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Dogs, Hospitals, And Unintended Consequences

Every day I go to the emergency room to admit my adults, I can hear the screaming babies and toddlers. Sometimes, the screams are actually from their parents after realizing  how much their visit is going to  cost.  But most of the time it’s really frightened kids in an unfamiliar environment.

Happy’s hospital used to hand out hospital stickers so kids would associate emergency rooms with a fun place to hang out.  It turns out, after  intense behind the scenes discussions with administration, that this policy was a covert attempt to increase the volume of our pediatric emergency room volumes.

After looking at the numbers, and understanding how hospitals get paid,I have now come on board and am part of a committee think tank that does nothing more than think of ways to get more people through the doors.   We invited the intelligence behind the 50% rise in pediatric ICU volumes after implementing the pediatric ICU art project. Read more »

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

Killer Dogs And US Dog Bite Statistics

Dog attacks are a major public health concern worldwide. In the United States, dogs bite more than 4 million people each year, occasionally resulting in fatalities. In an issue of Wilderness and Environmental Medicine (2009;20:19-25), Ricky Langley from the Division of Public Health in Raleigh, North Carolina published an article entitled, “Human Fatalities Resulting From Dog Attacks in the United States, 1979-2005.”

The statistics are instructive. In the years studied, there was an average of 19 deaths each year from dog attacks. Not surprisingly, males and children less than 10 years of age had the highest rate of death from dog attacks, with Alaska reporting the highest death rate. The number of deaths and death rate from dog attacks appear to be on the rise, perhaps for no other reason than there are more people and more dogs, in both absolute numbers and in proximity.

I am a dog lover (of friendly dogs), but am aware both as an owner and as an emergency physician that dogs will sometimes bite people, sometimes with serious consequences. Read more »

This post, Killer Dogs And US Dog Bite Statistics, was originally published on by Paul Auerbach, M.D..

Two Little Girls Mauled By Dogs: How They Healed

pitbullA surgeon friend of mine recently told me a story about a little girl who wandered into the territory of some pit bulls. These dogs were tied up with leashes in the neighbor’s back yard – specifically because they couldn’t be trusted to run loose near children. Tragically, the two year old wandered within their grasp after slipping through a protective kiddie gate and out of the house.

The dogs attacked her viciously, dragging her deeper within their territory and attempted to eat her alive. They tore off both her ears and shredded her chest and limbs. By the time she was discovered she was near death. The girl was rushed to the nearest trauma center – where my friend took her to the OR immediately. He spent the entire night putting the pieces back together, as it were.

A couple of days later, my astute friend noticed her having problems turning her head towards her mothers’ spoon during meal times. That observation triggered him to test her vision – and low and behold the girl was completely blind. A brain CT confirmed the clinical team’s worst fears: at some point during her resuscitation, the girl had a massive stroke, and her entire occipital lobe (the back of the brain) was damaged.

Wondering if there was anything he could do to help the girl, and devastated by what he assumed was a grave prognosis (a lifetime of blindness), my friend called a neuro-ophthalmologist for advice. Much to his amazement, the neurologist told him that her visual deficits were likely to resolve completely, because her brain would simply adapt. Children at very young ages can recover from otherwise devastating strokes because of neuroplasticity – the ability of the brain to rewire itself, and recruit healthy neurons to take over for damaged tissue.

True to the neurologist’s predictions, the little girl regained her site within a year. Fortunately, her body healed extremely well too – and despite thousands of stitches, her scarring turned out to be quite minimal. Today it’s hard to tell that she’s had surgery at all.

This story holds special interest to me, as I too was mauled by a dog when I was a little girl. Although I was bitten in the face, and nearly lost my left eye, I can’t remember the last person who noticed my scars or asked about them. They simply faded with time.

The extraordinary healing powers of young tissue cannot be matched in adulthood. However, some degree of neuroplasticity lives on in each of us, offering hope for brain rehabilitation for everyone – from the forgetful to those with major impairments.

Whether you (or a loved one) have internal or external scars – healing is always possible.

Quote Of The Day: An Observation From Emergency Medicine

Dogs, as a general rule, do not like to be kissed on the mouth by drunk people. 

- Edwin Leap, MD

h/t to Grunt Doc .

Latest Interviews

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Latest Book Reviews

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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

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