Grand Rounds Volume 7 Number 48

 Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active.

Thank you for coming to Grand Rounds 7:48, the weekly collection of the some of the best in online medical writing from all (doctors, nurses, patients, healthcare professionals).  Next week’s will be hosted by Health 3.0 Blog.

Along with the excellent posts, I’ve included pictures of the changes cameras have gone through over the years – from the pin-hole camera to digital phone cameras.  Enjoy!

Dr. Charles hasn’t had much time lately, but I was able to scribble down this pediatric poem:  A Beating.  As one commenter figured out, Dr. Charles is a new father.  Congratulations! and thanks for the poem.     (camera obscura – photo credit)

Jordan, In My Humble Opinion, writes about the covenant of being a doctor:

I mean it is kind of lonely....being your doctor. I picture it as sort of a covenant. Between you and I.

On one side you. And your family. And friends. Your house and your dogs. Your communities and lives.

On the other side me. Alone.

Skeptical Scalpel has written a post,  Do Surgeons Suffer From "Decision Fatigue"?, in response to a NY Times Magazine article.

……..Query: Has anyone seen studies linking surgical error rate to the time of day?”

The answer is, “Yes.”

But if the question had been, “Anyone seen any good studies linking surgical error rate to time of day?” the answer would have been, “No.” ………….

Dr. Schattner, MedicalLessons, talks about what she has learned from the offbeat and in some ways disturbing story of a young woman who's made a business of having had a rare form of cancer, epithe­lioid heman­gioen­dothelioma:   Notes on Crazy Sexy Cancer             (daguerreotype camera – photo credit)

Dr. Val, Better Health, asks Should Pharmacies Limit Teen Access To Protein Supplements?

A strange thing happened to me at a CVS pharmacy two days ago. I was attempting to purchase a protein drink when the girl at the counter asked me to show her my I.D. card. I assumed she meant my CVS savings card and was sincerely confused when she rejected it, saying, “No, your picture I.D.”

I dug through my purse to find my driver’s license while the girl explained,

“You have to be 18 years old to buy this product. I need to type in your date of birth into the computer.”  ……

Carolyn is a heart attack survivor who blogs at  HEART SISTERS.  In her post,    "How to be a good patient" , she shares her experiences and expertise she has gained in having a chronic illness.

Beth, Calling the Shots, discusses the controversial use of “war” terminology to describe cancer in her post:  Young Adults With Cancer: Why 'War' Analogies Work But 'Warrior' Analogies Do Not.

Many, many people don't like war analogies when it comes to cancer,  especially those of us who've been afflicted by it. We often hear that a comrade has lost or won his or her battle with cancer. Or about society declaring war on cancer. Or about someone fighting bravely against the disease.

Sure, this language of war is cliche, giving us a picture of the brave warrior fighting to the death against cancer.  ………….

Dr. Pullen

shared in his submission email his thoughts of using his own name as the name of his blog:  “I've thought a long time about why on earth I chose to use just my name as my blog name.  Thinking back it was probably not one that is going to draw much interest except from maybe the few who know me.  Maybe it was my interest in eponymous diseases.  This prompted me to have some fun with a word that is not on the tip of many tongues.”  Enjoy his post:  Eponymous Blog on Eponymous Diseases.         (Brownie   --- photo credit)

DrRich explains why direct-pay medical practices, contrary to official opinions, are not only ethical, but also may be the only remaining way for doctors to practice medicine in accordance with traditional medical ethics:  An Epiphany on Direct Pay Practices.

HealthBlawg takes a look at an unusual acquisition: a large health care system acquiring a Medicaid HMO.  What does it mean?  Check out their post:  Partners Health Care acquiring Neighborhood Health Plan: The 800-Pound Gorilla and the Fig Leaf?      (Canon F1 – photo credit)

Over at InsureBlog, Henry Stern reports on new breast cancer coverage for women only, and why that's not necessarily such a good thing:  Keeping Abreast of Cancer: Double-Standard edition

Laika,  Laika's MedLibLog, in her post -- RIP Statistician Paul Meier. Proponent not Father of the RCT – tells us  Paul Meier who recently died really had a great influence as a statistician in promoting the RCT (& he "invented" the survival curve).  Her post, however, focuses on the wrong headline in Boing Boing (the first headline she saw about the death of Paul Meijer), claiming that Paul is the father of the RCT.  In her post she tried to find out the real origin of the RCT.

Rick Pescatore, a medical student and EMT who blogs at Little White Coats  submitted a post --Help I've Fallen and I can't get up!  -- which details his experiences with senior falls as an EMT and provides a resource for seniors in his area (Philadelphia and Southern New Jersey area) to receive free medical alert devices from the PCOM Emergency Medicine Club.    (Poloraid  -- photo credit)

Amy, DiabetesMine, wants us to know about the upcoming summit on noncommunicable diseases at the UN next month:  Diabetes Battles for Obama’s / World’s Attention

Anybody heard about the first-ever upcoming United Nations (UN) High-Level Summit Meeting on Non-Communicable Diseases (NCDs), in which heads of state from around the world will meet in New York City on Sept. 19 and 20?  Um, we’re not sure President Obama has either, and that’s very bad news for diabetes, according to the International Diabetes Federation (IDF). ……….

Ryan,  ACP Internist blog, looks at the recent trends in healthy lifestyle choices by adapting two recent studies (and adding a touch of humor):   Smoking in front of the television must be really bad

ACP Hospitalist blog  feels doctors may already have all the skills they need to make the right diagnosis:  History and physical the best way to diagnose patients   (iPhone which includes camera  -- photo credit)

Geeners, Code blog: Tales of a Nurse, gives us a view of what it’s like to be a school nurse:  Interview - School Nurse

Well, what better time to post my interview with Erin at Tales of a School Zoned Nurse than now, when everyone’s headed back to the classroom? ……

Steven J. Seay, Ph.D. presents us with a timely post as school is back in session:   School Refusal & Parental Stigma: Am I a Bad Parent?

Like any other behavior, school refusal does not have a singular cause. This is pretty self-evident, but in the heat of the moment when your child is having a tantrum, this fact is quickly forgotten. It is simply too easy to conclude that you have raised a “bad child.” Sadly, much of society might wrongly agree with you. ……..

Louise, Colorado Health Insurance Insider, discusses the PPACA and changes made over the year since it was signed into law in her post:   Seeking Certainty

…. It's been over a year since the PPACA was signed into law.  Many Americans are eagerly awaiting 2014 when their health conditions will no longer limit them to high risk pools and when their health insurance premiums will be subsidized.  Health insurance carriers have already made numerous changes to comply with the law, with many more planned for the next few years.  A lot of states are working hard to come up with health insurance exchanges that will best serve their residents' particular needs.  Many other states have mounted costly legal battles against the individual mandate.  Some states - like Colorado - have done both.  In a nutshell, an awful lot of money and time is being expended on a law that still has a very uncertain legal future……….

Pathologist Gizabeth, Metodical Madness, sends us a poem, Monarch Butterfly and well wishes. 

REFERENCES
History of Photography by Mary Bellis
The Development of the Camera over the Years by Mandi
Canon Camera Story
History of the Digital Camera by Mary Bellis