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Grand Rounds 4.31: How Do You Feel About That?

Welcome to Grand Rounds 4.31, Dr. Val’s edition of the weekly rotating carnival of the best of the medical blogosphere. There are many approaches to summarizing submissions to Grand Rounds, and I have chosen one that has never (to my knowledge) been used before.

That’s right – I’m taking my inspiration from the limbic system, and have organized the posts according to the dominant emotion they elicit from readers. And because Dr. Val was one of those annoying medical students who brought 10 different colored highlighters to study class, I will also label some of the posts with the following tagging system (in brackets) to offer advanced readers an additional nuance:

[:-)] = A post that demonstrates literary excellence

[{] = Early bird – an author who got his/her submission in early, which is really convenient for the host(ess)

[:-/] = Naughty – an author who forgot to submit an entry to Grand Rounds but who was included nonetheless

So without further ado, here’s the Grand Rounds that will make you laugh, cry, stomp your feet, and become enlightened in the process.


The fun begins with the Clinical Cases and Images Blog, featuring a hilarious blogger “sweat shop” video to illustrate the heart attack-inducing stress that bloggers face on a daily basis. His post is called: “Death by blogging?

Dr. Rob Lamberts from Musings of a Distractible Mind has some parenting tips (including pole vaulting avoidance strategies) in his post called “The Sins of the Father.”

Happy, the Happy Hospitalist offers his perspective of what it would mean if physician satisfaction surveys (rather than patient satisfaction surveys) mattered.

Allen Roberts of GruntDoc describes how one misspoken word can result in unexpected innuendo.

[:-/] Dr. Wes predicts an upcoming hospital “performance Olympics” after one patient receives a record fast, door-to-balloon cardiac intervention.


[:-)] Laurie Edwards of A Chronic Dose tells the touching and amusing story of how one sick young girl was ostracized at summer camp  – and how new camps designed for chronically ill children are revolutionizing the camping experience. Her post is called, “Summer Camp: Sick Style.”

Barbara Kivowitz, from In Sickness and in Health, describes a husband who knows just the right thing to say in a stressful time. Her post is called “Mars/Venus Who Cares?

Lisa Emrich, from Brass and Ivory describes what it’s like to experience a relapse of Multiple Sclerosis and an MRI to evaluate the progression of her disease. Her post is called “Surfing the Magnetic Tube.”

Dr. A from Doctor Anonymous wonders if peace and contentment come from accepting one’s lot in life. His post is called, “With Age Comes Happiness?


ER Nursey relays the tragic story of a baby that died of a preventable illness. His mom decided not to vaccinate him against pertussis and was trying to treat the infection with “natural methods.” Her post is entitled simply: “Whooping Cough.”

[:-/] Abel Pharmboy at Terra Sigillata explains that since 1994, dietary supplements cannot be removed from the market until there is evidence for lack of safety, meaning that consumers must first be harmed before FDA is authorized to intervene. His post is called, “Must People Die Before DSHEA is Repealed?

[:-/] David Gorski at Science Based Medicine takes a critical look at the claims of a popular alternative medicine practice: colon cleansing. His post is called, “Would You Like a Liver Flush with that Colon Cleanse?

[:-)] John Crippen from NHS Blog Doctor explores the difference between a young doctor’s “gallows humor” and a senior physician’s deep and abiding concern for patients in this reflection on death certificates in Britain. The post is called “Ash Cash.”

A Canadian Medical Student and author of Vitum Medicinus tells the story of how a patient asked her doctor a question that she already knew the answer to, just to see if he was current in his knowledge of recent health news. The post is “What Trickery Is This?

David Williams of The Health Business Blog points out the fallacies inherent in one writer’s attempt to vilify the health insurance industry. His post is called, “There is no Health Insurance Mafia.”


This large group of posts may be further organized by the topic of enlightenment. First up we have practical health tips.

Health Tips

[{] We begin this section with an anonymous psychiatrist blogger at How to Cope with Pain. She has captured my little Rehabilitation Medicine heart with her three-part series describing office ergonomics, therapeutic exercises, and how to avoid computer-induced postural strain. Her very practical post (that will be very useful to you readers) is called: “How to Sit at Your Computer to Avoid Pain.”

Ramona Bates at Suture for a Living explains what to do if you’re bitten by a cat – she does a wonderful job describing the treatment options and possible infections that can result. Her post is aptly named, “Cat Bites.”

Paul Auerbach at Medicine for the Outdoors teaches us everything we need to know about preventing and treating foot blisters caused by hiking/walking. His post has the shortest name of this Grand Rounds: “Blisters.”

Jeff Benabio at The Derm Blog offers a comprehensive analysis of the dangers of tanning salons with some tips for safe sun exposure. His post is called, “Is The Tanning Industry The New Big Tobacco?

Nancy Brown at Teen Health 411 warns that outdoor tanning is also not safe. Her post is called “Sun Safety.”

Jolie Bookspan, The Fitness Fixer, tells the story of how a woman living in the Yukon learned that “doing exercises” doesn’t heal an injury if you go back to bad movement habits the rest of the day. The post is called, “Fixing Herniated Disk and Reclaiming Active Life.”

[:-/] TBTAM at The Blog That Ate Manhattan has practical tips for patients preparing for a new patient visit with an Ob/Gyn. Her post is called: “TBTAM’s Healthcare Team Tips for New Players.”

[:-/] Dr. David at Musings of a Pediatric Oncologist teaches us that HPV can predispose people to oral and throat cancers as well as cervical cancer. All the more reason to vaccinate boys as well as girls. His post: “HPV and Cancer Revisited.”

