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Understanding Risk Related To Outdoor Health

Dr. Robert “Brownie” Schoene, an enormously talented, accomplished, and insightful physician who resides within the bedrock of wilderness medicine, gave a wonderful presentation about the concept of risk at the 2010 annual summer meeting of the Wilderness Medical Society. Risk is inherent in outdoor activities, whether it is part of exploration, adventure, science, or industry. I am going to summarize his approach to the topic, which is among the most important general concepts in the field, and editorialize with some of my thoughts.

When one thinks of risk related to outdoor health, it is about the possibility of suffering harm, damage, or loss. When a person is aware of the possibility of a specific risk, he or she usually weighs the risk against the possible benefits. When you hike on a slippery, snowy trail in early spring, where the trail winds over patches of ice near ledges from which a fall would cause a severe injury, is the experience worth the risk? When you ride a wave on your surfboard when the waves are intimidating and you are outside your comfort zone, is the improvement in performance worth the possibility of a tumble and possible muscle tear or broken bone? Sometimes the answer is easy. When I travel to a third world country, I always run the risk of acquiring infectious diarrhea. The benefits of the mission supersede the discomfort, and I both anticipate the risk and prepare for treatment by carrying oral rehydration supplies and appropriate antibiotics.

I love the quote from Winston Churchill that Dr. Schoene used to illustrate a risk-taker’s approach: Read more »

This post, Understanding Risk Related To Outdoor Health, was originally published on by Paul Auerbach, M.D..

Patient Eats Toxic Chemical, Emits Hazardous Gas In Hospital

Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.

Which makes the ‘gas effect’ seem really odd, but possibly explainable.

A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.

The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.

via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press |

Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.

I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.

(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.

It’ll be interesting to see what come of this.

Lighting matches in the hospital is a nono, by the way.

*This blog post was originally published at GruntDoc*

Healthcare Reform: Why I’m Scared

I’m scared because I’m reading articles about people threatening to kill — note that word “kill” — elected officials because of their vote on healthcare reform.

A man was arrested last week for his threats against Nancy Pelosi. Another man was arrested for threatening the two senators from Washington state, saying, “I do pack, and I will not blink when I’m confronted. It’s not a threat, it’s a guarantee.”

One congressman’s campaign received an email that read, “If our tea parties had hoods, we would burn your (expletive) on a cross on the White House front lawn,” while another had bricks thrown through the windows of his brother’s house (which was listed as his official address) and the propane line to his gas grill was cut.

The Associated Press reported that the Senate’s Sargent-At-Arms, who monitors security in both houses, reported 42 incidents in the first three months of 2010 — nearly three times the 15 cases that occurred during the same timeframe in 2009, and all related to healthcare reform. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

Trauma Surgeon Flees Chaos Of Haiti: Needed Protection Of Jamaican Soldiers With M-16s To Escape Alive

Dean Lorich, MD

Dean Lorich, MD

I received this letter from a medical colleague today. It was written by Dr. Dean Lorich, Associate Director of the Orthopedic Trauma Service at NYC’s Hospital for Special Surgery. I hope to interview him for Better Health soon. Stay tuned for the audiocast…


I believe we went in with a reasonably comprehensive service we wanted to provide acute trauma care in an orthopedic disaster.  Our plan was to be at a hospital where we could utilize our abilities as trauma surgeons treat the acute injuries involved in an orthopaedic disaster.  We expected many amputations however came with a philosophy that would reasonably start limb salvage in what we thought was a salvageable limb.

David Helfet put a team together which included: Read more »

Why You Shouldn’t Take A Stroller On An Escalator

There’s an epidemic at our malls: parents taking their small children up and down escalators in strollers of all sorts of sizes and shapes. I ended up behind one such parent yesterday and found strollers heading up and down all afternoon. Some were small, some large. Some had bags dangling off of them, others not. Sometimes parents had both hands on the handles, other times they were balancing the stroller and a drink or cell phone. Read more »

*This blog post was originally published at Dr Gwenn Is In*

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…

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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…

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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…

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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…

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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…

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