Happy New Year 2008: Part Deux

For those of you who have known me for a while (like a year), you know that I attempted video blogging about a year ago and did not have the best experience. Now, with a new year comes new opportunities. Or, maybe I'm just stubborn. Either way, I've decided to try this video blogging thing out again.

Yes, I know, this makes me a lot less anonymous. Oh well. People who listen to my radio show live already know that I have a live video stream (sometimes).  I guess I could consider changing my blogger name, and my blog name, and my radio show name. What would I change it too anyway? There's a thought. But, when it comes down to it, I think people would keep calling me "The Blogger Formerly Known as Doctor Anonymous" - remember Prince (or that unpronounceable symbol?)

I've been watching this great site called Viddler. One of the cool things about it is the ability to give "timeline" comments during the course of the video. (To make comments on the Viddler site, you have to register. It's pretty easy to register. Thanks to Dr. Val for already leaving a Viddler comment!). Anyway, when I'm saying something, you can just place your comment anywhere in the midst of the clip - kind of like real-time commenting.

So, let me know what you think. I kind of like the B&W look to the video. Although, I think I have to work on the sound a bit. The sound is a tad bit on the low side for my taste. And the lighting - I should stop nitpicking. Anyway, give me some feedback here or on my Viddler site. Happy New Year 2008!

Happy New Year 2008

Just like last weekend, I'm taking a few blog days off this weekend. So, in advance, I'd like to wish everyone out there in blog land, a Happy New Year 2008! (Youtube video above)

This was my first calendar year of blogging, and I cannot believe that I have been blogging (off and on) for the past year and a half. Thanks to all of your out there who stop by and actually read what I have to write.

Thanks also to all the support that you have given to my radio show. I see big things for the show in 2008. And, hopefully, you'll be there to share those moments with me. Be safe this weekend, and I'll talk to you next week. Happy New Year!

Medical Myths Even Doctors Believe

I know, this sounds like the latest infomercial on late night television to get you to by some book that "doctors don't want you to have." Unfortunately, marketing tactics like this work. They sell books and my patients bring them in to ask me about them. (At least my patients come in and ask me about them, so that we can talk about it).

The title of this post is "borrowed" from an article from yesterday's New York Times. Researchers from the Indiana University School of Medicine made a list of items thought to be in the "conventional wisdom" of physicians and of the general public. What they came up with is a list of seven items proven NOT to be scientifically sound -- according to their research. This is an interesting list...

1. People should drink at least eight glasses of water a day.
2. We use only 10 percent of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Cellphones create considerable electromagnetic interference in hospitals.

Definitely check out the article for more details. I admit that a couple from that list surprised me (I won't tell you which ones - HA!). Not only is the article interesting, but also are the 142 comments (as of this posting) that follow the article. Some people added to this list.

Others who identify themselves as "physicians" say that they knew all of these were myths and that the title is misleading. Still others are taking this opportunity to attack traditional western medical care to promote their own "non-traditional" or "alternative" methods of wellness.

For me, it's a fun article. I'm not taking this article too seriously. Did I learn something - yes. Did it rock my world - not really. This shows again that a lot of angry people live in the comments section. Kind of sad, if you think about it. Take it easy people!

Post of the year 2007

I was reviewing my posts for the past 12 months, I can't help but be amazed by the journey that this blog has taken. I've went through many highs and one notable low during my blog life this year.

But, in reviewing all my posts this year, I have chosen one (for no particular reason), as my 2007 Post of the year. This is called Fat Fido and the comment section is also an interesting read. Enjoy the walk down memory lane.

What about you? This is not a meme, but especially for those of you out there who have been blogging out there for a while, it's an interesting exercise to review your posts over the past year and pick only one for 2007. What will it be? Blog about it....

New Year's Resolutions

So, it's the day after Christmas. And, what are the only commercials that I see on television this morning? It's all those, "Did you eat too many Christmas cookies? Why not make that new year's resolution now to lose the weight that you have always wanted to?" Sheesh! Gimme a break, would ya?

Above, you see how this 14-year old is thinking about for 2008 and what he's thankful for. Watching something like this is so refreshing, because too much of what you see is either so politically correct that it makes me nauseated, or so vulgar that it makes me sick....

For me, I'm always striving toward improving my physical and mental health. But, like everybody else, it's tough to follow that diet and exercise program, as well as dealing with stress. I always hope that next year will be better than this year.

How about you? Do you make New Year's Resolutions? What will be your resolutions for 2008? What are you thankful for? Don't worry, I won't tell anybody. I'll just keep it between us..... hehe

About

Merry Christmas

I'm taking a few days off from the blog. Actually, one of the things I have to do is finish my Christmas shopping this weekend and other things to get ready for Tuesday. So, I just wanted to wish everyone out there in blog land a happy and safe long weekend.

Above is a you tube clip from my favorite Christmas cartoon - and of course, it's Charlie Brown. This scene with Linus close to the end of the show still resonates with me today. Apparently, at the time, there was controversy with the broadcast network about whether to leave this scene in the show. I'm glad that they did. For me, it helps me remember the reason for the holiday....

Prostate cancer and tea

I know what you're thinking, "Dr A., what's the connection here?" I have to admit that I'm not really a tea fan, but my family is (maybe I was adopted - HA!). Anyway, there's a study from Japan that was just released stating that a certain type of tea - namely Green Tea - can decrease the risk of prostate cancer. (Associated Press)

A study of nearly 50,000 Japanese men aged 40-69 found that those who drank five or more cups of green tea a day reduced their risk of having progressive prostate cancer by half, compared with those who drank a cup or less, according to the Epidemiology and Prevention Division of the National Cancer Center in Tokyo.

Christmas is less than a week away now (Wow, I can't believe that). So, if you're like me and do all of your Christmas shopping on Christmas Eve (It's really fun!), then don't forget about the gift of tea. Who knows? It may make a good re-gift for someone in 2008. HA!

The Secret Society

As everyone knows, I'm a little obsessive over my blog stats (I need to work on that). Anyway, I was looking at my stats the other day to see where people are clicking from. And I saw this site, which I really found intriguing.

Here's the post title, "Physician Blogs: The secret medical network of doctors that blog." I never knew I was part of a secret society. This phrase has the undertones of the Da Vinci code (see YouTube clip above) - Yeesh! I guess I need to learn the secret handshake and get the secret decoder ring.

As far as the list goes, it's an interesting list. I wonder if there is a more complete list out there. Where would there be a database where one would go to see the physician bloggers? I guess this is a good start. I'll have to check some of these links out.

Medicare 10% cut averted - For now...

Hot off the press from the Associated Press is a story stating that Congress is about to pass legislation which avoids the proposed 10% cut in Medicare payment scheduled to take place 14 days from now.

