Sunday, December 31, 2006

Happy New Year

I can say this now, because it is 2007 in some parts of the world. The picture above is from Sydney, Australa (*waving to HP*).

I've finally caught up on my rest. I don't want to bore you with all the details, but it was just crazy at work last week. Great to have a weekend off to catch my breath.

On a day like today, one cannot help but reflect back on the year that was and the year that will be. Even though it's really cheezy to say, but it is a time of hope. A time to kind of give yourself a clean slate to start again.

Some are really into this new year's resolution thing. I admit that sometimes I make them and sometimes I don't. There's this columnist that says Forget New Year's Resolutions. But, for me, here we go.

Physical health: I know. I'm one of the many people who make this resolution. But, I really think that I can do it this time. Or, maybe it's the guilt of all those sweets that I consumed at holiday time. Hmm....

Mental health: Why do I feel like I'm confessing all my sins? Anyway, I could do a little better at dealing with stress. Usually, when I'm at work, I have no problem reaching for the M&Ms or whatever chocolate is around - especially last week when things were really busy. Finding a better way to deal with this will help. How to do this? I'm still working on that.

Better blogging: Yes, that's right. Even though you see links to all my fave posts in the sidebar, I really believe that my best blogging will be in 2007. Or, I'll completely lose my mind and write the worst posts ever. You'll have to stay tuned and find out. Have a happy and safe New Year's Eve and New Year's Day!

Friday, December 29, 2006

Still here

I know that there have been reports that I've been trapped at Denver International Airport all week. Wouldn't that be an interesting story? I feel bad for those people out there. Who wanted a white Christmas?

Anyway, I wanted to let you know that I'm still around - just swamped at work this week. Although, I was one of those millions who tried to use my iTunes gift card earlier this week and found a slow server. Finally was able to get some music.

Sorry about the boring update. I'm going to get some rest this weekend and hopefully be back to normal blogging next week. Happy New Year 2007!

Tuesday, December 26, 2006

Grand Rounds

I'm going to be working a lot this week. So, I want to apologize up front if I have a sparsity of posts over the next few days. The docs in our group take turns working the holidays throughout the year, and this is my year for the Xmas/New Year's stretch. Also, I've gotten lots of spam comments the last few days. So, I'll be moderating comments until I think the spam has slowed down. Sorry. And now, back to our regularly scheduled programming...

Grand Rounds 3.14 has went home for the holidays. If you have never heard of Grand Rounds before, it is a group of medically related posts brought together in one place every Tuesday. The final Grand Rounds of 2006 is up an running at Blogborygmi. Thanks to THE MAN, Nick Genes, for including my submit under the "levity" section.
Dr. Anonymous is upset about me being named Time magazine's Person of the Year (and here I was, thinking you were the choice). He proposes something else -- something that can be part of us, and yet, is distinctly not us...
Nick was also a little reflective talking about those medical bloggers who have stopped blogging and those bloggers who took some time off and now are back. If you have never checked out Grand Rounds before, I would encourage you to check it out this week. This is the best the medical blogosphere has to offer! It's Grand Rounds!

Sunday, December 24, 2006

Merry Christmas

On this Christmas holiday, Mimi Lenox is asking bloggers around the world to re-post their peace globes from the original blogcast for peace from November 7, 2006. This was a great idea, and I'm happy to be a part of it again.

In other news, I tried again to switch to the new Blogger, but was again rejected with the same message I received the first time from Blogger beta. Oh well, maybe something can be figured out for people like me who are having problems switching.

Finally, some time today, I will have had my 50,000 visitor to the Doctor Anonymous blog. I cannot believe it took only six months (plus one week). Are you the 50,000th visitor? Let me know. I mean, hey, YOU are Time Magazine's Person of the Year. Happy holidays from all of us here at Doctor Anonymous!

Friday, December 22, 2006

Do they know it's christmas

This is the 1984 video of the song by Band Aid. Found it on YouTube. I forgot how many stars (at the time) were on this song. How many can you name? I'm on call this long holiday weekend. So, I'll be around the blogosphere seeing what's going on. Don't forget to put up Mimi's Peace Globe on Sunday. Safe travel to those of you going out on the road, in the sky, or out at sea, or wherever you're at. Happy Holidays!

A Blogger's Story

There is an interesting concept that just started out there today in blogland. It is a soap opera story with the main characters being bloggers - Hmmmmm...
Ok folks here goes… ways back in the blog a thon days.. Cathy and I discused doing a soap with all these bloggers… now well I think I am going to do it and it will work like this.

If you want to partisapate let me know. You will be a part of the story as well as writting the story. Anything goes.. know that up front cause like.. Don’t want people getting offended ok.
Apparently, this has been talked about for a while by Wolfbaby and Cathy. Well, today, the first installment has been posted over on Dreaming and Believing.
Wolfbaby cleaned the bar top to a polished shine then looked around the new place with pride. It was almost opening time and soon all of her blog world friend would come to see the new meeting place. What an idea they had all come up with. A jointly owned and operated restaurant and bar to allow all the blog owners to safely meet debate and create. There was a safe haven for everyone. A library room for those who loved to read and write. Along the walls of the place were cubbies for painters to paint. Plenty of tables for people to eat and talk. Lots of good food and drink for everyone to enjoy. This was a proud moment for all of them. As the time drew nearer to open the doors for the first time Wolfbaby grew giddy at the thought of meeting all her friends in person. As she opened the door to greet her friends Wolfbaby wondered how this joint endeavor would turn out.

One year later...
How's that for a teaser? Read the rest of this episode on the post called WolfDen Soap Part 1. (Post your comments over there) Like I told them, I've a lover and not a writer. LOL! So, I volunteered to be in the story but not write anything. We'll see how the esteemed writers treat my character...

Thursday, December 21, 2006

Holiday personality

Your Holiday Personality is Fun

You're all about the celebrating. Whether you're partying hard or singing along to Christmas music, you're totally enjoying the holidays.
Make your own Christmas ornaments. Create a holiday mix for all your friends' stockings. Run around your neighborhood late Christmas Eve ringing bells.

Welcome back to holiday week here at Doctor Anonymous. Here's another personality test for you. Take the test yourself and post on your blog!

Wednesday, December 20, 2006

Gift cards

Since this is the holiday season, why not talk about gift giving. Back in October, I talked about the whole thing of re-gifting. And, that seemed to generate some discussion.

I have to admit that I'm horrible at picking out gifts for people. I dread going to the mall and trying to figure things out. When I was introduced to the gift card, my life changed dramatically.

I know some people are offended by this gesture, but for me, it says, "Hey, I know what ever I get for you, you're going to return anyway, and get what you really want. So, why not cut to the chase. Here's a gift card."

I was talking with one of my co-workers here at the office. She thinks the gift card thing is totally insulting and saw on television the idea of plastic surgery, er, cosmetic surgery, gift cards. What? Huh?

I did a little research on this and found an article in USA Today talking about giving the gift of plastic surgery. Hmmmmm....
Tina Baldwin, 48, of Newfield, N.J., was thrilled this fall when her husband gave her an early holiday present: any cosmetic surgery she wanted. She chose liposuction.

As others like Baldwin gear up to look their best for the holiday season, cosmetic surgery centers nationwide are offering gift-giving specials, where anything from wrinkle-reducing Botox injections to breast implants can be credited to the gift giver.
I would imagine some people would like to get plastic surgery as a gift from someone. But, I would also imagine that others may have a problem with this....
The gift giver may also offend the recipient, says Zachary Gerut, a Long Island plastic surgeon and assistant clinical professor at Albert Einstein Medical Center in New York. He says it's not uncommon for a husband to bestow the gift of a breast implant upon his wife this time of year. "Why don't you just insult the poor lady and be done with it? It's like telling someone they have bad breath," he says.
So, as you're making your final checks of your list to see who has been naughty and who has been nice, don't forget to factor in the plastic surgery gift card for someone your love. If that's too expensive for you, then there's always the Olive Garden. Happy Holidays!

Tuesday, December 19, 2006

Dr. A's person of the year

In case you haven't heard yet, Time Magazine's Person of the Year is YOU. That's right, YOU. I know, you're asking yourself, Huh? In my opinion, Time has reached a new low here. In an effort to offend no one, they took the easy way out and named everybody, er, YOU. That's pretty pathetic if you ask me.

