Thursday, June 28, 2007

Blogaholic Podcast

So, I'm trying this podcast thing again for the sixth time. Here are the show notes...

Opening Music by Kathy Reynolds (The song InSideOuT from the album Songs of Life)

In The News: Researchers to Docs: Shut Up!

Around The Blogosphere:
My Three Shrinks - Hopefully I'll be able to be a guest on your show soon...
Internet Radio: Here's an article about The Day of Silence
BlogTalkRadio: Want to host a radio show? Check out this site...
Dr. Blogstein - Hilarious stuff!
The Mo Show - Great first show. Can't wait for the next one...

Patient Story: A recent visit to our local extended care facility (nursing home)

Closing Music by Lori Malvey (The song When I Talk 2U from the album Love)

Just FYI, the file is 30MB (Yeesh!) and it's in the MP3 format. Enjoy Podcast #6.

Update: You can now either download in mpeg-4 format (11mb) or mp3 format (31.5mb)

Tuesday, June 26, 2007

Researchers to Docs: Shut Up!

In the past, physicians have been criticized for not spending enough time with their patients. In fact, many alternative and complementary medicine websites have used this research to promote themselves.

Alternative medicine has quietly jumped into the mainstream. By 1993, one in three people have used at least one alternative therapy and $14 billion was spent on those therapies according to the New England Journal of Medicine. Half of all U.S. medical schools teach about mind-body connections; alternative medicine is now offered at Georgetown and Columbia University.

Why the surge in interest? Many Americans find alternative approaches to be less expensive, with fewer side effects. Some feel that modern medicine is blind to the connection between mind and body. For others, the human touch is the real appeal. According to one source, the average doctor interrupts his patient 12 to 14 seconds after the patient starts talking. It is hard to feel cared about in that kind of environment. The alternative practitioners tend to spend time with their clients and actually listen to them.
Well, now there is research published in the Archives of Internal Medicine stating that physicians are "wasting" time of patients by talking about themselves during office visits (WebMD).
Researchers sent a group of actors posing as new patients to primary care doctors and found a third of doctors made unprompted comments about their own health, personal life, or political views. The vast majority of those comments (85 percent) weren't viewed as useful or relevant to the patient.

While a good bedside manner is important, researchers say that in an era of ever-shortening office visits doctors should keep the conversation focused on the patient.

"We found that physician self-disclosures were often non sequiturs, unattached to any discussion in the visit, and focused more on the physician's than the patients' needs," write researcher Susan H. McDaniel, PhD, of the University of Rochester School of Medicine and Dentistry, and colleagues in the Archives of Internal Medicine.

"Longer disclosures, both not useful and disruptive, interrupted the flow of information exchange and expended valuable patient time in the typically time-pressured primary care visit," they write.
This study is actually kind of funny to me. I like to establish a rapport with my patients, and that sometimes means talking about me. The "time-pressured primary care visit" phrase particularly strikes me as funny.

I believe at the core of Family Medicine is relationships - relationships with my patient and relationships with my patient's family. I admit that sometimes the banter I have with patients may not directly relate to their medical visit, but I still think it's good medicine - despite what these researchers say.

Prisoners get porn

With what little credibility this blog has left, I'll definitely lose it with this next story. You'd think that a convicted rapist, prison, and porn wouldn't go together. But, in Sweden, they do. (Associated Press)
The Supreme Administrative Court in Stockholm last week ruled that the Swedish Prison and Probation Service had no right to deny a rape convict access to his porn magazines.
Do you think I could make something like this up? Possibly, but, unfortunately, this is true. The article continues...
[But] The court, whose ruling cannot be appealed, said the prison service failed to prove that the magazines could "jeopardize the security of the institution."
Wow! Can you believe this? The article closes by saying that media like adult movies, television, and websites are not permitted. Child and violent porn are also banned. Well, at least they have some decency here. *cough*

In a related story, Paris Hilton was released from jail today.... HA! (image)

Jessie Davis case: Analysis of accused

You knew it was a matter of time before the press started covering things from Bobby Cutts' point of view. (image credit) There is an article this morning from the Associated Press and in the title is a "complex personal life." These include statements from his family:
Cutts' stepmother, Barbara Cutts, on Monday called her stepson a generous man who was good with kids and coached youth soccer, basketball and football. She said she and Cutts' father last saw him Saturday at his house in Plain Township outside North Canton, where he appeared drained and exhausted.

"It's very hard to accept," said Barbara Cutts, 46, a nurse's aide. "A lot of people are looking at him like a bad person, but he's not, he really isn't."
The next part of the article outlines the other relationships and custody cases that this guy is going through. But, the story eventually revolves back to Blake, the 2 year old child of Jessie and Cutts.
It was Blake who provided investigators searching for Davis their first clues earlier this month, saying: "Mommy was crying. Mommy broke the table. Mommy's in rug." Porter found the boy home alone on June 15, with Davis missing, furniture toppled in the bedroom and a pool of bleach on the floor.

Family members have told Blake that his mother is in heaven, [Patricia] Porter [Jessie's mother] said. "He has an old cell phone and he calls her and talks to her," she said. Porter said Monday she's not sure who Cutts is anymore.
Probably the best line of the whole thing comes near the end of the article:
Cutts played football, wearing No. 9, at GlenOak High School, a suburban school whose most famous graduate is goth rocker Marilyn Manson.
You know, I'm from around here, and I've been to GlenOak HS, but I never knew Marilyn Manson went there. How about these other people? What kind of connection do you think the press is trying to make here? You be the judge....