The legislation crafted by Democratic and Republican leaders of the Senate Finance Committee would give doctors a 0.5 percent raise when they treat the elderly and disabled. The Senate was expected to approve the bill Tuesday or Wednesday. The legislation would then move to the House, which hopes to wrap up work this week.

Like practically everything else in government, there's a catch. What's the catch? Well, this HUGE zero-point-five percent raise in Medicare payment will expire on June 30, 2008. Which means, that docs will have to go through this stress and anguish and Congressional advocacy efforts all over again in six months.

I know what you're saying, what's the big deal? Docs have all kinds of money anyway. They don't need a pay raise like everyone else does. I don't want to get started on a rant. But, I will say that patients are feeling the effects of status quo or less payment by the federal government and private insurance companies for physician services. Here is how one patient sees it:

Docs, especially GP's (or PA's, my GP was on vacation and also works with a PA who handles some things, you can make an appointment with either but the PA is available much sooner usually) are so pressed-for time, something needs to CHANGE to make it so they can spend a little more time with each patient, geez! Yet not lose money because they might be seeing fewer by a couple, each day . . . . . and then there's all the paperwork, etc. I'm sure Doctor Anonymous, aka Dr. A, can chime in with some comments to this post, from his point of view (he's a GP).

Presuming this legislation passes, I would like to thank Congress for the HUGE raise for taking care of Medicare patients. Of course, the private insurance companies will follow suit, or even continue their tradition of sometimes paying 80-90% of what Medicare pays. For all the Senators and Congress representatives out there reading this - Merry Christmas (er, for the politically correct, Happy Winter Solstice) and we'll see you in June when we have to do this dance all over again.

Do you Re-gift?

So, it's the week before Christmas. The office is deluged with sweets, and little gifts, and trinkets, and sweets. Did I mention sweets? I get a sugar high just walking through the break room. Sheesh! Anyway, sometimes I get a gift basket on my desk. And, sometimes it's stuff that I don't really need or want. So, why not re-gift?

Ok, so I wrote about this phenomenon/behavior last year? Do you know what this is? Well, according to the Urban Dictionary, here are the definitions:

(a). To give a gift that you have received to someone else.
(b). scandalously repackaging and claiming to have purchased on your own a previously received hideous piece of crapola and giving it to someone else as if you had actually been thinking about what they would enjoy.

Now, no one will admit it, but we all do it. It's those gifts that you get at the office Christmas party. You know, those "Secret Santa" gifts or in the office/work gift exchange. How about even on Christmas day (at your relative's house). "What would I ever do with this?," you ask yourself. Well, why not give the gift that keeps on giving. That's where the magic of re-gifting comes in.

I'm definitely into re-cycling. Go green! This year, don't return that gift you really don't want. Don't exchange that gift that you really don't want. Preserve the environment and give that unwanted gift to someone you love or someone you work with next year. You'll be glad you did. *cough*

Medgadget Award Nominations Open

Yes, boys and girls, it's that time of year again for the Medgadget Medical Weblog Awards. This will be the fourth edition of the awards and this year they are sponsored by scrubsgallery.com (must be nice to have a sponsor). There are seven categories for the 2007 awards. Nominations can be made in the comment section on that particular post.

Contrary to last year, I'm not asking for my blog to be nominated. In fact, I'm requesting that this blog not be nominated. I think there are a lot of other great medical blogs out there. In addition, I think I know some of the judges. So, that there is no awkwardness or any kind of conflict of interest, I respectfully decline any nomination for the Medgadget Awards.

Good luck to all, and be sure to nominate your favorite (other) medical blogs! The deadline for nominations is Monday, December 31.

Docs battle ice storm to save preemie

We had quite a winter storm come through here over the weekend. Tough for a doc like me being on call trying to get to and from work - although I'm less than 5 miles from the hospital. As I was scanning the medical news, I saw this story from ABCNews from last week.

Tuesday morning, a 2-pound baby named Dorotea Orgovanyi was born at 6:10 a.m. in Mount Pleasant, Iowa — three months premature and about 50 miles away from desperately needed treatment at University of Iowa Hospitals. Studies show that risk of death increases significantly when a preterm baby is born in a small hospital that does not have the specialized facilities for the tiny patients.

Under normal conditions, an ambulance or helicopter would have transported a special response unit to pick up Dorotea. But an ice storm made it difficult for the University of Iowa's Air Care helicopter and the ambulance to attempt such a dangerous trip. Travel advisories broadcast across the state warned people to stay off the dangerous roads.

Knowing the small community hospital in Henry County didn't have the facilities to treat the preemie, Mike Acarregui and John Dagle, neonatal doctors at the University of Iowa, took action.

Acarregui grabbed a rescue pack and the two doctors drove Acarregui's Audi four-wheel-drive sedan to pick up Dorotea and bring her to Iowa City. Meanwhile, doctors in Mount Pleasant improvised their own resources, rebuilding a warming bed in an ambulance for the baby to use on the trip back to Iowa City.

Our hospital here is a small community hospital. And, I take care of newborns. Although I cannot exactly relate to this situation, I can definitely imagine what this small hospital was going through. We don't routinely take care of preemies. We stabilize them until an ambulance with neonatal specialists can get there and take over care. As for this case, great job docs!

MexicoMedStudent: Runnin Down A Dream

I so remember this video. This is when MTV actually played videos on their channel. This was seen as "groundbreaking" at the time with animation. Plus, still enjoy Tom Petty and The Heartbreakers. My favorite songs include this one and Free Falling. Ah, yes, high school memories.

Last night's show was definitely different than any of the previous shows in that you can hear the emotion in the voice of MexicoMedStudent. The way that he described his experience with his medical school giving him the runaround on procedural and paperwork issues - the frustration is palpable.

He has his wife and daughter with him close to the medical school and hospital campus - just bought a house. His wife had surgery in the past few months. And, now, he was charged tuition for classes he did not attend. On top of all that, his status as a continuing medical student is even in question.

I cannot even imagine being in another country, with my family, recently buying a home, and being told that your medical school career is over. What are the options here? Pick up and go home to Texas? Transfer to another medical school? What about all the debt that you have already accumulated?

This story has also moved some bloggers out there so much that they are talking about this today. I encourage you to read the thoughs of Fat Doctor, Scan Man, and AbelPharmBoy. If you listened to the show live or on the archives, how do you feel about the situation? Something like this probably happens more than we know.

So, MexicoMedStudent, my thoughts and prayers are with you and your family. I hope you get good news from "that committee" that you referred to on the show last night. Keep "Runnin Down Your Dream" of becoming a doctor. We're all pulling for you!

Update: Enrico writes a very poignant and reflective epilogue to yesterday's show. I encourage you to check it out. Also, there's a great picture of his wife and daughter.

NHS Blog Doctor: What's happened?

