Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, February 27, 2007

Grand Rounds 3.23

In the beginning, there was the Big Bang; followed in short order by the dinosaurs, polyester, HMOs and the internet. Although the crowning achievement of creation -- Grand Rounds -- has already been accomplished, the only thing we can be certain about is that things change. The more they change the more they may stay the same, but they still change. So welcome to Grand Rounds, the weekly round-up of the best of the medical blogosphere, where we'll expore what's old, what's new, what's changed, what hasn't, and whatever else happens to strike our fancy.

The oldest of the old, of course, is the juxtaposition of life and death. MedStudentGod at Creating the God Complex describes his introduction to that emotional seesaw when the two careen out of control. Wyatt of Foggy Bottom Lantern provides a provocative post about dying on schedule. Kim of Emergiblog offers a harrowing description of a near miss, and reminds us of the life and death nature of addiction.

Birth doesn't always go wrong, of course. In fact, the opposite is true the vast majority of the time and so PixelRN is changing over to a midwife practice, a move I personally approve of heartily.

Nurses, it seems, have been around forever. Or nearly so, to hear Nurse Ratched tell it.

Once upon a time, children were children, and the words "Sexy" and "Girl" were understood not to go together. Nancy Brown decries the sexualization of children at Teen Health.

Does anyone else remember a time when Pre-Med was an actual undergraduate major? Welcome Vitum Medicinus to the blogosphere with his neo-Latin terminology and reminiscences of simpler times.

Speaking of which, when did "health" become thinking outside the box? The Fitness Fixer discusses this nicely.

Some things that are gone are not missed; least of all because of what they have left behind. Pearls and Dreams convincingly describes how the 1950s aren't necessary anymore.

Some procedures have virtually disappeared as our understanding of the diseases they treated were revolutionized, as Dr. Bob Centor points out about ulcers.

Some things are still here but shouldn't be (or at least shouldn't be used nearly as much as they are.) Xanax is one of them, according to Shrink Rap (and I agree.)

But enough of the old days, because the newest of the new is pretty exciting. The discussion of a new insulin delivery system ("don't say pump") at Diabetes Mine is nothing short of amazing. However marvelous the technology is, though, Sandra Miller at Shot in the Dark reminds us of the toll it still takes on the youngest diabetics.

Some of the new things still need some tweaking, of course. Manu Varma at Transplant Headquarters discusses the pros and cons of changes in the criteria for kidney transplant allocation. While surgical staplers are great gadgets, Sid Schwab still finds glory in sewing guts the old fashioned way.

Chronic Babe points out that the only way to really change is to let go of the old. Sometimes all you have to do is change your colors, according to Mom MD. Sue Palwick of Rickety Contrivances of Doing Good (what a great name for a blog) discusses a fascinating new way to look at the medical history.

Computers, while certainly in the "new" category, are also changing continually, as Dr. RW describes his first twenty years with them. The internet in general and blogging in particular are also relatively new, and Rita Schwab of MSSPNexus Blog points out that until a few years ago, she never could have imagined what she's doing now.

The old and the new aren't always so easily distinguished. There are times when old conditions garner new understanding, as both Difficult Patient and Moof point out in their discussions of Asperger Syndrome. Rare diseases, while also not new, need to be brought back to our attention from time to time, as Science Roll does with Pompe Disease. And sadly, some things never seem to change, as Sandy Szwarc of Junkfood Science tells us yet again that medical care of the obese is so much more than "just losing weight."

Whether we like it or not, alternative medicine has become enough a part of our patients' lives that it behooves us to at least address it, as Liana of Med Valley High puts so elegantly.

The business side of medicine is also changing, and David Williams at the Health Business Blog discusses the new phenomenon of Retail Clinics purely from an economic perspective. A newer blogger, poeMD, presents the most eloquent (and poetic) descriptions of how medical practice has changed -- and not for the better -- in recent years, with Prayer Pills.

