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The Differences Between Men & Women

Three of my favorite medical bloggers all posted hilarious observations about the differences between men and women.  I’m not sure what got them thinking on the same wavelength – maybe it’s because Father’s Day is coming up?

Dr. Rob writes:

You may have also noted that x-chromosomes have many more genes than
y-chromosomes. Many scientists believe that the feeling by many women
that jeans make them look fat comes from the fact that there are more
genes in a women’s body, and this is actually a cry for help from the
chromosomal level. Other scientists think these scientists are just
full of hooey.

Dr. Au writes:

Michelle: You accidentally threw out your old med school ID tag, but I rescued it.

Husband: Yeah, I saw that on the table. I threw it out again.

Michelle: Why would you throw it out? Wouldn’t you want to save that?

Husband: (Perplexed) Why?

Michelle: Because…because it’s nostalgic! Your old med student ID tag! Don’t you want to save that? Think how cool that’ll be, when you’re some old crusty attending, to have your med student name tag from the turn of the century!

Husband: Not…really. Why would I want that?

Michelle: Well, why do people save anything? Why do you save your med school diploma?

Husband: I need that to get a job.

Michelle: OK, bad example. Why do you save your graduation tassels?

Husband: I didn’t.

Michelle: You threw out your med school graduation tassel?

Husband: Well, I don’t remember saving it. What would I do with it?

Michelle: Look, if I have to explain why you would save something like that, you probably wouldn’t understand anyway.

Dr. Leap writes:

They [women] think we want nothing so much as another pineapple wall hanging
that they saw in Southern Living.  But men like gifts too!  We just
like them to be a little different.  We don’t want a day at the spa; we
want a day of quail hunting.  We don’t need a pedicure; we need to go
to the Indy 500 time trials.  We prefer to buy our own underwear,
thanks, but a pair of camouflage, Gore-Tex gloves for that winter
hunting trip would be really nice…

And over the years, I have developed a simple rule of three things that
almost every man will accept as a reasonable gift.  They are:  a pen, a
watch and a knife.  This will cover the gamut of almost all men in the
Western Hemisphere, and most in the rest of the world.  See, a pen
reminds us that our ideas and insights are meaningful, and sometimes
need to be recorded.  (And is useful for writing checks to buy flowers
and silky things on Mother’s Day).  A watch reminds us that our time on
earth is short, and we must use it well.  (And that we’re late for
work).   And a knife reminds us that we have capacity and usefulness;
that we are movers in our world, always armed with something that can
serve as tool or weapon as the need arises.  (And that we probably need
a tetanus shot).

I wonder if Dr. Leap’s advice also works well for “Metrosexuals?”  What do you think guys?  Is the best Father’s Day gift a pen, a watch, or a knife?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Grand Rounds 3.38 Immediate Release

Welcome to the latest round up of the best of the healthcare
blogosphere. Today it is my pleasure to offer you your weekly dose of Grand
Rounds, optimized for your state of mind.
I believe that there are two basic types of blog readers, and so you’re
getting Grand Rounds 2 ways (with a dash of cartoons thrown in for extra “feel
good” measure):

  1. Just
    the Facts
    : Distractible, hurried, currently in between seeing patients –
    or perhaps your kids, cats, dogs, llamas are begging for attention… or
    maybe you’re an ER nurse or surgeon who has no patience for long winded
    stories?  You’re category one and
    should proceed directly to Grand Rounds IR (immediate release – below).
  2. All
    the Details
    : Calm, peaceful, you enjoy good prose and a cup of chai
    latte.  You like reading all the
    juicy details of a grand rounds line up and will spend hours picking
    through the references – or maybe you’re an Internist or Psychologist who
    knows that the best medicine is found in the details?  You’re category two and should proceed
    directly to Grand Rounds XR (extended release – next post).

Many thanks to Nick Genes, father of Grand Rounds (who acts
behind the scenes to ensure the success of each host), and please check out
next week’s Grand Rounds at Code Blog: Tales of a Nurse.

Grand Rounds IR (asterisk
= honorable mention for great writing)

Happy Posts

*Starbucks Caters to Diabetics

Woman Saved by Bush Pilot in Frozen Tundra

*CEO Says He’s Sorry

Prayer Can Reduce Arthritis Risk?