Grand Rounds

Grand Rounds 3.40 is now up and running over at the Wandering Visitor blog. There was a theme this week, and it is called, "Things That Inspire Us." It's also a creative layout in the form of a research article with sections like, "Methods," "Results," "Discussion," etc. Thanks to WV for including my post in GR this week...
Laurie from A Chronic Dose writes about her ultimate inspiration – Dad. Some of his words of wisdom: “You can’t always get the answers you need to pursue the dreams you have. Sometimes you just have to make a decision that might not make complete sense now and grow into it. It’s a risk, yes, but there are very few certainties in this world.” Dr. Anonymous also shares some memories of his father.
If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, GR moves to Over My Med Body. Enjoy!

Monday, June 25, 2007

Jessie Davis case: 2nd arrest made

Myisha Ferrell was arrested Sunday and will be arraigned today, in addition to Bobby Cutts, in connection with the Jessie Davis case. (Associated Press, Akron Beacon Journal) I kept watching the local and national news yesterday learning more and more details.

Something that gets me really frustrated are those who are blaming the victim. "Why would you stay with someone with a past history like his?" "Didn't she learn after the first child, or didn't she learn after she found out that this guy fathered other children with other women?"

Why don't I just step out of the way so those people can just stomp on this woman's coffin and grave? Like I said yesterday, we don't know what happened between those two people - despite what anyone (even family) are saying.

You can blame this guy and his accomplice all you want (and I know everyone is presumed innocent until proven guilty), but pointing the finger at Jessie before we can learn more about this case - that's just wrong. Everyone around here will be watching the news very closely today as these two go to court.

Sunday, June 24, 2007

Jessie Davis found

This is definitely not how people wanted this to end up. Jessie Marie Davis, the 9 month pregnant mother from Ohio who has been missing for two weeks, was found in a Cleveland area park along with her unborn daughter. An arrest was also made of Bobby Cutts, her son's father. (Akron Beacon Journal)
Davis, 26, is believed to have been killed sometime between speaking to her mother by phone at 9:20 p.m June 13 and 5 a.m. the next day.

Cutts and Davis had a five-year relationship that included his fathering Blake and Davis' unborn daughter. Davis, her mother said, believed Cutts to be single for several years when, in fact, Cutts was married for about a year when he met Davis in 2002 and had two other children.
What a tragic situation. I have been watching this story closely, because this story is unfolding close to there I live and work. Unfortunately, as in the Laci Peterson case, I don't think we'll ever know the entire and complete truth. My thoughts and prayers go out to the family in a tragedy like this.

Saturday, June 23, 2007

Caller ID spoofing

I ran across a story from the great state of Delaware this morning where there is a guy who is saying that he is from the federal district court and harrassing people. Why did people think it was legitimate? Well, because the caller ID made it look like it came from a government telephone. I really didn't know people could do that.

As I was doing more research on this, I had no idea that what is being termed, "Caller ID Spoofing," is becoming a real problem around the country. I found an article from in which a congressman was being accused of harrassing his own constituents over the phone because they saw the number from his office.
In the last few years, Caller ID spoofing has become much easier. Millions of people have Internet telephone equipment that can be set to make any number appear on a Caller ID system. And several websites have sprung up to provide Caller ID spoofing services, eliminating the need for any special hardware.

For instance, sells a virtual "calling card" for $10 that provides 60 minutes of talk time. The user dials a toll-free number, then keys in the destination number and the Caller ID number to display. The service also provides optional voice scrambling, to make the caller sound like someone of the opposite sex.
Yeesh! That's scary. So, now I can't even trust what the caller ID says? Wasn't that the entire point of this service? I guess when new technology comes along, there is always those out there who will try to exploit it. For a pretty good news report from Chicago describing the problem, see the video above, or click here.

Friday, June 22, 2007

Buyer beware of sunscreen

Got sunscreen? Good, then give some to this guy because he needs it. HA! (image credit)

If you're going to the beach this weekend, or if you're just going to be out and about in the sun, you'd better take a second look at your sunscreen. According to a recent report by the Environmental Working Group (EWG), only 16 percent of products are "safe and effective." For a list of the best and the worst, check out this article at FoxNews.Com.
Dr. Linda Franks, director of Gramercy Park Dermatology and clinical assistant professor at New York University School of Medicine, recommends everyone wear a moisturizer with SPF for daily protection, but people should not depend on that protection for extended periods of time in the sun. "Either you need to reapply it or use something stronger in the morning," she said.

Neutrogena and Coppertone, both of which had products that landed in the 'avoid' category, stood by the lab results of all their products. Neutrogena would not comment specifically on the report but stated, "all Neutrogena products undergo extensive testing to ensure safety and efficacy."

The report faulted many sunscreens for having active ingredients that actually breakdown in sunlight and do not actually protect against ultraviolet-A. Coppertone issued this statement defending their broad spectrum products: "Coppertone has formulated 100 percent of their products to be photostable to resist breaking down under exposure to the sun."
Now, an article like this could not be complete without the EWG taking a shot at the Food and Drug Administration. The article states that the FDA has been debating sunscreen safety standards for 29 years, but has yet to finalize mandatory standards. What I don't get is this: Sunscreen is neither a food nor a drug, so why is the FDA the regulatory agency managing this?

Finally, the American Cancer Society estimates that in 2007 there will be about 60,000 new cases of skin cancer and about 8000 deaths. So, be careful out there this summer and wear the right sunscreen.

Military to fix mental health system

You know, to be honest, no one in this country does mental health care very well, whether you're in the public or the private sector. The Virginia Tech tragedy brought to light the lack of communication between mental health databases and criminal justice databases. The press in regards to Walter Reed reported the lack of support for outpatient follow-up of soldiers.

The Washington Post is reporting that on Thursday Defense Secretary Robert Gates (to the left in picture above) is promising to speed up needed changes in the military's mental health system.

A recent Congressional study states that more resources (meaning money and people) are needed for proper care. This is no surprise. The need for more resources is frequently brought up in the private sector as well.
The Pentagon has been working for some time to end the stigma of counseling. Studies indicate that soldiers most in need of post-combat health care are the least likely to get it because they fear that others will have less confidence in them, that it will threaten career advancement and that it could result in the loss of their security clearance and possibly removal from their unit.

The yearlong study released last week was required by Congress, which wants a corrective action plan within six months. "I have no intention of waiting that long," said Gates, adding that he'd directed a plan be finished in 60 to 90 days.
Who knows if this is political posturing and who knows if anything will be really done. This post is not meant to be a political hit piece, but what I do know is that these soldiers, these heros, need mental health support and I hope they are able to get it through the VA health system.

Thursday, June 21, 2007

VIdeo Game Addiction

Now, when I was growing up, we didn't have no playstation 3, xbox 360, or a Wii. The craze was above, the classic Atari 2600 (image credit). I played that thing for hours and hours. We didn't have fifteen different buttons like the consoles today. Nope, we had the "Red Button" and a joystick (insert joke here).

I remember my first (and only) Space Invaders tournament. I got killed on the first screen. I was crushed because I practiced hours and hours before that. I guess I just froze up. I remember counting down the days until Pac-Mac was released. Ah, those memories....

Little did I know at the time, that I had a problem. I had an addiction. I had an addiciton to video games. Yes, that's right. That was the reason I didn't go out and play outside as I was growing up. That was the reason I felt an attraction to computers and technology - because I couldn't get enough of it. That's why I'm not addicted to blogging.... Uh, sure.

The American Medical Association, my professional organization, is now going to bail me out. The organization I pay hunderds of dollars each year to be a member, is now going to vote to classify Video Game Addiction as a medical diagnosis (Associated Press).
A leading council of the nation's largest doctors' group wants to have this behavior officially classified as a psychiatric disorder, to raise awareness and enable sufferers to get insurance coverage for treatment.

In a report prepared for the American Medical Association's annual policy meeting starting Saturday in Chicago, the council asks the group to lobby for the disorder to be included in a widely used mental illness manual created and published by the American Psychiatric Association. AMA delegates could vote on the proposal as early as Monday.

It likely won't happen without heated debate. Video game makers scoff at the notion that their products can cause a psychiatric disorder. Even some mental health experts say labeling the habit a formal addiction is going too far.
I definitely have an opinion on this. Now, I'm not going to deny that probably a small percentage of children, adolescents, and adults will probably qualify for this medical/psychiatric diagnosis. We've all heard stories of addictions taken too far and destroying lives.

The problem that I have is that there will be many people out there who will try to take advantage of this and blame whatever is going on in their life to video games. A move like this by the AMA is going to continue to advance the idea of a lack of personal accountability and personal responsibility that is occurring in this culture.

We're all familiar with drug addiction. But, in recent years, there has been talk about internet addiction, sex addiction, and now video game addiction. When and where is this going to stop?

There are millions of Americans in this country right now who do not have basic health insurance. This move by the AMA will make is possible for insurance companies to cover treatment for Video Game Addiction. Is this the right thing to do?

Hey AMA, what about all the uninsured in America? Did you forget about them? What are you going to do about that? Maybe the Video Game Addiction lobby is making more contributions to your coffers than the uninsured are. This entire situation does not sit well with me. We'll have to see what the AMA does next week.

Doogie Surgeon, MD

Is this life imitating art, or art imitating life? You be the judge. The tv show Doogie Howser, MD (video above) was about a whiz-kid who becomes a doctor at age fourteen. And, yes, I do admit to watching the show when it was around. Little did we know that something like this would happen in real life.

The Associated Press this morning is reporting that Dhileepan Raj, a 15-year-old kid in India, performed a caesarean section "under his parents watch." Can you believe that?

How did people find out about this? Well, first of all, the entire thing was filmed. And, second, the kid's father showed the video at their local medical association meeting. How's that for being a proud father.

Of course, there is shock and outrage over this incident. I hope this guy's medical license is taken from him. Plus, there is talk over criminal charges being brought forth. Does this guy regret what he did? Absolutely not!
[Dr. K] Murugesan, who could possibly be prevented from practicing and face criminal charges for allowing his son to perform the operation, expressed no regret and accused the Manaparai medical association of being "jealous" of his son's achievements, [Dr. Venkatesh] Prasad [secretary of the medical association] added.

"He said this was not the first surgery performed by his son and that he had been training him for the last three years," said Prasad.

Murugesan told the medical association that he wanted to see his son's name in the Guinness Book of World Records [as the youngest surgeon].
Wait a sec. All this over getting into the Guinness Book of World Records? To jeopardize your medical license and international embarrassment, just to get some kind of world record? Sheesh! We'll have to see how this all plays out...

Wednesday, June 20, 2007

Adolescents doping up

Some of you out there may remember the commercial above by basketball player Charles Barkley where he said, "I am not a role model." This stirred up a lot of press at the time and a debate on whether professional athletes have a responsibility and accountability for their actions - especially with children as fans.

Now, what people don't remember is that Barkley later in the commercial says that parents should be the role models and not athletes. He makes a good point here, but as the press does, they take things out of context can causes an uproar.

A study from United Press International Wednesday reported something really disturbing. It stated that 3 percent of 15-year-old kids admitted using performance enhancing drugs. This study involved a secondary school in eastern France.
Health problems, including becoming violent, change of voice and loss of consciousness, were experienced by 4 percent of the users, according to the researchers.
What really bothers me is that this is probably an underestimation of the real number. Self-reporting studies usually gives an inaccurately low result. Much has been written about athletes taking (or allegedly taking) performance enhancing drugs from Barry Bonds to Floyd Landis to Ben Johnson to others.