Time has assured itself that this annual distinction is now irrelevant. It's like me naming a person of the year. So, why not! If Time Magazine can make itself look important, then I'll do the same.

My person of the year is not actually a person. In addition, there is not even an agreed upon name of this "person." Now, before you think I'm going to do a spirituality post (not that there's anything wrong with that), here are the many names that have been used for my "person": Bug, Bacteria, Virus, Germ, Infection....

Well, you get the idea. In 2006, the population of the world has gotten to know more about microscopic organisms than ever before. For example, ripped from recent headlines....

E.Coli: Forget about bagged spinach from California. That story is so three months ago. Now, the big thing is the infection raging through Taco Bell restaurants. Oops! I forgot, the CDC has now announced that Taco Bell is now safe to return to. I know that because in watching TV on Sunday, at least twice an hour, the president of Taco Bell had an announcement asking people to come back. I wonder how much that cost. Probably pennies compared to the revenue lost over the past few weeks. Anyone remember Chi-Chi mexican restaurant? They had an outbreak in 2003, not with E.coli, but Hepatits A. Chi-Chi's went out of business soon after that.

Pseudomonas aeruginosa: This is a bacteria usually found in water and soil. It may not sound familiar, but if I say this bacteria closed the neonatal and pediatric intensive care units at a Los Angeles hospital two weeks ago, then it may ring a bell. Five babies were infected and two babies died from this bug.

MRSA: The long name is "methicillin resistant staph aureus." This is a big and bad sounding name, and this bacteria usually is. This is a bug whose victims are usually elderly patients with extended hospitalizations. In this story from the UK, hospitals there are finding a more powerful strain of MRSA, meaning it is more difficult to treat. As bacteria get exposed to more and more powerful antibiotics, the bacteria adapt and become more and more powerful. A dangerous trend.

This virus first made it's mark on the scene on cruise ships. Remember hearing about cruise ship illnesses? This was norovirus at work. Now, it had made landfall - namely at Olive Garden restaurant in the Indianapolis, Indiana area. Almost 400 people in that community have been affected. One wonders how much that's going to hurt that business not only locally, but nationally as well.

Finally, I've already had my flu shot rant this year. I'm also upset about the media hype over flu shot surpluses. But, that's a rant for another day. What will 2007 bring? Well, in addition to all of the above, bird flu is still on the radar screen. What new bugs are on the horizon? We'll have to see. Congrats to Dr. A's person of the year! Don't forget to wash your hands....

Grand Rounds

Grand Rounds 3.13 is now up and running over at Nurse Ratched's Place. I love the title and theme this week: It's Christmas Grand Rounds, Charlie Brown! Thanks to Mother Jones RN for including my submit this week:
And speaking of eating Christmas goodies over the holidays, Dr. Anonymous writes about websites that take us into the world of anorexia and bulimia, and gives us his opinion about an aritcle that was written about these websites.
Grand Rounds goes home next week to Blogborygmi (say that fast three times). What a Christmas present that is, Charlie Brown! Dr. Nick Genes, the founder of Grand Rounds, will be taking the reigns for the December 26th edition. For now, enjoy the best the medical blogosphere has to offer this week. It's Grand Rounds!

Monday, December 18, 2006

My geek profile

I was tagged by that Super Steno Girl. Gee thanks! By the way, this is a great new blog just started on December 1st. Check it out if you can. As for my geek profile, unfortunately, no surprises here, ugh...

Your Geek Profile:

Academic Geekiness: Very geeky!
Internet Geekiness: High
Movie Geekiness: High
Music Geekiness: Moderate
SciFi Geekiness: Moderate
Fashion Geekiness: Moderate
General Geekiness: Moderate
Gamer Geekiness: Low
Geekiness in Love: Loser

The Nose Knows

Ah, to be a college student again. Those were the days. Partying a lot, going to class sometimes, and having that occasional "interesting" experience. Now, before any of you out there jump to any conclusions, the experience I'm talking about is taking part in a science experiment.

Today, the Chicago Tribune describes a study involving the sense of smell...
If the results are surprising, that may be because no one ever had tried putting a bunch of college undergraduates in a field wearing blindfolds and sound-muffling headphones, then had them crawl in the grass after a scent like pigs hunting for truffles.
Researchers at the University of California-Berkeley found that "most of the students could follow a 30-foot trail of chocolate perfume and even changed direction precisely where the invisible path took a turn."

Here's how they did the experiment (I'm not joking)...
To create a scent trail, the scientists soaked a line of string in the chocolate scent and embedded it in the grass. The people were set loose on the ground about 9 feet away from the trail, then had to find the scent and follow it.
Some people out there are probably saying, "Hey, it's Berkeley, that's the crazy stuff that they do out there." Some other people may think this is a fraternity stunt. But NO! This is in the name of science, by George. Here's how the article is trying to tie this in to scientific experimentation....
By revealing how noses locate smells, the scientists hope to lay the groundwork for electronic noses that could detect hazards such as land mines. Their work, published online Sunday in the journal Nature Neuroscience, was funded in part by the Army Research Office.
That's our tax dollars at work! I don't know if I buy that explanation. But, just you watch. Next summer, there will be a movie about this experiment and someone (probably from Berkeley) will make tons of money. Maybe another one of those lame American Pie sequels. Happy Monday!

Six-month blogiversary

Yup, that's right, boys and girls! Doctor Anonymous been around for six months. I can hardly believe it! Thinking back, I didn't even know if I would get through the first week, or even the first month.

It's fun looking back at old posts - especially on occasions like this. I'd have to say that the entire Blogaholics Anonymous thing really got me started. Granted, this is not an original idea, but I'd have to say that was definitely the spark to get things rolling.

Over the past six months, I'd have to say that there were three points where I got a lot more noticed. First, when Moof highlighted me on her blog in June, I remember getting a lot more traffic that I'd ever seen. She's always been great to me, especially when I first started answering all my naive blogger questions. I even asked another question over this past weekend and she got back to be right away. Thanks for everything, Moof!

The second most significant point in the past six months was when I was named Bestest Blog of the Day by Bobby Griffin in September. Especially, if you have been only blogging for about a month or so, get involved with Bestest Blog. You won't regret it. Thanks Bobby!

The third point was the entire Grand Rounds experience, which for me was almost the entire month of November. When Dr. Nick Genes contacted me to host that blog carnival, I had no idea how much exposure I would get and the people that I would meet along the way. For the medical bloggers out there, if you ever have the opportunity to be the GR host, definitely take advantage of it. Thanks Nick!

People have asked me how I've kept on going for six months. First and foremost, your blog should be for YOU and not for us. Write what YOU want to write about and not what you think we want to read about. Just like in the real world, people in the virtual world know when you're not being genuine and trying to "fake us out."

Adding a little piece of yourself goes a long way. Sure, I'm "anonymous" in that people don't know my name or what I look like. But, whether you like it or not, your personality will show through. If people connect with it, they'll be back to read more.

The second piece of advice I'd give is don't be afraid to write about things out of your comfort zone. Sure, when you started blogging you wanted to tell the world about medicine, or being a patient, or science, or sports, or news, or entertainment, or whatever. Don't be afraid to mix it up with different topics.

If you're starting out, don't be afraid to try to add a picture, or audio, or video to your blog. Try different types of posts, like interviewing a fellow blogger. Trying something out of the ordinary will keep things fresh as a writer and we'll enjoy that as a reader.

Finally, I'm the first to say that I'm obsessed with my numbers and my stats. I mean, just look at my sidebar. It's easy for me to say, but to keep your sanity, don't get too hung up on how many visitors you get on a daily basis. It doesn't matter how many people see your blog. It matters how many come back again and again to see your blog.

Speaking of that, thanks so much to all of you who come back again and again to read my blog. I never knew how much fun this all would be. I don't know if I'll be around in another six months, but it will be fun along the way!

Sunday, December 17, 2006

Never Question Mr. Nibbles!

You gotta like that YouTube. I saw this very funny commercial this morning, did a quick search, and BOOM there it is. Here is my favorite holiday commercial of the moment...
And, even though the commercial is not exactly the same, here is another version of the Mr. Nibbles commercial on the YouTube site....
Is Christmas really next week? What is your favorite holiday commercial?

