Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Case Of The Accidental Chemo Burn

One of the great things of being in a group practice is meeting and taking care of patients who may not necessarily be on your own personal patient panel. Walking into the room, I hear the patient say, “Doc, you gotta help me.” I see a red right forearm and on the “complaint” section, the nurse wrote “burn.”

So, I ask, “Well how did you burn your arm?” “Well, doc, I got cancer.” Hmm, that’s interesting. I didn’t make the connection until the next sentence. “It was my last treatment with chemotherapy about 2 weeks ago and for some reason, the needle slipped and the stuff went all over my arm. The cancer doc prescribed these pills, but they don’t seem to be helping. I asked the pharmacist about some salves and this is what they said.” He showed me a handful of creams and ointments purchased at the pharmacy.

Since I didn’t know this patient at all, I was leafing through a very thick paper chart to try to catch up. “Yeah, I’ve been coming to see Doc [name] for a long time now. I’m glad you were able to see me today since his schedule was full.” This very pleasant patient then told me about how they diagnosed his cancer – a tear came to his eye – it’s like he was re-living that moment again. Read more »

*This blog post was originally published at Doctor Anonymous*

A Brazilian Waxing Accident To Remember

I don’t know a thing about bikini line waxing.  But I do know there is a right way to wax your bikini line and a wrong way  wax your bikini line.  I present to you a story about how not  to wax your bikini line.  I do not know the original author, but I’m sure they want to keep it that way.

My night began as any other normal weeknight. Come home, fix dinner, play  with the kids. I then had the thought that would ring painfully in my mind for the next few hours:

‘Maybe I should pull the waxing kit  out of the medicine cabinet.’ Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Sometimes It’s Better To Amputate

There’s no technological substitute for the human hand. Manual dexterity is incredibly hard to replicate, and so surgeons will go to great lengths to save injured hands. Unfortunately, sometimes the injury is too severe to allow for any meaningful functional recovery.

In these two cases, well-meaning surgeons refused to amputate the unsalvageable hands, thus delaying recovery and adaptation of prostheses.

This is a photo of a trauma victim who underwent extensive reconstruction of the hand, including transplantation of a toe to the thumb’s position. Gangrene set in and tracked up one of the tendon sheaths.

toehand

Photo Credit: Dr. Heikki Uustal

In this case, a burn victim was hoping to have some fingers reconstructed from his fist. He declined amputation and fitting with a prosthesis, despite the potential for enhanced function.

mithand

Photo Credit: Dr. Heikki Uustal

In both cases, a wrist disarticulation (amputation at the wrist) and prosthetic fitting (such as this myo-electric device with a self-suspending socket) might have provided a better functional and cosmetic outcome:

Photo Credit: Dr. Heikki Uustal

Photo Credit: Dr. Heikki Uustal

Sometimes, it’s better to amputate.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles