Grand Rounds Vol. 4 #46

It has been a rough month here at Pure Pedantry.

At one point last week, I think I trained rats for 8 straight hours. (My job in the lab is training rats.) And let me just tell you, that is not particularly interesting. Visualize getting a repetitive stress injury moving around an pissed off animal with a limited attention span but to whom your entire future is chained. Anyway, in order to entertain myself, I have been playing every episode of South Park in order in the background. (Yes, I know...very, very sad.) Sufficeth to say, this has resulted in me having South Park on the brain. Thus, this particular edition of Grand Rounds will be South Park themed.

I would like to thank everyone for this very welcome breather from slowly losing my mind for the good of science. Thank you all for your submissions.

A Quiet Mountain Town

Rural Doctoring covers the traits that make for a good rural family medicine doc. High on the list: being a generalist and knowing when you don't know the answer. There is also a touching, if slightly disconcerting, story about delivering a baby amidst a crowd.

Clinical Cases and Images Blog expresses some concern about future doctors revealing too much about themselves on Facebook. They have some suggestions about how to avoid getting burned.

PathResBlog answers the basics: what is pathology? The breakdown is into anatomic pathology (which you probably have heard of...think autopsies and gross stuff) and clinical pathology (which you probably haven't).

Respect my Authoritah!

PalMD at denialism asks: are doctors really arrogant? His answer (and I agree): sure some of them are, but there is lots of medical education to prevent this. Paternalism in medicine has really changed between when my father went to school and now -- and changed for the better.

Dr. Rich at the Covert Rationing Blog takes the NYTimes to task for accusing dermatologists of a two-tier system -- one for skin disorders and one for cosmetic dermatology. (With declining Medicare reimbursements, if dermatologists have to make up the difference with Botox, more power to them.)

Rheumination wonders about the particular traits in clinical departments that cause them to self-destruct into in-fighting.

Musings of a Dinosaur spins a Tale of Two...(ahem)...Patients, both dealing with the results of mammograms. (Not actual title.) One gets surgery; one does not. Explaining why is a bit complicated.

You killed Kenny. You bastards!

Healthline discusses the medicine and science behind Tasers. Did you know that Tasers run on AA batteries? Amazing. They emphasize that one of the problems in Taser-induced deaths is that the subjects are often intoxicated or agitated. Or the fact that some police officers have been Tasing people multiple times, something they haven't been tested for.

Other things amanzi describes a shocking story about a patient who arrives unannounced and bleeding from their IVC. Yikes. Someone really didn't want to deal with this patient and kicked the problem down the road. Turf wars between hospitals can kill.

I'm not fat. I'm getting in shape. Beefcake!!!!

Suture for a Living looks at the characteristics that make for a fine booty -- and the surgical procedures that one might use if your booty is less than fine. There is in fact a term for having a fine booty: callipygian. That is without a doubt the most interesting thing I have ever learned, and I cannot wait for a cocktail party to bust out my fine vocab.

Chef: How's it going kids? Kids: Bad.

Neuroanthropology details the sad practice of prescribing antipsychotics for children diagnosed with bipolar -- though whether you could diagnose a young person with bipolar remains a dubious assertion. More importantly, a lifetime of treatment with some medications is likely to have unforeseen almost culture shifting side-effects in how parents deal with their children and how those children deal with the world.

Mind, Body and Soul cautions about the dangers of overprotecting your child and creating Vulnerable Child syndrome. We are not talking helicopter parents; we are talking smothering to the point of poor development. Scary.

The Back Pain blog discusses Neck Pain that Radiates and answers a reader question about radiculopathy.

Yeah, I want some cheesy poofs.

Degranulated details the effects of a program in Australia that allows medical students to write questions for their own tests. Shocking effect: rather than inane minutiae, now the questions actually reflect what might be useful in clinical practice. If only I could get the US schools to do something similar...

Vitum Medicinus compares different PDAs based on their utility for the med student and the physician. I'm heading back to the wards soon myself, and this was really informative for my next little toy purchase.

Six Until Me details the benefits of and the indications for continuous glucose monitoring (CGM) and urges the insurance companies to get aboard.

Highlight Health goes over the nit-gritty data in the first high-res MRI study to look at connectivity in the human brain. The researchers then use network theory to find the hubs -- or places that are most connected to the rest.

Thank you again for all your submissions. The next Grand Rounds is being hosted at Medical Humanities Blog on Tuesday August 12th.