Happy holiday weekend

For those of us in the United States, it is Labor Day weekend. The day we celebrate work - with a day off. However, call me a traditionalist, because I will be working this weekend. Yes, I'm on call until dawn on Tuesday morning...

So, as you're out and about at your picnics (image credit) and sporting events, just think of me, keeping America healthy and treating illness the best that I can. Yeesh! How cheezy is that? I'm probably jinxing myself, but usually these long weekends are really not that bad from a working standpoint. We'll see...

By the way, thanks again for everyone's support on the live podcast yesterday. I've been told that the sound level could have been a little bit better, and I'll be working on that. Otherwise, I think this is an innovative idea that I'll be exploring further. Have a great weekend!

Listen Live Today!

Doctor Anonymous Live! August 30th (today!) from 4:00-4:30pm eastern time

I've been working through the technical glitches this week. Who knew there would be so many steps where something could go wrong in connecting my computer to the main site? But, I think that I have everything worked out....

You can also participate in the show! That's one of the fun things about this. I'm going to be logged into google talk before the show. So, if you'd like to say hi and see me freaking out before the show, you can find me there. You can also send me an e-mail or leave a comment here. Finally, the fun part is that you can call into the show. Just click here for the number.

Can't listen live? Well, that's ok. One of the cool things about BlogTalkRadio is that they record their shows so that you can listen to them later. Starting at about 5pm eastern time, you can click here and listen to the recorded show.

I have to give a little shout out to A Mom Who Thinks Too Much who called me the social butterfly of the blogosphere. That's too funny. Thanks so much for the plug and for the link.

It's just a few hours away now. I hope that you'll be able to join me - either live or listening on the archives. What am I going to talk about? Who knows? You'll have to tune in to find out. I'm just a blogaholic, you know....

Update: Thanks so much to Chrysalis Angel and Cathy for the promo posts on their blogs!

Update 2: Thanks to Awesome Mom for the IM conversation and to Mother Jones RN for calling in and talking with me live on the air. That was fun!

Dr. A Live this Thursday!

Ahem... I have an announcement to make. I have decided to take a huge step out of my comfort zone of blogging and going to try the world of being a talk show host. How crazy is that?

I have to tell you, ever since I've gotten my iPhone, I've been fascinated even more with podcasts. As some of you know, I've tried doing my own podcasts but really have not had the same satisfaction that I've had with blogging. And, I think the reason is a kind of disconnect between the podcast and the listener/reader.

Then, I started listening to what I would call, "live podcasts," in which the listener can IM chat or even call in to participate with the host. That really fascinated me. So, this Thursday, August 30th, 2007 at 4PM eastern time, the first episode of Doctor Anonymous Live will occur on Blog Talk Radio.

I have no idea what will happen. I hope that I'll be able to navigate through all the technology logistics of the thing. So, it may go off without a hitch, or be my biggest disaster ever. Either way, you'll have to tune in....

Lunar Eclipse

In just a few hours, the second lunar this year will occur, and will be best seen in the western portions of North and South America. (AP)

People in Europe, Africa or the Middle East, who had the best view of the last total lunar eclipse in March, won't see this one because the moon will have set when the partial eclipse begins at 4:51 a.m. EDT. The full eclipse will begin an hour later at 5:52 a.m. EDT.

NASA has a great webpage about tonight's total lunar eclipse. (image credit) I guess those in the Eastern part of the US (like me) will only have about 30 minutes to see it. I know I'll definitely be up by then, because, hey, I'm on call tonight. And, you know what they say about being on call with the lunar eclipse....

Update: When I first posted this (six hours ago), the moon was full and high in the southeastern sky. Over the past few hours, while I was getting some winks and answering my pager, I saw the moon slowly move to the southeastern sky and closer to the horizon.

Something unusual for northeastern Ohio is a sky without any clouds at all. It happens around here maybe 2-3 times a year at night, and tonight was one of those nights. As 5:52 am got closer and closer, I saw less and less of that full moon that was there at the beginning of the night. Then, it happened - Total lunar eclipse.

Wow! I've never seen anything like it. Better than any picture than I've ever seen. Better than any astronomy class than I've ever been to. I tried to take a picture of it, but even that could not do it justice. What a great start to the day!

Less trans fat dunkin donuts

For some reason, those words should not be used close together. However, according to the Associated Press, this company will announce today that they will be eliminating most trans fat from their menu.

Now, I totally understand why this is happening. There is a lot of business and social pressure out there to do this. A lot of their competitors out there have already done this, or will be doing this. But.....

Is there nothing else sacred than a trans fat dunkin donut? Sure, the taste will be pretty much the same. Sure, there is an obesity problem in this country and in some places around the world. But, c'mon! And, forget going to krispy creme....