Saturday, December 16, 2006

Why Beta Why?

I'm having trouble sleeping tonight. So, I'm thinking, why not blog?

After days of going back and forth, I finally decided to make the switch to Beta Blogger, UGH! I felt it was really affecting me making comments on blogs. And, maybe it was preventing others from commenting on my blog. So, I took the step to make the switch.

When I was thinking to switching to Blogger Beta, I had this flashback to my blog post number one on June 19, 2006 called: Does this thing work?
I've got to admit off the bat that I'm no techno-expert. This entire sign on process was kind of traumatic. Is this what this blog is going to be about -- whining? Hope not. I'm glad just to be up an running. Don't worry, this sparse blogspace will be filling up soon. Just as soon as a figure out what to talk about...
Ah.... Memories.... Anyway, I heard that the side bar may be affected by switching. So, I made sure I saved the links of where all the third party stuff came from. I even printed out my front page, in case I had to re-create my sidebar on my new beta site.

Finally, I got through the first page of Beta registraton. I paused and took a big breath before clicking on making the move. Optimistic that everything would be ok, I clicked to the next screen hoping to see my new site. Unfortunately, I saw the following message.
Could not switch you to the new Blogger: Thanks for your interest in the new Blogger in beta! Unfortunately, we cannot switch your Blogger account at this time, because one or more of your blogs cannot be moved. Please see our help article for more information.
What! Blogger, you've been bugging me for MONTHS to get me to switch over. I've been hearing stories, both good and bad, about switching. Many of my blog friends have been bugging me to switch. I made the decision and went through the process, and this is what I get? How do I switch to wordpress?

After about half an hour, I think I've calmed down a little now. The good news is that I think the comment problem has been resolved (hopefully). I'm going to try again to check out my favorite blogs and comment. Feel free to comment here and let me know if this thing is stll working. I'm still thinking about wordpress...

Friday, December 15, 2006

Let The Games Begin

Thanks so much to those of you who nominated me for Medgadget Medical Weblog Awards. I really appreciate it! Who knew I would go from no blog at all to being considered one of the best blogs of 2006.

Now, if you don't tell anyone, I'm going to give you some insight here that you won't get on other blogs. I'm very flattered to be nominated for best overall medical blog of the year. But, at this point in my blog life, I think I'm minor league compared to some in that category.

So, even though as of this second, there are twelve other blogs in the Best New Medical Weblog category, I think I will concentrate my efforts there.

How am I going to do that? Well, here's the way I see it. It is three weeks until the polls open over there on Medgadget. I have three short weeks to earn your vote for Best New Medical Weblog of 2006.

Don't think your vote counts? Think again. In reviewing the rules over there, there will be a new voting system. Yes, there are nine judges (*waving at judges*) and they will have their say. But, your vote counts just as much! So, I have some work to do in the next three weeks to convince you and to convince them that I'm worthy of your vote.

What I'm going to say next is definitely politically incorrect. But, ever since my first day of blogging, I made a committment to myself that since I was going to blog anonymously, I must be open and honest with my readers. Today is no exception.

The politically correct thing is to say "Gee Whiz, it's just an honor to be nominated." No other blog out there is going to say this but me ==> I'm definitely out to win this award. Don't take that the wrong way. I'm not saying that out of a sense of entitlement, just because I've been blogging for almost six months.

Over the next three weeks, I'm going to work as hard as I can and blog my heart out to earn your vote beginning on January 3, 2007. For my blog friends out there (and you know who you are), if you have any advice along the way, please let me know.

I know I sound like one of those nasty politicians running a campaign. I'm just a blogaholic trying to reach for a goal that I never thought was possible six months ago. With hard work and your help, we can try to get there together. Let the countdown begin! Twenty days to go until the Medgadget polls open!

Thursday, December 14, 2006

Quick news stories

Obese Kids To Be Offered Surgery: The government in the UK is sending the ultimate message of accountability for your actions by offering surgery "as a last resort" to obese children. Richard Watts, campaign co-ordinator of the Sustain's Children's Food Campaign, said: "Instead of expensive and unpleasant surgery, we should look to improve children's diets by protecting them from junk food adverts before 9pm and making cookery lessons in school compulsory." DUH!

Of course, you could do something obvious. No, not encourage exercise. That's too easy. You can ban certain foods, like trans fats. Apparently, that's the fad now in the United States. Cities like Cleveland, Ohio are following the lead of New York City. Oh well. Maybe that will help the obesity problem in kids.

Longer Colonoscopy Time
Ups Detection: According to a new study in the New England Journal of Medicine, you have to ask your doctor if they spend more than six minutes doing their colonoscopy. The study stated that those colonoscopies more than six minutes found more abnormal growths than those less than six minutes. DUH!

What the study didn't show is the potential increase complication rate with more biopsies taken and increased time under anesthesia. Stuff like this is always left out of media stories. I wonder why. Hmmmmm.....

Gliding Mammal Lived More Than 125 Million Years Ago: Scientists found a fossil of what they're calling a "gliding mammal." The mammal was probably nocturnal and dined on insects. It was similar in size to a modern flying squirrel.

You're wondering, why did I pick this story? You know, I don't really know, other than I really liked the picture. What do you think? Have a great day!

Wednesday, December 13, 2006

Blogger problems

Imagine that? I'm not even in the dreaded blogger beta. Lots of difficulties with my sidebar this morning. So, I'll be fiddling with this thing this afternoon. Hopefully, I won't accidentally delete the entire blog. I'll be right back after these commercial messages. Thanks for stopping by today!

Update (2pmET): I have a question. Don't worry, I turned the comments back on. I figured some stuff out, but still having some problems.

Is my footer in the right place on your screen? On my firefox screen, it's beneath my profile. Gimme some feedback on this. For all you template gurus out there, if you could help me move it in the right spot, I'd appreciate it. Thanks!

Update (6:30pmET): Still can't figure out the footer thing, but that's ok. I'm glad I didn't mess up my entire template. I'm going to be adding things back to the sidebar in the next few hours. Please let me know if you see anything funky going on on the sidebar or on the footer. Hopefully, I'll have a more "normal" post tomorrow. Thanks for all of your help!

Tuesday, December 12, 2006

James Kim: Blame the victim

Warning: This is an irk alert...

The people on the west coast of the United States probably have been following this story closer than I have. And, I wasn't going to mention anything about the tragic story of James Kim and his family. But, I read a story this morning that really put me over the edge.

For those who may not know, James Kim and his family (wife and two young daughters) were stranded in the mountains of Oregon for approximately a week. I believe on day five or six of their ordeal, which included hearing helicopters but unable to get their attention, Mr. Kim decided to venture out to try to rescue his family. His family was eventually rescued, but he was not.

The first set of media stories portrayed him as a hero - which is what he was. Initial stories called him "Superhuman." As I did more research, I found out he was a senior editor for Cnet.Com. And, I remember seeing this guy doing reviews for computer and electronic stuff. Great guy. He mentioned his daughter a lot when he did his video reviews for cnet.

Now, the media stories are shifting. The story that really got me going this morning had this to say about the Kim family...
When we finally reached the spot where the Kims' car stopped after a long, winding journey, our traveling companions -- Sgt. Joel Heller, Josephine County Sheriff's office, and John James, owner of the Black Bar Lodge -- both had the same exact thought: Why did the Kims continue down such a desolate path when they so clearly did not know where they were going?
This just fires me up! I mean, this family was lost. It was obvious that they have never been there before. It was snowing. The signs were not clearly marked. Even with all these facts, they are blaming this poor family? I don't get it.

For the rest of the article, I was waiting for the passage saying, "We're raising these questions because we do not want this tragedy to happen again to another family." The tone of the article remained on the Kim family.

I know I shouldn't let the media bother me like this, but I think of the two little girls that are left behind. When they read about their brave father in 10-20-30 years, what will their reaction be when they come across stories like this essentially blaming their father for getting the family lost and leaving them behind? In my view, media stories like this are irresponsible. That's my 2 cents worth.

Nominate Me!

I have no shame. And, when you read this post, you'll see why. HA!

Yesterday, Medgadget announced the opening up of nominations for their 2006 Medical Weblog Awards. This is their third annual event. And, according to their website, "These awards are designed to honor the very best in the medical blogosphere, and to highlight the diverse world of medical blogs."

