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March 11, 2007
A new Pediatric Grand Rounds is up at Blog, MD. And I'd say that even if I weren't included, if I remembered. This edition contains some interesting parent perspectives, as well as lots of thoughtful, quality writing from the usual stellar suspects.
March 8, 2007
"I'm a 70-year old basket case," he said. He was right. He'd been admitted a month before for workup of what was thought to be a relapse of a malignant melanoma--an aggressive cancer. His chart told a story of overwhelming chronic anxiety and depression dominating his adult life and resulting in a…
March 6, 2007
The next issue of Pediatric Grand Rounds will be hosted at a blog I love, Blog, MD, on Sunday, March 11th. If you blog about anything related to pediatrics, send contributions to PGR by e-mailing them to samuel (dot) blackman (at) gmail (dot) com by Friday, March 9th.
March 6, 2007
"He's just a drug seeker." This was my signout from Dr. Dispo, an emergency medicine intern. He was going home, and I was taking over the care of any patients of his that still needed disposition, whether to the inpatient floors, a short-stay unit, the psychiatry department, or home. This last…
March 1, 2007
I know about 50 people who should enter this contest, wherein mere mortals submit t-shirt designs with a "science is culture" theme and win fabulous prizes. You know who you are. Get cracking.
February 26, 2007
For weeks, our emergency department (ED) has been "red," meaning that--theoretically, anyway--it is no longer accepting patients. Of course, sick people who come to the door are not turned away. Ambulances, however, are instructed to take patients not requiring high-level trauma services to other…
February 21, 2007
A few weeks ago, I wrote about a woman I met in the intensive care unit after she was successfully resuscitated with ACLS. Serendipitously, she ended up on the medicine service I switched to shortly thereafter, and I've been taking care of her on the general medicine floors for a few weeks. Today,…
February 18, 2007
I just talked to a regular reader of this humble blog, a good friend doing his residency in another institution. He brought up the code I mentioned here, and was appalled by the fact that procedures were still being done on a patient long after he'd died because the practitioners needed practice. "…
February 16, 2007
I love this*: To the left, next to "Paediatrics," I'd add, "Hates adults and children and self" > "Med-Peds." *Courtesy of the British Medical Journal.
February 15, 2007
Oh, that hospital. Yesterday was SO romantic. The hospital woke me up early with a big, sloppy kiss and had me all packed off to work by 6:00 a.m. An hour later, it gave me a code--a guy with a busted heart chamber. Get it? A heart chamber? On Valentine's Day? So thematically appropriate! I did…
February 12, 2007
I am totally f*cked.
February 11, 2007
This morning, I was writing in a patient's chart on a general medicine ward when I felt the energy around me shift. Everyone seemed to suddenly be walking faster and talking louder--something was obviously wrong. I overheard snippets of conversations swirl around me while disaster built: "patient…
February 7, 2007
Grand Rounds 3.20 is up at Tales from the Emergency Room. The focus this week is on the people behind the medicine. (If you ask me, the medicine should watch out, because the people is probably planning to give it an unannounced rectal exam.)
February 7, 2007
I'm always a little restless the night before a new rotation. Sunday night was no different, and I laid awake in my bed for longer than I'd hoped to, worrying about leaving behind the intensive care unit (the ICU) and switching to the general medicine floors. At about six o'clock Monday morning, I…
February 2, 2007
A few days ago, I posted here about a recent ICU admission of a patient with pancreatic cancer. Her admitting diagnosis was septic shock, and I'd initially included some detail about septic shock to help illustrate a clinical dilemma in her treatment. Although that portion was ultimately edited out…
January 31, 2007
At about 8 a.m. today, the code bells sounded. ("I love the smell of chaos in the morning," said a nurse nearby.) I ran to the code, but because I had to schlep over from the intensive care unit (the ICU), I was late, and I didn't make it into the room. Scowling, I trundled downstairs to get back…
January 28, 2007
Back in October, I admitted a patient to the general medicine service with a three-week history of abdominal pain and progressively yellowing eyes. She was a large, pleasant, quiet black woman who was almost always accompanied by her husband, a broad man with laughing eyes and a white beard who…
January 23, 2007
At about this time last week, I asked for bloggers' thoughts on the interface of scientific evidence with health and health care. In an unscientific poll of the blogosphere, about 40% of you gave this theme the finger, while about 60% of you found it interesting to the point of arousal. To the…
January 21, 2007
Don't forget: The deadline for submitting to this week's Grand Rounds is midnight tonight. Please note--as addended at the bottom of the original announcement--that although there is indeed a theme for this Grand Rounds, non-thematic posts will most certainly be given careful consideration. Plug…
January 17, 2007
For those of you new to Signout, I'm a first-year resident (i.e., an intern) in a medical residency program in the United States. Medical education is different all over the world. In the U.S., we spend four years getting a bachelor's degree (which doesn't need to be science-related); four years…
January 17, 2007
Further proving the existence of God (just kidding! Hi, neighbors!), I am now writing under the ScienceBlogs umbrella. This is terribly exciting for me, and I look forward to being part of this formidable community of thinkers and writers. To those new to Signout: Hello. Welcome. Have a cookie, or…
January 16, 2007
Next week's Grand Rounds will be hosted here at Signout on Tuesday, January 23. Every medical student takes courses in physiology, pathophysiology, histology, and pharmacology. A new science has recently been added to this basic battery: evidence-based medicine, the science of critically searching…
January 13, 2007
I just finished a rotation in pediatric hematology and oncology, where almost all of the kids I was taking care of had cancer. Most had leukemia or lymphoma with prognoses that were varying degrees of good. A few had other, highly curable solid tumors. Only one kid--a boy I've written about here…
January 7, 2007
There's a 3-year old kid on our pediatric hematology-oncology service who has a high-risk, stage IV, disseminated neuroblastoma: a bad cancer with a terrible prognosis. The mass in his liver is huge, and distends his abdomen way out of proportion to his limbs. He is otherwise a truly beautiful…
January 3, 2007
For several weeks in December, I worked with an adolescent medicine doctor who was like magic. Watching him massage our spectacularly manipulative patients into compliance was like watching someone fit a greased elephant into a cigar box. His motto was, as he told me repeatedly, "Every behavior…
December 30, 2006
And again, I point you to this week's Pediatric Grand Rounds. There's a great series on vaccines mentioned there, if you're into that sort of thing (and I know you are).
December 26, 2006
Now up: this week's Grand Rounds, into which I've again managed to squeak. This week: bloggers' best-of.
December 25, 2006
I'm an M.O.T., so for me, Christmas, meh. It's just kind of another day. I'm neither especially cranky about having to work nights through the holiday, nor is my heart filled with the dazzling light of yuletide joy. But last night, a colleague reminded me of something that brought home the true…
December 22, 2006
Yesterday, I discharged 5 patients from the hospital. Today, I feel dead inside. For patients, hospital discharge is a happy moment. Leaving the hospital means leaving behind the unflattering gown, the interrupted sleep, the food that does not resemble itself, and the constant parade of people…
December 19, 2006
Most of you know I'm not the only one writing about the medical profession out here in the blogosphere. This week, I'm honored to be in the company of many excellent medical bloggers at two weekly, appropriately named anthologies: Grand Rounds and Pediatric Grand Rounds. Please have a visit and…