surgery
oracknows | November 5, 2007About a month and a half ago, I discussed an e-mail that was being propagated far and wide that described the case of the mother of a 17 year old male who, or so the e-mail claimed, cured her son of stage IV melanoma using "natural means" and was supposedly thrown in maximum security prison by the Department of Child Services in California for "failing to properly care for her child." The e-mail, which was being used by an organization called Natural Solutions USA or Health Freedom USA (I was never quite sure), reproduced here, described what seemed on the surface to be a truly horrific abuse…
oracknows | October 30, 2007
Dave Munger and others have been spearheading an effort to promote the acceptance of a specific logo that science bloggers (ScienceBloggers, included) can use to let the reader know that the topic of a blog post is a discussion of real, peer-reviewed research. Use of the logo, which I've used for this post, means a blogger is not just commenting on research that's been reported in the media, but rather has gone, so to speak, straight to the horse's mouth to look up the original peer-reviewed journal article. It's a worthy effort, and I plan on going back through the last few months of…
oracknows | October 27, 2007A couple of weeks ago, I wrote about a favorite topic for amusement among general surgeons, rectal foreign bodies, particularly the strange things people like to stick up their bottoms for whatever reason. I pointed out at the time that sometimes the excuses such patients make when seeking medical attention are a bit--shall we say?--hard to believe. It figures that a mere three weeks later someone would send me an example of something different, a hospital administrator not accepting what seems like an absolutely honest explanation for how a foreign object got up there:
Doctors in central…
oracknows | October 17, 2007Via Health Care Renewal, I've learned of a study that, certain people may be surprised to learn, troubles me. Published yesterday in JAMA, it is, as far as I know, the most comprehensive quantification of one type of tie between industry and academia, specifically how many department chairs have ties to industry and what kind. Here's the abstract:
Institutional Academic-Industry Relationships
Eric G. Campbell, PhD; Joel S. Weissman, PhD; Susan Ehringhaus, JD; Sowmya R. Rao, PhD; Beverly Moy, MD; Sandra Feibelmann, MPH; Susan Dorr Goold, MD, MHSA, MA
JAMA. 2007;298:1779-1786.
Context…
oracknows | October 15, 2007About a week ago, I wrote about how the wooiest of woo, reiki, has infiltrated one of the best academic trauma centers in the U.S. In it, I lamented that I was feeling increasingly alone in being disturbed by this infiltration of religious pseudoscience into bastions of scientific medicine.
Fortunately for me, Dr. RW is as dismayed as I am:
Out here in the hinterlands I can only wonder what's going on in academic medicine these days. Is there anyone there for whom the standards of science mean anything at all? Well, there must be. There are plenty of people who teach and write about evidence…
oracknows | October 11, 2007I should have guessed.
Leave it to uber-crank (a. k. a. One Crank To Rule Them All) Mike Adams, the "intellect" behind what is perhaps the crankiest website known to humankind (at least when it comes to medicine), NewsTarget.com, to try to slime Breast Cancer Awareness Month. As fellow ScienceBlogger Mark points out, in his "report" Breast Cancer Deception, Adams accomplishes this by characterizing Breast Cancer Awareness month as nothing more than part of a conspiracy by the "male-dominated" cancer industry to keep women down.
I have to admit, in the realm of sheer wingnuttery, I've seldom…
oracknows | October 10, 2007Here we are, a third of the way into Breast Cancer Awareness Month, and I haven't yet written a piece about breast cancer. Given that it's my primary surgical specialty, perhaps some readers were wondering why not. Truth be told, I've always been a bit ambivalent about Breast Cancer Awareness month. Perhaps it has something to do with the fact that my job makes every month Breast Cancer Awareness month. Or maybe it has something to do with the crassness of some of the promotions designed to attract donations, well-meaning though such campaigns undoubtedly are. From my perspective, any month…
oracknows | October 8, 2007Regular readers know that I've long been dismayed at the increasing infiltration of non-evidence-based "alternative" medical therapies into academic medical centers (1, 2, 3, 4, 5, 6, 7). It's gotten such a foothold that it's even showing up in the mandatory medical curriculum in at least one medical school. I've speculated before that academic medical centers probably see alternative medicine as both a marketing ploy to make themselves look more "humanistic" and a new revenue stream, given that most insurance companies won't pay for therapies without solid evidence of efficacy, meaning that…
oracknows | October 3, 2007One of the stranger aspects of being a general surgeon or a colorectal surgeon can be summed up by this abdominal X-ray (click on the picture for a bigger image):
Yep. From time to time, every general surgeon will be called upon to pull something out of someone's ass. It's not super common, but common enough that pretty much every general surgeon's seen a few. In the case above, it would appear that the offending object is an aerosol can. I know what you're probably thinking first: Why? I also know what you're thinking next: How? (As in: How on earth did he get that up there?)
Believe me,…
oracknows | September 22, 2007Two words: Necrotizing pancreatitis.