I don't care what anyone says. Kids do see this stuff. In my opinion, kids are exposed even more now to the "win at all costs" attitude of sport. Being designated a winner means fame and fortune - just ask those kids going from high school straight to the NBA or kids like Michelle Wie who are balancing high school and being on a professional golf tour.

Finally, how about this. What if an accurate study could be done seeing what percentage of adolescents in the United States take performance enhancing drugs? What do you think the numbers would be? I'm kind of frightened to find out.

Mars seeking applications

Want to feel like you're going to Mars? Live in Europe? Well, have I got a deal for you. On Tuesday, the European Space Agency announced that it is seeking applications for you to spend 17 months in an isolation tank, and this will simulate you going to Mars. (Yup, not kidding -- AFP)
Their spaceship will comprise a series of interlocked modules in an research institute in Moscow, and once the doors are closed tight, the volunteers will be cut off from all contact with the outside world except by a delayed radio link.

They will face simulated emergencies, daily work routines and experiments, as well as boredom and, no doubt, personal friction from confinement in just 550 cubic metres (19,250 cubic feet), the equivalent of nine truck containers.
Are you excited yet? Where do you sign up? Well, the application form can be downloaded from their website. When you download the application form, it's really weird. Here is just a sample of their questions:
Mac or PC?

Have you ever seen 2001: A Space Odyssey?

What's your opinion of John Gray? How about Lisa Nowak?

Are you a member of the mile-high club?

What did you think of The Soprano's final episode? Genius or fraud?

Do you think Rosie should be the new host of the Price is Right?
Then, after the initial screening is completed, the website says that there will be a Survivor-type elimination round that will be broadcast on European television where viewers will vote on who is in and who is out....

Ok, enough of that silliness. Is this thing real? It looks kind of like that tv show big brother, but for 17 months. What will probably happen is that this will end up being a hoax like that kidney donation tv show was. But, we'll see.

Post-Katrina deaths

The accusations of bad medical behavior following Hurricane Katrina are continuing to be played out. About a year ago, Dr. Anna Pou and two nurses were arrested be the Louisiana Attorney General and accused of murder of four patients at New Orleans' Memorial Medical Center after the storm.

According to this article from CNN.Com, the investigation continues with the above two nurses being given immunity thereby isolating the physician who has been "the main target of the investigation" according to the article.
The investigation determined that the four patients -- ages 63, 68, 91 and 93 -- were given a "lethal cocktail" of morphine and midazolam hydrochloride, both central nervous system depressants, [Lousiana Attorney General] Foti said.

None of the patients had been prescribed the drugs by their caregivers and none of the accused treated the four before the injections, Foti said. "This was not euthanasia," Foti said at a news conference last summer. "This was homicide."
This case brought a lot of headlines a year ago. I remember reading many news reports about it at the time. However, this article continues...
The case has languished since. Foti said he turned his findings over to Orleans Parish District Attorney Eddie Jordan, who by law must either file charges or reject the case.

Instead, Jordan impaneled a grand jury, and has vowed to let it decide what charges, if any, should be sought. Jordan also directed New Orleans Coroner Frank Minyard to hire outside forensic experts to review the case. But sources close to the investigation say the case has moved very slowly.
Remember after Katrina, there were lots of stories and rumors going around about what was happening down there after the storm. I remember hearing about alleged atrocities occurring at the Superdome (image credit). Months later, it was reported that these rumors were false.

Speaking of false accusations, Mike Nifong now knows the consequences of trumped up charges and running a poor investigation.

Now, don't get me wrong, I admit I don't know all the facts in the Dr. Pou case. All of my information is from the press (and you know how reliable they are). I am in no way defending what this physician is accused of doing.

However, there are a lot of politicians out there who are still using Hurricane Katrina to score political points for whatever reason. And, it's always politically popular to accuse physicians of wrong doing. It happens everyday in America.

With Louisiana investigators dragging their feet on this Dr. Poe investigation, this is making me very suspicious about the accuracy of the accusations. I have a gut feeling that this physician is being used to get someone down there re-elected.

I'll leave you with this scenario. Say, this physician is exonerated and all charges are dropped. Do you think we'll ever hear about it? Do you think that the press will report this? I think not. I think they'll move on to the next accusation of medical wrongdoing post-Katrina and talk about that....

Tuesday, June 19, 2007

The Ten Commandments

You're probably going to think I'm making these up, but I'm not. According to CNN.Com, the Vatican today issues a number of statements about issues like road rage (image credit) and safe driving. They are calling these "The Drivers' Ten Commandments" Yup, I'm not joking.
The "Drivers' Ten Commandments," as listed by the document, are:

1. You shall not kill.

2. The road shall be for you a means of communion between people and not of mortal harm.

3. Courtesy, uprightness and prudence will help you deal with unforeseen events.

4. Be charitable and help your neighbor in need, especially victims of accidents.

5. Cars shall not be for you an expression of power and domination, and an occasion of sin.

6. Charitably convince the young and not so young not to drive when they are not in a fitting condition to do so.

7. Support the families of accident victims.

8. Bring guilty motorists and their victims together, at the appropriate time, so that they can undergo the liberating experience of forgiveness.

9. On the road, protect the more vulnerable party.

10. Feel responsible toward others.
Don't get me wrong, these are not bad ideas. It's just kind of silly to think that the Vatican discussing travel and driving. What's next? I know the comedians out there will help me out on this.

Why are there Ten Commandments? I did some research on this, and I think George Carlin has the best theory on this. Enjoy this video clip - click here....

One Year Blogiversary!

365 days and 386 posts later, I'm still here. Can you believe it? Thanks to everyone out there in blog land for your assistance, advice, and support over the past year. I definitely couldn't have done any of this without you.

By the way, has anyone seen the blogiversary cake that goes with this candle? Maybe it can be found over here. Thanks again. I appreciate it more than you'll ever know...