*Disaster Unpreparedness [Cartoon]

Med School Graduation Ceremony [Cartoon]

Nurse uses Star Trek Mentor to Set Course for Kindness
Galaxy

Shrink Rap Podcast: Prank Call with Dr. Phil McGraw &
More
[Cartoon]

*Cape Cod Vacation Derailed by Flood, Stroke, Famine & Infection

The Evils of Hand Washing

Sad Posts

Triage in the ED [Cartoon]

*Sad Cases in ED

Elderly at Risk of Death From Tranquilizers [Cartoon]

Life as a Nurse Assistant in Vermont

Hot Topics

Infanticide

Hucksterism

Healthcare Outsourcing (podcast)  [Cartoon]

Blog Censorship A

Blog Censorship B

Arrogant Docs [Cartoon]

Should Kim See Sicko?

Helpful Tips

To Fend off Bears

To Get the most out of Medicine, Web 2.0 style

To Get into Medical
School

To Avoid Kidney Damage from Contrast Agents

To Perform A Pyloromyotomy [Cartoon]

To Diet Successfully – Gluten Free [Cartoon]

Case Reports

Wii-itis

Rare pancreatic tumor

Uncategorized

Cost-benefit analysis of genetic testing

Commencement Speech for Harvard Medical
School Graduation

New Alzheimer’s Research [Cartoon]

New Genetic Research

Book Recommendation for Type 2 Diabetes

For the full text version complete with cheerful commentary, please go to Grand Rounds XR
(next post)


This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Grand Rounds 3.38 Extended Release

…continued from Grand Rounds 3.38

GRAND ROUNDS XR
(asterisk = honorable mention for great writing)

Happy Posts

*Kerri from Six Until Me tells the heart-warming story of a
Starbucks Barista who understood her diabetic needs and treated her with
special care.

Traveling Doc from Borneo Breezes Blog, submits a post about
the bush pilots of the Canadian north.
Even though it’s summer time you’ll shudder at this arctic tale of a
native woman whose life was saved by a bush pilot and an Australian surgeon.

Tony Chen of Hospital Impact submits a post by Nick Jacobs, the CEO of Winder Medical Center.
In it Christopher apologizes for being ill tempered and snapping at a
woman who posted a paper sign on the wall.

Dr. Jolie Bookspan of the Fitness Fixer Blog offers a
fascinating look at the physical healing power of prayer.  Jolie reports that the movements involved in
Muslim prayer (including standing, bowing, kneeling, and sitting) can promote
flexibility, increase quad strength, and burn up to 80 calories/day.  She explains that similar prayer posturing
(found in Russian Orthodox prayer and some forms of yoga meditation) may be
equally useful.

Rita Schwab at MSSP Nexus Blog writes a really funny post
about disaster preparedness.  She muses
about how she had been taught to hide under her school desk in case of a
bombing, and even then (at the tender age of 8) wondered how the desk vs. bomb
equation would really pan out for her.
But the real amusement comes when you click on her link to the CDC’s
recommended communication releases on such plagues as tularemia.  Yes, the bacterium found in rabbits and
rodents (that perhaps 125 hunters succumb to each year in this country) is not
contagious from human to human and causes flu-like symptoms.  I’d give this a fear factor of 1 out of 10.  [Cartoon]

Dr. Bruce Campbell of Reflections Blog describes the medical
school graduation ceremony – the first time “doctor” is officially tied to the
graduate’s name.  [Cartoon]

Mother Jones, RN from Nurse Ratched’s Place, confesses to
being a trekkie.  She did find a good
role model in nurse Chapel, though.  Now
here’s my confession: I’ve been known to utter a few “Damn it, Jim-s!” when
asked to do non-medical related work at my current job.

Roy
at Shrink Rap pulls a “Jerky Boys” style practical joke on Dinah.  He uses prerecorded audio clips of Dr. Phil
McGraw to simulate a live Skype conversation with her, and gets Dr. Phil to ask
Dinah outrageous questions and give her bizarre advice such as, “I want you to
live as a gay woman.”  Poor Dinah falls
for it for a short time… and it’s rather funny, especially if you enjoyed the
Jerky Boys prank call to Hooters with Arnold Schwarzennegger clips.  [Cartoon]

Laurie at a Chronic Dose tells a hilarious story of 3 chronically ill family members who experience a comedy of errors during a vacation in Cape Cod.  Somewhere between the brain aneurysm, flood, sunburn turned staph cellulitis, and cell phone lost in the ocean, there’s humor in the midst of tragedy.

Susan Palwick from Rickety Contrivances of Doing Good describes the evolution of hand washing requirements for all staff (including chaplans) at her hospital.