I just got a distressing e-mail from my blog friend and colleague The Angry Medic. The last post on the NHS Blog Doctor's blog is on October 17th, 2007. As I scrolled down, I see 129 comments (as of this posting). The most disturbing is the following:

Hello to you all.

This is not an easy comment to write, and I apologise for the lack of a full post, but 'John' was more than a little security conscious when it came to passwords, I have contacted "blogger" to explain circumstances but as yet have not had a reply.

Getting to the point, so to speak, I am a senior partner at 'John's practice, I have only become aware of this 'weblog' after accessing his email account through our internal system. Other partners have read this website, but none of us knew who the author was - although in retrospect there are a number of clues we could have picked up on!

There is no easy way to say this, but the doctor known as 'John' or 'Crippen' passed away in a road traffic accident mid-October. Although I appreciate the esteem in which many of you obviously held him, I must ask that the emails cease as of now - they are all redirected to our mail server and this is causing some difficulty.

Dr. Crippen's identity may no longer need to be secret for his own purposes, but out of respect for his family and remaining colleagues I shall not be sharing this here, neither will I post another message or reply to any left. This webblog will be removed once I can circumnavigate the security protocols for obvious reasons of confidentiality.

This said, I thank all who visit here for their support of our dear, and much missed colleague.

Kind regards, Dr.P.

Wednesday, December 12, 2007 11:20:00 PM

I'm not one to spread rumors, but this comment, although sounding genuine, was very disturbing to me. Has anyone heard anything? Does anyone out there know anything? I hope this is not true. This is a true pioneer and legend in the medical blogging community. I hope this rumor is not true...

Update: People have been e-mailing me over the past 9-10 hours saying this is not true. I don't want to "out" my sources here. I really feel bad if I'm spreading an inaccurate statement. But, I guess there really is no way to confirm or not confirm this, unless someone in the UK can help clarify this. If someone wants to go "on the record," put it on your blog and I'll link to it.

Update: Someone commented on KevinMD that this report is false. The Holford Watch states "unequivocally that there is no truth to this cruel story."

Tonight's Show Changed

The good news is that I'm not going to cancel The Doctor Anonymous Show tonight. The bad news (and it's not really bad news) is that something has come up to make me change topics for the show tonight.

First of all, Dr. Val contacted me saying that she was feeling ill and was not able to be on the show tonight. Everyone send Dr. Val a "Get Well" e-mail! I have three words for her - "Physician, Heal Thy Self.' HA! Hope you're feeling better.

Next, MexicoMedStudent (pictured above) contacted me and told me about what his medical school is doing to him. Here's just the beginning of his post called "School Beating Me Down Once Again", but I encourage you to read the whole thing...

This post is way late in coming, but I can’t hold it in anymore. As many of you might remember, I took a voluntary leave from school this semester to focus on personal matters. I said that the worst of all possibilities was that I’d look back on this time, now drawing nearer to a close, and feel that I wasted 6 months of my life, having gotten no further in my personal goals.

Well, UAG doesn’t disappoint, and they’ve trumped themselves in the sodomizing students department. While I do have some regrets about things I didn’t get to accomplish during my break (which, as I remind myself, is not over), the reality is UAG has given me the biggest stressor of all: creating an untenable situation which would force me to leave school altogether, the last two years of my life wasted and over 120k of debt for my troubles.

Wow! You can feel the emotion just come through the screen. So, naturally, he's not really in the holiday spirit.

One of the reasons I started a radio show was to talk with people and have them share their stories - and this is a compelling one. This is a show that you need to listen to. There's a lot of crap on television that is called "reality TV." But, boys and girls, this is real life.

This is a story of a guy who has a dream of being a doctor. From reading his blog and talking with him a little bit in the last hour, someone who has went through some personal and professional trials and tribulations. And, just TODAY, learned that his dream may be delayed, or even destroyed by the medical school that he his attending.

This is a story that needs to be told. This is a story that you have to listen to. This is a story that you need to listen to. Tune in Tonight at 9pm Eastern Standard Time on The Doctor Anonymous Show.

Listen LIVE tonight!

Thursday, December 13th, 2007 at 9:00pm Eastern Time

Join us tonight for The Doctor Anonymous Holiday Show. Our distinguished group of panelists include Dr. Val, MexicoMedStudent, and Dr. Blogstein. You can join us as well by calling the show and/or being in the chat room. 

Need any help getting your thoughts going on this topic? Well, I have the perfect show-prep material for you. The Mo Show last night also talked holiday stuff, so you can check that out. See you tonight!

For first time Blog Talk Radio listeners:

*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*After registering, don't forget to make me you BlogTalkRadio "friend" and "favorite show." You can even give me 5 stars if you like the show. These will help my stature as a BTR host (hehe). Thanks in advance for considering this!

*To get to my show site, click here. You can even ask the BTR site to send you an e-mail reminder so you don't miss the show! As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of my show site. If you are registered with the BTR site, your registered name and picture will appear in the chat room. (If not, you will be designated as "guest")

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

Checkpoint Vodka

So, you get all the way to the airport. You wait in line to find a parking spot. You wait in line at your airline check in desk. You wait in line to drop off your checked bags at the security station. You wait in line at the next security check point before getting to your gate. Your patience is wearing thin, because you just want to get to your gate.

As you're waiting in line with the other million people who are waiting to get through, you see a sign that says this: "The following liquid materials are prohibited and cannot pass through this checkpoint." What? Who made up all these silly rules? What else am I not allowed to bring on the plane?

"Let's see," you tell yourself. "Let's see what's in my carry-on bag that may get me in trouble." Hmmmm.... Vodka? In my bag? Who put it there? Did I actually put that in there in my rush to get out of the house this morning? Well, I can't bring it on the plane. What to do? Here's an Associated Press story about a guy did at a Berlin airport.....

Berlin - A man nearly died from alcohol poisoning after quaffing two pints of vodka at an airport security check instead of handing it over to comply with new rules about carrying liquids aboard a plane, police said Wednesday. The incident occurred Tuesday at the Nuremberg airport, where the 64-year-old man was switching planes on his way home to Dresden from a vacation in Egypt.

New airport rules prohibit passengers from carrying larger quantities of liquid onto planes, and he was told at a security check he would have to either throw out the bottle of vodka or pay a fee to have his carry-on bag checked. Instead, he chugged the vodka — and was quickly unable to stand or otherwise function, police said.

A doctor called to the scene determined he had possibly life-threatening alcohol poisoning, and he was sent to a Nuremberg clinic for treatment. The man, whose name was not released, is expected to be able to go home in a few days.

The Dr. A Holiday Show

Join us this week for the long awaited Doctor Anonymous Holiday Show! Even though there will be very little medicine discussed, but there will be a lot of fun!

