Grand Rounds Vol 6, No 26

I want to thank you all for contributing such wonderful posts for this week's Grand Rounds. And, thank you for allowing me to make it a "women’s” theme as March is the month of International Women’s Day and Women’s History Month (here in the United States).

Sterile Eye tells us the story of Jan van Rymsdyk – Drawer of Wombs. Here is one of the beautiful sketches included in the post.

In October 2008 I visited the Hunterian Museum in Glasgow, where William Hunter’s great book of obstetrics was on display. Published in 1774, The Anatomy of the Human Gravid Uterus did much to advance the understanding of human pregnancy. The book contains 34 copper engravings. 31 of these magnificent medical illustrations were made by a mysterious man called Jan van Rymsdyk.

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Our medical librarian Laika, Laika’s MedLibBlog, tells us about a wonderful woman scientist in her post Stories [1] – Polly Matzinger, the Bunny & the Dog.

….He continued with his typical Czech accent, serious but with a twinkle in his eyes.

“It is a SHE” …….

“It is a she and ….… a very beautiful one”

Then he told us that Polly Matzinger, for that was her name, was once a Playboy bunny and a waitress at a bar frequented by scientists………..

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Captain Atopic’s beautifully written post tells us about a woman and her tattoo: Freedom.

The building had four stories. In a narrow street in Baoji, west of Xi'an, the damp shell of a structure housed backpackers on its top three floors. The dorms exuded marijuana, travel must and provided many visitors with a fresh case of athletes' foot or worse. The occupants sat, huddled in the subzero temperatures playing cards and sharing a bong, partly for warmth, partly just to negate the feelings of loneliness and despair Baoji seemed to extract from twenty-something global travelers. …….

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Julie, Bedside Manner, helps us with Making Sense of Suffering Through Poetry. She presents a poem written by her friend and colleague Beth Lown, MD.

…... The poem is about Beth’s effort to imagine this patient’s experience and to empathize with her suffering…….

Let me know what you think of the poem.

Leylo and the Land Mine *

An ebony leg leaned
against the clinic wall,
snow melting
on its sandal-clad foot

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CancerDoc write a powerful post about the impact of a patient on a doctor: Denmark

R.N. just died.
She was my first breast cancer patient out of fellowship and training. My first breast cancer patient where I was the "doctor". No backup. Nobody to turn to for advice. I write the orders, I explain the side effects. I hold the hands.

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From Mothers in Medicine comes the first Topic Week post: Tips for Surviving Call while Pregnant. There are actually, good tips for non-preggers folks too. There are ten great tips. Check them out and check out the blog.

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Laurie, A Chronic Dose, asks how effective Doctors as Advocates? are as she discusses communication skills in advocating for their patients.

……….An advocate is someone who realizes there is a lot more to a successful outcome (surgical or otherwise) than simply what data reveals.

We all deserve advocate

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Kevin,MD feels Pelvic exam simulators do medical students a disservice due to the missing communication (feedback) between patient and doctor

….no matter how good the simulator is, it cannot replicate an actual person. Especially for men, doing a pelvic exam is more than the procedure itself, but learning how to interact with the female patient from beginning to end……

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Dr Am Ang Zhang, The Cockroach Catcher, notes this is the 30th Anniversary of the National Women’s History Project with her post: NWHP: Writing Women Back into History. “It was an interesting experience looking back at “treatment modalities” of mental disturbance in one of the most cultured city in Europe at the start of the 20th Century.”

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I’d like to introduce you to a fairly new medical blogger, Deborah L. Benzil, MD who blogs at Women Neurosurgeon: Heart and Hands. Here’s the beginning of her poem: First Meeting.

Wash hands

Step over the red line

Irish gentleman

Stripped of dignity and clothes…

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Dr Shock tells us about women and anorexia nervosa in his post, The Neuroscience of Anorexia Nervosa.

One of the most striking features of those suffering from anorexia nervosa is their perception of their bodies. You can put them in front of a mirror and they will still tell you they’re to fat when in fact they’re skinny. A recent publication in Nature Proceedings has an explanation

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Dr. Charles, The Examining Room, tells us how Non-Homogenized Milk is Better Than Disneyworld

Mmmm. I just discovered non-homogenized milk – the kind with the thick layer of cream on top and more watery milk below. You have to shake it up before each serving, and the little flecks of buttery cream never quite disappear. …. But the taste is far superior to homogenized milk. Think milk with a hint of butter.

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And while Dr Charles makes the point “In terms of diet, weight loss, and optimal health, moderation seems prudent” Bob Vineyard, InsureBlog, writes about a woman who doesn’t seem to believe in moderation. Bob ask Who is the Biggest Loser?, the woman who wants to gain weight or society who will end up paying for her efforts. (photo credit)

Donna Simpson is proud of her plus size 600 pound figure and wants everyone to know it. Her 150 pound husband not only approves but is encouraging her to continue her pursuit of tipping the scales at 1000 pounds.

Happy Hospitalist weighs in on the same woman in his post: Super Morbid Obesity: Woman Proclaims "I Want To Be 1000 pounds. Happy and I both see this as a sad story of a woman who's main goal in life is to weight 1000 pounds so men can watch her eat in bikini.

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It seems apparent that Mrs. Simpson doesn’t care to exercise, but I am a fan of exercise. I believe it is important for good health. So does Dr. Ves Dimov, Clinical Cases and Images: CasesBlog, who tells us How to Exercise While Blogging or Doing Other Computer Work. Good information!