Dunkin' is ahead of Krispy Kreme Doughnuts Inc., which has yet to roll out a zero gram trans fat doughnut but hopes to do so. Brian Little, a spokesman for the North Carolina-based chain, said, "We continue to work aggressively with outside supply partners, and our goal is to get to zero trans fatty acids while maintaining great Krispy Kreme taste."

Oh well. What am I going to do now? Maybe I'll try to unlock my iPhone - that sounds like fun. Sorry I was away so long away from my blog. I'll try harder to be here this week.

Busy week

Sorry I haven't been around this week. It was just a busy week at work. I'll try to catch up on blogging this weekend. Thanks to everyone who sent me an e-mail checking up on me. Other than being very tired, I'm doing ok. More soon....

Medicare threatening hospitals

Thanks to MSSP Nexus Blog for pointing out this story. In today's New York Times, there is a story describing a significant policy change directed at hospitals. Of course, this will save Medicare millions of dollars, but what are the unintended consequences of this policy?

Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.” Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products. The new policy — one of several federal initiatives to improve care purchased by Medicare, at a cost of more than $400 billion a year — is sending ripples through the health industry.

Now, don't get me wrong. I definitely agree with the intent of this idea. There are definitely some hospital infections that could be prevented, and it's been well documented the impact of medical errors during a hospital stay. I understand why patient advocate groups are happy with this policy decision.

With regard to preventing falls, does that mean that hospitals will have to utilize bed restraints more - because in the middle of the night, sometimes patients are confused and don't know that they're trying to get out of bed. Restraints are already a no-no according to some regulatory agencies.

When it comes to preventing infection, I see more unnecessary testing being done to prove that an infection was obtained before hospitalization. What will be the cost of this? In addition, I see even more increased use of antibiotics, which will further increase the resistance of organisms - and complicating the treatment of infections in the future.

So, while the government's intent is noble, I'm afraid of what the unintended consequences will be. If the government wants people to be accountable, they should start cleaning up their own house first. Of course, we know that will never happen...

Government program for medical marijuana

Are you a supporter of medical marijuana? Do you support the legalization of marijuana? Well, this story is for you. The governor of the great state of New Mexico is proposing a government program to pay for those who need marijuana for medicinal purposes. (Associated Press)

On Friday, [New Mexico Governor Bill] Richardson directed the [New Mexico Department of Health] to plan for full implementation of the program, such as preparing the regulations that will permanently govern how it operates.

Under the law, the department is to issue the rules by October, including for licensing marijuana producers and developing a system to distribute the drug to qualified patients.

The new state law allows the use of marijuana for pain or other symptoms of debilitating illnesses such as cancer, glaucoma, epilepsy, multiple sclerosis, HIV-AIDS and certain spinal cord injuries.

New Mexico is the 12th state to legalize marijuana for certain medical uses, but it's the only one calling for state-licensed production and distribution of the drug.

Supporters of this policy should be cheering, right? Well, there is a little itty-bitty hangup in federal law stating that the distribution and use of marijuana is illegal -- DUH! So, this may become a state government vs federal government media circus.

New Mexico, and any other state considering taxpayer sponsored medical marijuana, has to be very careful if they actually decide to implement this. (My personal feeling is that this is political posturing, and will never happen since the NM governor is running for US president.)

Canada made this same move. And, instead of people being happy, they eventually became upset because of the perceived low quality marijuana that was being given out. Check out the news report below or click here.

Too much depression?

Not very long ago, mental illness, particularly depression had this negative stigma. Many were embarrassed to even talk about it. It was thought of as "going crazy" or "going insane." I believe there have been many positive strides in both the recognition, diagnosis, and treatment of depression.

Now, there is a leading British psychiatrist who is saying that depression is being overdiagnosed? He just completed a 15 year study looking at 242 teachers and found that more than 75 percent of them fit the current criteria for depression. (BBC News)

Professor Gordon Parker claims the threshold for clinical depression is too low and risks treating normal emotional states as illness.

He writes in the BMJ [British Medical Journal] that almost everyone [in the study] had symptoms such as "feeling sad, blue or down in the dumps" at some point in their lives - but this was not the same as clinical depression which required treatment.

He said: "Over the last 30 years the formal definitions for defining clinical depression have expanded into the territory of normal depression, and the real risk is that the milder, more common experiences risk being pathologised."

Now, this may surprise you, but I do agree with the professor to a certain extent. Currently, the cultural norms are such that the term depression does not carry as much negative connotation as in the past. In fact, one could argue, that the current en vogue mental illness diagnosis is bipolar disorder as this is more prominent in the media these days.

I would even go as far as saying that there is a certain element of Western culture, especially American culture, which loves to avoid personal responsibility and accountability. I wasn't really speeding, I was responding to my bad day at work, and it's their fault that I was going so fast. Alcoholism is an illness, so I cannot control any of my actions, so I'm not responsible for any consequences.

Don't get me wrong, I believe it is appropriate to treat substance abuse and depression as illness. But, I also believe that some people in the culture use this as an excuse of convenience. And, that is very sad...

Need cash? Lose weight!

You're probably going to think that I'm making this up. In the northern Italy town of Varallo, Mayor Gianluca Buonanno is offering cash rewards to its citizens not only to lose weight, but to keep it off as well. (Associated Press)

"We wanted to encourage people to lose weight, and we thought that both the money and the idea of joining a group could be stimulating," Buonanno said in a telephone interview Thursday.

Participants in the week-old Varallo initiative will be given $67 when they reach their ideal weight. If they don't gain any weight back after five months, they will receive $268.

If they maintain their ideal weight for a year, they will get $670 more. So far, 30 of the townsfolk have signed up, Buonanno said.

It's an intriguing idea, but will it work? People say that money is motivating. But, to maintain your ideal weight for one year for approximately $1000? Will the combination of less weight, increased health, and cold hard cash be the secret to success?

The baby formerly known as baby

Remember in the mid 1990's when Prince was mad as his record label and changed his name to that unpronounceable symbol? What happened? It really didn't do to much for his career and everyone called him "The Artist Formerly Known As Prince" or "The Artist." Meethinks that a Chinese couple has been listening to too many Prince albums lately.

BEIJING (Reuters) - A Chinese couple tried to name their baby "@", claiming the character used in e-mail addresses echoed their love for the child, an official trying to whip the national language into line said on Thursday.

The unusual name stands out especially in Chinese, which has no alphabet and instead uses tens of thousands of multi-stroke characters to represent words.

"The whole world uses it to write e-mail, and translated into Chinese it means 'love him'," the father explained, according to the deputy chief of the State Language Commission Li Yuming.

While the "@" simple is familiar to Chinese e-mail users, they often use the English word "at" to sound it out -- which with a drawn out "T" sounds something like "ai ta", or "love him", to Mandarin speakers.

Uh, yeah. I get it. In looking at weird baby names, one doesn't have to look to far. I mean, just look at Hollywood babies. Some of them are definitely scarred for life. I also did a quick Google search of changing names to people like Peyton Manning and Jesus Christ. What is the most unique baby name you've heard of?

Beginner's guide to medblogs

As you all know, I'm addicted to my stats, and I'm always interested in who is linking to this blog. When I was browsing through my Technocrati stats, I saw a post linked to this blog which I wanted to share with you. (image credit)

The post is called "New to medical blogs? Vitum's Beginner's Guide to Reading Medical Blogs." It was a long post (at least for me) to read. But, I thought it was well done.

It starts off with this question, "What is the Medical Blogging Community?" And, it goes on from there. This blog is not mentioned by name, but the blogger did put a link to my post about Flea in the "Medblog Gossip" section. (Thanks so much for the link)

So, if you're new to the medical blogosphere, or, even if you've been around a year (like me) or more, I encourage you to check out the link above. It's an interesting read. Who knows? You may learn something you didn't know before.

Doctors failing obese patients

Here's breaking news: Doctors are responsible for America's obesity epidemic. Did you know that? Well that's what the press in this country want you to believe. Here's the latest example. (image credit)

According to a study involving almost 10000 patients at the Mayo Clinic in Minnesota, only 20% of study subjects had their obesity formally documented. However, if this condition was documented, then patients were more likely to be given a treatment plan which included exercise and diet instructions. (Reuters)

Not surprisingly, [the principal investigator] noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.

I have a few of problems with this. First, I never knew that I was responsible for the obesity epidemic continuing. Those of you conspiracy theory people out there probably even believe that docs are intentionally not treating obesity because it would decrease business for medicine. How ridiculous is that?

Second, this article appears to want doctors to label their patients as obese so that they can get the proper treatment. No one likes to be labeled. In fact, if I even hint at the word obesity with my patients, I know that they would leave my practice. Labeling is a big no-no - whether it's obesity, mental illness, or any other term with a negative perception.

Third, even if I give my patient a very specific treatment plan, am I responsible for them to follow it? Well, according to the concept of pay-for-performance, physician accountability is more important than patient accountability - meaning if the patient does not lose the weight, it is my fault and it will hit my pocketbook. I know you doctor haters out there don't care about this. But, I have an office full of staff and I care how much this would affect them.

So, now that I'm done rambling, this article is just part of my continuing frustration with the press in this country. Not that I care, but articles like this create a false perception. Perception is reality to some people. And, it is this false reality that makes it difficult for me to deliver adequate health care to my patients.