We will be talking about everything to do with the holidays including Christmas, Hanukkah, New Year's, and any other holidays that come at this time of year. We will be "debating" the very controversial topics as the following: Favorite Holiday Cartoon, Best/Worst Holiday song, Favorite Holiday Movie, and any other topics that come up.

I know I've been discouraging people from sending me e-mail and leaving comments about their faves, but Kb sent me her favorite holiday song and favorite holiday movie. I encourage the rest of my faithful Doctor Anonymous listeners to call into the show on Thursday night to share your thoughts.

We have a distinguished panel who will be talking about these and other holiday issues. They are Dr. Val, MexicoMedStudent, and BlogTalkRadio personality Dr. Blogstein. So, write it down! Thursday, December 13th, 2007 at 9pm Eastern Standard Time. Advertise it on your blog. The Doctor Anonymous Holiday Show on Blog Talk Radio. Be there!

Need sleep? Forget the hospital

Anyone who has been admitted to the hospital or whose family member has been admitted to the hospital or works in the hospital knows this fact - The hospital is the worst place to get some sleep - Even though I "prescribe" adequate sleep to everyone who comes into my clinic.

Well, now, there is research that was just released which supports this. According to this article from Reuters, researchers at the University of Texas Southwestern found that the healing process may be interrupted because of inadequate sleep (restorative sleep) in the hospital.

[Dr. Randall Friese, lead researcher] monitored the sleep patterns of 16 patients in the ICU who had suffered traumatic injuries or had abdominal surgery. Although it appeared the patients were getting enough sleep, Friese said their brain wave patterns showed their sleep was fragmented and superficial.

"There are two major things contributing to abnormal sleep in these patients -- the pathophysiology of the disease process itself and the stressful environment of the ICU," Friese said. "If we can neutralize the stressful environment, maybe we can shorten the hospital stay, lower infection risks and increase patient wound healing."

Now, don't get me wrong, I'm not saying totally ignore the intensive care patient while in the hospital. But, there may be something to this sleep/healing connection. And, if there is some way to increase restorative sleep and accelerate healing and shorten the hospital stay, I'm all for looking into it more. I know our patients would appreciate this.

Gasoline price drop

Here's something that the majority of the press will not report on - an actual price drop in gasoline - at least in Ohio. According to the Associated Press, Ohio gasoline prices have dropped 12 cents in one week. Yipee!

The statewide price is now $2.91 according to the American Automobile Association. A week ago, prices were just above three dollars a gallon.

Now, compared to a year ago, the price is up about 70 cents. That will probably spark some remarks in the comments section. But, any kind of price drop, I'm happy to report. So there....

Pro-biotics

Now, everyone has heard about anti-biotics. But, look out, because the latest craze in the health food world is the area of "pro-biotics." What are these? Well, as you can probably figure out, these are "friendly" bacteria - and they are found in the digestive tract. A recent article from the Associated Press discusses this further.

Experts say probiotics are generally safe, and in some cases might be helpful. More research is needed, and it's a hot new area, reflecting a growing understanding of the role that naturally occurring intestinal bacteria play in health. This week, the National Institutes of Health is hosting a conference where top scientists will discuss recent advances.

From a business standpoint, this is a fast growing sector. According to the article, over 150 food products that have probiotics have been introduced in the market this year - compared to about 100 last year and just 40 the year before that. But, do they actually work?

Small studies have suggested that certain probiotics might help treat or prevent some types of gastroenteritis, diarrhea and allergic skin reactions, and the bugs are being investigated for many other ailments.

The NIH has declared the study of gastrointestinal bacteria and probiotics a major research initiative. The agency's upcoming meeting will highlight current science so it can identify research gaps and determine the direction of future research, said Crystal McDade-Ngutter, who heads an NIH working group on the topic.

It's still too early to say whether these probiotics deliver substantial health benefits. The research still has to be done. Pro-biotic detractors say that without a gastrointestinal condition, probiotics just exhibit a placebo effect.

In my clinical experience, in talking with some of the specialists around here, feelings are mixed as well. Some put all their patients on probiotics, and others say it's just a waste of money and give patients false hope of symptom relief. Me? I'm cautiously optimistic. I have read and I am intrigued from some of the early studies. But, I'm not completely sold - yet.

Round 3: OTC Cholesterol Med?

I talked about this before back on October 3, 2007 (why does that feel like two years ago as opposed to two months ago?). Anyway, USA Today is reporting that the US Food and Drug Administration (FDA) will again consider whether cholesterol medication will be able to be available without a prescription.

For the third time, Merck is seeking FDA approval to sell over-the-counter Mevacor, the brand name for lovastatin. In 2000 and 2005, advisory panels recommended against that move. The FDA is not bound by advisory committee recommendations, but it usually goes along with them.

Public Citizen, a watchdog group (and, in my opinion, sometimes goes too far in the alarming the pubic at times), is against making cholesterol medications over the counter. I would agree with this group on this issue.

"People can't, on their own, evaluate whether they are at sufficient enough risk that they could benefit from this drug," says [Sydney] Wolfe, [director of the Public Citizen Health Research Group.]

On the other side of this issue is, of course, the pharmaceutical industry who has been chomping at the bit to push this entire drug class onto pharmacy shelves for patients to purchase and for docs to deal with the side effects.

Over-the-counter Mevacor "fits with the philosophy that patients should take more responsibility for their health care decisions," says Antonio Gotto, former president of the American Heart Association and dean of New York's Weill Cornell Medical College. He will serve as a Merck consultant Thursday.

Steve Francesco, a pharmaceutical industry consultant in West Orange, N.J., who specializes in prescription-to-nonprescription switches, says switching Mevacor "would be a real turning point."

You betcha it would be a turning point. As a prescription medication class, cholesterol meds are a multi-Billion dollar industry. If this is made over the counter by the FDA, the pharmaceutical industry will see dollar signs. But, what will patients, doctors, nurses, and others who take care of patients see? I hope the FDA rejects this request again on Thursday...

Seven Million Dollars

What would you do if you stole with seven million dollars? Would you try to hide out just 350 miles away and hope for the best? That's exactly what a trio of criminals did after nabbing an armored car. The story from our local paper is below. It's kind of interesting, what do you think?

Youngstown — A trunk filled with more than $7 million can take most people, or at least the average imagination, on a trip around the world. While traveling, throw in exotic cars, expensive clothes and fascinating people.

That same amount of stolen loot took Roger Dillon, 22, and his girlfriend Nicole Boyd, 24, as far as a trailer in Pipestem, W.Va. Extravagance? The couple did manage to buy an 18-year-old van along the way — before the FBI came knocking at the trailer door.

Dillon and Boyd are charged in the theft of more than $7 million in cash and checks from an armored car company in Liberty Township. On the run, their heist spawned local pondering of where were they and what would you do had you done the deed.