Kenneth Trofatter, at Fruit of the Womb offers a detailed analysis of when it might be appropriate to use Fondaparinux to reduce the risk of clotting in pregnant women. His post: “Use of Fondaparinux During Pregnancy.”

Joshua Schwimmer at Tech Medicine offers some tips for doctors. Practice makes perfect, and this new teaching mannequin has some nifty bells and whistles. His post is: “The iStan Medical Mannequin: it Sweats, Bleeds, and Breathes.”

More healthcare for dummies is offered by Jan Gurley of Doc Gurley Blog. Her post is called: “Playing Surgeon.”

Next up, a series of posts about Web 2.0 principles.

Web 2.0

Allergy Notes describes a small study in the BMJ demonstrating that text message reminders can improve compliance with asthma medication regimens. The post is called, “Text Messaging Can Help Young People Manage Asthma.”

[{] Sam Solomon of Canadian Medicine describes a new trend in Canadian medical research – using blog tools to analyze public opinion. His post is called, “Putting Clinical Depression under the Microscope and on the Blogosphere.”

Mic Agbayani at GeekyDoc, suggests that patient privacy is violated by YouTube when a video is posted of healthcare professionals laughing during a surgical procedure to remove a foreign body from the rectum. His post is called, “Patient privacy and YouTube.”

[:-/] Richard Reece at Med Innovation Blog explains that doctors get a bad rap when it comes to EMRs and IT in general. See his post: “Bad Rap on Physician IT Use Not Deserved.”

[:-/] A counter-point argument for the mandatory use of EMRs (at his hospital) is made by John Halamka at Geek Doctor. His post is called: “Accelerating Electronic Health Record Adoption.”

Health Policy and Medical Ethics

This is our largest and final subgroup of enlightening posts. You’ll find some great reasoning here (and Dr. Val is partial to reason).

First up we have the inimitable Sandy Szwarc of Junk Food Science. She takes a close look at the numbers and shows that the current Student Nutrition Policy Initiative is failing to stem the tide of childhood obesity and poor eating habits. Her post is called, “JFS Special Report: Major Findings on Childhood Obesity Programs.”

Amy Tenderich at Diabetes Mine has a terrific post about the need to revise the Americans With Disabilities Act. As a physiatrist, I cheer her on. Her post: “Disability and Diabetes Revisited.”

[:-/] Dr. Rich at The Covert Rationing Blog explains the financial incentives behind Medicare’s new “never event” initiative and how it will impact care for the elderly, obese, and those with bleeding disorders. His post is called, “Never Events? Never Mind.”

Bob Coffield at Health Care Law Blog writes that some argue that preventing disease does not decrease health costs. Bob disagrees, but isn’t sure if he can prove his case. His post: “Is prevention cheaper than treatment?

[:-/] #1 Dinosaur of Musings of a Dinosaur explains that reducing expenditures in a patient’s last year of life requires perfect foresight into his or her life expectancy. His post: “End of Life Care Costs: A Logical Fallacy.”

Maurice Bernstein at the Bioethics Discussion Blog argues that, over the past 50 years, the ethics of medicine has changed more than any other aspect of it. Technological advances and the advent of medical consumerism have changed the way medicine is practiced. His post is: “50 Years of Medical Practice: Changes, Benefits, Costs, Dilemmas.”

Louise Norris at the Colorado Health Insurance Insider would rather be treated by a salaried physician who has no incentive to order additional and perhaps unnecessary tests and treatments. Her post: “More Care Does Not Mean Better Care.”

[:-/] Charlie Baker at Let’s Talk Healthcare offers a nice summary of a recent NEJM article about how to cut healthcare costs in the US. See his post: “Partners HealthCare Weighs In On Health Care Costs.”

[:-/] Kevin Pho at KevinMD has a series of posts called “My Take.” This one on legitimate malpractice lawsuits and anti-aging is very interesting.

Kerri Morrone at Six Until Me raises her voice for Type 1 Diabetes awareness. Her post: “My Raised Voice.”

[{] Ian Furst from Wait Time and Delayed Care wonders if visual cues could be developed to reduce patient wait times. His post is called, “Clutter of the Brain.”

And finally, an anonymous medical student at a blog called From Medskool argues that there is no primary care shortage, that incomes are fine, and that PCPs won’t abandon Medicare. Anyone wish to debate this with him? His post: “Four Myths of the Primary Care Crisis.”


And here’s a special message from next week’s Grand Rounds hostess, Jan Gurley:

Grand Rounds in medicine often means a morgue-cold auditorium, a sea of starched white coats, and staccato squeaks from irritable chairs. Doc Gurley is hosting April 29th’s Grand Rounds of the medical blogosphere with a more WWF-type approach: Grand Rounds Smack Down Week. Do you want to take on a behemoth topic with some chest-beating frenzy? Or just climb into the Internet ring wearing your most outrageous verbal-costume? Here’s your chance to go for it.

Thanks to all who sent me submissions, and many thanks to Nick Genes our fearless leader. Let me know how this Grand Rounds made you FEEL!This post originally appeared on Dr. Val’s blog at

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5 Responses to “Grand Rounds 4.31: How Do You Feel About That?”

  1. DrDavid says:

    Great job, Val!  And thanks for including me.  Your grand rounds makes me feel PROUD to be a part of such an outstanding group of writers.  It’s good we didn’t go to med school together… I was the guy in the very back row cracking jokes under my breath and barely staying awake.

  2. TBTAM says:

    WOW what a lt of work and a great collection of posts. Thanks so much for incluindg mine!

  3. Number One Dinosaur says:

    Excellent job! And thanks so much for including my unsubmitted post. Sorry it was so last-minute.

  4. aenea says:

    What a great list of posts- thanks for doing such a wonderful job! 

  5. jeisea says:

    Great collection of sites and information.

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