Antioxidants don't help heart

I'm probably going to get in trouble for saying this, but there are many homeopathy and complementary health professionals (image credit) who are scratching their heads following the latest study from the Archives of Internal Medicine. (abcnews.com)

A study released today in the Archives of Internal Medicine is the latest to put a dent in the theory that vitamins such as C, E and antioxidants such as beta carotene can reduce the risk of heart attack, stroke or other cardiovascular events.

Although previous research has come to similar conclusions, the study at hand is perhaps one of the largest to debunk the idea that these vitamins can lead to a healthier heart.

In the past, conventional wisdom (as well as some early research) stated that there was a protective effect that antioxidant vitamins had on the prevention of heart disease and stroke. In my opinion, there has been an entire alternative medicine industry built on this belief.

"Although theoretically these antioxidants would appear to be protective … these antioxidant vitamins have not lived up to their promises," says Dr. Carl Lavie, director of cardiac rehabilitation and prevention at Ochsner Medical Center.

"Studies of nutrients for disease prevention all indicate that the active ingredient in a healthful diet is a healthful diet, and not some isolated nutrient we can put in a pill," says Dr. David Katz, director of the prevention research center at Yale University.

Of course, research is ongoing. And, probably in 3-6 months, there will be another study published claiming to debunk this study. Don't get me wrong, I'm not saying that complementary medicine is bad and the type of medicine I practice is better.

I'll just be curious on the public reaction to this news. For example, when I mention any prescription drug, my patients can list all the side effects that they say on television. 

How about when I tell them, "You know, the $50 you spend every month on antioxidants may not help your heart as much as you think." Will people stop taking their antioxidant vitamins based on these study results?

Revisited: Blogging Personna

About a week ago, I wrote a post about the thoughts I had about how a blog reveals the type of person that you are. I very much appreciated everyone's comments on this. Today, A Mom Who Thinks Too Much wrote a post called, "Is This Blog, Me?" I usually place my comments in the 'comment section.' But, her post brought out an assortment of thoughts that would probably be better expressed in a conversational full post.

Some bloggers, like some "people," are simply more steady in the face they present to different people (these are the people who say "my blog is pretty much me"); others are more chameleon, showing a different face to different people. There's nothing wrong with either way. Personally, my blog is in many ways the core me---but it isn't the full me. Sometimes when I write an edgier post, that departs from my normal "sweet, but cerebral" self, I feel I am taking a risk.

At least for me, blogging is kind of like a window into the soul. What the heck do I mean by that? When we're with certain people, or in certain situations, we can (and do) reveal what we want to reveal about ourselves and our personality. I can be upbeat or more subdued when I'm with certain people or in certain situations. Writing posts are the same thing. But, when it comes to your core self, I believe that blogging, as in real life, there are certain qualities that you cannot hide.

But even our cores have more than one side. My friends would add "wicked" (and "funny"), my mother would add "stubborn---but sweet," my husband would agree with the "stubborn" part but would protest vehemently that I am not as sweet as I appear. (He is my spouse after all.) Casual friends would be surprised to find me as talkative and opinionated (even cutting) here than I am in their company. (Though it depends on the person. Some people "see" us better. Why is that?)

I believe that with certain people whom you "just click" with. There are some whom I immediately feel a connection with (granted this is a very small number). But, I definitely understand that some people just "see" us better. Here's a final comment that I will respond to:

I know some bloggers, when they feel a need to depart from their usual "face," or when they are moving into a different phase of their life, will start a new blog entirely. Often it is still even linked to their profile. (Naturally, we don't see easily those that aren't.) "This blog isn't me anymore. I've now moved to ...." It's interesting. I see that and I know exactly what they mean.

I'm so glad that you brought this up. I contemplated for a long time whether to close up this blog and start over - start over with a new blog name and a new blogger name - as a kind of transition to myself. Obviously, I elected not to to that.

Even if you change your clothes, or hair color, or where you live, or whatever external changes you want to make to yourself - or, even if you change your blog color, blog address, or whatever appearance changes to your blog - the essence of your blog comes from within. Your true blog readers and your true non-blog friends will accept you for who you are.

Thanks AWMTTM for your insightful post and your thoughtful response. I feel I'm more of a chameleon type like you...

USA: The World's Best Medical Care?

I seldom read the New York Times, because I pretty much know what I'm going to get even before picking up the paper. (image credit) But, in this morning's editorial section, there is an essay called, "World's Best Medical Care?" Here's the opening paragraph:

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

Groups like the World Health Organization and the Commonwealth Fund have ranked the US low in certain areas. The NYT piece goes on to outlines eight areas in which the US could do better which include areas like lack of universal health care, high infant mortality rate, low life expectancy at age 60, poor patient satisfaction, and being slow to adopt electronic medical records.