There are seven categories, but the one I'm most interested in is Best New Medical Weblog (established in 2006). To be honest, I don't think this blog really fits into any of the other categories. Oh BTW, there's a new category this year for Best Patient's Blog. So, for you DA readers who have patient blogs, you can play, too.

Anyway, this is where I'm asking you, the Doctor Anonymous reader, to help. If someone, anyone, would nominate me for Best New Medical Weblog - I'd really appreciate it! I'd nominate myself, but that seems kind of lame to me. Plus, the judges may not take to kindly to self-nominations.

Speaking of the judges, some of them look familiar to me. I think I may have put them in the bottom section of my Grand Rounds 3.09 posting last month. So, they may not like me too much. Oh well. We'll have to see what happens. If nominated, then I'll be shamlessly be seeking your vote from January 3-14, 2007.

What's interesting is that you can only vote once - period. Not once an hour - not once a day - just once - period. I wonder how they'll monitor that. But, hey, they're Medgadget. They can figure it out. But, first thing is first - the nomination. Thanks for your consideration....

Update: To help generate some controversy, the grand Empress Bee herself has obtained some totally illegal pictures of me (LOL) in her post called "They Are Coming Out." Your curiousity piqued yet?

Another Christmas Meme

It looks like Cathy gave me by Christmas present early in the form of a meme. The interesting part is that I did not recieve the dreaded "You've Been Tagged" e-mail message. That's a new strategy (thanks Ipanema - HA!). Here we go!

1. Hot Chocolate or Egg Nog? Absolutely hot chocolate.
2. Does Santa wrap presents or just sit them under the tree? Neither - The elves wrap the presents and Santa's personal assistants put them under the tree.
3. Colored lights on tree/house or white? Colored lights on tree. Too lazy to put lights on house.
4. Do you hang mistletoe? Nope. Bums me out too much.
5. When do you put your decorations up? When I finish my Christmas cards. Usually in mid-December. Just put some decorations up last weekend.
6. What is your favorite holiday dish? All Christmas desserts. My patients usually bring in bunches and bunches of stuff for me and my staff this time of year.
7. Favorite Holiday memory? Midnight mass with my family. One of the few times all year we're able to get together as a family.
8. When and how did you learn the truth about Santa? In high school, Santa at the mall was arrested for DUI. Many kids around here bummed by that....
9. Do you open a gift on Christmas Eve? When I was growing up, ABSOLUTELY NOT! Mom would have none of that. She would allow us to open one present after midnite mass, but the rest was for Christmas morning.
10. How do you decorate your Christmas Tree? When I was a kid, it was a fun family activity that we did in one afternoon - probably just after Thanksgiving. Now, it takes me a couple of weeks to decorate the tree.
11. Snow! Love it or Dread it? I love to watch it snow, but hate to drive in snow.
12. Can you ice skate? Once - never again. Nothing tragic happened, just embarrassing.
13. Do you remember your favorite gift? I admit I was a spoiled brat growing up (some people would say that has never changed). My love for electronic stuff started when I was a kid.
14. What's the most important thing? The reason for the season - The birth of the Savior.
15. What is your favorite Holiday Dessert? Like the rest of the year - anything with chocolate is my favorite.
16. What is your favorite holiday tradition? My parent's years of piano lessons comes out once a year when I dig out the Christmas music and play some carols. Granted, it's still the same grade school music, but it's always fun to get the family gathered together.
17. What tops your tree? Sponge Bob Square Pants. Just kidding, it's an angel that lights up.
18. Which do you prefer giving or Receiving? I have to be honest. The whole gift thing really stresses me out. But, there's always one or two gifts that I find for a friend/family that I really look forward to giving. And, I look forward to that moment.
19. What is your favorite Christmas Song? See my Christmas Song Meme.
20. Candy canes, Yuck or Yum? Gotta love the candy canes!

Grand Rounds

Grand Rounds 3.12 is now up and running over at Anxiety, Addiction and Depression Treatments. GR is up early this week. Thanks to the bloggers over there for including my submission this week. I really appreciate it.
A recent AAP report on advertising and children drew our ire. It also drew the ire of Doctor Anonymous, and he discussed his reactions in a great post that led to some healthy comment discussion.
On a quick glance, I counted 36 links (unless you count My Three Shrinks as three separate posts instead of one). Well done. However, I couldn't leave a kudos comment over there because the verification characters wouldn't come up on my firefox. Oh well, Kudos to AAaDT for their work this week.

Look out! Next week, GR journeys to Nurse Ratched's Place. But meanwhile, enjoy the best the medical blogosphere has to offer - It's Grand Rounds!

Monday, December 11, 2006

Pro-ana and Pro-mia sites

Someone sent me a link to an article from Newsweek entitled "Mixed Messages." It talks about websites taking us into the world of anorexia (called pro-ana sites) and bulimia (called pro-mia sites). Here's a sample of what they say:
Drink ice-cold water ("your body has to burn calories to keep your temperature up") and hot water with bullion cubes ("only 5 calories a cube, and they taste wonderful"). When a food craving strikes, give yourself a manicure ("applying extra layers of slow-drying polish. It will keep your hands occupied").
The article goes on to outline the debate that is occurring on whether these sites are good or bad. Those in favor of the websites state that the internet is a huge support group for these (in general) troubled teens who visit it. Others say that these sites promote and glamorize this type of lifestyle.

It's a pretty balanced article and I encourage you to check it out. The question comes back to this: Can a website CAUSE a change in behavior, especially in younger people? Here is one point of view from the article:
The pro-eating-disorder sites feed into anorexics' competitive nature, says eating-disorder specialist Dr. David S. Rosen, a professor of pediatrics and internal medicine at the University of Michigan. "They're constantly trying to be the sickest, the thinnest, the most unhealthy. If you go to a Web site where people are describing their eating habits, their vomiting practices, if you're in the throes of a serious eating disorder, no matter how that information was intended when it was put out there, it may be a challenge to eat less, to take more diet pills, to weight less. That's where the harm is."
Here is another point of view:
Could the sites somehow lure a completely healthy girl into becoming an anorexic? "You've still got to have some sort of predisposition," says John Levitt, director of the eating-disorders program at Alexian Brothers Behavioral Health Hospital in Hoffman Estates, Ill. "It's a little bit difficult to believe they went there and were pure." Most patients "don't need the advice," he says. By the time he sees them, they already know the tips and tricks. But, he says, "if you have a predisposition for something, you get reinforcement for it."
I have never been of the opinion that media (whether it be violent movies, certain video games, certain types of music, etc.) has a causal relationship with a person's behavior. People should be accountable for their choices and actions. For parents, they should be accountable for supervision of their children and teens.

But, this article does make some compelling arguments to make me think. I haven't changed my position. But, as I alluded to in Direct to Kid Advertising, it seems like it's getting more and more challenging for parents to de-program their kids from the media message saturation.

Sunday, December 10, 2006


I'm not talking about the first nighttime shuttle launch in four years. This was great to see on television. I would love to see this live and in person.

But, I digress. I'm talking about the countdown to my six month blogiversary. I can't believe that it's coming up next week. To be honest, I didn't think I would make it this long.

Thanks so much to all of you for continuing to stop by and occasionally leave comments. Forgive me over the next week as I may look back a little bit, to reminisce, and to reflect. It's that holiday spirit, I guess.

Finally, thanks to those of you who sent notes when I was feeling ill. I really appreciate it. I guess all the handwashing in the world can't totally prevent getting a cold this time of year around here. I'm feeling better - Just in time for me to be on call for the Christmas holiday. Oh well...

Saturday, December 09, 2006

Heart Attack Grill

Now, we here at Doctor Anonymous are not afraid to cover the hardest hitting news stories out there in the internet....

There's a huge controversy occuring in Tempe, Arizona over a restaurant called the Heart Attack Grill. Surprisingly enough, the controversy is not over its menu which includes things like quadruple bypass burger and flatliner fries.

The waitresses call themselves nurses and what they're wearing is nothing that I've ever seen in a hospital. You'll see in this picture from the Heart Attack Grill what I'm talking about.