Sadly, it seems that big business will never change. PreMedPilot certainly calls it like it is, without mincing words like "parasite." And just when you thought Big Tobacco couldn't stoop any lower, Anxiety, Addiction and Depression Treatments lets us know that they do.

As February changes into March, Dr. Deb Serani reminds us that March 1st is Self-Injury Awareness Day.

Finally, apropos of nothing much, a story heard before but given a fresh spin with wit, panache and peanut butter M&Ms by Sowing Mild Oats: the not uncommon tale of needle localization breast biopsy marvelously titled Mammosity.

And in closing, we offer the last random word to the venerable Dr. Dork: to dream, perchance to sleep.

Thanks for tuning in to this week's edition of Grand Rounds. Don't forget to join us next week at GruntDoc for a special treat: Grand Rounds without a theme -- for a change.


At Mon Feb 26, 09:52:00 PM, Blogger The Angry Medic said...

Slick read! Very nicely put together, Dinosaur.

And I understand how people feel about Grand Rounds not having a theme, but I'm old-school; I like a theme every now and then. You achieved a happy medium quite well.

At Mon Feb 26, 10:28:00 PM, Blogger Sid Schwab said...

I agree: as one who bloviated about themes, I think this entree is deftly done. Like a good umpire, your requirements were hardly noticeable, letting the players play their game. I withdraw my objection, your honor, but reserve the right...

At Mon Feb 26, 10:33:00 PM, Anonymous Anonymous said...

there are a few fewer posts than usual.

At Mon Feb 26, 11:40:00 PM, Anonymous Anonymous said...

Well done, Dr. D!

At Mon Feb 26, 11:48:00 PM, Anonymous Anonymous said...

Very nice job, Dr. Dino, well put together. It flows.

Thank you for hosting!

At Tue Feb 27, 12:19:00 AM, Blogger Dreaming again said...

Very nicely done!!
Thanks for the include!

I can't wait to be able to dig into the posts tomorrow and really read them!

At Tue Feb 27, 12:31:00 AM, Blogger Cathy said...

Dr. Dino, I like the way you did this. Very easy to follow.

At Tue Feb 27, 01:19:00 AM, Blogger The Tundra PA said...

Nice job, #1! I agree with angry medic and sid; I've grown a little tired of the themes, but you did this beautifully. I'm sorry I did not have a post to submit (again) this week. Can't wait to go back and read all the good stuff here. Thanks for commenting on my blog--I've missed you!

At Tue Feb 27, 02:45:00 AM, Blogger Awesome Mom said...

A very well done Grand Rounds! I enjoyed every entry.

At Tue Feb 27, 02:59:00 AM, Anonymous Anonymous said...

Just enough articles, funny lead, but no unneccessary themes. Really nice work, Dr. Dino!

At Tue Feb 27, 04:54:00 AM, Anonymous Anonymous said...



At Tue Feb 27, 10:13:00 AM, Blogger Dr. Deb said...

Great Subjects.
Easy to Read.
Nicely Done!

At Tue Feb 27, 11:24:00 AM, Blogger Kim said...

Thank you for hosting!
Great job!
Thanks for including Emergiblog and giving me an excuse to use a photo of Jeff Goldblum from Jurassic Park to illustrate my GR post!

It's the simple pleasures in life...

At Tue Feb 27, 12:22:00 PM, Blogger Mother Jones RN said...

Hi Dino:

Great job. Thank you for hosting Grand Rounds and for including my post. I had a lot of fun reading everyone else's posts.


At Tue Feb 27, 01:55:00 PM, Blogger Nancy L. Brown, PhD said...

Wonderful - thanks! I love reading the posts included in Grand Rounds - I learn something new every week!

At Wed Feb 28, 12:26:00 AM, Blogger Robert W Donnell said...

Nice job, and thanks for including my post!

At Wed Feb 28, 07:47:00 AM, Anonymous Anonymous said...

Nice job!

At Mon Jul 16, 04:32:00 PM, Anonymous Anonymous said...



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