I'm not going to dispute most of this article. There are some good points and it is a decent analysis of how the American health care system could improve. But, like most things in the New York Times, I took it as a political commercial as opposed to an informative piece of journalism.

After throwing the US health care system under the bus for two pages, the NYT does try to make a comeback with this kind of backhanded compliment - or maybe it's not a compliment.

Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.

Is health care the most important issue in the upcoming US presidential election? Some people think yes and this editorial is proof of that. For me, it's just too early. It's a long 15 months until the election. However, I do appreciate that health care issues are probably getting a little more press than they did a year or two ago. Nothing will change without getting the public's attention. As I always say, we'll just have to see how this all plays out....

Paintball practice

In today's addition of Dr. A's small town news, here's a funny quote from the police blotter. It's always interesting to see what our citizens are doing around here.

A state Route 9, Salem, man reported Wednesday someone in a passing car fired paintballs that struck his son-in-law’s vehicle and nearly some children playing outside. Denny reportedly chased the vehicle into Perry Township, where it was stopped by police.

Viewing the video above, I never knew that paintball is such a big deal to some people. Of course, who am I to judge? I mean, for enjoyment and relaxation, I hit a little white ball around - but I love it!

Microburst

The weather experts were in town yesterday examining the damage (image credit) to declare if indeed a tornado went through here two days ago. In my meteorlogically naive mind, I thought it was self evident. I mean, there's wind and rain, and what looks like tornado damage. If it walks like a tornado and talks like a tornado, isn't it a tornado?

I guess not. In today's local paper, the official ruling is that what happened on Thursday is called a microburst. Huh? To me, that sounds like some like of science fiction term where Martians fly down, blow up your supermarket and gas station, and then leave.

“We were lucky,” Salem police Chief Robert Floor said after a Friday press conference on the storm damage at Eastgate Plaza.

“Yes, you were,” said Richard Kane of the National Oceanic and Atmospheric Administration.

Kane, a meteorologist based in Pittsburgh, was in Salem to advise city officials and the media that Thursday’s storm damage was not caused by a tornado but an 85 mile-per-hour microburst. Kane placed the event at 1:15 p.m.

Of course, being a skeptic on this, I did my own research on this. Don't get too excited. It was just a couple of Google searches. I did find some interesting information - at least for my education.

According to weather.com, here is the definition of a tornado: A tornado is a violently rotating column of air extending between, and in contact with, a cloud and the surface of the earth.

According to this article on the NOAA website, here is the definition of a microburst: A downburst is a strong downdraft which induces an outburst of damaging winds on or near the ground. Damaging winds, either straight or curved, are highly divergent. There are some interesting illustrations here.

Fortunately, there were no fatalities (there were rumors to the contrary) and there were no serious injuries -- just minor cuts and abrasions from flying glass and debris. Life is pretty much back to normal now.

The people around here (including me) will be trading "Where were you when it happened?" stories for a long time. Stuff like this never happens around here. Here's my favorite quote from the article.

No one was sucked out the door [of a local business during the microburst], the spokesperson said debunking a rumor, but a customer’s money was.

How funny is that? When I read that quote, I couldn't help but think of the 1996 movie called Twister with Helen Hunt (Ah... Helen Hunt...) and that what's his name guy. I remember seeing farm equipment and even animals being drawn up into the special effects tornados. Cool stuff - especially for 1996. Here's the trailer.

Tornado

This is what happened to my car (just kidding). Very weird here yesterday afternoon. I saw patients here at the office in the morning, and then actually had the afternoon off. This means that I went to the hospital and was in the medical records department doing some paperwork.

As the rain and wind got worse, at around 1:30pm, I said to myself, "At least I can finish more of my paperwork." I did hear some fire engines and police sirens outside. At the time, I didn't think it was that big of a deal. I mean, it is a hospital. There are sirens blaring around here all the time.

Little did I know what was going on outside. Less than a mile from where I was sitting, there as a possible tornado taking place. You'll see pictures of what was happening here, here, here, and here. Sheesh!

Where the picture was taken above was less than half a mile from our office. Authorities had to evacuate the area around the supermarket above because of a propane tank that came loose.

So, what our office staff told me today (because I wasn't here), was that authorities came into the office around 2:30pm yesterday afternoon and evacuated this entire medical complex/plaza. (I was at home at this point underneath my desk.)

It calmed down a bit for a couple of hours, then another line of storms came through. The winds were not as strong later in the afternoon - but a lot more rain. This storm will definitely be the talk of the town today. I may have an update for your later.