Monday, June 18, 2007

Father's day memories

My dad and I always play golf on Father's Day. We usually begin the day with a family lunch, and then dad and I watch a little bit of the US Open golf tournament on television before going out to our local course.

I think I was about 10 years old when dad introduced me to the game of golf. I remember seeing Jack Nicklaus on television and asking my dad about the different shots that I was seeing on tv. I had no idea what he was talking about, but he was so happy trying to teach me.

As we went out to the practice range those first few times, it was kind funny trying to fit a 10 year old into adult golf clubs. I was lucky to just contact the ball. Dad was always patient with me, even when this snotty kid was throwing his clubs in frustration.

Through the years, golf has been a connecting point between me and my dad. We talked about golf and talked about life. He always managed to teach the lessons of life through golf - be patient, don't beat yourself up when you're frustrated, always remain optimistic, and shake off the bad shot because there's always another chance to do better.

In the last couple of years, I've come to the realization that dad is not going to be around forever. That's really a humbling thought. "Hey Dad! When can we play golf again?" As I said that today, I had a flashback to years ago when he was first teaching me the game. Happy Father's Day, Dad...

Friday, June 15, 2007

Revisited: Fireworks safety

When I was re-reading things from last year, I came across this one from June 30, 2006 which still cracks me up. It kind of goes with yesterday's post of Flag Day and with the Fourth of July coming up again in a few week, thought you may get a kick out of this one again. Have a great weekend everybody!

This is a public service announcement from Doctor Anonymous.

Since the Fourth of July is next week, I just wanted to review some important safety tips when it comes to fireworks. The Consumer Product Safety Commission and the National Council on Fireworks Safety offer
these tips to help make your holiday a safe one.

In addition, please review the following educational video to see what
could happen to loved ones when fireworks are used improperly. You may want to turn up the sound a bit to get the full effect. Click here for video. Remember, fireworks are not a toy, so use them wisely. (It's a tough day to be a stuffed animal -- HA!)

Thursday, June 14, 2007

Happy Flag Day

The Fourth of July was traditionally celebrated as America's birthday, but the idea of an annual day specifically celebrating the Flag is believed to have first originated in 1885. BJ Cigrand, a schoolteacher, arranged for the pupils in the Fredonia, Wisconsin Public School, District 6, to observe June 14 (the 108th anniversary of the official adoption of The Stars and Stripes) as 'Flag Birthday'. In numerous magazines and newspaper articles and public addresses over the following years, Cigrand continued to enthusiastically advocate the observance of June 14 as 'Flag Birthday', or 'Flag Day'.

Wednesday, June 13, 2007

The Kevin MD Top 8 List

Here's something interesting hot off the press over at Kevin, MD:
I am pleased to introduce the MedBlog Power 8.

I'm publishing a list of medical blogs that have had an exceptional week of blogging, similar to the "Power List" rankings you find on various sports websites - the so-called "Power 8" medical blogs.

Here is how it works:
* The list is revised every Wednesday and published every 2-3 days
* The blogs I choose to include, and subsequent rankings, is a purely subjective process. The decision is final and without debate.
* Kevin, M.D. is ineligible to be on the list.
This is an interesting concept. I wonder what the reaction will be out there in the medical blogosphere. There is no doubt that Kevin, MD is influential and being named to the Top Eight List is a recognition that most medbloggers will be shooting for (hint, hint).

I wonder why the number "eight" was chosen instead of a "top 10 list" or some other number. Curious. Plus, the "purely subjective" criteria will be interesting to see how that all plays out. You can kind of get some hints of Kevin, MD's interests by seeing what he highlights on a daily basis.

Kudos to the group from the Shrink Rap blog for making the very first Medblog Power Eight. Guess I have some work to do to try to make the list. I've always liked a challenge. We'll have to see how the concept of a top medblog list all plays out....

Revisited: Blogaholics Anonymous

Now, I realize that I'm not the first person to come up with the term "Blogaholics Anonymous." (Thanks Moof for the pic!) A quick google search finds about 30,000 results. Nonetheless, BA came along at the perfect time in the infancy of my blog.

Here's a little piece of the post from June 28, 2006 (day 9 of the blog):
I can hear the radio ads now, "Hi, I'm Dr. A, I'm not only a doctor, I'm also a client!" How about this as a slogan, "Join BA today! It's no BS!" Or, "Think you're addicted? Well, let's blog and find out!" There could be t-shirts, mugs, posters, mouse pads, key chains, etc --this could be HUGE!
And, HUGE it was. Little did I know how this thing would take off. I encourage you to check out the "minutes" of the BA meetings and see all the places that we have been to in the past. It was quite fun!

You know, I'm thinking about having a BA meeting next week. Hmmmm..... How would that go over? Would people show up? Would people have a good time? With everything going on in the medical blogosphere right now, it wouldn't hurt to try to have some levity. Interested? Check out I'm A Blogaholic for details....

Revisited: Friends

No, not those Friends. Back in August 2006, I was in the midst of one of my blog block sessions, which I go through every few weeks. I'm glad that I'm not the only one who goes through this.

I don't know about anyone else, but I've always found it challenging to keep in touch with the friends that I have around here (I'll call them my non-blog friends). It has always been difficult to get our schedules to match up.

But, having blog friends means that you can keep in touch pretty much anytime. Contrasting these two types of friends fascinated me. And, naturally, I blogged about it on August 23, 2006....
In this day and age where electronic communication is more common and more convenient than in-person communication, do I have communication more with my blog friends or my non-blog friends? Now, the people at work don't count, at least for me, because all of you know how much I work (too much).

