Keeping with the tradition, my classmate Jay wrote another list of things he learned. Again, used with permission.
1) Chest pain at rest can also be diagnostic of 3+ cups of coffee before 10am.
2) Being in med school, I achieve a high Woodcock-Johnson every morning.
3) After one week of teaching us about chronic pain, the take-home message is to not call our patients liars.
4) I get all teary-eyed in only 2 situations: watching the ending of the movie Rudy, and being bedside at a live birth.
5) It is possible to almost completely forget what you had known front-to-back the previous week... and do this over and over for 20 straight weeks.
6) Me, and possibly most of my friends, have this condition called Orbitofrontal syndrome.
7) Apparently, the local hospital administration is willing to disrupt/discontinue the medical education of hundreds of 2nd year medical students, because of food and drink inside a lecture hall... and that hundreds of 2nd year med students respond by shrugging and using that forget-what-just-happen-last-week ability.
8) Toxic megacolon is pretty much exactly what it sounds like.
9) Everything you do in med school is the next hardest thing you've ever done.
10) Oh my god... in 2 months, they're going to expect me to make real-life decisions about patient care... wtf, I'm PRETTY SURE that I'm not ready to do that.
If you enjoyed this, check out the top 10 things Jay learned in first year.
Sunday, June 15, 2008
Top 10 List: Ten things I learned in second year med school
Monday, May 12, 2008
Vomiting is more fun than PBL.
On a scale of 1 to 10, how ironic is it that I got food poisoning at the hospital cafeteria?
Sunday, May 11, 2008
Learn the brain in 1 minute, 24 seconds
This is all I'm using to learn the neuroanatomy of the brain for my neuro final.
Even if you aren't interested in neuroanatomy, I highly recommend you watch it - the technology they use for animation is stunning and it really captures the essence of what happens in real life. As well the narration helps embed the anatomy in your memory.
Helps that this was one of my favourite shows as a kid.
Tuesday, May 06, 2008
Cool body tricks: Nystagmus
In class a few weeks back, we learned that if you put hot water in one ear and cold water in another (the "Caloric test"), you can induce nystagmus, a symptom that involves your eyes quivering back and forth.
A guy in my class changed his MSN name today to: "I just did the caloric test to myself... it works."
Med students are a funny breed.
Of course, the coolest tests come with a cool mnemonic: the mnemonic for this one is COWS.
Monday, March 24, 2008
Is there anything in your life causing you stress?
The reason for the patient's visit only said "difficulty sleeping," and the inexperienced first-year medical student had been sent in to take a preliminary interview.
It was going well, as usual. The patient was asking about work stress, home stress, and the like, and the patient kept responding that there wasn't any stress in those areas.
"Is there anything else that could be causing you stress right now?" the student asked.
The patient replied, "Well, nothing, other than my trial."
"Your trial? Are you a lawyer?"
"No," replied the patient. "I'm currently on bail, but I have a trial date coming up next month. I have to go on trial because I murdered my boss."
Note the patient didn't say "on suspicion of murder." The patient flat out admitted that he was on trial "BECAUSE I murdered my boss."
Apparently the doctor knew about this rather unsettling part of the patient's history, but sent the student in unaware... just to teach the student that you should never make assumptions about your patient.
Lesson learned? I'd say.
I am so glad that my family practice supervising doctors never put me in a situation like this.
Oh, and yes, while identifying details have been changed, this is a true story.
Sunday, January 27, 2008
How To Clean your Brain, as told to me by a schizophrenic patient
Shortly after I decided to go into medicine, I knew the day would come when I would have to deal with a branch of medicine that both fascinates and intimidates me: psychiatry.
I'm not sure what it is about dealing with psychiatric patients that makes me so nervous. Perhaps it's how much I value my own cognitive abilities. Maybe it's the stories I've heard of patients in acute psychotic episodes, throwing furniture and yelling obscenities. Or it could be that every psychiatric ward I've ever been to or seen in movies sends chills down my spine.
But now that I've started my Clinical Skills unit on interviewing psychiatric patients, my naivety has resulted in a few surprises. I was blown away when I interviewed someone who has a severe form of a psychiatric condition, yet could still carry on a coherent conversation. I was also quite stunned after the patient told me about their ability to carry on conversations with squirrels in the park and according to their chart had to be tied down in four-point restraints on admission to the hospital, yet answered a number of Mental Status Exam questions testing insight, judgment and thought process as any normal person would.