Sad Posts

ERnursey from ERnursey: Stories from an Emergency Room Nurse
gives us an eye-rolling perspective on exactly how emergency departments are
abused by drug-seekers and non-emergent cases of ridiculousness.  Triage ain’t easy.  [Cartoon]

*Type B Pre-med from the blog by the same name, offers a
tear jerking slice of life from the ED.
A woman with breast cancer finds out that it has metastasized to her
brain while a 9 year old sexual assault victim waits for the doctor to see him
next.

Christian Bachmann from Med Journal Watch reminds us that
tranquilizing medications are associated with shorter lifespans in the demented
elderly population.  [Cartoon]

Matthew at Path Lab tells the sad story of a bariatric patient’s woes in the hospital, and what daily life is like for nurse assistants.

Hot Buttons

Dr. Tara Smith at Aetiology, discusses the tragedy of
infanticide, and the events that led up to the recent murder of a newborn in Iowa.  She asks whether designated “safe havens”
(where mothers can drop off unwanted babies, no questions asked) are not
promoted enough by the media or if the state of mind of a woman who has just
given birth to an unwanted baby wouldn’t be receptive to that messaging.

Dr. Hsien-Hsien Lei interviews the CIO of Suracell Personal
Genetic Health to try to get to the bottom of whether or not nutrigenomic
testing is a form of hucksterism.  This
quote followed an objection about nutrigenomic supplements costing more
than similar products in health food stores: “Well, our clients like paying
more for what they believe is something better than the cheaper versions.”  Orac should take a look at this.

David Williams of Health Business Blog submits a
thought-provoking podcast of a recent interview he conducted with the founder
(founded in 2002) and creator of Planet
Hospital, Rudy
Rupak.  Rudy starts the podcast
explaining that his company arranges surgical treatment for travelers who need
emergent care in foreign countries, but later on explains that the primary
income stream for Planet
Hospital involves
healthcare outsourcing for American women who are “too wealthy for Medicaid and
too young for Medicare” and want cosmetic procedures or IVF done at a lower
price.  Rudy then explains that he has a
program called “the best of both worlds” where plastic surgeons travel overseas
to perform their procedures for cash – outside of malpractice laws and with
lower overhead. [Cartoon]

Henry Stern, at InsureBlog comments on the recent loss of
Flea and other medical bloggers.  He says
that “There’s a creeping reticence in the blogosphere… and maybe that’s a good
thing.”

Amanda from It’s All About the Walls marries her frustration
with her own health issues with some frustration at the apparent censorship of
certain bloggers.

N=1 from Universal Health offers this challenge – doctors
should try to get outside of their egocentric shells and get to know (and learn
from) all of the knowledgeable, competent allied
health professionals around them, especially nurses. [Cartoon]

Kim at Emergiblog expresses deep inner conflict about going to see Michael Moore’s new movie, Sicko.  If she goes, she donates $10 to his cause, if she doesn’t go she’ll be left out of a hot topic of conversation.  This is a tough call, fair sister.

Helpful Tips

Dr. Auerbach from Healthline describes how to handle
encounters with bears.  I didn’t realize
that humans should respond differently, depending on the kind of bear.  Check out what to do if you run into a
Grizzly versus a Black Bear.

Bertalan Meskó from Science Roll lists some “Web 2.0”
activities for patients and physicians alike.
But Bertalan forgot about Revolution Health!

Sarah (a bubbly Aggie from Texas A&M) has some
practical tips on how to get into medical school.

Dr. Joshua Schwimmer from Healthline explains that
Gadolinium used to be the contrast agent of choice for patients with kidney
disease (since the regular iodine-based agents can cause “contrast
neuropathy”) but now new cases of a scleroderma-like condition (called
“nephrogentic systemic sclerosis”) have been associated with Gadolinium.   Bottom line: if you have kidney disease, any
sort of contrast dye is risky!

Dr. Lisa Marcucci from Inside Surgery offers up the
technical how-to’s for an open pyloromyotomy to repair baby stomachs.  Some little ones are born with a narrow,
thickened area in the junction between the stomach and the intestine so food
can’t pass through.  But thank goodness
for surgeons like Lisa who can fix them in a jiff!  [Cartoon]


Chronic Babe describes her impulsive eating habits and what
she’s going to do to try to avoid chocolatey, salty days in the future.  [Cartoon]

Case Reports

Dr. Ves Dimov of Clinical Cases and Images – Blog –
discusses the New England Journal’s recent case report of Acute Wiiitis
(contracted as an overuse injury from the Nintendo video game Wii remote
control).  He rightly points out that as
far as medical nomenclature is concerned, “itis” is more appropriately appended
to the name of the affected body part (e.g. tendon-itis).  As far as we know, a Wii remote is not part
of the human body – though one can see how the NEJM editors couldn’t resist
accepting the resident physician’s title selection.