When they were arrested, you could almost hear the chorus back home: “West Virginia?” Piling on were the details of their plan. One cop called them stupid.

So .... We wondered what others would do with more than $7 million and the world to explore?

The Office Christmas Party

No, not that Office Christmas party. I mean, those Hollywood writers are on strike. We probably won't see a new Office episode for weeks (or even months). What do I watch on TV now? I'm catching up on re-runs of MASH and Whose Line Is It Anyway?

So, our office Christmas party was Saturday night. It was actually at a new place for us. It's usually in this country club setting - which I don't really enjoy. It's really hard to have fun there. I always think of movies like Trading Places and other movies where people act non politically correct and get thrown out of the joint.

This year, it was at a local coffee shop that had a lot of old historical memorabilia. Who knew this small town had so much history? The food and drink were great, and the atmosphere was perfect to mingle with the staff away from the office.

I admit it was difficult to try to talk about anything other than work. I mean when you talk about medicine and medically related things for 8-10 hours a day with this same group of people, it can be hard to talk about anything else. But, it was nice to learn about other people's families and Christmas plans.

Overall, I think things went well. Of course, I'm probably the last person to hear about gossip. So, I may be adding to this post later. For those of you who had office Christmas/Holiday parties, how did they go? I'm curious....

Listen LIVE tonight

Thursday, December 6th, 2007 at 10:00pm Eastern Time

Join us tonight for GruntDoc: Ramblings of an Emergency Physician in Texas. The "Most Popular Posts" section of the blog is also an interesting read, including "Nursing Home MAR’s sent to the ED with all times removed: A new and horrible trend." This post has garnered a slim 44(!) comments so far. See you tonight!

For first time Blog Talk Radio listeners:

*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of my show site. If you are registered with the BTR site, your registered name and picture will appear in the chat room. (If not, you will be designated as "guest")

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

Update: Thanks so much to Grunt Doc for being on the show. Also thanks to Dr. Val and Scanman for calling into the show. I really appreciate it. The chat room was as busy as I have see it. Maybe this show is really starting to catch on. Yay!

In our interview, Grunt Doc talked about how he found his ER career (cute story). Then, we discuss medical television shows and how they portray docs.

With regards to blogging, he mentions some of the first blogs that he read, including medical blogs. The GruntDoc blog started in May 2002. Dr. Val describes him as a "pioneer" in medical blogging, and I would have to agree.

Then, right on cue, I get kicked off the system. I think it was Skype, but I'll have to do a post morteum on this show to figure out what happened. I don't know how long the silence was, but, as always, it was too long for me.

If you did not tune in live, you missed a treat. Not only was the chat room hopping, but the video feed from my iSight camera was working and I was waving at the listeners - Live video feed - pretty cool. I've been trying on other shows to have a video feed as a guest, but without success, yet.

I'm also kind of concerned because the archive for tonight's show is not available yet (30 minutes after the show ended). It's usually up by now. I'm starting to get worried. For the Grand Rounds Premiere show, I think it was about 18 hours before the archive was available on the BlogTalkRadio site. We'll see what happens this time.

Next week, look out! It will be The Doctor Anonymous holiday show. Little medicine, but a lot of fun. I will have a panel of holiday experts (hehe) to debate the very controversial topics of the following -- favorite holiday song, fave holiday cartoon, fave holiday movie, and favorite holiday memories. The Panel: Dr. Val, MexicoMedStudent, and Blog Talk Radio personality Dr. Blogstein. So, come back next week for the fun. Have a great weekend!

The GruntDoc Interview

This week, The Doctor Anonymous Show welcomes the one and only GruntDoc who authors GruntDoc: Ramblings of an Emergency Physician in Texas. Among his blogging accomplishments include the 2004 Medgadget award for Best Medical Weblog (I'm jealous).

I definitely recommend taking a look at the "My Favorite" section in the left hand column - especially "My Grandfathers' Guns," which was featured in the Editor's Picks of my Grand Rounds edition last year. My other recommendations include "Best Chief Complaint of The Night" from last year and "LCPL Anthony Sledd, USMC" from 2002.

Join us on Thursday, December 6th, 2007 at 10PM Eastern Standard Time where we will talk about this and a whole lot more. You can also join us in the live chat room (the show within the show) or even call into the show to ask us a question. The chat room worked for the last show. Let's hope it works again. You'll just have to tune in to find out. Check here tomorrow for details.

M&Ms: Mint Chocolate

First of all, I want to apologize for not really blogging that much lately. No excuse! I've been trying to get back to the swing of things, but not quite there yet. Maybe too much goofing around on Facebook lately...

Anyway, our office is completely out of Diet Coke. What a travesty of justice! So, I ventured out to the local superstore and got my usual 20 ounce of caffeine fix to take with me back to work. As I was standing at the checkout counter, I heard this bag of M&Ms calling me. "Dr. A....."

I looked at it and the bag read, "Happy Holidays! Mint Chocolate - Limited Edition." So, naturally, I had to try it out. Let me tell ya - There's nothing like it. Great stuff. I know what you're thinking - Diet Coke and M&Ms? Yeesh! Anyway, if you haven't tried it out, I recommend the holiday edition of mint chocolate m&ms. They have the Dr. A seal of approval!

Lowest gasoline prices in Ohio

Are you tired of the high gas prices out there across the state and across the country? Well, then why not drive to Salem where we have the lowest gasoline prices in the entire state of Ohio, according to Ohiogasprices.com (at least as of this posting). You can read all about it in our local newspaper.

Salem — Christmas presents came early for Salem area residents — gasoline prices that appear to be the lowest in the state. Smith Oil on East State Street posted its lowest price in some time Tuesday — $2.71 a gallon.

“We’re swamped,” said Paula Crum, station manager.

Out-of-towners are among those filling up. Crum has spoken with numerous people from the Youngstown area and Pennsylvania who were driving through town and stopped when they saw the prices. These people know a good deal when they see one.

Ohiogasprices.com lists Salem has having the lowest prices in the state. The Web site, which uses prices reported by drivers, lists five Salem stations as the only ones in the state to have prices under $2.80. No other area stations were even close.

Facebook: Docteur Incognito

I briefly talked about this during my show last week. About a year ago, I was totally against social networking sites. In fact, I have made fun of them in a post back then. Maybe it was just an anti my space thing. Who knows?

But, since then, I've been further exploring and investigating this. I guess I really started appreciating social networking after I got my radio show up and running. Through some of the features on Blog Talk Radio, I how have supporters of the show who call themselves "friends" and even make my show a "favorite" (Thanks so much).

After that, I started doing a little bit more with my Twitter account. And then, someone invited me onto Pownce. Although, I admit that I'm not as much a Powncer as much as I am a Twitter. You can definitely waste a lot of time on these sites.