This entertains an interesting question: When it comes to citizens of the blogosphere, do people have more blog friends or non-blog friends? For me, I've come to find out that it's the former -- not that it's a bad thing, but an interesting realization. How about you? Do you have more blog friends or non-blog friends? Do you care? Does it bother you one way or another?
Little did I know how much discussion it would generate. There are currently over fifty comments over there. I guess people really like talking about their friends. And, who can blame them?

It's hard to believe that almost a year has passed since that time. But, I still remember those thoughts like it was yesterday. I'm going to reflect on other posts in the next week during the countdown to my blogiversary. Hope you enjoy this series, because I know I am!

Tuesday, June 12, 2007

Revisited: The GR experience

Even though I initially said that this is not a medical blog, I eventually found myself blogging about - guess what, medical stuff. I guess I initially said that because I didn't want this to be all about medicine. There is no way that I wanted to become some kind of medical resource of information. There are a lot of other blogs out there with the reputation and quality information for that sort of thing.

I forget who first mentioned Grand Rounds to me, but I was very much flattered that people thought I could submit a post over there. As I was reading GR every week, I learned that there were a lot of great writers out there in the medical blogosphere. And, you guess it, I didn't think I could be in the same league as them.

My first Grand Rounds was July 11, 2006 over on the donorcycle blog. I was even excited that I made the "editors top picks." "Yay me," I said at the time. I was definitely on my way at that point.

For the next few months, I tried to write something for every GR. Sometimes I was able to, and other times I could not (or didn't like anything I wrote that week). It was really weird (in a good way) because my blogroll started to grow and people started to recognize/remember my blog.

Then, November 9th is a day that changed this blog forever. That was the day that I got the e-mail from Nick Genes asking me if I was interested in hosting Grand Rounds. Like, duh! This was a no-brainer. The catch was that I would be hosting in like two weeks.

So, what did I do? I held a press conference, asked for some reader feedback, described what GR was, tried to hype things up to generate interest, and waited, and waited, and waited for the posts to roll in. And, did they! That weekend was nuts for me. If I recall correctly, I was on call that weekend as well. So, trying to balance everything was challenging (and fun!).

The big day quickly arrived. Grand Rounds 3.09 premiered on Tuesday, November 21, 2006 to big fanfare (or at least what I thought was big fanfare). In the weeks prior to this, there was debate about the use of themes for GR (there is still occasional discussion on this). I didn't use a theme, but chose to break things up in three sections. Looking back on things now, I may have been a little bit harsh on those in the bottom section. I don't know, but maybe that treatment will prevent me from hosting in the future - well see.

Other than that, I was very happy about how things turned out. That time was probably at the height of my obsession with stats and how many visitors I was going to receive. As I remarked on my hosting experience in part 1 and part 2, this will probably be the only time in my blog life that I will receive 1000 visitors in one day. I was ecstatic!

Are grand rounds still a priority for me? I guess it is, but I'm not pushing myself every week to submit something - like I did in the past. In my opinion, anyone who calls him/herself a medical blogger should go through the experience of organizing some kind of blog carnival like grand rounds, pediatric grand rounds, change of shift, etc. It's a great experience.

It's hard to believe that almost seven months have passed since that time. But, I still remember those thoughts like it was yesterday. I'm going to reflect on other posts in the next week during the countdown to my blogiversary. Hope you enjoy this series, because I know I am!

Revisited: Does this thing work?

Welcome back to retrospective week here at the Doctor Anonymous blog....

So, here is a little synposis of how this little blog got started. As I have probably remarked before, my first exposure to blogging was with political blogs. And, as I did further exploring, I wondered whether there was any blogs about medicine.

I think back then, I typed "doctor blogs" in a search engine somewhere, and one of the first blogs that came up was Fat Doctor. I read every single post she wrote and was captivated by the story telling. Of course, this was in early 2006 when she only had been blogging for a few months.

For the months following, I kept asking myself, "Could I do that? Could I write about myself or write about medicine or both?" Like most bloggers-to-be, I went back and forth.

The next step for me was to go from "blog lurker" to "blog commenter." I remember commenting on her blog and other blogs. And, it was a good time. I was amazed that people were commenting on my comments. The back and forth conversations and banter was fascinating to me. My blog confidence grew, and I knew I had a decision to make. Could I go from "blog commenter" to "blog writer?"

I decided to go for it. For an introverted-type person like me, to risk something like this (for me) was huge. The next step was deciding on a blogger name and blog name. I was reading anonymous lawyer at the time and thought that anonymous doctor would be kind of interesting, but found out the name was taken.

How about the name Doctor Anonymous? I could use "Dr. A" as kind of a nickname. I hoped that it wasn't taken as well. I typed it in, and, Voila! A blog and a blogger are born.

Now, what the heck do I talk about? And, thus comes my very first post on Monday, June 19, 2006 called Does this thing work? It was just four of five lines just to get me started...
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...
I was so proud of myself when I hit the "post" button. I had no idea was going to happen. But, I told myself at the time that even if I got zero comments, I had an idea out there in the blogosphere for everyone to read. That concept amazed me then and continues to amaze me now.

It's hard to believe that almost a year has passed since that time. But, I still remember those thoughts like it was yesterday. I'm going to reflect on other posts in the next week during the countdown to my blogiversary. Hope you enjoy this series, because I know I am!

Monday, June 11, 2007

The Sopranos finale

I have to tell you that I have never seen The Sopranos, but in reading the press this morning, everyone was surprised and/or upset by the ending of this series. Here is the Washington Post point of view this morning.

So, in case you missed it, here are the final five minutes of the episode. Watch it now before YouTube is forced to remove it from their database. Personally, I don't get the ending, but, I guess that's how the writer/creator wanted to leave it.