Dr. Iñarrito-Castro from Unbounded Medicine presents a
fascinating case report of an exceedingly rare pancreatic tumor.  Beautiful imaging and photos.


Uncategorized

Dr. Keith Robison of Omics! Omics! Blog describes his
thought process of what it might take to determine the underlying genetic cause
for one little girl’s unknown syndrome.
In the end he suggests that it might cost $1 million (to map her entire
genome) and result in no clinically useful benefit.  In this cost-benefit analysis, it looks as if
mom got it right – love the child as she is, and spend your money on mobility
enhancing equipment.

Dr. Joe Wright submits his commencement speech (for
Harvard’s graduating class of MDs and DDSs) for your consideration.

Girlvet from Madness: Tales of an Emergency Room Nurse
describes some promising research in Alzheimer’s Disease and how her own mom died in a nursing home from complications of the disease.  [Cartoon]

Nurse JC Jones from Healthline, highlights the recent
Wellcome Trust announcement of significant advances in the genetic
underpinnings of several major diseases. She includes a recent photograph of
James Watson (of Watson and Crick fame), who is now 79 years old.

Rachel from Tales of My Thirties highly recommends a book
about Type 2 Diabetes.

SPECIAL BONUS POSTS

Now, because Dr. Val has a keen eye and is very meticulous, she has rounded up some savory morsels that she found on her own – these posts were not formally submitted to Grand Rounds 3.38, but will be included because she’s sure their authors wouldn’t object:

Dr. Richard Reece from MedInnovationBlog summarizes Regina Herzlinger’s arguments for consumer driven healthcare.

PandaBearMD explains why he believes that Chiropractors are quacks – and other controversial issues.

Kevin, MD points out that while websites designed to allow patients to rate doctors are gaining acceptance, websites that allow clients to rate lawyers are causing a legal meltdown.

Dr. Stanley Feld (former President of the American Association of Clinical Endocrinologists) takes a very well argued swipe at Dr. Steve Nissen’s recent article about Avandia in the New England Journal of Medicine.

Dr. Charles exposes the quackery of Dr. Heimlich (of the Heimlich maneuver).

Dr. Au from the Underwear Drawer accidentally summarizes the difference between men and women in a conversation with her husband about whether or not to save an old medical school name tag.

Dr. Rob from Musings of a Distractible Mind offers some hilarious genetic explanations for male/female differences.

Hallway Four captures a fascinating disconnect between what a patient thinks a doctor is doing and what a doctor is actually doing.

Dr. Hildreth at the Cheerful Oncologist gives us 8 ways to cope with a malpractice lawsuit.

Dr. Scalpel presents a case of a scratch (plus toenail fungus) sufferer presenting for a work excuse.

#1 Dinosaur argues that obese doctors are more empathic counselors for obese patients who wish to lose weight.

TBTAM recounts a sexual history dialogue in which a patient had condoms delivered at 5am from a local deli.

Ian from ImpactEDnurse continues the condom refrain with an interesting analogy: how practicing “safe nursing” is like practicing safe sex.

FLASHBACK:  And for the all time coolest classic blog post… let’s go back to GruntDoc circa 2004 for a look at the scariest menace in the ED: “Some Dude.”

Thanks for reading!  Hope you’ll tune in for our regular Wednesday feature of Revolution Rounds – the best of the 27+ person Revolution Medical Blogger team posts, organized and served up friendly by yours truly.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Bodies Exhibit

Not sure how many of you are aware of this touring
anatomical science exhibit – but it’s been making its rounds through major cities in the U.S. and Europe.  I finally went to see it this weekend in DC, and it was both amazing and slightly disappointing.

It was amazing because of the meticulous dissection work done by the Chinese scientists.  It was disappointing because, after months of viewing the awe-inspiring marketing photos of colorful cadavers playing soccer, football, conducting an orchestra, etc. I had some sort of unconscious expectation that there would be movement in the exhibit, or at least some medical animations and multi-media.  Instead, the exhibit was flat – nothing moved, no multi-media, and much of it was comprised of cadaver slices and organ sections.  The attractive, eye catching cadavers made up a very small portion of the exhibit.

Now, I wondered how these cadavers could be unscented (I was told beforehand that there was no odor problem – the way there was in anatomy lab in medical school), and as it turns out it’s because they are not cadavers at all.  No, the Bodies are actually plasticized fossils.  So the reason they don’t smell is the reason why dinosaur “bones” don’t smell – there are no bits of tissue left.