Which leads me into Facebook. For months and months, I've been hearing the hype from the media. And, I've had people send me invitations for be Facebook friends, but I initally ignored them. Not anymore. Last week, I opened a Facebook account.

I was kind of inspired by my podcasting Facebook friend who is the Dashing MD. Or, his Facebook profile lists him as "Dashing Docteur." So, naturally, I had to seek out the Facebook name "Docteur Incognito." That has kind of ring to it, doesn't it?

So, if you're so inclined, please make me your Facebook friend. How often will I be over there? Who knows? But, it looks kind of fun. Just another Web 2.0 social networking site to pass the time on. Do you have Facebook? Why or why not....

Show # 16 Epilogue

Well, that's another show in the can. It was weird. It's been two weeks since I've done this internet radio show, and I totally forgot how to do it. It really took a few minutes until I got back into the rhythm of things again. And, of course, there was the usual beginning of the show glitch. For some reason Skype cut out at about 16 minutes in. Why does it do that? Who knows?

The international reach of the show still amazes me. Bongi tuned in live from his computer in South Africa. And, Scanman who is in India again was able to join the chat room for the live show. Something cool (and helpful) is that when you register at the BTR site and make my show a favorite (yay), the site sends you an e-mail an hour before the show. I would imagine this is very helpful halfway around the world when you're trying to figure out which time zone you're in.

Thanks so much to Kerri for being a guest on the show. Reading her blog this week, she told us that she is being treated for strep throat. So, I really appreciate you calling in even though you're feeling under the weather. Hope you're feeling better!

I did want to highlight her post called, "An Open Letter To My Pancreas." Very well written, and I highlighted it on my Grand Rounds post last year. We talked about her blog, the growing diabetes internet community that is going on out there, her work at dlife.com, getting ready for her wedding, and she's almost convinced me to try to learn code so that I can get out of blogspot and create a unique website of my own (that would be scary, huh?)

The chat room got a little surprise at the end of the show. I'm not going to say anything, yet. And, I hope those who were there in the chat room at the end of the show will keep the little secret. I'll reveal it in due course (cue sinister laugh).

Finally, I did not have a guest for next week, until I started hanging out in the chat room afterward. Grunt Doc who joined the chat room before the show even started and stayed the entire time; Grunt Doc has graciously agreed to be a guest on next week's Doctor Anonymous Show. How cool is that? So, stay tuned for more details...

Dashing MD Podiversary

Just wanted to give a shout out to the Dashing MD for reaching the one year anniversary of podcasting. He's a great guy and you could really tell by his appearance on the show a few weeks ago. Check out his one year anniversary podcast. There, he recites poetry and tells you why his cats are better than your cats (no kidding). And, as he does best, he answers e-mail questions from his listeners. Hats off to D,MD! I wish you continued success with your podcast!

Change of Shift: Vol 2, Number 12

Welcome to Change of Shift, the best of the nursing blogosphere!

Thanks so much for Kim for inviting me to be a host. Actually, she asked me about a year ago. So, I'm sorry that it took so long for me to accept the invitation. You may be familiar with my work on Grand Rounds this year and/or last year. Hopefully, I can uphold the high quality of this nursing blog carnival.

By the way, if you haven't already, I encourage you to check out my interview with Kim on Doctor Anonymous LIVE which is my internet radio show. It was a great time and I hope to have Kim back soon on the show. Now, onto the links!



The holiday season can be very stressful, especially Christmas Eve. But, as ERNursery shares, even though the ER was packed with people, there was still room for A Holiday Surprise.

From the UK, Mousie relates a tragic story of a eight year old girl and how her death affected her mother. Reading this really made me think about a lot of things. The 20 comments really shows the impact of this story as well.

Emily from Crzegrl.net reflects on how difficult it is to be a flight nurse in her post "Potent Thanks." She writes, "I am grateful for every moment I am given with those I love." How true.



Do you remember playing the game telephone when you were growing up? Oh yeah, I did - with the soup cans and the wire and the whole thing. How does this relate to patient care? Well, Rae tells us in a post called "Let's Play Telephone." Phone triage and phone handoff of patients are always interesting. The end of the post shows how one can make a diagnosis just by talking for another 3.3 minutes on the phone.

A Float Floor RN shares a story of how difficult one shift can be. Did you know that "Sometimes It Just Hurts To Be In The Hospital" - especially when you can't get any narcan?

Kintropy In Action describes two hypothetical patients with possible diagnoses and possible treatment plans. He gives three pieces of advice from a parent of a child with disabiliies. He ends this post with a simple statement, "Let's work together, doctors, to keep her well, shall we?" I agree.



When I was a medical student (which wasn't that long ago), I remember that it was a challenge to find a case of C. difficle infection in the hospital for a case study write up. Now, it's so commonplace, that we add the letters MRSA and VRE in this discussion as well. Heart Matters reminds us that we as health care professionals and the public need to still respect C. diff and its potential fatal complications.

Speaking of MRSA, Fit Buff writes an educational post defining the term, its symptoms, and ways to prevent acquiring/spreading this contagious and potentially fatal disease.

Getting back talking about medical school, I remember my first day on the ward. It's that stereotypical first day that's depicted on television shows where virtually everybody ignores you and you as a student question why you're even there when you only feel like you're in your way. The Oracle is a student nurse now and shares a similar story in this post called, "What?"



The docs I work with at the hospital have 10-20 and sometimes 30 years more clinical experience that I do. I get intimidated when I sometimes have to say, "I think that's done a little bit differently now." Disappearing John RN asks, "How do you teach someone who knows more than you?" The story of a less experienced preceptor and a more experienced pupil.

When you pass on from this earth, have you ever thought of who will sit in judgement of you? Brain Scramble has and believes that it will not be a deity, but your patients will meet you at the pearly gates -- maybe.

What is high quality health care? This is something that Life in the NHS is asking. Even though, as a health care provider, you may hit your number targets for cost and quality numbers, the patient's perception of health care is also important.

Did you know that according to the CDC, one person out of one million who are immunized with the flu shot may be at risk of getting Guillian-Barre syndrome? The Pixel RN discusses this further and also nurse-run shot clinics.



Congrats to Pixel One, Purl Two for passing a national certification exam in her specialty. Unfortunately, she's not feeling the love from her employer who rewarded her with a huge 1/2% raise. Yeesh!

Kate from the Alternative Nursing Careers blog proclaims that nurses can do so much more than pass meds. Do you want to go beyond clinical nursing? In these posts, she outlines three steps to get you started. She also describes the career of information technology and how nurses are uniquely qualified for this type of work.

Patient privacy and confidentiality are issues that medical professionals constantly struggle with. The Nurse Practitioners Place shares some tips on how to keep patients comfortable as they share information with you.



