Grand Rounds Vol. 5 No. 2

Welcome to the 2nd edition of Grand Rounds Volume 5. I am honoured to be hosting Grand Rounds for the 2nd time.

In this edition, I have a theme of “medicine and war”.  Personally, I have never experienced war, only simulated war-like conditions in military exercises. But my forefathers in Singapore have, during the Japanese occupation in Singapore during World War 2. The British could not defend Singapore and we fell to enemy hands. The Japanese Occupation forms a major part of Singapore’s history. When our government formed, we realised having our own credible defence force was necessary. As such, all able Singaporean males have to serve 2 years of conscript service. As my blog tag line says, i used to learn how to kill. Now in medical school, i learn how to heal.

I have tried my best to include every submission.  As such, it might not correspond with the theme all that well. Let me know how i went with my attempt. I hope you enjoy this edition.

This famous picture is that of Kim Phuc, a nine-year old girl running naked and severely burned on her backby a napalm attack. She is one of the many casualties of the Vietnam war. (Image credit)

At the war front…

Bongi at “other things amanzi” recounts a friend’s tale, wherein everything that could go wrong in theatre… went wrong, in “old rural surgery“.

The picture on the right, entitled “Flashlight Surgery In Saipan” by Robert Benney captures his story perfectly. (image credit)

War is one of the places where physical and emotional pain are most rampant, where life-changing realizations occur. The “How to cope with pain” blog reviews a book entitled “Age of Iron” by JM Coetzee, describing the experience of pain in life.

Trauma trauma trauma! The Samurai Radiologist who blogs at “Not Totally Rad” shares a story of a ENT friend who made his reputation after he literally “sewed the guy’s head back on..“. (image credit)

He continues to muse on the vagaries of professional reputation, particularly a radiologist.

Dr Deb points us to an interesting study which shows how social isolation can be experienced as “cold”, literally. Soldiers in war zones may be thrown in tough situations and be forced into social isolation. But will they literally shiver?

Or perhaps… will they become suicidal? Could the war environment increase risk of developing bipolar disorders? If so, should they be treated with lithium? Retired psychiatrist and author Dr Am Ang Zhang gives his take at his blog “The Cockroach Catcher”, whilst remembering the Rape of Nanking. (image credit)

Whilst still on the topic of suicide, Sam Solomon of “Canadian Medicine” reveals the internet’s deadly influence, after his highly popular post “The best way to die“.

Social isolation… suicidal intent… More often than not, depression is the mix as well. Ramona Bates from “Suture for a Living” addresses an important yet often unaddressed issue of “doctors with depression“.

Returning war veterans should be remembered and given the help they need. Recently, a New Yorker article highlighted the trauma experienced by soldiers who have taken lives in Iraq. “You can’t imagine what it’s like to kill another human being, until you’ve done it.” The bright side of things is that people who have killed can heal; they can make their peace with God. Susan Palwick at “Rickety Contrivances of Doing Good” highlights 2 individuals whom she knows, have done so.

Ian Furst at “Wait Times & Delayed Care” also met a WWII veteran. In his post “What have you done?“, he retells the war vet’s amazing bail-out stories, while deliberating on the provision of health care access in a prompt and timely fashion.

Casualties of war are inevitable. An estimated 160 million people died in wars in the 20th century, accorind to this source. It might even be more. Probably not relevant then, but now at least you can tell the time of death from body temperature. Really? Find out from Jolie Bookspan at “The Fitness Fixer”.

Caroline Vines, a Georgetown medical student on academic sabbatical living in Jordan, shares in her blog “From Dupoint to Abdoun”, some ramblings on episiotomies and more. In her debut into Grand Rounds, she shares her unique experiences in the Middle East, a highly volatile war zone. I highly recommend reading some of her other posts as well.

On the C-130…

(The C-130  [image credit] is often used to transport troops between war zones and safe zones in army bases, etc. When you’re on the C-130, you’re in between safe haven and challenging war scenarios. This section is dedicated to posts that are seemingly related to war, but not really.)

Finding joy during war is next to impossible. Similarly, patients suffering from chronic illness can find it difficult to enjoy things in life and find joy. Jenni Prokopy at “Chronic Babe” shares some tips on loving and living.

 

More on coping with chronic illnesses, Laurie Edwards at “A Chronic Dose” suggests “re-vision” by checking our expectations when we’re patients, and keeping an open mind when it comes to possibilities.

