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Dr. Paul Auerbach’s Update From Haiti

Today was another remarkable day. Here are some of the highlights:

The team continues to be incredibly strong and we are receiving reinforcements from all directions, both from International Medical Corps and from many other NGOs. Before I go any further, I want to express my appreciation for the incredible effort from the U.S. Army, which has provided protection, supplies, transportation, medical assistance and most important, peace of mind. This is not an easy situation, and having a compassionate and responsive military, never shirking a task when we need their help, is incredible.

We continued to triage, operate on and otherwise treat approximately 700 patients, with injuries that will change their lives forever. We have seen countless amputations, disfigurements and open fractures, and face wounds that are in some circumstances infected to the point of gangrene. The medicine is intense, but we are up to the task most of the time. It is quite hot outside and there is little time to eat, drink or go to the bathroom, so by the end of the day we are quite tired and bit dehydrated. But we do not complain, because these people are so strong and now so disadvantaged. Read more »

This post, Dr. Paul Auerbach’s Update From Haiti, was originally published on Healthine.com by Paul Auerbach, M.D..

Saving Murderers In South Africa

Being South African these days sometimes means we see things in a slightly skewed way. It seems to be the way we have become. I have touched on this before, but there is another story which illustrates the point.

The recent run of hijackings were fresh in all our minds because the perpetrators had shot and killed, execution style, a mother and her three year old child just the previous week. There were reports that one specific gang was working the area and were responsible for most if not all the hijackings and associated killings in the area. So when our patient came in, even before the police told us so, we just assumed he was one of this gang. Read more »

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

The Most Disgusting Hand-Shake Ever

Shaking hands is not really such a good idea, especially in a hospital where there are all sorts of nasty bugs floating around, seeking whom they may devour. So generally I do not shake hands unless the patient absolutely insists and I think the cultural slight may be more than he can bear. But one incident highlighted to me the reason you generally don’t want to shake hands so well it could just have well been written all over the hospital in bright neon lights.

I was on call that night so it fell to me to evaluate and treat the patient in casualties which the casualty officer said had a perianal abscess. I approached the bed and introduced myself, but I made a point of positioning myself in such a way that the patient wouldn’t be able to greet me with the traditional handshake. Experience had taught me that this was one case where this cultural idiosyncracy was patricularly ill-advised.

I asked what the problem was. without saying a word his hand moved to his gluteal cleft in one smooth motion. Moments later I found myself staring with morbid fascination as he pulled his butt cheeks apart and started prodding what was clearly an abscess with his finger. It had already broken open slightly so there was a thin stream of pus oozing out and following the natural pull of gravity. The patient’s grubby finger scratched, prodded and poked this poor stream of sepsis, completely disrupting its attempt to soil the bed linen. Read more »

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

Breast Health in 2010 And Mammogram Guidelines – What You Need to Know

Unless you’ve been living on another planet, you know that in mid-November, the US Preventive Services Task Force released new recommendations on screening mammography, in which they recommended against routine mammogram screening in women under age 50, and recommended that mammograms now be every two years in women ages 50-74.

What you may not have heard is that the Task Force has acknowledged that the mammogram guidelines were poorly worded, and have revised their original statement to clarify their intentions, mostly by removing those two little words “recommends against”. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Lithium for ALS – Angioplasty for MS: Why We Should Be Cautious About Medical “Breakthroughs”

Peter Lipson reported Monday about new research suggesting that Multiple Sclerosis may be caused by venous blockage. He correctly characterized some of the hype surrounding this story as “irrational exuberance.”

This is a phenomenon all too common in the media – taking the preliminary research of an individual or group (always presented as a maverick) and declaring it a “stunning breakthrough,” combined with the ubiquitous personal anecdote of someone “saved” by the new treatment.

The medical community, meanwhile, responds with appropriate caution and healthy skepticism. Looks interesting – let’s see some more research. There is a reason for such a response from experts – experience. Read more »

*This blog post was originally published at Science-Based Medicine*

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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