All that being said – I really have to tell you that seeing these meticulously dissected fossils made me realize how useless medical school anatomy lab really is.  A surgeon once told me that he found anatomy lab “a total waste of time” since the anatomy of living flesh bears little resemblance to the greasy beef jerky (sorry to be so graphic – but it’s true) we poke through for months on end at medical school.  These Bodies were incredibly beautiful – and I truly saw (and understood) for the first time the exact relationship of every nerve, muscle, tendon, artery and vein to the greater picture.  How I wished I could take one of the bodies home with me to study it!  Netter is great – but there’s nothing like 3-D to really understand the relationships.

So I can only hope that medical schools will seriously consider offering courses conducted on these beautifully dissected fossils, rather than the smelly, obese cadavers that we muck through today (no disrespect meant to the donors – they are kind to offer their bodies to science).  Anatomy is critically important in medicine – but I’m not convinced that the current educational system is set up for maximum impact.  Skip anatomy lab – spend some time at the Bodies Exhibit.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Is that your real skin?

I’ve been thinking about skin cancer lately.  A young, fair skinned friend of mine
recently had a small mole removed from her leg.
It turned out to be melanoma!  It
didn’t take me too long to make the connection between her complexion and mine,
and the fact that I’d been avoiding the dermatologist for several years,
worried that I’d come out like a punch biopsy pin cushion since I have quite a
few freckles and moles (and I’ve heard that dermatologists like to err on the
side of caution and biopsy anything remotely suspicious).  But the melanoma story galvanized me into
action.  I made an appointment with a
dermatologist (yes, I had to wait 4 months to get an appointment!) and got a
skin check.  Luckily for me, all was fine.  But I started to reflect on various conversations
I’ve had about my skin recently.  All you
Irish types out there will relate…

Conversation 1

Coworker A: Val, are you ok?
You look kind of sick.

Me: I’m just fine.

Coworker A: But Val, you look a little… bluish…

Me: That’s just my skin color.  My veins show through my skin because it has
no melanin.

Coworker A: (Appearing sympathetic) Oh, well glad you’re
alright.

Conversation 2

Coworker B: (in the middle of a conversation with me, sitting
across from one another on chairs.  I’m wearing a skirt.  Suddenly she lunges forward
and touches my knee and gasps).  Is that
your real skin?

Me: Um… yes.  What
else would it be?

Coworker B: Well, I thought you were wearing white pantyhose.

Me: Nope.  It’s too
hot for pantyhose so I just go bare legged.

Coworker B: (still in shock).  But that’s your skin?  Just like that?

Me: Yeah.  I don’t
tan.

Coworker B: (appearing sympathetic) Oh, wow.

Conversation 3

Dermatologist: Hi, I’m Dr. XXX. (Peering at me, seated on the examining table
in a paper gown.)  Are you Scandinavian?

Me: No, I’m part Welsh – you know, “Jones.”

Dermatologist: Oh, well the Vikings probably invaded Wales
at some point.

Me: (to myself) well thanks for alluding to the raping and pillaging
of my ancestors.

Dermatoligst: You’re high risk for skin cancer.  People like you need to have careful skin
exams every year.

Me: Yes I know.  But
please don’t take any unnecessary biopsies!
I think my moles are all fine.

Dermatologist: Well let’s see…(tearing the paper gown in two).  You definitely need to wear SPF 50…

Me: Sigh.  I know…

Conversation 4:

Husband: (giving me what I thought was a tender look.  He leans in…) Your eye lids are kind of pinkish purple

Me: Yes, that’s the color of the capillaries that show
through my lid skin.  Hard to get a tan
there you know.

Husband: You don’t need a tan – I like your color.  Kind of pastel pink and blue. (He leans in even closer to inspect my eye lids.)

Me: Yeah, not exactly attractive in a bathing suit. (I pull away.  He laughs.)

Husband: Well, yeah.
It’s better not to be out in the sun or on the beach, but you can still
go outside!

Me: Thanks.

Conversation 5:

Asian manicurist: (looking at my hands) Your skin is so white!

Me: Yes, I’m afraid my past efforts to alter that have failed.

Asian manicurist: How did you get your skin so white?

Me: I didn’t do anything.
It’s like that naturally.

Asian manicurist: (looking closer at my hands) I wish I had skin like yours.

Me: Why? (Hoping she’d say something flattering after all).

Asian manicurist: It looks clean.

And so I guess despite all the people I’ve worried with my vaguely cyanotic appearance, there’s one thing for sure: I look clean.  I guess I can live with that.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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