GRAND ROUNDS, Vol.2, No.35

EDITORIAL
Elusive Balance - the painter Henri Matisse said it best ---"What I dream of is an art of balance." This can never be more evident in the lives led by medbloggers. Medbloggers are doctors/nurses/paramedics first, family persons second, and bloggers too, when there is still time to squeeze from a very, very busy day. That order may or may not vary. It depends on the person involved. Most of us agree that the biggest news of the past week is Medpundit saying goodbye to blogging. After more than 4 years of dedicated blogging, she found out that family and work must take precedence over writing regularly. While I think that is a wise decision, I cannot help but feel sad with this development. I sincerely wish she comes back with her excellent and insightful posts. I pray she --- and those of us also contemplating to quit --- find the elusive dream and art of balancing time.

This is my third time to host the Grand Rounds, now on its second year, and growing strong. We have more than 50 excellent entries today. I chose a medical journal theme to present these posts. Of particular interest are the PERSPECTIVES and FIRST PERSON ACCOUNTS sections which I encourage all of you to pay close attention to, as the posts here are full of substance and show that more and more health personnel are becoming sympathetic to patients' plights.

Enjoy your readings!

EDITOR'S CHOICE POST

• So Long, Farewell, Auf Weidersehen, Adieu - the pioneer and inspiration of most medbloggers (like me) says goodbye to the blogosphere because she can no longer find the time needed to do it.

PERSPECTIVES

1. Would You Want To Be There? - should the family be at bedside of the patient during a code-blue resuscitation?



2. Why Doctors Order Unnecessary Tests - does your doctor order so many lab tests on you? Read why this happens as Kevin, MD explains.



3. Blah, It's Monday! - how you can overcome the "Monday Blues."



4. Holy See, Birth Control and Water Supply - providing clean water is key to sustainable development, but may have unexpected consequences: higher birthrate and child malnutrition.



5. How To Appreciate Your Oncologist - the family of a breast cancer patient uses a local news feature to praise the academic medical oncologist and her team who have been providing her care.



6. The Lifestyle Chronicles - More Of Pogo Knows - how "wrong philosophical underpinnings" can affect your health.

CLINICAL PEARLS and TIPS

1. "Would You Mind If I Do a Rectal Examination?" - the NHS Blog Doctor reviews his past experiences with a physical examination maneuver we are all familiar with, but seldom know from a patient's perspective.



2. The Charles Sign - pending peer review, Dr Charles proposes a new medical eponym as he narrates an amusing story on how the unlikely characters are the first to fold when it comes to blood extractions.



3. Eyes and Thighs - the routine use of erythromycin ophthalmic ointment and intramuscular Vitamin K immediately after birth is discussed by Dr. Flea



4. While You're Tattooing "Do Not Resuscitate" On Your Chest - there are other additional tattoos which KidneyNotes wants us to consider when we examine our patients.



5. Air Ambulance - ATLS - here's an educational funny video made by Unbounded Medicine on how the ATLS maneuver is done.

SCIENTIFIC STUDIES

1. Britain's First Fetus Genetically Screened For Cancer - in the future, it might be possible to have babies who are born cancer-free. This is what Ruth Schaffer focused on in her submission.



2. Detection of Sperm Protein P34H - a new predictor of male fertility is on the way.



3. The Evolution of Poliovirus Vaccine Strains: Implications for the Poliovirus Eradication Effort - the weakened poliovirus in the Sabin vaccine may potentially evolve toward increased infectivity. Science Matters says this directly affects healthcare professionals involved in the poliovirus eradication effort, because they use the Sabin vaccine extensively



4. Varenicline Tartrate for Smoking Cessation - there is hope for smokers wanting to quit.

ORIGINAL CONTRIBUTIONS

1. War of the Sugar Substitutes - choose your poison? Which is the best sugar alternative?



2. What Is Happiness: Sandburg's Answer And The Role of Rose-Tinted Spectacles - we need a little bit of denial to help us live through the complexity of our lives. People who are depressed may be more realistic and accurate in their assessments, but this is not necessarily good for our well-being.



3. Treat Me Like a Child - a transplant coordinator discusses her own patient demands should she get ill in the future.



4. Big, Fat, and Ugly . . . ! - the "A-word" as extensively explained by a Difficult Patient.



5. Organ Donation - why you should seriously consider becoming one.



6. No Third Honeymoon, Thank You! -surprising psychological stress scale results lead Moof to relate her honeymoon stories.



