowth of hearing nerve cells. This essay includes links to press releases.


Quackery:


Orac, as usual, comes through with another well-written story, the tragic account of The Orange Man. This story discusses “alternative medicine” and how damaging it is when desperate people choose to believe the claims of quacks whose only care is lining their pockets with “blood money”.


Practical Support:


Dr. Bob at The Doctor is In explains his idea for providing health care for poor people in Turning Back the Clock. As you might know, lack of health care to the un(der)employed is one of my top three blog rants, particularly since I am living this scenario right now. I think that the good Doctor’s idea is elegant; fund health care for the poor by providing tax credits to physicians who provide charity care.

Have you found yourself staring at a computer screen, wondering where the heck that note that you just wrote disappeared to? Well, join the club. According to How to Kill Patients Through Bad Design, published by Over My Med Body, medical usability is an increasingly important issue that will affect more medical practitioners as time goes on.


Medical Philosophy:


Medviews is a blog written by a doctor who teaches a Health Policy class. As the result of a discussion in this class, he has written a particularly interesting story about the ethics of expending large resources on patients with limited life spans in The Market for Hearts.

Different River writes a piece, Doctors Without Conscience, about an article that recently appeared in the New England Journal of Medicine. The original article by Elie Wiesel, asks how doctors and other educated people can become murderers. Different River’s conclusion? Academic education is not moral education; that is, it does not provide any morality whatsoever.

In this whimsical essay, Bioethics Dude compares diagnostic challenges encountered by Tom and Ray, the hosts of CarTalk, to those encountered by medical doctors in the Trouble with Diagnosis: Car Talk vs. Doctors.

Do gifts from pharmaceutical companies influence your choice of which medications you prescribe for your patients? No? Well, think again, according to DoctorMo. According to a recent opinion linked from this essay, the evidence shows otherwise. DoctorMo’s essay, Prescribing Under the Influence is part of a series of articles that will appear about this topic. (I just love the title of his essay, by the way!).

Sue Pelletier at Capsules also discusses this same issue in Is it possible to take the bias out of medical education? She concludes that other things, such as improved patient-doctor communications, often have a greater impact on patient care than what’s available in a physician’s medicine chest.

“Did you read my blog?” As everyone knows, keeping a blog is a hobby that is taking the world by storm, freeing people to express themselves semi-anonymously in writing. But can blogging affect the doctor-patient relationship when patients blog about their doctors? Shrinkette considers the implications in this essay, particularly for psychiatry.


Gripes:


Blogborygmi took a break from his studies to talk about the Multiple Gripe Test, otherwise known as the Medical Board Certification Exams, that he will be taking soon. This essay also could have been included in the “Rites of Passage” section.

Speaking of Medical Certification exams, Aggravated DocSurg has a few interesting comments about the Medical Certification board exams in light of the FDA’s recent decision to allow silicone breast implants onto the market again in his article, Interesting Precedent.

In this concise essay, GruntDoc wonders why a nurse with experience, a been-there and done-that nurse has to accept being addressed by their first name by anyone, especially new docs in Patronizing Nurses.

Even though I am your host this week, I have been ill and unable to write much recently, but I didn’t want to disappoint you all by not giving you anything of mine to read. So I decided to link to my somewhat humorous living will. I hope you enjoy it.


Reader Recommendations:


One of the highest compliments that any writer can receive is when another writer recommends their material to others. This moving piece, written by Head Nurse, was recommended by Shrinkette. In this essay, Head Nurse eloquently describes her delight in, and passion for her career.

This story could also have been included in the “Rites of Passage” category. The author of the blog, The Chaplin News, recommended this story written by a Marine now medical student, “Doc Russia”. In “First Time for Stitches”, Doc Russia describes his first time stitching a laceration, located between the toes of a 13-year-old kid. His words of wisdom; “If you want to do procedures as a medical student, you have to fake it until you make it.”

This story is my own recommendation. Written by Joe, it is the moving story about the sudden and unexpected hospitalization and long recovery of his friend, Vasco. It is published in four parts; Part I, Part II, Part III, and Part IV.



Next week, Grand Rounds XXXI will be hosted by Dr. Tony. If you did not get your submission published in this issue of Grand Rounds, please accept my sincere apologies. I was feeling much sicker as the evening wore on, and so I finally called it quits and published Grand Rounds at 1 am so I could go home and get some sleep. If you were not included in this issue of Grand Rounds, please be sure to send your article link to drtonyblog AT hillsides DOT com. Of course, new submissions are being sought by DrTony, too.

I am going home now for a well-deserved rest. If there are any errors that need to be corrected, please let me know by sending email to GrrlScientist at yahoo and I will take care of it as soon as humanely possible.