Of course, the psychiatrist training us told us that there are a few exceptions to this.
For example, some patients will speak in what is termed Word Salad (ie. "I was running down the sidewalk, over the alleys in the supermarket. Sometimes the store is full of nuns, and sometimes the airplanes fly lower. But when I was younger, they threw me over the furnace and the time was singing."), and another patient he remembers didn't speak a single word in the interview, later revealing that he did so because he thought the psychiatrist could read his thoughts.
The patient I interviewed was a bit shy at the start but completely warmed up to me after a little bit. I was a bit nervous when the patient listed off their favourite weapons, stood up to demonstrate self-defence fighting techniques with intense enthusiasm, and then looked at me with hollow, peircing eyes and shouted "I'M GOING TO F------ KILL YOU!" (fortunately while recounting a conversation with somebody else, but it was still pretty intimidating!).
After getting a bit of history from the patient, I looked through the interviewing handbook we'd been given, and asked a couple questions from the "Anxiety" and "Depression" categories, but didn't get very far. Then I picked a question from the "Psychotic" category: "Do you have any abilities that other people don't?" and the patient lit up like a Christmas tree.
"Oh, definitely. I can clean out my brain."
"Really?" I replied, trying hard to stay professional and not crack a smile.
"Oh, yeah, I do it all the time."
"Could you tell me how you go about doing that?" I inquired.
"Sure, all you have to do is fill up the inside of your skull with water. Let it fill up slowly - not high enough that you'd drown, but close to the top." The patient held up hands to demonstrate the appropriate depth. "Then, all you do is shake it around a bit" - again I was given a demonstration of proper procedure - "and after that let it drain out, all through your nose and drool it through your mouth, all the way out until it reaches your navel."
After the interivew, I mentioned to the preceptor that I was stunned that given a demonstration like that, the patient could still answer a number of simple Mental Status Exam questions testing insight, judgement and comprehension correctly. "That's normal for someone with this disorder," said the psychiatrist. "Some of my patients with schizophrenia are incredibly high-functioning - they carry on normal lives with successful jobs - accounting, engineering for example." I wonder how many are doctors.
So that was my first psychiatric patient. I'll get to watch other students in my small group interview a number of other patients over this unit, and hopefully see a variety of pschiatric conditions. For me, however, after a few weeks' exposure to psychiatry, I've concluded that to me, psychiatry is a speciality just like pathology. While I'd never want to become a pathologist given the stigma, I have to admit that the more I learn about it, the more fascinated I am by it.
Friday, January 11, 2008
Rite of passage (or, Delicious Irony)
Every medical student comes to a point in their career where they must perform their first digital rectal exam (DRE).
Today, during a clinic rotation, was my turn.
In a delicious twist of irony that I think was lost on my preceptor, another physician in the office was having a going-away party which we visited directly after this little procedure.
In other words, within minutes of performing my first DRE I was celebrating my new-found skill with a slice of...
...wait for it...
...chocolate cake.
Monday, October 08, 2007
Education mirrors reality in a series of random coincidences
I got a text message from a friend this morning:
"Leafs forward Jason Blake diagnosed with CML (Chronic Mylegenous Leukemia) - More at TSN.ca."
The guy who sent me this text message is a huge Ottawa Senators fan, and he knows how much I love the Leafs (I still owe him $5 because of a game that Toronto couldn't pull out of the hat last week). As often as he can, he tells me how much he thinks the Leafs suck, even though the Sens haven't won a Stanley Cup for way longer than the Leafs.
So, combine that with the fact that our last week of class involved learning about all the types of leukemia, lymphoma and myelodysplastic syndromes, and it's obvious that I would interpret this text message as him reaching a new low in mocking my favourite sports team.
But then I checked it out. He wasn't kidding.
Odd coincidence? Yep. Virtually impossible? Okay, probably not even close... but still weird.
It's not just with this story, though.
This week's Extreme Makeover: Home Edition built a new home for a family of a girl with another type of cancer we learned this week. Don't ask me how I know that.
It gets better. Last week, the cover article of the Canadian Medical Association Journal matched exactly what we were learning that week. We were learning about blood formation - and the cover article was on Erythropoitein, a hormone that influences red blood cell growth, and its role in the therapy of critically ill patients.
