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A Doctor’s Many Hats

I have taken on the task of writing 50,000 words for a novel in November (NaNoWriMo) and would have to carve time out of work or family [my posts are decreased by this new hat]. I can only wear so many hats.

But I am here, and my writing has been far more enjoyable than I expected. This is the time when it is easy to hit the wall (we get daily encouraging emails from successful writers to get us through this time), but I’m okay so far. I am writing about a doctor who encounters a very unusual patient. I am writing in the first-person, which was a good choice, as I know the first person of a physician intimately and stand no risk of getting those details wrong. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Male Laptop Users: Beware Of An Overheated “Lap”

83kdkjj.jpgMale readers be advised! Using your laptop placed on your knees to read this post may cause your testicles to heat up quite significantly. However surprisingly, this is not due to the heat dissipated by many laptops, but rather due to the positioning of the legs. A study just published online in the journal Fertility and Sterility investigated ways to avoid the testicles from overheating while using a laptop computer.

Right and left scrotal temperatures were measured in 29 volunteers while working on the laptop in different positions: With closely approximated legs, with closely approximated legs with a lap pad below the laptop, and sitting with legs apart at a 70° angle with a lap pad below the laptop. After 60 minutes with closed legs, temperature increased about 2.4 degrees Celsius, using the lap pad yielded a slightly smaller increase of 2.1 degrees, while spreading the legs resulted in a modest increase of 1.4 degrees.

The authors conclude that prevention of scrotal hyperthermia in laptop users is not feasible, although we would like to disagree and suggest using a flat surface, such as a table or desk, to position your laptop in order to preserve your fertility.

Article abstract: Protection from scrotal hyperthermia in laptop computer users…

Image credit: Pitel…

*This blog post was originally published at Medgadget*

How Much Pesticide Is In That Cigarette?

I had a fascinating discussion with an ex-tobacco farming expert. He’s an expert because he used to grow tobacco, but not anymore. If you’re a smoker, or user of any tobacco leaf product, what he said should shock you. I take that back — you’re a smoker: “shocked” is never going to happen to you.

What did he say that was so striking? I’m not a farmer, so it became a little difficult to understand all the science behind the conversation. Needless to say, he said they used to farm vegetables and tobacco side by side. He said something about potato farming being timed with tobacco crops, and when the potato market went south he got out of the tobacco farming business for good and went with just vegetables. Now he’s a full-time vegetable farmer.

While he was a tobacco farmer, how did he run his tobacco farm? Like I said, he grew vegetables and tobacco side-by-side. He used different pesticides for the vegetables than he did for the tobacco farming. He farmed based on the concept that people who ate vegetables were looking for a healthy food. So he used pesticides in their lowest recommended concentration and applied them at the longest recommended time frame between applications and used the safest formulations available. None of his chemicals carried the skull-and-crossbones warning. And what about the tobacco farming? Read more »

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

Doctors, Voicing Concerns, And Fear Of Retaliation

Shouldn’t it be possible to voice a concern about a medical treatment, procedure, or claim without the fear of retaliation? If the claims are backed by science, then simply addressing my concerns would be enough.

Fear of retaliation silences discussion. Fear of retaliation makes it difficult to do the “right thing” when the public or an individual patient is at risk.

This incidence involves a British plastic surgeon threatened with libel action by the ‘Boob Job’ cream’s manufacturer after she voiced concerns/doubts of its effectiveness. Sense About Science has a great summary of the entire affair: “Plastic surgeon threatened for comment on ‘Boob Job’ cream.” Read more »

*This blog post was originally published at Suture for a Living*

Is The Young Pharmaceutical Rep Right?

I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety, generic medicine-only doctor.** Sadly, my status changed today. Dabigatran (brand name Pradaxa) was the culprit.

It was a little nerve racking. I wrote the order, looked at it, thought it out again, talking to myself: “John, are you sure you don’t want to do it the old way? [pause to think] No, I am embracing the new.”  And then, I closed the chart and handed it to the nurse.

“What’s that? Pradaxa?” asked the nurse. “Stop the Lovenox? You sure?” My face must have told the story.

Eight days had passed since dabigatran’s approval. “That’s plenty of time to mourn warfarin’s demise,” I thought. Enough studies, enough blogs — it was time for the rubber to hit the road. Read more »

*This blog post was originally published at Dr John M*

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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