Update: After a couple of hours since the original post, the above video had already been "deleted by the user." I've also seen this message today: "This video is no longer available due to a copyright claim by Home Box Office, Inc." I did manage to find found another YouTube link (for now). If you haven't seen it, click here before this is deleted.

Countdown To Blogiversary

I'm going to continue on this sentimental streak of thinking/writing that I've been having. It started with yesterday's post. Over the next week or so, I'm going to be taking a little bit of a departure from the "usual" Doctor Anonymous style posts.

So, next week is my one year blogiversary. And, over the next seven days or so, I'm going to be re-visiting some past postings and give some perspective of what I was thinking then. I'm actually really excited about it. I've been in a kind of blogging rut lately. I needed something to mix things up - and this is perfect.

BTW, if you haven't had a chance yet, check out the most recent installment of My Three Shrinks where they hear from Dr. Phil. It's a great interview - Hilarious! I'm going to be a guest on their podcast next week. You know, I call myself the "unofficial Fourth Shrink" (that's kind of like The Fifth Beatle - HA!).

For my faithful readers out there, do you have a favorite Doctor Anonymous post, or a post that you particularly remember over the past year? I'm kind of curious if my favorite posts list is similar to yours....

Sunday, June 10, 2007

High school graduation

It's high school graduation around here this weekend (image credit), and I cannot help but get a little nostalgic. I guess that tends to happen every year as I get further and further away from my own HS graduation. Why does that happen?

Anyway, way back when, I couldn't wait to get out of there. It's not that I had a bad high school experience. But, like almost all people that age, I was ready to move on to the next step in my life. Some of my friends went into the working world, some of them went into the military right out of high school, and some people went to college. I was in that last group.

But, before that, I remember my last two months of high school like it was yesterday. I went in with about a dozen of my friends to purchase a "class car." It was a beat-up old boat-sized vehicle, but it was ours. We painted the thing; we drove it everywhere; we pushed it to the gas station when it ran out of gas; and we took it to the graduation ceremony as we were dressed in our caps and gowns - Good times!

And, then, for the rest of June, there was graduation party after graduation party. Little did I know that would be the last time that I would see some of those people -- because hardly anyone moves back to this economically deprived area. For a lot of my friends, it was time to move on to bigger and better things.

For me, I had a feeling of accomplishment that I finished high school. I was going to miss my friends, but I knew it was time for me to move on as well - to the next step in my life. I was excited, yet a little scared of what was to come - namely college.

Thanks for this quick stroll down memory lane. Maybe I'll have more to blog on this later. Any fun high school graduation memories out there?

Tuesday, June 05, 2007

Blogblast for Peace

Don't be surprised if you see this graphic in a lot of places on June 6, 2007. I'm posting this a little early because I'm afraid that I'll forget tomorrow....

The message is pretty simple: Peace on Earth. Were you there on November 7, 2006 when this first happened? You can read all about it here. The idea came when Mimi saw a plane.

Outer peace (meaning world peace) always must start with inner peace. And, I gotta tell ya, trying to organize and trying to control my life has been really difficult lately. So, as I go forward on this special day, I know that the only way that I can be of any impact to anyone else is to look in the mirror first.

Finally, kudos to Mimi Lenox, who appears to have made it her passion to spread this message to so many people in the blogosphere. I hope to see many more peace globes around blogland as compared to November. Great job Mimi!

Grand Rounds

Grand Rounds 3.37 is now up and running at Inside Surgery. It's a pretty no nonsense and straightforward format this week. About 30 links which are easy to navigate and read. Great job and thanks so much for including my post...

People in the News
Doctor Anonymous writes on the Kevorkian Effect

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

Next week, GR moves to Dr. Val & The Voice of Reason. What an interesting name for a blog. Want to submit to GR for June 12? Click here and read on....

Monday, June 04, 2007

Pass the chips, or not

Here's the weight loss tip for 2007 - Stop watching television. I know what you're saying - like, duh, Dr. A, we knew that. Well now there's scientific proof, and it involves late night television.

I'm a Letterman guy myself (image credit). Not that there is anything against Leno. But, being in high school in the late 1980's meant one thing to me - staying up until 12:30am to watch Late Night with David Letterman. What do these guys have to do with a weight loss study? Read on and find out...

According to this Reuters article, researchers at the Smell and Taste Treatment and Research Foundation in Chicago (no joke) took people, potato chips, and television and developed a experiment around it.
Forty-five volunteers ate as many chips as they wanted during five-minute intervals over three-week periods while they watched monologues by late-night talk show hosts David Letterman and Jay Leno.

They also were given chips to eat when the television was off. [Alan] Hirsch [neurological director of the Smell and Taste Treatment and Research Foundation] found people ate an average of 44 percent more chips while watching Letterman and 42 percent more while viewing Leno, than when they did not watch TV.
My question is what potato chips were they using. Because, for me, I'm partial to the BBQ flavor - and maybe salt and vinegar. But, other flavors, not so much....
At each session, volunteers were asked to concentrate on the sensory characteristics of the food such as taste and smell. Researchers say these sensory clues, in addition to internal body changes, signal satiety.

But when distracted, a person does not pay attention to either the body's sensations of feeling full, or to the sensory characteristics of the food. Many studies have linked obesity to watching television and that link is likely due to inactivity, Hirsch said. But perhaps entertaining shows are also contributing.

"If you want to lose weight, turn off the television or watch something boring," he said.
Something boring? I wonder what that means. I'd make some suggestions, but then, I know that dozens of Hollywood attorneys and television producers would be attacking my blog. *cough* Happy TV watching everybody!

Sunday, June 03, 2007

Go Cavs!

Congrats to the Cleveland Cavaliers who are on their way to the NBA Finals. This is the first chance in a long time for Cleveland to win a major sports championship in decades. From the Associated Press, this pretty much sums up what's going on in Cleveland this morning. Good luck in the Finals!