And - get this - that's happened almost half a dozen times with the CMAJ. I'm talking cover stories, too - not just articles within the journal.
During our pulmonary unit, the week we learned about deep-vein thromboses, there was a cover article on that in the CMAJ. Our intestine week was accompanied by a CMAJ cover story on colon cancer screening. And there was a cover article on Ovarian Cancer right about when last year's class was learning about reproduction.
Not only that, but a cover article on alcohol use was right during the week when we medical students were drinking a lot of alcohol (okay, that one wasn't a coincidence at all... that could be any week).
But, to top it off, during the very week we learned about Congestive Heart Failure, not only did the cover story match that topic... but my PBL small-group tutor had written an article in that edition of the CMAJ.
Thursday, September 27, 2007
It had to happen eventually: "That sounds like something I read on a blog once."
When I'm hanging out with med friends, as much as we may try to avoid it, every conversation turns to school somehow... some gross thing we saw, some cool clinic case, or general hatred or love for certain professors. (The professor who approached me and told me he reads my blog fits into the latter category, of course).
The other day I was at a classmate's house having some incredible steak, and for some unknown reason, the conversation turned to our cadavers.
We were talking about the nature of our cadavers and how some of the ones with high BMIs are really hard to dissect... some of them you're cutting through the skin and you cut and there's fat, so you go deeper and there's more fat, and you go really deep and you're in the muscle, and so you go back and realize that there isn't any distinction really between the fat and the muscle like there is on the really nice cadavers; instead, on the more fatty ones it's more of a gradient and the fat and muscle is all mixed together, making learning the muscles of the thigh and buttock a much different experience than if you had a different cadaver.
Anyway, a girl who's also in my class piped up that on some of the cadavers, at room temperature the fat is mostly liquid, and this requires suction to get rid of the extra liquid.
"Mine's a lot like that," I said. "It seems like every lab I'm suctioning the fluid... the dead human body fluid... mine had so much I ended up with it dripping all over my leg once."
At this point, my buddy's brother, piped up. He's not in medical school but is interested in going; otherwise he probably wouldn't be able to stand hanging out with med students and listening to their med chatter. He was apparently interested - not grossed out - by my story. "How did that happen?" he asked me.
I explained the story that I've written here before under the heading of Great Moments in Anatomy Lab, where I had proceeded upon a course of actions that resulted in DHBF (Dead Human Body Fluid) dripping down my leg.
This is where things started getting weird. Not dead body weird, but, well, read on.
After I told him the story of how I ended up with DHBF dripping down my scrubs pants, he looked at me and said, "That's funny, there's this medical blog I read, some medical student somewhere in the Carribean - the exact same thing happened to him."
I knew right away where this conversation was going to end up.
"Vitum writes a blog," said his brother. "Maybe you read it there."
"No," he replied, "this one I read was from a student in the Carribean, I think. The exact same thing happened to him - he ended up with DHBF all over his leg."
Either somebody is plagiarizing my blog, I thought, or he's referring to my story. "Yeah, I think that's my blog," I said.
"No, no," he insisted, "I really think this was some medical student in the Carribean that wrote the story."
I loaded up my blog on my mobile phone's web browser and said, "Read this."
Before he read it, he said, "Okay, okay, the story I read on this blog ended up saying the guy was upset that he had cadaver juice running down his leg, but the worst part was that this was the second time it had happened."
Which is exactly the premise of my story.
I handed him my mobile phone and stood back, watching it sink in.
He finished reading and looked up. "Weird... so that's you... well, I've read a fair bit of your blog. I had no idea."
I thought it was funny but he seemed a bit weirded out. Ten minutes later he was still talking about how weird it was that he'd been reading my blog all along, and he knew me, yet didn't know I was the author.
I did warn him I'd be writing about this. Still, I hope that reading about himself here won't be too weird.
Sunday, September 23, 2007
"I'll show you, bitch!"
The other day at the hospital, while I was shadowing in the emergency department, a physician called me over to the x-ray computer terminal.
"Vitum, come take a look at this."
He showed me an X-ray very similar to the one I've borrowed from Wikipedia thanks to the GNU Free Documentation License, photoshopped to match my story, and placed here.
"What's wrong with this picture?" he asked.
"Well," I replied, "I haven't done my musculoskeletal study unit yet, so I could be way off... but aren't hands supposed to be attached to arms?"