7. Hypochondria - how medical school can be a gift and a curse to a student like Axis.



8. Gender - a lively debate told by the Neonatal Doc on who has it better in life, men or women?

LETTERS/CORRESPONDENCE

1. The Reason I Went To Medicine - a wonderful letter from a patient addressed to Dr ibear explains why he chose the field of Medicine to be his profession.
   
   
2. I Run All Day and Seem to Get Nowhere! - an unusual letter to the editor from the Cheerful Oncologist celebrates some good news about the benefits of exercise yet at the same time complaining about the manner in which the experiments were done.
   

CURRENT CONCEPTS

1. Re-Examining Chemotherapy for Breast Cancer - chemotherapy may not be the silver bullet everyone is looking for in breast cancer cases.



2. Medicare to Hold Payments - Medicare is going to hold all claims for the last 9 days of FY2006. Why this is a bad idea.



3. Most Common Diagnoses in Patients Transported by Ambulance to Emergency Departments --- United States, 2003 - most of these are inter-related according to GruntDoc.



4. Not My Imagination: This Allergy Season Sux - there's no fun being an allergy sufferer after this year's bountiful rains. HealthyConcerns provide us with explanations and solutions.



5. Pop A Pill For Heart Health - taking medicines to treat heart disease is easier than changing your lifestyle habits.



6. Hospitals Capitalizing on Consumerism - what hospitals can do right now to start preparing for the consumerism tidal wave.



7. Brain Tumor Cluster in Melbourne - from an epidemiological standpoint, the jury's still out on the cause of the "cluster," or even whether it's a "cluster" at all at this point.



8. ER in Crisis - demand for emergency care is at an all time high, but more than a thousand hospitals have closed down their ER's.



9. CDHCC Tech Wrap: Intuit Interview and the State of Consumer Health IT - an interview with Intuit on their plans to develop "Quicken for Health Care."



10. Does Early Antibiotic Use Increase The Risk Of Asthma? - antibiotics should be used sparingly and when needed only.



11. A Disturbing Report on Intimate Partner Violence - bruised, battered, and depressed. One out of ten women is affected.



12. Google Rates High Medical Blogs - medical and health personnel should blog, blog, and blog even more.



13. Making Friends, Not Enemies - a quick run down on consumer-driven health care and suggests how everybody working together as friends rather than fighting as enemies can perfect new models of care like “mini clinics” that benefit both providers and consumers.

TRIBUTE

• A Farewell Party for Medpundit - as the pioneer MedPundit bade everyone adieu last week, Shrinkette gathered some medical bloggers as a tribute to the one who started it all.

FIRST PERSON ACCOUNTS

1. Personal Insight Into A Misunderstood Disorder..... - a doctor is one of the best persons who can describe what it means to have Tourette Syndrome.



2. Swing It Again, Sam - a superb encounter between a doctor and an old jazz musician who does not like doctors.



3. Top 10 Confessions of a Pediatrician - this pediatrician from India doesn't mind waking up at 3am if it's an emergency.



4. Not Too Sure What To Think - highly recommended for doctors and nurses. A patient's sentiments that will stir you.



5. So How Exactly Does This MD/PhD Thing Work? -an MD/PhD student explains his situation.



6. Whadda Cheap Date! - why you should keep Nitrosprays in a safe place, and why a nurse can be mistakenly assumed as a "cheap date."



7. "When Mudman Screws Up An Already Screwed-up Day" - why Clayface can cause too much distress at home.



8. Thinking Outside the "Box" - a student nurse learns how to deal with patients sufferring from addiction and substance-abuse.



9. Confessions of a First-Year Med Student - what goes inside the heads of medical students.



10. New Certification - according to Janet, this is for her colleagues who take themselves too seriously.



11. Full Circle - a humbling experience on very last day of residency 16 years ago.

BLURBS

• BloggerCon IV: June 23-24 in SF, Medicine Track? - an invitation from Medmusings to all who can make it to a medblogger meeting at Bloggercon 4 in SF on June 23-34 (a tradition from the previous 3).



• Next Grand Rounds at KidneyNotes - be sure to submit your choice posts on time next week. Take note, perennial late submitters. I had several people submitting posts way, way beyond the deadline.



• Pediatric Grand Rounds: Volume 1, Number 3 - go and visit when you have time. It is hosted by Blog, MD.



• June 7th Pediatric GR hosted at AADT - submit posts for consideration at jtschnaars@treatmentonline.com.



• T H A N K Y O U ! - my sincere gratitude to everyone who has contributed for this issue of the Grand Rounds. Thanks also to Nick of Blogborygmi for continuing to dedicate his time and guidance to this weekly effort, and for conducting the Medscape interview (needs registration).