Update: Here's a quote from the AP story on the storm -- "Wind also damaged a restaurant and blew out car windows in a supermarket parking lot in Salem, about 15 miles southwest of Youngstown."

Genes may influence friendships

What really influences you - Genetics or Environment? This is a question that researchers have been asking for a long time. And, they have been applying this question to all aspects of the human condition. (image credit)

What about the friends that you pick? Is it the outside environment that influences you more, or your genetic make up? A study published in the Archives of General Psychiatry tries to answer this question. The researchers interviewed about 1,800 male twins aged 24-62 born in Virginia and listed in the Virginia Twin Registry. (WebMD)

In Kendler's study, identical twins were more likely than fraternal twins to make similar choices in their friends. So the researchers reason that genetics may play a role in choosing friends.

That doesn't mean that identical twins always chose the same type of friends. The findings aren't quite that iron-clad.

But Kendler's team estimates that when kids are 8-11 years old, genes explain 30% of their choice in friends, wiih that percentage rising to about 50% from age 15-25, as people mature into independent adults.

As always happens when this question is asked, the answer is somewhere in the middle. Yes, genetics play a role somewhat. And, yes, the environment plays a role somewhat.

For me, it's just interesting to think back to the friends that I had in childhood and compare them to the personalities and people who I am friends with today. I guess I do see some trends. I will be interesting to see as the rest of my life plays out to see if this trend continues.

Take cover!

Days and days of hot and humid weather around here culminated with big storms this afternoon - even with some tornados. It's still very windy and lots and lots or rain - as the above radar picture shows. Don't worry. I'm hiding under my desk - and blogging! I'm just a blogaholic, I guess....

Vasectomy for iPhone?

No, this is not a personal anecdote. But, this does beg the question, what would you do for an iPhone?

There's a story in today's Denver Post about one Sean Johnson (Yes, Mr. Johnson - How can I make this up?). Apparently, he was vacationing in Colorado Springs for a family reunion. He purchased an iPhone, but, according to the story, did not seek the permission of his wife first. Here's the rest of the story...

"We have five kids combined - sort of like our very own Brady Bunch ... and we have two children together," Johnson explains. "And she had made me promise that I would get a vasectomy at some point. I love having children, so I always thought in the back of my mind that there would be a chance that she would change her mind. But she didn't seem like she was going to be convinced. She didn't really want to go through another labor."

Who could blame iWife?

When the family met up at Denver International Airport to complete the trip, however, Johnson was "pouting" and carrying on as children often do without their toys.

That's when the wheels were set in motion for one of the most infamous deals in the history of nerds.

The deal stipulated that Johnson obtain a vasectomy, putting an end to the idea of more Johnson children. In turn, Johnson would be allowed to splurge on his iPhone.

Now, who would ever do this? I can just picture what this guy looks like and what his computer room at home looks like. There is no way that I (a post-modern and metrosexual man) would give into a deal like this - HA! So, did Mr. Johnson do through with this? This final quote sums it up...

"It's far from perfect, but it's by far the most perfect phone I've used."

(thanks to the Today in iPhone podcast for the story) (image credit)

Pinoy Prisoner Thriller

Judging by the almost 4 million views already on YouTube, I'm probably the last person to hear about this video. But what do you get when you put the above three words together? Courtesy of Wikipedia, here's what I found.

Pinoy: Pinoy is a demonym used by Filipinos for their compatriots in the Philippines and around the world.

Prisoner: A person incarcerated in a prison or jail or similar facility.

Thriller: Thriller is a 1984 hit single recorded by Michael Jackson.

Being a Filipino-American myself, I'm not sure whether to take pride in this video, or be really embarrassed. I mean, this is prison! I'm trying to think about how all of this was organized. And, in doing more YouTube searches, this is not the only song that this group does. Oh well, what did you think the first time you saw this?

Fechr.com

This is Doctor Anonymous for Fechr.com. I apologize if this post sounds like a commercial, but this is an interesting website that is worth checking out - especially for new blogs. (Disclaimer: I have not and will not receive any financial compensation for this post.)

Bobby Griffin and his former blogger site, The Bestest Blog of All Time, have definitely driven more traffic my way, and I very much appreciated that. His new project is described below, in his own words...

Fechr.com (pronounced feature) is a new site with a simple idea. 1 site, 1 day, 100+ visitors! Every day, at around midnight EST, a new site is “fechr-ed” on the home page. Get featured is FREE for a limited time! I specialize in bringing traffic to those who deserve it! So if you think you deserve it, just stick with me and we’ll get you some.

How can your site be featured? It's FREE! Eventually, once the site grows a little more in popularity, I plan charging in the neighborhood of 1-4 cents average per visitor to be featured (ex. if site is averaging 1000 visitors per day, would charge in the $10-$40 range, depending on demand). But until we get to at least 500-1000 average visitors per day, getting featured is FREE!