"Right!" the doctor replied. "Trust me, the story is just as good as the X-ray. It even made the newspaper."
Assuming that a story in the newspaper presents fewer issues of confidentiality, I'll share the exciting story with you here, with only a few altered details. Truth is indeed stranger.
Apparently, this gentleman was involved in a fight with his girlfriend, and all hopped up on drugs. The fight got more and more heated to the point where our patient reached his boiling point. "FINE!" he shouted. "I'LL SHOW YOU, BITCH!!!"
And show her he did. He proceeded to leave the house, go to the garage, and fire up the chop saw. He placed his arm under the saw, and sliced his hand off clean through at the wrist.
It gets better.
He realized that he was bleeding profusely, as typically happens when you slice your hand off (I assume), so he figured he should do something about that.
He went into the kitchen, fired up the stove, and in tribute to what happens in one of the Rocky movies - so I'm told - he mashed
the freshly-severed stump of his arm into the red-hot stove element, cauterizing it to stop the bleeding. SSSSSSSssssssssttttttt.
Wednesday, August 15, 2007
The day the ER nurses ganged up on me
I swear I was being good. Really, I was! Honest!
But still, they hunted me down and cornered me, like an angry, bloodthirsty pack of shewolves avenging the death of their young. Or something like that.
Tonight, during a ER shadowing shift, I was sitting unsuspectingly at a computer (I don't know how else to sit), looking up the difference between ringworm lesions and lyme disease target lesions. You know, minding my own business. I thought I heard some nurses off in the distance saying something like "student" or "medical student"... but I brushed it off and ignored it. I went back to my googling.
And then it happened.
I felt a massive shadow coming up behind me.
I turned around... in time to see half the ER nursing staff approaching me in a pack akin (great word) to a pack of shewolves (yes that word is worth the repeated reference).
I hadn't done anything wrong (other than written a certain blog post several weeks ago which shall remain unnamed here) but I figured I was screwed.
I felt like those folks must feel when the infamous Sumdude - a.k.a. 'some dude' - jumps them without warning, rhyme, or reason. By the way, for those who don't know, Sumdud is an emergency medicine phenom (another great word) documented by paramedics, respiratory therapists, nurses, and doctors alike.
Anyways, they surrounded me, towering over me - only because I was sitting down - and shone a light in my face. And thus they began their brainwashing session.
"Be nice to nurses!" they said. "Nurses know best." The skinny one in the back of the herd adjusted the giant, whirling spiral which I can only assume was meant to hypnotize me into oblivion. "And nurses love coffee - bring your nurses coffee."
I shifted uncomfortably. Their tactics were working. I was feeling their efforts to convince me were working. I nodded my agreement in an attempt to signal to them that the giant stainless steel probe they were holding just inches from my face wouldn't be necessary.
Okay, I was wrong about the light, the whirling spiral, and the probe. But a group of nurses did corral me today, and did tell me to be kind to nurses. They were mostly joking, but obviously there is a certain level of seriousness to their comments - I'd be dumb to assume that these nurses haven't been cruelly treated by a doctor at one time or another - though the doctors I was working with today were outstanding.
Fortunately I was able to explain to them the same thing I said in that other, previously mentioned but unnamed post, that I've been told all this already by my nursing friends and my nurse mother.
I wish this story had a more dramatic ending, but that was it, really; my comments seemed to appease them. The rabid pack broke apart, most of the nurses wandering off into the meds room, still laughing about their indoctrination method, and sharing stories of nursing back in the days when nurses used to stand up when doctors entered the room and mustard poultices and turpentine were common treatment methods, and I went back to my Tinea corporis and Borrelia burgdorferi.
Friday, July 20, 2007
Top 10 List: Foods that Med School has ruined
Not for the faint of heart...
I've written more than once about medical school taking over my life, but now, I'm about to demonstrate another, entirely new and different, way that being a medical student is invading every aspect of my daily existence.
Actually, there will be further ado, a warning that certain individuals may find the following quite disturbing. If you fall into that camp, I don't mind you choosing to not read this post, so long as you shower me with empathy anyways.
(You're lucky I provided a warning, by the way. I didn't give my sister a warning before I took her on a tour of my school's pathology museum. She lasted about 6 seconds. Bless her soul.)
An anatomic specimen of an athersclerotic aorta seen in pathology lab bore a stunning resemblance.