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Dr. Jolie Bookspan, The Fitness Fixer, relays how New Healthy Employment Programs for Developmentally Disabled can be accomplished.

Peggy Santamaria is bringing my healthy daily life techniques to developmentally disabled adults. She has made a new program to transition developmental disability to Developmental Ability. After her success story appeared - Shoveling Snow - Reader Wins Mother Nature's Fitness Challenge with Fitness Fixer,…

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How to Cope with Pain tells us about the Connection Between Headaches and Abuse.

Did you know that a history of abuse - emotional, physical and sexual – is common in women who have headaches. A history abuse is also associated with depression and stress. So reports a new study by Gretchen Tietjen, a Professor of Neurology at the University of Toledo and Director of their Headache Treatment and Research Program.

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David, Health Business Blog, writes More on the overuse of mammography in elderly women

An oncologist friend spotted my blog post (Overuse of mammography in elderly women with cognitive impairment) …..…..

I’d like to see the debate broadened to include a frank discussion of the potential harm from too much screening. Excessive screening and associated harm to the frail elderly population is one aspect of that story.

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Nancy, Teen Health 411, sends us a post regarding a new marketing campaign by Kotex that pokes fun at the previous tampon ads: Feminine Care Rebellion - Period! (photo credit)

Women are talking about their bodies and their health - which is good! Right?
You would not think so if you are following the debate around the new UbyKotex.com marketing campaign, which I think is brilliant! …….

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Joseph Kim, NonClinicalJobs.com, ask if the question To CME or not to CME?

The other day, I was speaking with a physician about job opportunities in the CME (continuing medical education) industry. There are fewer jobs in CME compared to 5 or even 3 years ago. Why?

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GeriPal feels that Social Workers are Awesome

….I know we should avoid generalizations, but isn't it the case that all social workers are nice? Perhaps it is this niceness, combined with their knowledge and skills that makes them so indispensable. …….

Geriatrics practice would be impossible without social workers.

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Pallimed comments on Palliative Care: (Un?)-Necessary Specialty

One of the web's more popular doctor bloggers, the anonymous* Dr. Lucy Hornstein (aka #1 Dinosaur - her blogging pseudonym), recently posted an entry titled: Palliative Care: An Unnecessary Specialty.

Now before you get too mad or defensive (like I first did), go read the post and the comments. She is a family medicine doctor and the main thrust of the article (despite the provocative title) is that all doctors and especially primary care doctors should be skilled in palliative care. …….

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David Harlow, Health Care Law Blog, interviewed Peter Neumann, Director, Tufts Center for the Evaluation of Value and Risk in Health, about the role of cost-effectiveness research in health care policy.

The national debate on health care reform is currently focused on health insurance reform -- coverage, one of the proverbial three legs of the health care reform stool: coverage, cost and quality.

In order to bend the cost curve -- no matter what the approach to health care reform: be it federal legislation, state initiatives, federal pilots and demonstration projects, and/or private sector initiatives -- most would agree that we need a rational approach to cost-effectiveness research, or comparative effectiveness research that we can all rely upon……….

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Kim, Emergiblog, has some thoughts regarding health care reform legislation which she addresses in her post: between the lines of fear and blame

…..Our system has issues, no question.

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So, will the new health care legislation make for healthier communities by providing jobs, parks, grocery stores, education opportunities and health care clinics to poverty-stricken neighborhoods?……

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Dr. Mary Johnson, Dr J’s HouseCalls, tells us about the horrific ordeal of being sued for “libel” even though the suit was unsuccessful in her post: On Oprah Winfrey And Nomvuyo Mzamane And A Defamation Lawsuit In Philly.

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Bongi, other things amanzi, tells us of an exemplary fellow South African surgeon

part of the job is to treat some unsavoury people. sometimes you know what it is they have done. mostly you don't. sometimes you even may make a difference. but mostly you just do your job. after all it is not our part to play judge and jury (and, in our case, executioner)……..

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Chris, Life in the Fast Lane, tells us about doctors in the emergency department Wrestling with Risk

….It’s true I am fascinated by the concept of risk, and decision-making in environments that are time-pressured and information-limited. Nevertheless, Dr. David Schriger raised more than a few points in his talk that even the most ‘risk averse’ person would find interesting, some of which I’ll discuss below…….

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Paul Auerbaur, Medicine for the Outdoors, tells us about a man who helped his dog (man’s and woman’s best friend) who got bitten by a rattlesnake in his post he did what?

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Allergy Notes, tells us how Basophil expression levels of CD203c might be used to monitor asthma.

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Beka, Medscape Blogs, wants to hear from fellow nurses regarding input about Charge experiences.. has it changed over time...? Do You Recall Your First Shift Charge Nurse Experience? (free registration required).

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Amy, Diabetes Mine, wants to educate us on the FDA Hearings on Blood Glucose Meters – A Patient Advocate’she Perspective

Experts are always split on these issues it seems, so I’m sure you are as curious as I am as to what came out of this great debate. I was fortunate to spend some time on the phone with Ellen Ullman, a patient advocate and research associate at Close Concerns — who was the ONE AND ONLY PATIENT REPRESENTATIVE invited to speak at these FDA hearings.

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Next week Grand Rounds will be hosted by Evan Falchuk, See First Blog. Thanks to Dr. Val Jones and Dr. Nick Genes for the work they do to ensure the continued success of Grand Rounds. If you would like to be a future host, please contact Nick.