Demystifying Medicine One Month at a Time

Category: Grand Rounds

Grand Rounds

Welcome to Grand Rounds, where writers, readers, and bloggers send in their best stuff on a weekly basis to share, cross-pollinate, and build new audiences.

Tip of the hat to Grand Rounds co-creator Nick Genes, MD, PhD, an ER doc in NYC who knows a thing or two about blogging, tweeting and now Tumblr.

a timeless and inspiring read...

The theme of this week’s Grand Rounds is “Finding Meaning in Medicine,” with full attribution to Dr. Rachel Naomi Remen, author of the masterful book Kitchen Table Wisdom: Stories that Heal. My wife and I had the privilege of meeting Dr. Remen in 2008, learning from her during a glorious week in Bolinas, California at the Institute for the Study of Health and Illness.

Dr. Remen is an expert at re-connecting health professionals with what brought us into medicine in the first place. I can think of no better Grand Rounds topic than asking bloggers to share their meaningful stories.

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Stories of Meaning

Starting off, I’m linking to a story from Zocalo Public Square by Ken Murray, a family doctor at USC. His piece titled “How Doctors Die” has gone viral, as evidenced by the fact that I’ve seen it linked, sent, and tweeted more than a dozen times in different media.

Murray’s piece raises big issues of Meaning: namely, the big one: the meaning of life, and a less big one: the meaning of medicine. I, too, wrote a piece like his a while back, expressing my view that most doctors would never wish to die in a hospital, and share it with you here so that you can compare. Feel free to tweet mine, too, if you find it worthy. It’s called “A Good Death.”

Ed Pullen, a family doctor from Puyallup, WA, sent in a concise post from his self-titled blog explaining the value of ‘Keeping Perspective.’ He demonstrates that doctors offer meaning to our patients when we help them think through and make challenging medical choices. He gives several real world examples.

Jessie Gruman, founder of the Center for Advancing Health, sent in a poignant piece from the “Prepared Patient Forum” describing her frustration with how slowly the world of medicine makes progress. Using the metaphor of “It Takes Two to Tango,” she writes that a true patient-doctor relationship takes time and practice to establish. Forces outside of the relationship are often having a deleterious effect.

Medaholic, a medical student from Canada with an eponymous blog, posted about the time his grandfather was hospitalized and the formative emotional impact that it had on his medical education.

Elaine Schattner posted her reaction to Abraham Verghese’s novel Cutting for Stone on her blog “Medical Lessons.” The book raises the untold issue of doctors going into medicine to heal ourselves. Hmmm…..

Pranab Chatterjee, a fascinating medical blogger from India who writes at Scepticemia.com, sent in this post finding meaning in the “…madness of…[a medical school] examination.” I can’t believe the nutty things they ask on exams there. I’m glad the concept of ‘educational reform’ has taken hold here in the U.S.

Paul Auerbach, a professor at Stanford and the foremost authority on wilderness medicine, wrote in: “One of the ways that I find meaning in medicine is by educating people. There are many ways to feel good about being a doctor; one of them is having the opportunity to deliver information that might truly help someone prevent or treat a disease or injury.” He sent in a post clarifying breast cancer screening recommendations, particularly for patients that might be going into the wilderness for any length of time.

Finally, Dr. Grumpy, a prolific and funny medical blogger sent in this holiday-themed photo, positing for those that want to keep Christ in Christmas:

Happy Holidays!

Dr. G always reminds me that humor is the highest form of defense mechanism against medical, winter or holiday doldrums. And not taking ourselves too seriously has great meaning.

Grand Rounds will return to the blogosphere in 2012. I wish you a healthy and happy new year…and may the Force be with you!

It’s China(town), Jake

One of the more bizarre experiences I’ve had in medicine occurred on a recent trip to China.

Nicholson as Gittes: Best Movie Ever?

I’d been invited to meet with a doctor for a discussion and tour of Renmin (“People’s”) Hospital in Hubei Province. Before I went, she asked me to “give a talk.” Reasonably, she asked what  I was planning to speak on, though she indicated it would be good if I could talk about something in the category of “Functional GI Disturbances.”

Not being a subspecialist in that field (or any field, for that matter) I suggested that I’d be interested in learning about how hospitals in China are organized, or how health care is practiced, delivered, financed, and experienced. The kinds of things I think a lot about in these here United States.

We settled on “Clinical Ethics,” a topic that I could speak to, since I serve on GlassHospital’s ethics faculty and help in teaching the introductory course on medical ethics to first year students here.

I thought it would provide an interesting comparison of how health care is practiced in the two countries: would a “typical” American medical ethical dilemma translate into Chinese? What gives pause to doctors there and how do they work though clinically ambiguous situations?

I was a little nervous when the day came, never having rounded in a Chinese hospital before. I was also worried about getting lost in translation.

When I showed up, I was asked to “review the slides.” Always a good idea to mentally re-rehearse things.

I riffled though 74 slides. Not the ones I had sent. And wouldn’t you know? They were on GERD (gastroesophageal reflux disease) and NERD (yes, NERD!: non-erosive reflux disease).

The doctor who’d invited me was asking me to look over her slides, right? Maybe she wanted me to have a preview; maybe to make sure that things looked OK in English or in the medicalese.

I get it, I thought: reciprocal talks–first her on her topic, then me on mine.

“Looks great,” I told her. “Pretty detailed, in fact.”

“Excellent,” she smiled back. “Please proceed then.”

Huh?