There's nothing like repeated trips to the operating room to scoop out bits of dead pancreas, trips sometimes so frequent that we leave the abdomen open to facilitate repeat visits, in patients who are about as sick as any patient you'll ever see. There are few, if any, problems in general surgery more challenging, and saving such patients gives an enormous sense of accomplishment. It's also one area that distinguishes general surgeons from all other specialties. There's no other surgeon or internist who can handle these cases. When the pancreatitis…
oracknows | September 16, 2007I've been very remiss about this, but the e-mail notifying me of it happened to arrive a couple of weeks ago, back when I was out of town because of the recent death in the family. While cleaning out my e-mail boxes, I came across the notice again and decided it was time to rectify my oversight, do my surgeonly blogging duty, and plug these carnivals.
It looks as though there's a new blog carnival in town, and it's all about surgery: Surgexperiences. The latest edition is at Other Things Amanzi. Check it out.
The next edition will be at Suture for a Living on September 30.
oracknows | September 11, 2007Jake over at Pure Pedantry pointed the way to an article in Science that I hadn't seen yet because of my absence. Just like yesterday's topic, this one too is right up my alley. Specifically, it's about something near and dear to my heart, namely the trials and tribulations of being a physician-scientist. The article paints a rather grim picture, with the observation that, although most MD/PhD's would like to remain researchers, many are dropping out in order to become straight clinicians, clinical instructors at medical schools, or industry researchers. Jake's commentary is certainly worth…
oracknows | September 10, 2007Sadly (with regards to vacation) and not-so-sadly (with regards to the events of last week), it's time to dive headlong back into the "real world" at work, starting with clinic today. It also means it's time to get back to my favorite hobby (blogging) in a much more regular way, although I will say that a relatively prolonged break from the blog was good, and my traffic only suffered mildly for it. I may have to do it more often, if only to keep things fresher.
One of the tasks that confronted me this weekend as I got ready to face a full week back at work was to try to catch up on all the…
oracknows | September 1, 2007Vacation time! While Orac is off in London recharging his circuits and contemplating the linguistic tricks of limericks and jokes or the glory of black holes, he's rerunning some old stuff from his original Blogspot blog. This particular post first appeared on June 3, 2005. Enjoy!
Grrr.
I was browsing one of my favorite science blogs, Pharyngula, enjoying PZ's evisceration of a clueless creationist foolish enough to resurrect once again that long-debunked hoary old creationist canard that evolution is somehow not consistent with the Second Law of Thermodynamics, when I saw this in the…
oracknows | August 21, 2007I've been meaning to mention this post by Sid Schwab of Surgeonsblog for a while now. It's a wonderful example of how nothing heals like surgical steel in even the most humble-seeming conditions. In this case, he's talking about anal fissures, a condition that makes defecation very painful. It turns out that, for cases that won't heal with conservative measures, there's a very simple and underutilized operation that can be done in the office known as the lateral sphincterotomy, which can relieve the pain and in essence "cure" the condition instantly. Few operations provide such instant…
oracknows | August 20, 2007After a lot of the not-so-Respectful Insolence⢠of the last couple of weeks, I've been meaning to get back to living up to the name of the overall mega-blog, namely ScienceBlogs. Meeting up with my fellow SB'ers over the weekend in New York Fortunately, last week a topic just so happened to pop up related to my area of expertise, when a study in The Lancet was published evaluating the use of MRI in breast cancer. It happened to get a bit of press when it came out last month, some of it a bit breathless, as though this were a revolutionary observation. (To some extent it was unexpected, but…
oracknows | August 13, 2007I debated for a while about whether or not I wanted to comment on this one. The reason, of course, is that, to some extent, I've commented on a similar article before. Also, given the utter contempt that the blogger who posted this series holds me in and his delusion that I am somehow "obsessed" with him, I worried that commenting about this series, which he posted with some fanfare, might feed that delusion some more. In the end, though, because the series was by someone other than this particular blogger and because, as before, it was presented as a stinging indictment of our system of…
oracknows | August 12, 2007
Science tattoos have been all the rage lately. Even though I'm a scientist, I'm also a surgeon; so naturally I was wondering if there was anything that I'd like to see too.
There is.
Over at Street Anatomy, there's a great collection of anatomy tattoos. Anyone who has any surgery-related tattoos, send a picture of them to me, and maybe I'll get in on the action by posting it. A tattoo of the abdominal contents on someone's abdomen would be really cool.
oracknows | August 7, 2007The third season of Doctor Who is over. There's nothing on the horizon for many months (such as the return of Doctor Who or Torchwood) that's interesting enough to me coming out of the U.K. that I'd go to the trouble of firing up BitTorrent to check it out, rather than wait until it somehow finds its way to these shores.
Until now.
Yes, it's Richard Dawkins' long-promised investigation of alternative medicine and New Age practitioners, entitled The Enemies of Reason:
Prof Dawkins launches his attack in The Enemies of Reason, to be shown on Channel 4 this month. The professor, the author of…
oracknows | August 4, 2007I really, really wish the Discovery Institute would stop putting out idiocy like this:
We have blogged in the past about the growing numbers of doctors who are skeptical of Darwinian evolution to explain the complexity of life.
Those numbers are continuing to grow, and conesquently doctors are beginning to organize themselves and reach out to others who hold similar positions. Physicians and Surgeons for Scientific Integrity (PSSI) has for sometime had a website at www.doctorsdoubtingdarwin.com. Recently they have begun using the site to organize and promote conferences about Darwinian…