Nurse advocates are outraged by this establishment. Not only do they dispute the way that the waitresses are dressed, but also that they're not real nurses. You're going to think I'm making up this next quote, but it's right from the Associated Press article.
"Nurses are the most sexually fantasized-about profession," said Sandy Summers, executive director of the Center for Nursing Advocacy, based in Baltimore. "We're asking people, if they're going to have these fantasies, please don't make it so public. Move these sexual fantasies to other professions."
Is this the best soundbite that this person could come up with? Keep your sexual fantasies private and not make them public? Doesn't make sense to me. But, oh well....

The restaurant is soaking up all the publicity. There's a section on their Heart Attack Grill Website devoted exclusively to 'the controversy over nurses.' They even have a theme song.

There are two problems that I have with this. First, I can't believe that I didn't think of this idea first. HA! Second, the only thing I would add is sexy male "chippendale" waiters and call them doctors. I mean, you're ignorning an entire demographic who also go to restaurants!
Courtney Chapman, a 20-year-old waitress at the grill, said she found nothing wrong with the uniform or the stares she gets.

"They definitely look at us, but they're guys," she said. "If our butts are coming out the bottom of our skirts, and our boobs are coming out the top of our shirts, we're kind of asking for it."
That about sums it up for me. So, if I'm out in Tempe any time soon, I'm going to have to check out the Heart Attack Grill. By the way, how's the food there? HA!

Wednesday, December 06, 2006

Direct to kid advertising

How upset do you get when you see drug ads which say, "Ask your doctor about..." This just burns me up sometimes! I see both sides of this in that patients come in and ask me about their medical conditions. But on the other hand, they sometimes demand to be placed on what they saw on television.

In the marketing world, they call this "direct to consumer" advertising. This has definitely transformed the sales of prescription medications. OTC manufactures have also followed suit. (What's that product you apply directly to the forehead? AHHH!)

The American Academy of Pediatrics (AAP) recently published a report stating that children and adolescents are constantly exposed to advertising on television, and even in schools. If adults can be lulled into these ads, think of the effect on children.
"Advertisers have slowly but steadily infiltrated school systems around the country," the [AAP] committee [on communication] writes. "The '3Rs' have now become the '4Rs,' with the fourth R being 'retail.' Ads are now appearing on school buses, in gymnasiums, on book covers, and even in bathroom stalls," notes the AAP.
I defninitely agree with this. In doing more research on this, I found an article from the Palm Beach Post talking about marketing to kids for toys and video games.
Nine times. That's the average number of requests a kid has to make before Mom and Dad cave and buy a toy, according to a national survey commissioned by the Center for a New American Dream, a Maryland-based consumer group.

That's if Mom and Dad are lucky. One of every 10 kids ages 12 to 13 cheerfully reported he asks his folks more than 50 times for something he really, really, really wants.
Then, there's this article from USA Today talking with James McNeal who wrote a book about direct marketing to kids.
Last year, marketers spent $1.4 billion per month marketing to children — 15% more than the year before, McNeal says. "I call it 'surround selling.' "

Mattel Brands President Neil Friedman says Mattel will spend half its ad budget — estimated at $460 million by Advertising Age — in the fourth quarter.
The American society makes such a big deal of people like drug dealers and predator teachers preying on innocent children. In my opinion, there is another group who should be included in this outrage.

Frankly, advertising, as an industry, should be ashamed of itself. To target those in our society who are most vulnerable to slick marketing techniques is deplorable. Parents are put in the precarious position of trying to de-program their kids from the daily onslaught of these brainwashing messages. They're using your kids to help their bottom line. What do you think about that? Happy Holidays....

Tuesday, December 05, 2006


Now, I failed miserably at NaBloPoMo last month. For all of you who succeeded (and didn't win any real prize), there's this reward for you. HA!

So, anyway, I'm a glutton for punishment. I ran into another blogging challenge over there on the Frectis blog. The challenge is easy - Post every day from December 1st through January 1st (sound familiar).

I guess there are two tiers to Holidailies. The top tier registration is closed and they're enforcing daily posts. If not, then you're demoted to the lower tier which they are affectionately calling the "home game" version of Holidailies 2006.

So, the underachiever blogging self signed up for the Holidailies at Home. If you haven't checked it out over there yet, I encourage you to do so. Lots of great writing and reading over there.

Speaking of which, I'm still considering accepting Cathy's challenge of writing a post ending with the line, "I shall not waste my days in trying to prolong them." Hmmmmm. I don't know if I have the creative juices for that. Still thinking...

Grand Rounds

Grand Rounds 3.11 is now up and running at The Antidote: Counterspin for Health Care and Health News. The host is Emily Devoto. No theme this week. Thirty-seven links are divided into nine categories. Here's my contribution:
Dr. Anonymous briefs on this week's new research findings on chemo-brain - now there's evidence of a neurologic basis for the phenomenon; with luck, the findings could spur further research to understand and address the problem.
Thanks Emily for including my submit this week. Next week, Grand Rounds moves to Anxiety, Addiction, and Depression Treatments. Experience the best the medical blogosphere has to offer this week. It's Grand Rounds!

Monday, December 04, 2006

McDonald's Children's Hospital

How was your weekend? Mine was wonderful and relaxing, thanks for asking! A time to just take a break. Until, this morning when I read the news....

Here's a question, how often have you seen McDonalds or other fast food restaurants somewhere in the hospital? How about if you have ever been at a children's hospital?

In a study recently released, researchers in Pittsburgh are very upset about this. The article is in today's Washington Post and is entitled, "Fast Food at Kids' Hospitals Causing Worry."
The researchers queried 200 pediatric residency programs in 2002-03. About 30 percent, or 59, had fast-food restaurants in their hospitals. McDonald's alone or in combination with other fast-food restaurants were located in 22.
The article goes on to say that this sends a mixed message to parents, especially with the growing problem of childhood obesity in the United States (no pun intended).

Now, I totally agree that childhood obesity is a problem. But, do hospitals serve McDonalds in patient rooms? I don't think so. Who buys the fast food for their children? Oh yeah, that's right! The families of children buy the fast food.

Now, I know what you're going to say. "Dr. A, if fast food wasn't IN the hospital, then it wouldn't be a problem." Are fast food places the ONLY places to get food in the hospital? How about parents taking their kids to the hospital cafeteria? I'm sure a children's hospital would choose healthier food for their own cafeteria, right?

Here's are some facts that are left out of the above article. I did a quick search of the website for Ronald McDonald House Charities. Did you know that as of 2004, more than $400 million in grants worldwide have been distributed to benefit children. How many times have you heard about the Ronald McDonald House helping someone you know?

Also, I did a quick scan of the sponsor lists for charities like St. Jude's Children's Research Hospital, the Children's Miracle Network, and the Muscular Dystrophy Association. Did you know that they have sponsors like Anheuser-Busch, Wal-Mart, Dairy Queen, and Coca-Cola? Oh no! This is definitely sending the wrong message to children! C'mon, gimme a break.

In my opinion, this Pittsburgh study is another attempt to attack fast food establishments and give parents a free pass on the care of their own children. So, according to this article, the solution is simple - If you want to solve the problem of childhood obesity, go to the hospital cafeteria!

Friday, December 01, 2006

Condom Olympics

After my last two posts, here is something a little lighter today. Question: How are you observing World AIDS Day? Here are two examples...

A Canadian community is holding the condom olympics which organizers call a "light-hearted face on a very serious issue." Events will include blowing up condoms, condom relay races, shooting condoms, and condom volleyball using flyswatters to keep blown up condoms in the air. Laurel Petty, the city's AIDS Community Action Project coordinator says said this, "It will be a fine evening brainstorming with the kids."

If you haven't had your fill of condoms (*cough*), then get on a plane to Thailand. Because there, you will be trying to make history with a Guinness World Records attempt at the "longest condom chain". I'm not making this up. Here's the quote:
Participants at the "Condom Chain of Life" festival will link 25,000 condoms and will be led by UN Aids special representative Mechai Viravaidya, a national Aids activist formerly known as "Mr Condom", who was named a 2006 Time magazine hero for his groundbreaking HIV prevention efforts. The attempt will take place at 7:30pm inside the King Rama VI entrance to Lumphini Park.
I just want to go on record right now, and place my rubber stamp of approval (*cough again*), to these two projects. Now, before you throw stuff at me, don't get me wrong. I realize that AIDS worldwide is a considerable concern.