That's it! Thanks so much for checking out Change of Shift: Doctor Anonymous style! Feel free to check out the rest of my blog. Make yourself at home. Also check out The Doctor Anonymous Show where we go "Beyond The Blog" to bring you the brightest stars in the medical blogosphere. Thanks Kim for the opportunity to host Change of Shift. The next edition of CoS will be December 13th over on Emergiblog. So, get those posts ready!

Listen LIVE tonight

Thursday, November 29th, 2007 at 10:00pm Eastern Time

Join us tonight for Kerri Morrone who authors the award winning blog Six Until Me. I'm hoping the show will be "featured" again on the front page of the Blog Talk Radio website. We'll just have to see.

Also, this radio host and blogger was given some props by Alan Levy, the BlogTalkRadio CEO on a radio show last night. Don't believe me? Well, tune in to my show tonight and I'll play the sound clip for you. HA!

For first time Blog Talk Radio listeners:

*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of my show site. If you are registered with the BTR site, your registered name and picture will appear in the chat room. (If not, you will be designated as "guest")

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

The Kerri Morrone Interview

This week The Doctor Anonymous Show welcomes Kerri Morrone who authors the award winning blog Six Until Me. In my opinion, Kerri is one of the most popular bloggers in the diabetes blogosphere. Kerri, a type I diabetic, has reached out and touched so many people with diabetes and their families.

Join us on Thursday, November 29th at 10pm Eastern Time where we will talk about her blog, her life, and other things. She's planning a wedding for next year. That's got to be fun!

Yes, she's a Boston Red Sox fan - and as you probably know, they beat my Cleveland Indians on their way to a World Series victory. I was watching some of those games during my blogtalkradio shows. Finally, I think she has a thing for Larry Bird. If we have time, we'll have to go into that.

I've been having a string of shows where I have internet issues at the beginning of the show. Will that happen again? Will the chat room be working? Will a mutiny occur during the show? Will chaos ensue? Well, you'll just have to tune in to find out. Check back here Thursday for more details.

Grand Rounds

Grand Rounds 4.10 is now up and running at Prudence, MD: Medicine, General health care, and science. GR comes to us all the way from the Philippines this week. I wasn't able to submit anything but she still gave my blog a plug. Thanks so much for this!

This blog carnival of medical posts is already the 10th volume for the fourth year of Grand Rounds. I’ve been hanging around for a while, eversince I caught the GR bug at Doctor Anonymous’ blog. It’ll be my first time hosting this, thanks to Dr. Nicholas Genes of Blogborygmi. 

And I think the G.R. is a fine opportunity for me and for other bloggers, too, both medical and non-medical practitioners, to be able to learn more about the practice of medicine in other places (as I’m a general medicine practitioner here in the Philippines) and also other stories that are medically related that happen in other parts of the world, as well as locally. I’m glad that there’s a good turnout of posts for this week.

When I was on my blog break, I neglected to mention that Grand Rounds 4.09 was posted up at Mexico Medical Student. This was a great mix of links and music. I encourage you to check it out, if you haven't already.

My apologies to the past two hosts for not submitting anything. I was in my own little GR recovery period. Hopefully, I'll be submitting back to GR soon.

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, Grand Rounds moves to Enoch Choi's Medhelp site.

The Cardiac Feud: DeBakey Vs. Cooley

I wouldn't call myself a history buff, but I enjoy reading about the past - especially about medicine. In today's New York Times, it tells the tale of what apparently was a huge feud in medicine - specifically cardiac medicine - for four decades. For me, the most controversial medical issue I remember learning about was the discovery of the AIDS virus and the two people who tried to get the credit for that.

But, this cardiac feud is one of the best historical stories that medicine has. Both these surgeons were pioneers in the area of cardiac surgery working in Houston. And, for 40 years, these two gentlemen spoke little to each other and couldn't even stand to be in the same room after "the incident." What happened? Here it is from the NYT:

The breach began in 1960, when Dr. Cooley left Dr. DeBakey’s practice at Methodist and moved the few hundred yards to St. Luke’s Hospital, where he later established the Texas Heart Institute. But it was an incident in 1969 that turned the rift into a full-blown feud.

It happened when Dr. Cooley, without approval from Dr. DeBakey or Baylor, commandeered an artificial heart from his former partner’s lab and implanted it in a patient at St. Luke’s.

Over the years, Dr. DeBakey has called that first-ever use of a total artificial heart a theft, a betrayal, unethical and “a childish act” to claim a medical first. Dr. Cooley defended the implant as a desperate, if ultimately unsuccessful, act to save a life.

What? Did I read that right? I mean, in today's medical world, I can't even imagine something like that happening - especially with all the double checks, paperwork, and bureaucracy that happens in today's operating rooms and hospitals. But, to think about it, I'm trying to think logistically how that happened, and it fascinates me.

I encourage you to read the entire NYT article. It really gives you a flavor of all the background that happened after "the incident" in 1969 and the decades that followed. Apparently, recently, they have reconciled. But, to be a doctor there in the 1960s. Definitely interesting to think about and dream about. A whole different world of medicine and a whole different world around us back then....

What's up with Sitemeter?

Every time I try to log into Sitemeter this morning, I get a message saying that my account is unavailable. Is anyone else having this problem? Does anyone know what's going on with sitemeter today? Maybe it's just my account? Yeesh!

Update (3:30pmET): After finally getting to load up the front page of Sitemeter, I found this announcement dated today:

Sometime during Thanksgiving day SiteMeter experienced some major internal system problems. At the moment it appears that access times to SiteMeter.com and all stats pages are extremely slow.

We are also aware that access to s21 accounts appears to be disabled. We are working as quickly as we can to try and find out what the problem is and to get everything back online and working normally. We apologize for the inconvenience. Sincerely, The SiteMeter Team

Doctor SWAT

I'm back from my blog break! Thanks to everyone who sent me all the supportive e-mails and comments. Nice to know I was missed, but, now, I'm back...

People may not believe that I'm old enough to remember this tv show from the 70s. But, you betcha I remember the TV show SWAT. The intro is above on a youtube clip. One of the most memorable tv themes - ever.

Apparently, now docs are being a part of these SWAT teams. How cool is that? In this AbcNews article, Dr. Alex Eastman's day job is a surgeon at Parkland Memorial Hospital in Dallas. But, in his spare time (hehe), he is part of the Dallas SWAT team (cue music). He wears a bulletproof vest and the whole thing.

Having a doctor along can mean the difference between life and death when a cop is shot. Police Lt. Carlton Marshall is living proof. Marshall was shot in the neck during a raid Oct. 17.

