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

Latest Posts

Watching A Man Die

The myth of the glory of war is perpetuated in part due to the fact that the stories are only told by survivors. If the guy that took one through the neck in no man’s land in world war one and then slowly faded away in a mess of saliva mixed with blood, lying in his own stools, crying for his mother were to tell his story from beyond the grave it wouldn’t look so glorious at all. It would maybe be a better reflection, though, of the reality of it. In a certain sense we run the risk of glossing over medicine too. I would hope this blog does not.

I am extremely affected by the patient calling out to me to save him in strained monosyllabic speech at the last moment of his life. It is almost too much to bear. And yet I am the survivor. I walk away to live another day or to tell the story or to enjoy a sunrise in the African bush. Read more »

*This blog post was originally published at other things amanzi*

Bad Behavior In South Africa – A Gory Story

South African society is a completely lawless society. Pretty much everyone does just what they like and more often than not they get away with it. Red lights are just a suggestion, yet it is not uncommon to see a taxi stop in the middle of the road without warning. This attitude goes through almost all levels.

Yet there are some laws that people do obey. The law of gravity comes to mind. Mostly if you trip or fall off a wall or out a window you do approach the earth with increasing velocity and finally come to rest in some form of disrepair when you finally meet said earth, even if you are South African.  Another law that is obeyed was well illustrated by a patient we once saw in the old days. Read more »

*This blog post was originally published at other things amanzi*

Domestic Violence: When A Baby Is Shot

A while ago I treated a woman with rhabdomyolysis. You see, her husband beat her so severely that she had enough muscle injured that she ran the risk of kidney damage due to breakdown products. I spent some time chatting to her. I couldn’t understand that this beautiful, intelligent woman could find herself in this sort of situation, especially seeing that the bastard had assaulted her twice before. But actually this post isn’t about her. She had finally realised there is no chance that this sort of person is going to change and that she needs to leave him before he kills her. No, this post is about someone else. Read more »

*This blog post was originally published at other things amanzi*

A South African Surgeon Flees The Twilight Zone


We can sometimes look good in our jobs. I suppose it comes with the territory. But sometimes this is not a good thing.

Danville is an interesting place. Actually the place itself is drab but it is full of interesting people. To say it is populated by the lower echelons of the gene pool is an understatement of note. For some reason every reprobate and inbreed seems to have found their way there. Throw a few generations of fetal alcohol syndrome into the mix and you have the average Danville resident. Then add a strong predilection to grandpa (a local aspirin caffeine headache powder) to round off with. Usually when they presented to the hospital it is with a bleeding peptic ulcer or a perforated peptic ulcer. In fact they seldom present to us with anything else. Read more »

*This blog post was originally published at other things amanzi*

Breast Cancer: How One Surgeon Protected A Patient From Another Surgeon

After having spoken about when you seem to know more than your consultant, I was reminded of another incident from my internship year where a colleague of mine taught me that sometimes it is best to do certain things under cover of darkness.

The patient (a sangoma) turned up at the surgery clinic one day. My colleague asked her what the problem was. Without uttering a word she lifted up her shirt to expose her breasts. The left one had a massive tumour that had fungated through the skin probably some time ago. There was a large stinking cauliflower-like mass with central ulceration that caused a fist sized cavity right up to the chest wall. The smell was also remarkable. Read more »

*This blog post was originally published at other things amanzi*

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