2. Cocktail shrimp
A procedure called "Transurethral Resection of the Prostate" (TURP!), where they shove a large, narrow .... up male patient's... nevermind ... results in tiny "cores" of the prostate gland being removed. When collected on a surgical towel and photographed, they look like shrimp. In case any student failed to make the visual association, the professor was kind enough to draw our attention to it.
3. Popcorn
Fortunately, my mind has blocked out this reference. Must have been too traumatic. I only remember that it was mentioned in a pathology lecture.
4. Tomato Juice
Duh.
5. Cream Cheese
Doesn't help that the actual term to describe many pus-esque exudates is "cheesy."
6. Pulled Pork
Frighteningly stunning resemblance to certain human muscles that have been thorougly examined by anatomy students.
7. Beef Jerky
Frighteningly stunning resemblance to human abdominal muscles that have been drying out in a body bag for several months.
8. Sheep Brain
Though I enjoyed this delicacy before medical school, it just reminds me way too much of human brains now. (Okay, just kidding. I never ate sheep brain.)
9. Fettucini
One word: Tapeworms. Actually, it technically wasn't medical school that ruined this - I found this one on a blog post.
10. Cream of Broccoli Soup
Turns out this was the food that my body donor had chosen as her last meal. Please don't ask me how I know. As sad as it is gross.
Tuesday, July 17, 2007
Patient Billed $49 million - This is news? Okay, maybe it is.
I may have appeared to sympathize with the San Francisco hospital that billed a patient $12,000 supposedly "for a broken rib," (Patient "billed $12k for broken rib" - this is news? [7/14])...
... but I'm not sure than any amount of explanation will make anybody believe that a $49,000,000.00 hospital bill is reasonable.
Glad I live in Canada.
Monday, July 16, 2007
The Official Grand Rounds, Volume 3, Number 43
Welcome to Grand Rounds, Volume 3.43, hosted for the first time ever at VitumMedicinus.com.
Having used Grand Rounds as a springboard into the world of medical blogging when I first started reading medblogs, it is truly an honour to be hosting Grand Rounds.
The template for this Grand Rounds is as follows:
Description: In his quest to bring you Grand Rounds, Vitum Medicinus went from excitement to panic to enjoyment. Excitement = signing up for Grand Rounds months ago. Panic = when 22 submissions had arrived in my inbox by Friday morning. Enjoyment = putting GR together. Once I got started, it was actually nothing to be panicked about.
Why you should read it: There are some stellar posts in this edition, and for every post I’ve spelled out why it’s worth your time. As well, for the bloggers observant enough to notice that I requested they submit their favourite food along with their blog post, you’ll notice their dish of choice represented pictorially beside their entry. Just one more way Vitum Medicinus is going above and beyond in an utterly pointless and time-ineffective manner.
Award: Grand Rounds 3.43 gets the Vitum Inclusivus award, for subscribing to the age-old (and very childish) “Everybody Wins” concept. This has been manifested in the following manner: Each of the 35 blog posts that were submitted and received a confirmation e-mail have been included, and every one has also received a cryptic Latin-ish award of some sort. (If you need a certificate of your award for your office or bedroom, for reasons of ego-bolstering or personal gratification, you are welcome to print one for yourself.)
Please enjoy Grand Rounds volume 3.43. Feedback, discussion, and criticism of this edition of Grand Rounds are requested and are very much welcome.
It’s pretty annoying to have to deal with a spoiled kid who says “I’m telling my dad!” when they don’t get what they want. Val Jones, MD at RevolutionHealth.com writes about a young man with VIP syndrome, who does just that, and complains to his dad that he wasn’t admitted when there was no medical indication that he should have been. This guy treats the hospital like it’s a casino – at the end, he expects that his care should be comped because his dad threw a lot of money into it. (This would rarely happen in Canada, by the way.)
Why you should read it: You’ll be disappointed to read how elaborate this becomes, involving the CEO of the hospital and the patient’s insurance company… especially when you find out who gets the shaft at the end. As well, you might be interested reading or contributing to the discussion generated by this post.
Award: The Geographicus relocaticis award, for rightly putting this arrogant, snotty, spoiled brat in his place; as well, placement in Vitum’s Top V.