But, the condom olympics and the condom chain of life? Pleeze! Will hyped events like these have an overall positive effect over time to advance the cause of worldwide AIDS education? I guess time will tell.

Update: Just when you thought you had enough condom talk, I saw this item at MedGagdet this morning. The title of the article is Spray On Condom = Instant Lovin'. No joke! Check it out.

Thursday, November 30, 2006

Chemo Brain

All cancer patients treated with chemotherapy swear that the very treatment which helps their cancer ultimately affects brain cells. Friends and family of chemotherapy patients describe neurological side effects like memory loss, dementia, and even seizure.

In an article from Thursday's BBC News, there is now scientific evidence that this is in fact the case. Patients call this syndrome "Chemo Brain." Researchers at the University of Rochester found, in lab tissue samples, that at high chemotherapy treatment doses, not only are cancer cells killed, but also a significant percentage of the normal brain tissue is destroyed.
Lead researcher Dr Mark Noble said: "This is the first study that puts chemo brain on a sound scientific footing, in terms of neurobiology and cellular biology."

The Rochester team carried out tests with three drugs used to treat a wide range of cancers: carmustine, cisplatin and cytosine arabinoside.

All three drugs were toxic to several types of brain cell whose job is to repair other cells in the brain - even at very low concentrations.
So, if you're a cancer patient who has received chemotherapy, how do you react to this news? Some may find solace in the fact that for the first time, there is solid scientific data confirming their suspicion of chemotherapy side effects on the brain. Prior to this, cancer patients had to wonder why their doctor did not believe them when they talked about neurological side effects.

For others who have not started chemotherapy, it may make them think twice about receiving treatment. To be honest, I hope that doesn't happen. Being given the diagnosis of cancer is devastating in itself. Treatment options include surgery, chemotherapy, and/or radiation - possibly a combination of these. All carry side effects. But, the alternative of no treatment (depending on the severity of the cancer), has it's own ramifications.

Hopefully, this newly discovered data will assist oncologist researchers to develop neuro-protective properties in chemotherapy agents. Cancer research has always been furious and technology is always changing. I have hope that more treatment options will be available for patients with cancer.


I had an interesting conversation with a patient this week. As you may or may not know, I'm the soccer doc for our boys high school soccer team. We got to talking about my experiences with the team when she said, "You know, I don't think I want to have children."

"Really," I said. "Now, doc, don't give me that look that everyone else gives me when I say something like that." We got to talking a little bit more. She's in her mid-30's, married, and she states that she's doing well in her career.

"Don't misunderstand, I like kids," she said. "I could be wrong, but I've never really believed that you could have it all - meaning both family and career - at least for women." She continued, "At least with the people that I know, when you try to go for both, then one suffers, and I never wanted that. I always knew I could be a good mom, but I didn't feel that I had the passion or drive to be a good mom."

Now, I know people out there in blog land are trying to figure out if I'm trying to make some kind of political statement with this post. I'm not. In talking with some of my female staff members at the office after this encounter, I guess this having children thing (or not having children) can be a divisive issue.

I did further research on this and found an article in today's Washington Post called Childless: Some by Chance, Some by Choice. The columnist begins the article by talking about how she had a stillborn baby. Soon after that, she and her husband divorced and the columnist chose to remain childless.

The next part of the article describes her work on a documentary about childless women. The reasons for remaining childless are similar to my patient's reasons.
Just as some women talk of a visceral urge that propels them to have children, others speak of an equally visceral urge that propels them not to. Laurie, a transplanted southerner who teaches history in New York, began to realize at an early age that she didn't want children, as she watched wealthy mothers in Richmond hire other women to care for their children. "These people compelled to have trophy babies in certain socioeconomic echelons don't want to face the realities of raising a child." She is now infuriated by what she calls "that Mother Right" -- the assumption that everyone will make way for a woman with a stroller or a child in tow. She goes on to challenge me: "If we believe that this is the hardest thing that anyone can do, then why should it be assumed we should all be doing it?"

This has been a more painful journey for my friend Lori from Tennessee, who, though quick to find humor in things, was devastated by a miscarriage. Her husband, who had two children from a previous marriage, was reluctant to try again. She's irritated by the signs in parking lots reserving spaces for parents with children: "I park in those spots sometimes just out of sheer defiance -- I'm a peri-menopausal woman under stress -- and I need a sign!" Lori argues that "if you don't have children you've . . . thrown a brick in your path that you're going to spend your entire life trying to crawl over. It would have been a lot easier having had children."
I realize that I'm putting a big target on myself and my blog for bringing an issue like this up. I have found that the "child people" Vs. "childless people" are very passionate about their respective points of view.

Me? I'm not passing judgement on this either way. I will be further exploring both sides of this issue, because I think it will help me better understand a patient's point of view.

Tuesday, November 28, 2006

Christmas Song Meme

Yes, that's right, boys and girls! It's not even December yet and I'm starting this meme. Can you believe it? Well, I figure that I actually still like Christmas songs right now. Ask me two weeks from now, and I'll be totally sick of them.

This meme is pretty simple: List (at least) five of your favorite Christmas tunes and tag (at least) five of your favorite blog friends to keep the meme going. Simple, huh?

My Fave Christmas Songs (in no particular order):
Christmas Time Is Here from A Charlie Brown Christmas
Christmas (Baby Please Come Home) by U2
Santa Claus is Coming To Town by Bruce Springsteen
Run Rudolph Run by Brian Adams
The Chanukah Song by Adam Sandler (I know, not a Christmas song)
Christmas Eve (Sarajevo 12/24) by Trans-Siberian Orchestra
Please Come Home For Christmas by The Eagles
The Christmas Song by Nat King Cole
(I'd better stop here, or I'll be here all day...)

The lucky people I'm tagging:
Mimi from Mimi Writes (The Meme Queen)
Julie from Flip This Body (It is meme Tuesday, isn't it?)
Kim from Emergiblog (Are there any Notre Dame Christmas songs?)
Fat Doctor (Check out her blog Thursday for the Change of Shift blog carnival!)
Morgen from the Blog Eat Blog World (Gimme the BIG MO song list!)
Skittles from Skittles Place (Just a quickie list would be fine. HA!)
Ipanema from Under the Canopy (Great wreath on your site!)
Irene from Pregnant Pauses (She has the best gift on her site for you!)

If anyone feels left out, then consider yourself tagged as well. Give me your top five Christmas songs and tag five other people for me. (Just place a link back to this post so I know who's in!) This will be fun! Go for it! Gimme your favorite five songs!

What to do with a MeMe: Copy the idea of the MeMe into a new post on your blog. Fill in the answers. Tag people! (Thanks Skittles. I forgot to add this sentence in case people didn't know what a meme was or what tagging people meant)

Grand Rounds

Grand Rounds 3.10 is up and running at Notes from Dr. RW. It is self-described this week as a "running commentary, stream-of-consciousness style, to provide some structure to this incredibly diverse collection of links and perhaps liven things up a bit. I’ll sneak a few opinions in here and there, but you’ll know them when you see them." Thanks to Dr. RW for including my submit this week:
Ectopia what??? Ectopia cordis---a rare developmental anomaly in which the heart is situated outside the chest. Dr. Anonymous writes about a recent case.
For those of you sitemeter watchers out there (I am definitely one of them), it'll be interesting to check out the Dr. RW sitemeter as it goes through the day today.

Next week, Grand Rounds moves to The Antidote: Counterspin for Health Care and Health News. That's funny. Does that mean that Grand Rounds is a poison? Tune in next week to find out. Enjoy Grand Rounds!

Monday, November 27, 2006

Hosting Grand Rounds 3.09 (pt2)

(Look below for part one of this post)

This post will be a little more free-flowing. I thought I would have some steps that you could follow, but it was hard for me to boil down my experience into some simple steps. I encouage you to check out Emergiblog and Tundra Medicine for some other feedback on GR hosting.

I was on call the weekend before my GR posting. So, my schedule was just crazy. As I've said before, my job gets in the way of my blogging. I tried to keep ahead of things by reading submissions as they came in. Sunday was kind of nuts because it was a busy day on call. And, Sunday night after the deadline, there were some people still submitting. That's when I came out with my submission closed posting on Monday which some people remarked as a little moody.