As his teammates danced and carried on while wearing baseball caps and T-shirts proclaiming "Champions," LeBron James walked around in a daze with a smile etched across his face. "This is like a dream," he said, shaking his head. "This is probably the best feeling that I've ever had in my life." An entire city felt the same.

For the first time in a long time, championship-starved Cleveland has something to feel good about. The Cavaliers, once the punch line to jokes and Michael Jordan's favorite foil, are Eastern Conference champions — and on their way to the NBA finals.

TB Double Standard?

Last week, I was only peripherally following the case of Andrew Speaker. He's the guy who flew to Greece to get married and it was found out that he had a form of drug-resistant tuberculosis. There was a lot of media coverage about who was exposed on the airplane, and the process of contacting all these people. Apparently, Friday, he went on national television to apologize.

Right now, Speaker is under US government quarantine (the first since 1963) while he is undergoing further evaluation and treatment. His medical plan is to stay in a Denver hospital for possibly two months to receive antibiotics and possibly surgery.

As I was reading this story, there were aspects of this that sounded kind of familiar to a previous post that I wrote. Then, it hit me. I wrote two months ago about Robert Daniels (pictured above - image credit) and his ordeal in Arizona.

Daniels moved from Russia to Arizona and it was found out that he has drug resistant tuberculosis. Reports state that he refused treatment or even to wear a mask. For these reasons Daniels ended up in jail and is still there to this day (Read TB patient in jail for more details and an interesting comment section).

I started asking myself: How can one guy be under federal quarantine and placed in a hospital, and another guy be under state/local quarantine and placed in jail? As I did more research, I found this article on MSNBC/Newsweek.
Robert Daniels has been confined to his small, cinder-block room for nine months so far and he doesn’t know when his confinement will end. He has one barred window that is frosted over so little light shines through, a metal toilet with a metal sink and he spends most of his day in bed. He hasn’t had a hot shower since his detention and has to bathe with sanitary wipes, since he has only been allowed out of his room once. But Daniels is not a criminal, and has not yet been charged with any crime. Instead he is a tuberculosis patient who was quarantined at the Maricopa County hospital in Phoenix last July after failing to wear his mask in public.

While tuberculosis patient Andrew Speaker, at the center of a media storm this week, was the first person since 1963 to be quarantined by the federal government, some others, like Daniels, are detained by local and state officials.

[A]fter Speaker's case went public, [ACLU attorney Linda] Cosme says she will be filing a motion to move Daniels' case to federal jurisdiction. "Speaker's treatment is much better," Cosme says. "While Robert acknowledges that he should be quarantined, he should be allowed out to exercise his legs and be in the sun." As long as he’s wearing that mask.
Is there a double standard here with one quarantine in a hospital and the other quarantine in a jail? Well, the ACLU is going to make an argument for this. Do I agree? If these cases where similar, then I would say, yes, there has to be consistency here.

But, I think there are more differences than similarities in these two cases. Daniels was pretty adamant about not wearing a mask in public, lied about not wearing a mask, and didn't follow other public health recommendations. These choices landed him in jail.

Meanwhile, Speaker was already in Europe when he learned of his disease state. Granted, he ignored health official recommendations not to take a long flight home, but I'm willing to give him a pass on this (I'm starting to hear the hypocrite chants) because the guy was scared and thought he was going to die. Plus, since getting home, he states he's been feeling guilty about taking those long flights and has been apologizing to anyone who will listen.

Is there a double standard going on here? Am I being a hypocrite here? Well, you be the judge (and I know you'll let me know). These cases will be more and more interesting as they continue to unfold.

Saturday, June 02, 2007

Flea thoughts

I just want to warn you right now. There are going to be no new relevations in this post. If you're looking to see if I have this uniquely new spin on this situation, then just click on to whatever you were going to read next. This post is going to be just rambling thoughts....

Over the past two days or so, I've been reading and reading and reading all the reactions and analysis on this situation. There are very emotional posts, there are blame directed posts, there are self-righteous posts, over what? Over a guy who got called out on having a blog...

This just happened to be a great media moment because it happened on the witness stand. Just wait, one of the fall season premiere episodes of Grey's or House or whatever medical TV show, is going to have this moment....

Some people out there in blogland are proclaiming that this case proves that there is no such thing is anonymous blogging. Heck, I could have told you that - and I have - here, here, and here....

There are even some out there who say that either any docs who blog anonymously are cowards and should blog under your real name anyway (they say this case proves that). Or, still others who say that medical bloggers should make up a set of rules and stick by them. Uh, yeah, that's a great idea (I don't think so).

Just from my personal point of view (i'm not speaking for anyone but myself), if I wanted to blog under my real name, than I would from the beginning. It took the realization about six months ago that anyone out there can find out who you are, where you are, and any kind of personal information that they want to. This really freaked me out, but I kept blogging nonetheless.

About a set of rules, I think this is great for people who use their real name blogging. I also think it's ok for those who feel the need that medical bloggers need some kind of credibility and legitimacy. However, I think this sets the bar higher than it needs to be. Just another reason for enemies to come after you and your blog.

I'm all for patient privacy, but to put all of your credentials out there, for me, I'm not sure about that. If you "anonymously" blog, if you put your credentials out there that some of these rules say, why not just use your real name anyway.

Are there any huge ramifications to the medical blogosphere because of this case? I continue to stand by my past statements in which I've said I'm concerned about the continued growth of the medical blogosphere from the grassroots. Many of these blogs will continue to go private quietly and other potential bloggers will be discouraged to even start.

You know, Flea is probably out there right now, watching all of this happen, and laughing at us for all the attention that we're giving this case. He's probably started a new blog, with a different name, with a different identity, and blogging about anything but medicine. All the best to you, Flea.