On the battle field, a keen sense of hearing and a heightened sense of caution are essential. Medical student/pharmacist Captain Atopic at “Degranulated” talks about his whispering wind of caution when thinking all things ‘medical’. (image credit)

Can corruption ever be eradicated? One might wonder if the money one donates for humanitarian aid ever reaches the people who really need them. Fret not, because Amazimtoti shows an example of corruption elimination in South Africa why we can still hope.

Homeland affairs and mini-wars…

Wars, in many other forms,  are rampant back at home. That is, if you look hard enough.

Sandry Szwarc, who blogs at “Junkfood Science”, elaborately talks about the battle against the epidemic of childhood obesity and diabetes. In similar statistical focus, she debunks the link between tylenol and asthma in children by critically appraising the controversial Lancet study. The strive for accurate facts and sound methodology in literature lives to fight another day. Allergy Notes also addresses a common physician-supported myth about seafood allergy and radiocontrast media.

David Williams at “Health Business Blog” shares this thoughts on the recent Chinese melamine milk scam. The war for safety in food products wages on.

At “Notes from Dr. RW”, a duel unfolds between the external forces and General Internal Medicine as a specialty. Will this specialty be no more in 20 years to come?

Ambulances are on the brave souls at the front lines of a healthcare delivery system. David Harlow at “HealthBlawg” blogs about the recent banning of ambulance diversions in Massachusetts, USA.

More war rages on, this time against the media which blast scary things when they don’t necessarily matter and don’t always hype the stuff that does matter. Dr Mintz has a recent post on some of the negative data regarding COPD drugs.

The Back Pain Blog also has declared war on neck pain. Link on to see how to win.

The fight against brain tumours and cancer seem to have a breakthrough. Read about it “Highlight Health” as it reports about the Cancer Genome Atlas’s molecular characterization of the brain tumours.

Amy Tenderich at “Diabetes Mine” reflects about peace-keeping attempts between life partners when diabetes is in the mix. Her reflections are prompted by birdie’s thoughts on a diabetes marriage.

The crusade for creativity and innovation in teaching marches on. “Clinical Cases and Images Blog” highlights a professor who uses Twitter for teaching his courses.

The internal fray against one’s own doubts and inadequate knowledge can be seen, as 3+speckled at “Rheumination” reveals how he was a denier of the S3 heart sound, its apparent magical powers, and a phonocardiogram’s “usefulness”. I can totally identify with the idea of denialism in an attempt to not look stupid in the wards.

Liz, a medical student blogger at “Urban Medicine”, reflects on her family medicine rotation, where patient confidentiality and sexually transmitted infections (STIs) clash.

While we are on infections, why not hop on over to “Medicine for the Outdoors”, where Paul Auerbach talks about poison oak allergic contact dermatitis.

As can be seen, mini battles exist everywhere. There exists a group of passionate people who look at the larger issues in..

Health policies and such…

Duncan Cross expounds passionately on health care, rights, and the “hypocratic” oaf.

Pete Zavislak at “Medical Pastiche” gives his piece on the necessity of medical underwriting and the fallacy of Obama’s socialist healthcare plan.

Louise at Colorado Health Insurance Insider talks about healthcare reform, and how the current economic crisis takes precedence, unfortunately.

Ironman over at “Political Calculations” offers an interesting hypothesis on how the disparity between life expectancies of the black and white population in USA can be attributed to Vitamin D deficiency.

Kim at “Emergiblog” interviews Denise King, president of the Emergency Nurses Association at its 2008 annual meeting, and highlights how getting involved is all that important.

Is medication non-complaince causing insurance dollars to be wasted? Over at “InsureBlog”, guest blogger Dr Val Jones has the inside scoop, and some startling results.

Type 1 diabetic and health writer Kerri Sparling at “SixUntilMe” takes on the insurance company, once again, for coverage for a continuous glucose monitoring system. Will the voices of seemingly insignificant patients ever trump and influence a giant corporation? Will infantry ever beat a mighty armoured tank? As a tank officer, i assure you the possibility. (image credit)

 

Privacy issues plague doctors as they search for a user-friendly online database. Joshua Schwimmer from “Tech Medicine” revisits Evernote, and advocates doctors should use it. Australia surgeon Dr Cris Cuthbertson also shares at “AppleQuack” 20 ways surgeons should user Evernote.

While on the topic of data management and sharing, head on over to “Medicine and Man” and hear what open source scientific data sharing is about.

Humour

Lastly, a dose of humour to finish things up. Dr. R at “Medical Jokes, Cartoons, Videos” enlightens us on copyright. or is it copy wrong? Find out here.

The next edition of Grand Rounds will be hosted by M.D.O.D on 7 Oct.

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