If somebody tells you that after this year’s Running of the Bulls, they have “reviewed with interest the reports and video clips of the bulls goring the runners,” they are either a) a bit out to lunch or b) a surgeon. Having not done clerkship, I have no bitterness towards surgeons (yet?) so I will not take the well-set-up opportunity to say something like “you have to be ‘a’ to be ‘b’.” Won’t go there.
Instead, I will simply say that the editors at Inside Surgery have put together a unique post they call “Possible Types of Injury after being Gored by a Bull.” I don’t think any more explanation is necessary. Strangely enough, this submission is eerily similar to my medschool friend’s desire today to discuss “Possible Types of Injury after being Beaten with a Hammer” (he came up with two thanks to his ER shadowing shift last night).
Why you should read it: Because you don’t want to be in the situation, inevitably someday, when you wish you did. Read it, and then you’ll be the hero who knows what to do when you’ll have to provide first aid to / assess / refer a patient who has been gored by a bull. Subsequently, eligible members of the opposite gender will flock towards you. (Not guaranteed.)
Award: The Practicalus improbabalus award, for being practical advice for an unlikely situation; as well, placement in Vitum’s Top V. Maria at Intueri.org hosts a Literary Medblogging Project called A Picture is Worth A Thousand Words. The writing in this little project is so good that I can’t even top the description that Maria submitted: “Five medbloggers of the more literary persuasion collaborated on what has become an (at least) annual event--you know, to take a break from the usual randomized, double-blind, placebo-controlled rants that usually occupy our blogs.”
Why you should read it: Stunning writing. Times five.
Award: Serialus excellencissimus award, for high-quality writing over and over; as well, placement in Vitum’s Top V.
In an old man’s final hours, a nurse came into his room with a syringe and hooked it up to his IV. When the patient’s son asked what she was administering, she said, “Oh, just some morphine. Just to make him comfortable. We don’t want him in any pain.” It wasn’t long after that my grandfather breathed his last.
Geena at Code Blog submitted a story that reminded me a lot about this incident with my grandfather, and her and I actually got into a little bit of a discussion about this practice that happens in real life but isn’t taught in nursing school. In her post “On the verge of what society finds acceptable,” she reacts to a physician in the UK who took this one step further, administering not a sedative but a paralytic to an infant with agonal respirations.
Why you should read it: You should know where you stand on topics like this one. If it happened to my grandfather, it could happen to yours, or to your child, or to you. And if doctors are apparently taking this one step further, you might want to know about it.
Award: The Contemplatus arresticus award, for discussing something that goes on in the hospital that makes you really stop and think for a minute; as well, placement in Vitum’s Top V.Over my med body!'s Graham Walker gets top points for putting together ... get this ... The Clerkship Video Workout Guide, specifically targeted at preclinical students who are about to enter the world of the wards. This video answers a lot of my questions about clerkship, especially the burning one, "What physical manoeuvers can I practice to prepare for my clerkship?" My favourite exercise: "Surgery Exercise Number 1: I like to call it... Just stand there." It's almost as good as the final surgery exercise. Anyone who will one day hold (or has held) a retractor at an uncomfortable and awkward angle will identify quite well with this video.
Why you should read it: Because it’s not even a blog post that you have to read; it’s one you watch. And laugh at.
Award: The Goldenglobus Oscarifficus award, for putting his dashing likeness on camera; as well, placement in Vitum’s Top V. "A patient refuses a life-saving treatment. What do you do?" Virtually every medical student has looked over ethical cases in an effort to prepare for their medical school interviews. This is all well and good, until you realize that an ethical situation takes on a whole different meaning from reading about it in a book, to when you're on the wards and it's a patient staring you in the face. Sid Schwab writes a post at Surgeonsblog called "Blood Oath" on one of the classic med school interview ethical cases... and talks about how in real life, finding the edges of the often blurry ethical 'line' can be a lot harder than citing a textbook on ethics - or simply falling back on legal precedent.
Why you should read it: Instead of reading about an ethical dilemma discussed by a philosopher sitting in an office, try reading about an ethical dilemma by a physician who has had to put ethics into action in a life-or-death situation. Trust me, it's much more compelling.
Award: Honorarius medicinus, for having the honour to respect patient's wishes, even when some ethicists would say he's wrong, and when colleagues have said they won't do it. As well, a placement in Vitum's Top V (which I suppose is now the top VI) as a way to apologize for my oversight in not including his post in Grand Rounds from the start.