All you need to do is write up a short blog post about Fechr.com (ex. what we do, what you think of the idea, explain to readers how to get their site featured, etc.) and submit it at our site.

Since the free features idea is brand new, if you submit your site today, you have a good chance of being featured (and receiving 100+ visitors) as early as tomorrow! Even if the line does get a little long and you aren't featured immediately you'll still have a link in our buzz directory in the mean time.

If you have any other questions about the site, you can check out the FAQ or email me BobbyGriffin@gmail.com! Thanks!

Dr. A & iPhone: Episode deux

Welcome back to the adventures of Dr. A & iPhone. (Cue theme music) Let me get iPhone out of my trusty utility belt (Insert cool sound effect here). Here we go! (image credit)

Even though I'm still pretty much a novice at this, I've already received a couple of questions. The first is from Rahul.

Hi Doctor, I'm a medical student preparing to begin MSIII. Would you recommend usage of iphone as a PDA w/ medical software? Thanks -R

The second is from Mary Lu:

Yo Doc A! Welcome back from the boonie's of iPhone-land. You've been missed. The PharmD Husband is looking at one of those things to enhance his work as well.. (he's a hospital director of pharmacy,)

He asked me... to ask you... if you get any good ideas or finds on applications that can make his time/life more productive let us in on the info, please? Between us, I know he's looking for any excuse to get a new iPhone!

Let me tell you, I am very much flattered by these questions. In combing the medical blogosphere, I'm not really seeing much as far as resources for those of us with the iPhone. I have no idea how helpful this post will be, but I'm happy to share some thoughts.

First of all, Rahul, good luck as you begin your third year of medical school. I very much remember those days, and, to he honest, I'm glad that I'm done with them (hehe). At least for me, third year was tough. But, if I got through, I know that you can.

Getting back to your question (and this kind of relates to Mary Lu's questions as well), as far as I know, there is no medical software specifically written for use on the iPhone (yet). The stuff that I've seen out there makes use of the iPhone's wireless internet connection.

For example, I've read some things on medgadget that promote themselves as software for the iPhone. What I've seen them do is have the iPhone log into their medical website - and that's what they're calling medical uses of the iPhone. I don't really buy that.

I used to have a palm product as my PDA. At least for me, the most useful medical software I was using was epocrates. I was using this both in the office and in the hospital. ("Mandatory" conflict of interest statement: In no way am I compensated by the company mentioned above. I'm just a happy consumer of their product).

As of this point, there is no epocrates software specifically written for iPhone (yet). That being said, my hospital does have wireless internet, and what I do instead is that I log into the epocrates website via iPhone to find out the medication information that I need. This workaround is doing ok for now. But, if there are any epocrates employees out there - Please write software for iPhone - Pretty please.....

Mary Lu asked about "applications that can make life more productive." In reading the blogs, there's a bunch of stuff that people are writing, but it seems like all of them involve entering programming code into the iPhone - meaning there is not really an easy user interface (yet) to do these things.

I'm always weary of breaking into the software code of iPhone. I call myself tech "educated" but not necessairly tech "savvy." Call me chicken, but I'm afraid of crashing my iPhone and then missing an important call or text or whatever. So, I'm eagerly awaiting easier ways to get cool applications on my iPhone.

Thanks so much for your questions. I have no idea if this was helpful, or not. At least it was fun for me. Keep those questions coming and I'll do what I can to answer them. Well, that's it for now. (Cue theme music). Join us next time for the Adventures of Dr. A & iPhone.....

Blogging Persona

This week, I've been catching up on reading blog posts and listening to various podcasts. I just cannot help but be fascinated by the wide range of topics and ideas that people are passionate about. I mentioned earlier this week that I'm trying to find perhaps a fresh approach to my blog and to blogging. (image credit)

I've never been a person who likes to get into a rut. I like to try to keep things fresh and not get bored. I've never been one that likes to be stereotyped - either in real life or in my blog life. What the heck am I talking about? Who knows sometimes?

Reflecting on some of the conversations that I've had on blogs and e-mails, I keep thinking about how blogging people are in real life. Sure, a person's personality is reflected somewhat in her/his style of writing. But, in thinking about a person's blogging persona - Do people come to expect a certain tone or a certain type of post after reading someone for a while?

Just a bunch of abstract thoughts, I know. I'm in one of those kind of reflective-type mood tonight as I write this. As I place the mirror up to my blogging face, I ask myself what I see? Do I like what I see? I know I have portrayed myself as a certain type of blogging personality - or sorts.