I spent the entire day Monday trying to stay awake and make my final edits on the GR post. I was switching posts from the bottom section to the middle section, from the middle section to the top section, and all combinations in between.

The GR post went live at 6:30am and I waited. To further punish myself, I put up two poll questions to seek feedback on the GR layout and on the quality of GR. I had no idea what the reaction would be to the "link dump" at the end of my post.

At 6:30am, my site meter read 100 total visitors for the day. For the first few hours, it was reading between 20-30 per hour. Then at 9am, it spiked up to 52 visits in an hour. The next few hours, it was between 40-50 visitors per hour. Then at 2pm, the number read 72 visitors the prior hour. A few more hours went by, and then at 5pm, here's what the sitemeter read:

Yes, that's right 183 people saw the GR post in the last hour. Plus, in seeing more data, there were 85 people on my site at the same time! Thinking about this is just incredible.

Then, I was wondering if I hit 1000 visitors in one day. This occurred just before 8pm. Yay! The final question I had on that Tuesday was how many total visitors? When all was said and done - just over 1,300 visitors!

I had no idea what Wednesday would bring. I thought things would cool off a bit, especially because it was the day before Thanksgiving in the US - usually a huge travel day - and not expecting too much blog traffic. Then, at 10am, I saw this from site meter:

Little did I know that at the end of that day, I would have just below 1,400 visitors - quite a shock to me. Then, reality set in and on Thanksgiving day (Thursday), I only had 600 visitors.

Looking back, this was a memorable experience for me. People have asked me how much time out of my day did it take to put everything together. Hmmmmm. That's a tough one. People have estimated about 20 hours total during GR week, I guess that sounds right. Knowing me, I probably spent more time than that. I hope I get the opportunity to host again - although maybe not very soon. HA!

Finally, here are the poll results:
What did you think of Grand Rounds 3.09?
  • One of the best: 38%
  • Great: 51%
  • Ok: 8%
  • Below Average: 0%
  • Awful: 3%
Did you like the format/layout of Grand Rounds 3.09?
  • Yes: 94%
  • No: 6%

Hosting Grand Rounds 3.09 (pt1)

So, you're thinking about hosting Grand Rounds? I have to be honest by saying that I was totally intimidated by the entire notion. But, when the opportunity presented itself, I took it and then tried to figure out how to make it happen. If I did it, and so can you! Just follow these steps....

Step One: Prepare, prepare, prepare!
The first thing I did was go right to the source which is the Blogborygmi site. I did that because I wanted to see the origin of this idea and the original target audience. GR is not targeted toward the medical blog commmunity. It is targeted toward the general public. I think this is the right idea, because this is the only way that the medical blogosphere will grow. Read about my research in this GR background post.

Everyone has told me that the more work you do up front, the less crazy GR week will be for you. I cannot agree more. However, I did not have that much time to prepare, so my timeline was very much truncated.

About the Grand Rounds interview - Take my advice. Do NOT take this lightly. As of this writing, I've had about 2,500 referrals from the medscape interview site. Plus, I'm still getting referrals six days after the original posting.

The more memorable you make your interview, the more people that will check out your site. How do you make your interview interesting? Well, you have to think a little bit like a PR marketer. What do I mean by that? Well, if you can think of a witty soundbite or "one-liner" that people will remember, then that will make your interview more interesting. The only other thing I would say is just be honest and talk from the heart - people like that.

I did not have a theme, mainly because I'm not that creative with that type of thing. Plus, I put a poll on my site and the majority of people didn't want me to have a theme.

If you do opt for a theme, make sure you have a vision for this before you're awarded Grand Rounds. With all the craziness of GR week, I don't think there'll be a way for you to figure out a theme and read all the posts that week. The only other thing I would say is that it's possible to be TOO cute with the theme and not be able to convey to the reader what the link is about. Be careful of that.

Step Two: Promote, promote, promote!
Your first item of promotion will be asking people for submissions. Usually, the GR host before you will announce your site and get the ball rolling. Now, the ball is in your court. Figure out when your deadline is, because this will be the first question that you'll get as host. For me, I was really paranoid that I would not be done on time, so I made the deadline on Sunday night. Usually, the deadline is sometime on Monday.

Usually, the top section of the GR post is called "Editor's Picks." The next question people want to know after the deadline is how to get into that top section. For me, I know I wanted to highlight well written stories. Also, I knew that I wanted to keep some kind of order to the submissions as they came in. So, in my submissions guidlines, I put the deadline date/time, my vision for the editor's picks and directions on how I wanted the submissions (blogger name, blog name, blog URL, post name, post URL, one line description of post). I also preferred that submissions be sent to my e-mail, so I included that also.

As the posts came in, I put them in one of three sections: top 1/3, bottom 1/3, and the rest. You'll have your own instincts on what's good. Trust those instincts. There will be at least a couple of posts which won't feel right. Again, trust those instincts. The people that know you will send you their submissions first. But, like everyone says, the bulk of the posts come in on the weekend.

I kind of overdid the GR promotions on my blog during my week, but I was really trying to hype things up. In addition to posting your GR submission post a week prior, I would suggest at least one more GR post during that week to help your own promotion. Also, look to your own friends for postings, even if they have never posted to GR before. This can potentially grow the GR audience.

Step Three: Follow up, follow up, follow up!
With each submission, I would send an e-mail thank you back to the blogger. I knew I would be moving posts around on the priority list right up until the last minute. So, I would send a generic thank you to the person, not "promising" where I would put the post, only that I would "consider" their post - which was true.

Also, with each submission that would come in, if I had time, I would take a quick read of other posts on that person's blog. There was a couple of occasions where I thought another post would fit better with my vision of GR. Topher asked people for revisions, and I didn't feel comfortable with that (just my personal decision).

Be firm with your submission deadline. People will try to push you and give you every excuse in the book to try to get into GR. And, some people just ignore your deadline and then will expect to be included in GR. It's your choice how to deal with this. But, always remember, don't try to make everyone happy, because it's not going to happen.

Everyone has said this, but I think it's important. Double and triple check every link before you go live. Don't be too bent out of shape if one or two slip by. And, don't be too bent out of shape if one or two authors e-mail you to clarify their URL - this happens every week.

After you publish your GR post, there will be many people who will announce GR on their site. Make sure you place a comment of "Thank You." This will definitely go a long way. I added a bunch of links the past week also, because I had no idea how wide the reach was.

Oh no! This is running a lot longer than I thought. Re-reading it, it may not be as helpful as I intended it to be. I'm happy to answer any questions. I'll have to work on a part two post....

Sunday, November 26, 2006


In case you didn't have the opportunity to check out my interview from last week, here it is. Also, just to let you know, Patient Anonymous did turn on her RSS feed, so feel free to put her in your bloglines, google reader, or whatever...

The "Anonymous Doctor" Finds a Voice on the Web
Posted 11/21/2006 -- Nicholas Genes, MD, PhD

After discovering political Web-logs a few years ago and medical blogs this year, a young primary care doctor was tempted to start his own site: Doctor Anonymous. Despite his unfamiliarity with the medium, Dr. A's humor, attentiveness, and genuine rapport with his readers quickly earned him a large, faithful audience. I'd guess those same traits would make him a good physician, but I suppose we'll never know for sure...

Corresponding with Dr. A this week, I had the chance to learn a little bit more about the man and what he thinks about his online endeavors.

Dr. Genes: Many blogs come and go, but few start off with -- and maintain -- the exuberant enthusiasm of yours. Is this your first foray onto the Web and having an online presence? Are you like your posts would suggest, or are you more reserved and bookish in person?

Dr. A: Probably like most other people, at first I was intimidated by starting my own blog. There are so many great blogs out there that I really didn't know what else I could contribute or what I could do to set myself apart. It was a good 5 or 6 months of me going back and forth on whether to become a blog writer and not just a blog reader. My first blog was in May (not many people out there know that), but it did not work out at all. I was using my real name at the time. I live in a small Midwestern town in the United States, and I didn't realize that people on the Internet can learn all kinds of information about you. I then became very paranoid about what I was writing, and the blog was just boring. So I scrapped that idea and didn't know if blogging was still for me.