Bongi, the surgeon who writes at Other Things Amanzi, submitted two equally disgusting stories of experiences in the operating room. If you think the job of Grand Rounds editor is easy, it is making decisions like this which choosing between these two posts that would convince you otherwise. I went with the one that doesn’t have the high likelihood of ruining a popular food for you…(medicine tends to do that with food…check back here soon for a post on that, in the works) though I’m sure you’ll easily be able to find the post I chose not to include, if you look for it.
Why you should read it: To prove to yourself that you have a strong stomach, and to catch a glimpse of just how big that mythical creature known as the Ego of Surgeons actually is.
Award: The Incitus Vomitus award for the most disgusting post to Grand Rounds this week. (I won’t translate the name of this award into English. If you really want to know, look it up in any reputable Latin textbook).
It’s a medical student’s greatest dream come true. They are standing in the wards, when, all of a sudden, “CODE BLUE” comes squaking out of the intercom. All of a sudden, the student gets to witness one of medicine’s greatest orchestrated lifesaving ballets in action: running a code. After reading about CODE RED at Rickety Contrivances of Doing Good, I found out that a CODE RED is just like a CODE BLUE - the only difference is, in a code red, nobody knows what to do. Random fact: “Paging Dr. Pyro” is used by some hospitals to mean “Code Red,” according to the infallible Wikipedia. As a patient, I’m not sure which would be more unsettling to hear over the intercom.
Why you should read it: Because experiencing a real live Code Red, albeit vicariously, is pretty exciting (at first).
Award: The Combusticus avoidicus award, for averting certain disaster by fire.
From Counting Sheep, Tales from the Nurse Anaesthesia Front comes a story of a combative nurse who wrestles a patient into TKO, despite the patient being the greatest heavyweight boxing champion of all time. Pretty macho for someone who claims that their favourite food is “any kind of chocolate cake with a warm molten center.”
Why you should read it: This story has to be read to be believed.
Award: The World Heavyweight Boxing Championship Trophy. For obvious reasons. 
A post from Musings of a Distractible Mind called “Joi de vivre” talks about how life and work can really get to you. “Life often seems like a hamster wheel - the harder you run, the more tired you get, but you never get ahead,” writes Dr. Rob – sound familiar?Why you should read it: Because that’s not the end of the story; Dr. Rob has found “a ray of sunshine” to light up the dreary days, and you should read to find out what it is.
Award: Employerus exemplari, for making “Equal Opportunity Employer” more than just an empty statement stamped on his office’s want ads.
In a post titled simply “Loss,” Neonatal Doc writes an incredibly touching story that outlines one of the most tragic moments in any parent’s life – the loss of a child. It’s a moment that admittedly neither a fresh medical student like myself, nor a seasoned physician like neonatologist looks forward to.Why you should read it: Because it is better to be in a situation of consoling grief once you have read a post like this, which (along with its reader comments) tells you what you should and should not do in that situation.
Award: Lacrimarum nostrum, the tear-jerker award, for making us cry. Have a tissue handy.
Just as in the previous post, the McCanns are suffering from a lost child, but in another, entirely different and equally devastating, manner – their daughter simply disappeared, victim to abduction. Dr. Rima Bishara at The Doctor Blogger has passed on what was originally an e-mail the family hopes will be forwarded extensively so that this four-year-old girl can be found. (Of course, should you choose to donate money to any cause online, make sure that you are looking at a legitimate website - some pathetic criminals have tried to profit from this family’s loss, defrauding people into giving to fake funds by setting up fake websites).Why you should read it: Because Madeline has such a unique birthmark that unlike many other missing children’s photos, you won’t forget her’s.
Award: Compassionatus empathaticus, for showing the compassion and empathy characteristic of an excellent physician by petitioning for this child’s speedy return to her family.
Bruce Campbell, MD writes a reflection on the difference between “knowing” and “understanding,” as he was taught by a five-year-old boy. Let’s just say that it happened on the 5th of July, many years ago, and like a good dramatic story, this one contains a good dose of suspense.Why you should read it: Generally, any time a story starts with “This is something I have never forgotten,” it’s usually a pretty good story. As well, this post was designated by a reader as a piece of wisdom worth saving for her unborn grandchild.
Award: The Paternalis aureus award, for providing golden, fatherly medical advice in the form of high-quality writing.