As I'm trying to find my blogging voice again, sometimes I have nights like this when my mind wanders. Is it possible to re-invent your blogging self? Do I want to try to change something about my style - just for the sake of change - just to satisfy my need to not be stereotyped as a certain style? I dunno. Sorry for the randomness, just my thoughts for tonight....

Tadd Fujikawa

On Thursday, in the great gambling state of Nevada, Tadd Fujikawa will be starting his journey as a pro golfer. This is not your typical "amateur turning pro" story. Here's the kicker - this kid is only 16 years old. (image credit)

Tadd has made a couple of media splashes in the past 12 months. About a year ago, he qualified for the US Open tournament, which is arguably the most difficult tournament in the world to qualify for. Then, this past January, he made history as the youngest player in half a century to make the cut at a PGA tour event (professional golf tournament). Here are some quotes from a July 12 AP article.

"I'm really ready for this," he said. "It's something that I want to do."

"It showed me I can compete with the best players in the world and I can handle myself in front of the cameras. But sometimes I get a little nervous," he said.

Finances weren't really a factor in the decision.

"I'm not in it for the money at all. I just want to play with the best players in the world," he said.

Call me skeptical, but I don't think he was really the one making the final decision on this one. Can a 16 year old really make a decision like this? I mean, there is no going back. It's not like he can bomb out of this tournament or a second tournament and then decide to go back and be an amateur. This following quote from a July 31 AP article sums it up for me.

For a high school junior missing his first week of the new school year back home in Honolulu to make a run at a $3 million purse, he offers a remarkably mature take on what's most important in his life.

"I think it's more about me. I think that is more important than golf," Fujikawa said.

I think this kid (and his parents and his other close advisors) are seeing the potential dollar signs in the short term and not the big picture. I think they're trying to take the "American Idol" shortcut to success, fame, and fortune. I certainly wish the best for this kid, but I don't think it's going to work out as all of them have planned.

The sad part is that there really is no backup plan for this kid. If this little stint doesn't work, then it's not like he can accept a college scholarship to play golf - he's now declared himself a pro golfer. If he doesn't make it on the US tour, then his only other options are to play golf tours around the globe until his skills mature enough to return to be a regular on the US golf tour. Oh well, we'll have to see how this story plays out.....

Surprise

When I got to work this morning, my nurse surprised me with the cake above, a thoughtful card, and a "congratulations" balloon. How sweet of her. Of course, the cake was gone before the end of the morning. I guess I need another 30-45 minutes on the treadmill tonight - oh well. BTW, the above photo was taken by my iPhone and tweeked a little bit by iPhoto and then posted here. How neat is that?

Work-iversary

Is your anniversary at work something that should be celebrated? Well, for me it is. I see it as kind of a landmark or a benchmark. I've been working at the same place for six years now. (image credit) For those Family Medicine docs out there, you've probably already done the math and see that I need to take my Boards next year to remain Board certified. That will be a fun process next year.

Big shout out to those newly graduated Family Medicine residents and other newly minted residents who may be starting new jobs today. For the great majority of people (in the US), residency ended June 30th. and the new graduates usually take July off to take their Boards and/or vacation, and then join the real world on August 1st with their new jobs. At least that's how I started.

Of course, the practice I'm at right now placed me on call overnight on August 1st. That was quite a joy. I remember that night on call. It's not like it was that busy, but it was like I was a first year resident all over again. I couldn't find my way around the hospital. I didn't know how to work the computers or the dictation machine. Looking back it was quite comical.

But, I got through it and not it's six years later. Every so often I get the "business" talk from the senior partners about how well or not well I'm doing from a business standpoint for the practice. "The numbers" as they call them always could be better. Industry in the part of the state is not exactly growing, even maybe getting more economically challenging.

With decreasing jobs around here means decreasing people with health insurance. Of course it's not great for patients, but from a business standpoint, that makes things challenging for me as well in trying to improve my business standpoint. Don't get me wrong, I'm not whining. It's just when I reach a work anniversary like this, it doesn't hurt to re-evaluate things.

When I look at my peers whom I graduated residency with a few years ago, some of them have had six different jobs in these six years - some even more than that. The medicine industry is not immune to the turbulent business cycle that's taking place in this part of the state and region.

So, all in all, I'm happy where I'm working. Yes, it's an economically deprived area of the state. Yes, young people and young families are leaving the area for success elsewhere in the country. And, yes, I myself could probably move down south or out west somewhere to make more money and have a better lifestyle with less on-call hours.

But, this is home for me. I was born in this area. I grew up in this area. My family is still in this area. I could not see myself living or working anywhere else. This post is probably one huge rationalization of why I'm still here. But, I don't care. I still love what I do and I have no regrets on my career choice. How many docs can say that these days?