You mean, you’re asking me to deliver a 74 slide lecture on a topic that I haven’t prepared in Chinese?

(OK, I was definitely not being asked to give it in Chinese.) But still.

I had been briefed in the pre-trip orientation about Chinese culture and the idea of avoiding shame and saving face.

And here I was, in front of 20-30 Chinese doctors and trainees, being asked to deliver clinical teaching rounds on a topic that I hadn’t prepared and in which I claim no expertise.

What would you do?

I felt the the heat on my cheeks, but to avoid causing offense, and perhaps because this was how things are done or at least interpreted, I jumped right in. I’m a bit of a ham, and I enjoy performing.

After all, the doctor who’d invited me had no doubt slogged away putting this beast of a talk together. And she’d done it for me! The least I could do was give her talk in clean, entertaining English. And let’s just say, at 74 slides, that there was a little redundancy built in.

Thank God it was on GERD, something I see every day as a practicing doctor, and not acoustic neuromas.

Oh, and NERD. I know a bit about that, too. Just never thought of it that way before.

By the way, later in the day I did get to give my talk on clinical ethics. It wasn’t nearly as fun as the one earlier in the day.

A Grand Rounds Celebration!

Hope you had a wonderful holiday weekend.

GlassHospital is proud to host this week’s Grand Rounds, a compendium of medical-related writing and blogging from around the world. This week’s theme, in honor of the holiday, is CELEBRATION. Here at GH we’re pleased to be celebrating the six month anniversary of our debut.

We have 21 pieces to share with you, including one poem and one photo. This week’s submissions, all celebratory-themed, seemed to cluster into five main categories: Aging gracefully, history & literature, medical drama, health care policy, and good ol’ humor. So pull up a chair, maybe a nice iced coffee, and dig in.

Here we go:

Aging Gracefully

Delia O’Hara, a former Chicago Sun-Times reporter, who blogs at Birth Story, wrote a beautiful post celebrating her older daughter’s graduation, and her own good fortune in being there.

Eve Harris, writing at A Healthy Piece of My Mind, wrote in about her family’s “Cancerversary,” a 20th anniversary remembrance of her mother and how the Internet has changed the ways we gather knowledge.

Dr. Elaine Schattner, who hosted last week’s Grand Rounds on her blog Medical Lessons, submitted a wonderful post about the performances of James Taylor and Carole King together both on television (and later after seeing them in concert at Madison Square Garden). Wearing her doctor’s hat, she can’t help but celebrate Taylor’s apparent success in kicking drug addiction. “Life gets better as you get older,” the music made her think. Amen!

Marie Cooper, blogmaster of Nourish: Living, Laughing, Whining sent in a celebration of her resiliency in the face of multiple sclerosis. Fireworks are loaded with meaning for her as she courageously faces her chronic illness.

Finally in the Aging section, we offer Dr. Kimberly Manning, author of Life at Grady, a blog about her doctoring at Atlanta’s most famous public hospital. This post was sent courtesy of the American College of Physicians publication “ACP Hospitalist.” Poor Dr. Manning thought she was the hippest, coolest attending around. Then an outdated reference blew her cred. All of it. Boy, can I relate to this one…

History & Literature

Some of us liberal-artsy types make it here in Medicine. We often celebrate with our writing. Examples:

Look no further than Medical Resident, blogger at A Medical Resident’s Journey. She wrote a lovely poem celebrating her stethoscope.

Michelle Wood, blogger at Occam Practice Management, submitted an interesting history of physician signers of the Declaration of Independence. Very theme appropriate. Know how many signers were docs? Three. [Correction: Four!]

I was lucky enough to be driving last week around the same time as Dr. Charles, and got to hear the StoryCorps piece on NPR from last week about Lillie Love. Dr. Charles sent in a wonderful post about celebrating life inspired by her story, at his blog The Examining Room of Dr. Charles.

Lastly, though not exactly celebratory, Inside Surgery sent in an interesting tidbit that medical buffs and historians will like:  how snake oil earned its reputation–despite purported health benefits!

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Grand Rounds Vol. 6 No. 41

GlassHospital is excited to announce that on July 6th we’ll be hosting the worldwide web’s Grand Rounds.

What does this mean?

Tune in here July 6th. We’ll be posting the finest medical writing from around the blogosphere. Anyone writing about an aspect of medicine is eligible to send in a post. Doesn’t matter if you’re a doctor, nurse, resident, student, or patient. That’s right, as long as it has a medical bent (and it’s topical), there’s a good chance it’ll be included here. Heck, we’ll even include administrators.

Submission Instructions

  1. E-mail submissions to our editorial board directly at glasshospital@gmail.com.
  2. Put Grand Rounds in the subject line and give us a <brief> description of your blog.
  3. Please include your name (nom de blog is acceptable), the name of your blog, and the url.
  4. One entry per blogger.
  5. Recent posts between 400 and 1000 words are preferred.
  6. Posts are to be written for a general audience.
  7. If there’s a potential conflict-of-interest, either don’t submit your post, or disclose it.
  8. Stick to this week’s theme, at least in some indirect way. If it’s not obvious, don’t be shy about telling us why it fits.

This week’s theme:

In honor of our nation’s birthday and the big holiday weekend, the theme of the week is CELEBRATION.

Send along a post that involves celebration (happy or sad, if you know what we mean); picnics, Fourth of July, Summer, fireworks, Mom, apple pie, patriotism, heroes…

DEADLINE for submission is 1 a.m. Central Time on Monday, July 5th.

Looking forward to your submissions.

GlassHospital

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