Within minutes of hearing "officer down!" Eastman and his partner, Dr. Jeff Metzger, went to work. Metzger held the officer's head while Eastmen performed an emergency tracheotomy, cutting a hole in the officer's neck to allow him to breathe.

Now, with the writers strike still going on in Hollywood and New York, here's an idea for a new television show. Watch Doctor SWAT on Thursday night right before The Doctor Anonymous Show. Dr. Eastman and Dr. Metzger play "good doc" and "bad doc" - Fighting crime and saving lives at the same time. Tune in Thursday night for Doctor SWAT (cue music).

Change of Shift here next week!

As I revealed on The Doctor Anonymous Show last week, I volunteered to be the host for the wildly popular nursing blog carnival named Change of Shift. What was I thinking? I guess I wanted to get all of my hosting duties all done in one month.

Actually, Kim has been asking me for the past year to be a host. So, I figured now was the time to step up and "take on the nurses" as she describes in a recent post. So, look out! Next week, CoS is coming here. How do you participate? Well, follow this link to Emergiblog for details.

Medscape Pre-Rounds Interview

Welcome to all of you who clicked on over from the Medscape site from my Pre-Rounds interview with Dr. Nick Genes! As of this posting, there have already been over 250 clicks over here (that's a lot for this little blog that could - hehe).

Welcome to my blog! I hope that you check out some of my other posts and my internet radio show. For those who haven't checked out my interview, I have copied it below. Enjoy!

"Dr. Anonymous" Survives Turbulent Year for Medbloggers

It's been a tumultuous year for "Dr. Anonymous." Since we last spoke to the mysterious but jovial figure behind the eponymous Web site, he has been featured in the national media but has also received hate mail and personal threats. For a while he thought about quitting his online activities, but he somehow pressed on with a new style and new technology to carry his thoughts. I caught up with him recently.

Dr. Genes: You prophesied last year that your writing would evolve -- more commentary on news, less about personal life and your opinions. Has it unfolded that way, and if so, why?

Dr. A: Hosting Grand Rounds has always found me at transition points. Last year, I was changing from blogging about patients to more news-oriented posts. Now, as we'll discuss more below, I find myself shifting again to incorporating more live Internet radio shows in addition to posts.

Blogging has really been a reflection of my life. Blogging about patients was a comfortable zone in which to write. Then, I wanted to push my writing skills a little bit to do commentary on current events. I guess now, I find it challenging and exhilarating to see what I can do with live Internet radio. Who knows what will happen a year from now? We'll see.

Dr. Genes: Where are you finding the material to comment on, and how do you decide what's blogworthy?

Dr. A: Even in high school, I was a news junkie. I like to know what's going on in the world around me. For blog posts, I hit the US and world health news headlines first and see if anything finds my fancy there. In the past few months, I've also been drawn to commenting about news that is more local to me: for example, a local high school student diagnosed with MRSA, a recent high school shooting incident, or even a tornado that occurred less than a mile from my office.

Dr. Genes: Are you concerned or frightened when other anonymous medbloggers get outed? Have you ever considered calling it quits or going public under a new guise?

Dr. A: On January 26, 2007, my blog was featured by a major news organization. This was the start of the best and the worst week ever in my blog life. The first couple of days were the best, with congratulatory comments and emails. Then the negative feedback and personal attacks started. Being the type of person that I am, I took the negative stuff too personally -- and really considered quitting blogging altogether. But, my blog friends really kept encouraging me to continue, and after days of thought, I did come back. That was definitely a long week for me.

As far as other medbloggers being outed, I was at a medical meeting in May, using the free Wi-Fi, reading blogs instead of paying attention to the lecture, when I learned that both Dr. Flea and Fat Doctor took their blogs down on the same day. That sent a huge ripple throughout the medical blogosphere. (Editor's note: Fat Doctor has resumed blogging.)

In the days that followed, there were reports of other medblogs being taken down, and some (including me) questioned the future of the medical blogosphere.

I started the I'm a Blogaholic group blog during this time. This was an opportunity for a few popular medbloggers who had to shut down their own blog to maintain contact with their readers until their new blog was up and running. I think it really fulfilled a need at that time -- if, for anything else, to give scared medbloggers a place to meet and vent about the current situation.

Dr. Genes: Last time we spoke, you were immersed in blogcasts. Now you've graduated to live blog talk radio with a chat room and dial-in participation. Can you explain the attraction? Isn't there enough interactivity and participation on blogs -- and perhaps more time for reflection, references, and nuanced thought?

Dr. A: Blogcasts are "prepackaged podcasts." I enjoyed them at first, but found myself frustrated with the entire editing process. I wanted to get the blogcast out to the listener as soon as I could -- and editing really slowed the process down.

I was immediately drawn to the live Internet radio show because it is real-time interaction with the blog reader -- better than any instant message or text conversation, or even a live chat room. For a live show there is also no audio editing involved, and the radio show site almost immediately puts it into a podcast format for listeners to download. Even with technical difficulties I have had during the show (and I've had a bunch), it's a different type of exhilaration I get doing a show live as opposed to writing a really good post. It's hard to explain.

Dr. Genes: What's next? Are you thinking about video?

Dr. A: I tried that during my best/worst week ever. I recorded and posted a video blog. But I eventually took that down -- basically out of fear of being outed at the time.

Dr. Genes: Yikes! Well, what about some new writing you're particularly pleased with?

Dr. A: Over the past few months, my best writing has been about ethical issues in medicine that hit the front pages of newspapers. These, by far, generated many more comments than other types of posts. I encourage readers to check out the following: The Ashley Treatment, Uterus Transplant, and The Baby Emlio Debate.

As for radio interviews, I've always wondered how a person's real voice would sound. I've read a person's blog for months, and in my mind, I have a "voice image" of what they sound like. It's been a lot of fun talking with them on Internet radio and seeing if my mental image of their blog voice matches with the real voice.

What's next? I'm going to further explore this talk show gig. I'm thinking about trying to assemble a colorful cast of characters to do a monthly or weekly analysis of health news that makes headlines in the mainstream press. Maybe I'll call the show "DA 360," or "The Dr. A Factor," or "The Weekly Show with Dr. A." Those names aren't taken, are they?

Dr. Genes: Ah, no. But readers are welcome to tune in when Dr. Anonymous hosts Grand Rounds on Tuesday, November 13, 2007. Dr. A will be organizing and presenting the week's best writing from the medical blogosphere -- from students, economists, nurses, researchers, and doctors (anonymous or not) -- on his site. As a bonus, he'll be introducing Grand Rounds live, over Internet radio, on Monday, November 12, 2007; you can download the archived version to listen to that broadcast. Check it out!

Nicholas Genes, MD, PhD, second-year resident in emergency medicine, Mount Sinai Hospital, New York, NY

Medscape Med Students. 2007; ©2007 Medscape, Posted 11/13/2007