Dean Moyer describes himself as “a guy who discovered one day that he had a bad back and then spent 10 years ignorantly seeking chiropractic treatment for it.” And yet, for an anti-chiropractic blog, it’s actually really well put together and respectable – arguments are objective, the website takes a tone of contemplative disappointment rather than ignorant rage, and he’s not trying to sell quack creams or potions. As you might expect, there are people who take offence to his website, particularly people who stand something to lose should the chiropractic profession be challenged. The post “Dumb Day and Disk Decompression of Delaware” talks about the unusual response of one of these people to Dean’s website. Make sure you click through the “Continuing Saga” links at the end of the post to get the full story.Why you should read it: A few reasons: 1. The alliteration in the title of his post. It’s incredibly impressive, in its intelligent idiosyncrasies (I spent more time on that sentence than I did on all of Grand Rounds). 2. Hillbilly humour. Always gets a laugh (what I like to call a ‘universal punchline,’ kindof like Chuck Norris jokes). 3. In all seriousness - you might be surprised at the way these “professionals” have responded to Dean’s website when you get to Part 3.
Award: A Bloggisimus novicus award, for being a First-time submitter to Grand Rounds! Welcome Dean!
ERnursey at, uh, ERNursey writes a post just like the ones that got me hooked on medical blogging, called “Dumb reasons to come to the ER.” I don’t know why I get such a kick out of patients demonstrating lapse in judgement, when they’ll inevitably be a source of major frustration to me once I actually become a doctor.Why you should read it: Because you won’t believe how dumb some of these people are, and because you should leave a comment encouraging ERnursey to provide more stories like this.
Award: Toothicus clenchicus award. For being able to clench her teeth and get through having to deal with these stupid, stupid patients.
“Suffer the children who don’t fit the mould,” by nurse Sandy Szwarc at Junk Food Science, is another one of those posts best described by the author. It begins: “Imagine having a daughter with a rare condition that is poorly understood and health authorities seem disinterested in helping to diagnose. It’s not that girls and boys just like your daughter haven’t been seen throughout history, but today she’s mocked and viewed as a freak and everyone is pointing the blame at you — so much so, that government officials have taken your daughter away and made her a ward of the state.”Why you should read it: Because you’ll be shocked to read the ridiculous reason this girl was taken away from her family. And, Sandy uses rational discussion to propose that a dramatic blanket crackdown on childhood obesity may NOT be that well thought out.
Award: The Advocatius familii award, for using her background in clinical medicine and scientific education to advocate for the unfortunate parents.
Dr. Linda Regan, a contributor for the NY Emergency Medicine blog, discusses some of her experiences as a female physician ranging from breast feeding to ordering morphine that suggest gender disparities still exist in the world of medicine.Why you should read it: Because when you read the first story of how she was treated by a chief, you’ll be shocked that things like this actually happen in real life.
Award: The Feminatus commendibus award, for being a female having to put up with what is, in many ways, a male-dominated profession.
Dr. Paul Auerbach talks about a trap that caught his friend during a camping trip. You will be surprised to see how dangerous such simple consumer products can be.Why you should read it: Because pictures tell a thousand words, and you should click the link lest ye end up in the same trap.
Award: Solutionatus ingenious award, for coming up with more than one possible solution for an unexpected problem. . . and choosing the better one.
When I put out a call for posts containing drama, action, OR humour, I never expected to get a post that tried so hard to fit all three (and did so successfully). Interestingly enough, it doesn’t seem like Kim at Emergiblog had to try so hard – she was treated to all three elements during a shift on her 50th birthday.
Why you should read it: Because a) you need to click on the link so that you can comment and wish Kim a happy 50th birthday, and b) because once you read this you will be convinced to take off work any birthday of yours that ends with a zero (or two).
Award: Kim basically begged for an award, so she gets the Desperatus inclusivus award, for working hardest to fit the theme of this week’s Grand Rounds. You’re one in a million, Kim. (well, one in 35.) Look, you even got your own category!
At first I misread the e-mail and thought that a ham and cheese sandwich was Anonymous Therapist's (Keep Breathing) favourite food, but later realized that a ham and cheese sandwich is instead an integral part of the plot for The Tale of Mr. Bignose, one of AT’s favourite patients.
Why you should read it: Uses a ham and cheese sandwich as a plot device, as well as the word “curmudgeon.” And stories about favourite patients are always worth reading.
Award: The Keenerificus maximus award, for being the first blogger