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Latest Posts

BBC America Introduces New TV Show About Real Life In The ER

You know me.

I’m all over anything that is from the BBC.

But this is different.

There is no TARDIS. And there are nurses along with the doctor. Lots of nurses.

And the only people flying through time and space are the trauma patients before they hit the bus or the ground.

24 Hours in the ER premiered last night on BBC America. I received a copy of the first two episodes from BBC America unedited for American television. Of course in Great Britian, this was called “24 Hours in A&E”.

On a personal level, I like it. It reminds me of the old “Trauma in the ER”.

On a professional level, Read more »

*This blog post was originally published at Emergiblog*

The Devastating Emotional Impact Of Missed Diagnoses

Bongi is an amazing writer, and if you haven’t, I strongly urge you to read his latest post, titled “The Graveyard.”

I imagine that a huge number of doctors know exactly what he means. I remember being told by a surgeon, while I was in medical school, that “you’re not a real doctor until you’ve killed someone.” I thought at the time (and still think) that there was a puerile bravado behind that admonition, but there is also a grain of truth. I have my own graveyard. Curiously, not all of its inhabitants are dead. They are the cases where I screwed up, or, charitably, cases that went bad where I feel that maybe I could’ve/should’ve done things differently.

The missed SAH

The missed DVT/PE

The missed AAA

The missed Aortic dissection

The missed MI

I remember them all, clearly and in detail. Read more »

*This blog post was originally published at Movin' Meat*

Surgeons Advised To Give Up On Worst Injured In Case Of Nuclear Detonation

Researchers concluded that surgical triage following a nuclear detonation should treat moderately injured patients first, then severely and mildly injured people, because of the limited medical personnel and material resources that would be available.

The model of time and resource-based triage (MORTT) tests different hospital-based triage approaches in the first 48 hours after a nuclear detonation of an improvised nuclear device. It’s not a tool in and of itself, but it examines the effect of various prioritizations and focuses primarily on the surgical needs of trauma victims.

The report appears in Disaster Medicine and Public Health Preparedness. The entire issue, devoted to nuclear preparedness, is open access. Read more »

*This blog post was originally published at ACP Hospitalist*

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*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

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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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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