The Doctor Anonymous blog launched on June 19, 2006, with a mere 5-line post. Being anonymous really has let me be free to not worry as much about what I'm going to type. Being a doc in a small town is tricky; I'm constantly worried that anything I say or do may end up in our local newspaper, so I'm constantly filtering what I'm going to say. With blogging, I feel a sense of freedom of expression that I haven't felt in a long time.

People ask me what I'm like in person. I guess that's hard for me to describe. I certainly didn't make up this phrase, but I would describe myself as an "extroverted introvert." For the most part, I'm a pretty laid-back guy, but sometimes when I get around people, I'm a lot more outgoing. I guess that's what happened when I started my blog.

I absolutely had zero experience at producing any kind of Internet content. I have a lot of experience at being an Internet consumer, but not a producer. So those first 2 weeks of blogging, I had no idea what I was doing. The one thing that really fascinated me was the interaction with people in the blogosphere. I talked about my first contact with other bloggers.

Dr. Genes: What are some of your favorite posts? Something that really resonated with readers, or captured something you worked hard to express?

Dr. A: One post that sticks out in my mind is called "Why". I wrote it during a bad night on call. It was definitely a change in the upbeat style I was doing for the previous 4 weeks. I hesitated on posting it, because I didn't quite know what kind of response I would get. But I did anyway, because I wanted my blog to be a reflection of me, and sometimes you have bad days. I was quite surprised by the response I got. For the next couple of days, my frequent readers did a type of reflective post of their own. And I really learned that people outside the United States were reading my blog. To think that my little blog is reaching people around the world blew my mind.

Dr. Genes: Some of your posts point to a soul-searching about what your blog should do for you, where it should go. Has writing frequently become too much of a chore? Will you be going more or less medical? What have you gotten from this community of readers and fellow bloggers?

Dr. A: I try to have a mix of medical and nonmedical topics. In my first posts, I had a lot of blogging questions. So I just put questions out there like, What does it mean to be tagged? Or, Do I have to respond to all the comments in my comment section? Or, What is Grand Rounds? Sometimes, I would ask questions I was just curious about, like, Do you prefer your doctor to wear a lab coat or not? I have very much appreciated the interaction that I've gotten from my readers.

There were times when I talked about blogging feeling like a chore. I have told myself that when I feel like blogging is like work, then that's the time for me to take a blog break, or even consider giving it up altogether. People have even told me that they sense that my energy level is not like it was that first month. But I guess that's normal, right? Whenever you first start a project you really like, there is a natural excitement. But as time goes on, that honeymoon period dissipates, and you ask yourself whether you want to keep blogging.

Even though it's only been 5 months since I've been doing this, I feel a significant change in my blog coming in the near future. My early posts talked a lot about patient encounters, and now I feel like I've shifted a little bit more toward news commentary. What the next change will be, I don't know.

I feel very lucky to have achieved what I have up to this point. And that's the advice I have for anyone considering blogging. Here's what I wrote on June 21, Day 3 of blogging, and I think it still holds true: "Blogging is like being at the podium, and to get people to listen to you, your thoughts have to be pretty well developed, or people will walk away. The good blogs that I've run into make me think a little bit and make me post a comment. The interaction with people (conversation like interactions) takes place in the comment area. The blog is kind of like the lecture and the comments are like the Q&A."

Dr. Genes: The shadowy but genial figure of Dr. Anonymous steps into the spotlight this week to host Grand Rounds, the collection of the best in online medical writing. Check out Dr. A's edition of Grand Rounds on November 21, 2006.

Medscape Med Students. 2006;8(2) ©2006 Medscape

Friday, November 24, 2006

Patient Anonymous

Yup, you read that right. This past Wednesday, I posted something called Opportunity in which I talk about being approached by an insurance company for statements I made in my blog. (BTW, I still haven't decided what I'm doing yet.)

I read this comment by someone calling herself Patient Anonymous...
I just found your blog courtesy of your Medscape interview. I should probably read more of it before just jumping right in and posting but I'm all about immediate gratification and lack of impulse control at the moment.

I would not respond to this. I used to co-moderate a support board/group of fora for mental illnesses, meds etc... and I won't go into the details but we received trolls like this.

Also, it just sort of screamed, "Let us pimp you out!"...and such a cheery (form) letter from an insurance company? Yeah.

If you wish to get published, go for something a little more reputable.

Oh, and I just picked this name in quick, rather unoriginal random fashion so if someone else already has it, apologies--I'll change it.

Thanks and I look forward to reading more here.
There are two thoughts that pop into my head. First, I absolutely do not want to make this person mad. LOL! And, second, this person, whomever she is, really needs to start a blog. So, I responded in my comment section (with the second part only - HA!).

Now, I never believed that this person would take me up on this. So, the very next day, here is the beginning of the first post for the Patient Anonymous blog...
Well, I blame Dr. A for all of this. I posted on his blog and he said I should start one of my own because he thought I'd make a good blogger. Huh. Well, I'm sure this will prove him wrong!...

...Well, if nothing more it will prove to be an interesting "experiment" and I love experiments! It will either be the most pathetic blog in the history of the internet or I may actually get someone (besides Dr. A) to read it.
So, if you could do me a favor, and show some love to the newest person in blogland. Please stop by and say hello. And, don't forget to tell her that Dr. A sent ya! HA!

Ectopia Cordis

This is the name of the congenital birth defect which caused Naseem Hasni's heart to be outside his chest. He was born on October 31, 2006 and has been at a Miami children's hospital ever since. (Miami Herald)

On Wednesday, the first of many corrective surgeries took place to try to correct the defect. Now, a thin film along with a thin membrane of his own skin cover his beating heart. Soon, he will be fitted with a plastic chest to protect the heart. It's optimistic, but Naseem may return home by the end of December in time for the holidays.

This defect is so rare that it occurs in only eight in one million babies. Most are stillborn or do not survive the corrective surgery. One can beat the odds, however. I found the story below about Christopher Wall who was born in 1975. Chris set the record for living the longest with the heart outside the chest. This is from a TV broadcast in 1998 and the piece is about 8 minutes long. Very inspiring story.

Thursday, November 23, 2006

Happy Thanksgiving

Rocky and Bullwinkle love Thanksgiving, do you? It's the day to spend with family, eat too much, watch the parade, and watch football. How do you spend the day? All the best to you and your family.

Wednesday, November 22, 2006


I know I said I was taking a break, but I wanted to tell all of you about something that just happened. As I have been enjoying the accolades of a successful, Grand Rounds, I received the following e-mail below about an hour ago...

I am contacting you as the editor of [insurance company program] Newsletter. We are an international provider of medical and managed care insurance. Our clients consist of health plans, managed care organizations and health insurance companies within the US and Canada. [Our company] is the nations foremost insurance based managed care consulting programs. We have been in operation since the 1980's.

[Our program] is designed to partner with our customers to control risk, reduce cost and more importantly support quality healthcare outcomes. Although, we offer a variety of services, one important component of our program is to provide research and educational opportunities. [Our newsletter] is one avenue in which we provide clients of [our company] with information on a wide variety of topics related to catastrophic medical case management. Case histories, facility highlights and similar articles are intended to serve general information not endorsements of facilities, programs or products of any kind.

In addition to submissions from each of our [company] physician consultants, I plan to include specialty clinical related articles from outside sources i.e. [our company's] consultant's or vendors that we may have a relationship with. It is my goal to rotate topics to meet the needs of our broad audience.

I am contacting you to request permission to include something from your blog entries. Something for variety for our clients. Although, I am not familiar with "blogging" after review of your blog entries, I am intrigued.

If this is something of interest to you, please let me know. In addition, if you have any specific topics or ideas for an article, I welcome your suggestions.

Thank you for your consideration. I look forward to hearing back from you and have a Terrific Thanksgiving!

XYZ company
Now, I probably blew my whole deal with broadcasting this on my blog. But, I was curious to see what all of you thought. How does this letter read to you? Is this a potential venture that you personally would consider?

Personally, for me, I'm leaning no, at this point. Probably, they would want me to reveal all kinds of personal information (like my name, etc). How credible would their newsletter be if there was a quote from a "Doctor Anonymous" - probably not much. I'm not ready to come "from behind the curtain" yet (Wizard of Oz reference).

People have e-mailed me that they are curious about the relationship that I have with my readers. This is probably one of the reasons why. I'm curious what you think, no matter what it is....