| KevinMD.com

The only words that explain Sandy Hook: Pure evil

BirdStrike, MD

Physician

December 18, 2012

Since the massacre of innocent school children and those that gave their lives educating and trying to protect them this past Friday at Newtown Connecticut’s Sandy Hook Elementary School, I’ve struggled to make sense of this calamity as much as much as anyone.

As a physician who has worked to save the lives of sick and injured children, and as a father of children the same age as those massacred in …

How do you know if a second medical opinion is justified?

Denise A. Somsak, MD

Physician

December 18, 2012

A patient of mine was seeing a local specialist. The parents wondered if it would be appropriate to get another opinion. Contrary to what patients might think, most physicians are absolutely fine with this and some even encourage it. However, patients often want to know if seeking another opinion is justified. It is my job as a primary care provider to help families decide when or how to obtain that …

After Newtown, treasure the preciousness of time

Kevin R. Campbell, MD

Physician

December 18, 2012

The events of the past week in Connecticut hopefully have given us all pause to appreciate the fragileness and uncertainty of life. We have all cried with heartache for the parents who have lost children. We have honored the adults that gave their lives to protect the students in their charge. We have all stood with outrage at the senselessness and brutality of this crime. As time passes, the families …

How to set a realistic bar in family medicine

Aaron George, DO

Physician

December 18, 2012

My fourth grade teacher labeled me “most inquisitive,” and I’d like to believe that superlative still rings true. But I challenge you to stop and think about it for a second – how do you set the “bar” of expectations in your own life? With your patients? With your family? With your commitments?

Are you the kind of person to place the …

I work for my patient because I care for my patient

Peter Elias, MD

Physician

December 18, 2012

As a physician for 35 years, I have strived to live up to a quote I first heard from my father: the goal in medicine is to cure sometimes, to relieve often, and to comfort always. During my more than three decades of practice, I have learned that one must combine a willingness to care and ability to hear with an offer to help in order to comfort – let …

Both mental health and guns deserve our attention

Jennifer Gunter, MD

Physician

December 18, 2012

The Newtown school shooting. It’s a tragedy that a mass shooting requires a qualifier, but this is America so we need to be specific as not to be confused with Aurora, Columbine, Arizona, or Virginia Tech. Colorado massacres require a site specific qualifier.

There are 2 common elements with all these massacres: mental illness and guns (not hunting rifles, but firearms designed to cause maximin human carnage in the shortest amount …

A gun owner responds to Sandy Hook

Edwin Leap, MD

Physician

December 18, 2012

“Hi, I’m Edwin, and I own firearms!”

Right now, in the shadow of the horrors of the Sandy Hook shooting, it feels as if every gun-owner is on edge. Some are apologizing, distancing themselves from gun advocacy groups. Some are saying all the right words, “well, my target gun is locked in a safe.” Like telling your Baptist Preacher grandpa, “my whisky is in a cabinet and is only for medicinal …

Read more…

A gun owner responds to Sandy Hook

Honor the memory of the Newtown children by taking action

Claire McCarthy, MD

Physician

December 18, 2012

I don’t know how to move forward after the shootings of the children in Newtown.

A lot of it has to do with the fact that I have a first grader. Whenever I close my eyes, I have visions of a gunman storming into his school. My son’s classroom is just off the main lobby–it would be his class a gunman would get to first. When I see the list of …

Why physician led pain care is important for patients

Stanley W. Stead, MD

Physician

December 18, 2012

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

All of us know the unpleasant feeling of pain. Often we know what caused it: a burn, a sprain or a surgical procedure. Most pain stops when the cause is removed and healing takes place. That is acute pain. When pain arises and persists for three months or more without …

Sandy’s wrath is no match for nurses’ strength

Barbara Ficarra, RN, MPA

Conditions and Diseases

December 18, 2012

While Hurricane Sandy’s fury wreaked havoc on the Northeast and caused massive destruction, one thing is for sure: Sandy’s wrath is no match for nurses’ strength.

Nurses’ role in the media is often overlooked because it often focuses on the heroic activities of the doctors. Health care isn’t a competition between nurses and doctors. Doctors and nurses are colleagues. Health …

Medical eponyms and their connection with Nazi crimes

Ilana Yurkiewicz

Medical Education

December 17, 2012

In 1977, a group of doctors began a campaign to change the name of an inflammatory arthritis after discovering it was named after a Nazi doctor who planned and performed gruesome forced human experimentation that killed thousands. In one of these experiments, for example, Hans Conrad Julius Reiter inoculated Buchenwald concentration camp inmates with the microbe causing typhus, resulting in the deaths of over 250 people. The …

Please don’t wear perfume to the doctor’s office

Jennifer Middleton, MD

Conditions and Diseases

December 17, 2012

Along with about 8.4% of the US population, I have asthma. To promote good doctor-patient communication, I can’t sit too far away from you. To perform a high-quality physical examination, I must enter into your personal space. Several minutes of inhaling that strong scent, however, can cause me to have trouble breathing.

I’ve never been brave enough to bring this up before, …

Grief is not a disorder and should be considered normal

Eric Widera, MD

Conditions and Diseases

December 17, 2012

Have you been tearful and sad after the death of a loved one? Did you notice changes in appetite, difficulty sleeping, troubles concentrating, and decreased energy for at least two weeks after the loss? Did you think that was a normal, healthy, and adaptive response to a major loss? Well, if you believe the new DSM-5 criteria approved by the …

Who’s responsible for Newtown? We all are, to some degree

Jeffrey Parks, MD

Physician

December 17, 2012

The events in Newtown, Connecticut will hopefully jump start a national conversation. That’s about the only solace I can take from the senseless murder of 20 schoolchildren in a classroom.

This conversation ought to transcend minutiae like the specifics of gun laws and gun show loopholes (although there will be a time for redressing these inanities). I don’t want to hear about …

Saving the world from unnecessary prescriptions

David Gelber, MD

Medications

December 17, 2012

Today I experienced another example of the growing efficiency of the healthcare world: The Steward of Scripts.

First, a little background information is necessary. After I perform surgery it is necessary to perform a number of immediate post operative duties. The operative note must be dictated, a brief note is written in the chart, post operative orders are written and, for patients that are going home the same day, prescriptions must …

I wonder about the mental effects of amplified noise

John Mandrola, MD

Physician

December 17, 2012

I grew up in Connecticut. It was in a town just like Newtown. It was safe and it was quiet.

I am a father and a grandfather. My life is surrounded with children.

This weekend has been tough. You try to read or write something, but the mind wanders. Then you feel sadness. The more you think about the specifics, the sadder it gets. Your heart aches.

Our nation feels it. I recently …

Do we make gun ownership a fifth vital sign?

David Mittman, PA

Physician

December 17, 2012

Please read the next few lines closely. This is not about the Constitution. Not about the “right to bear arms” or banning guns. Not about you answering this with some canned speech either way. Nor is it about having the answers. What it is about is the fact that even in small town America our neighbors have now learned what the big cities have known for a long time. It …

How a psychologist explained Sandy Hook to his children

Dominic A. Carone, PhD

Physician

December 17, 2012

The shootings at Sandy Hook Elementary School in Newtown, Connecticut have been traumatizing for the entire nation. While we have unfortunately become used to hearing about school shootings and other public mass shootings in the U.S., the brutal murder of 20 innocent elementary school children (all ages 6 and 7) is just too much to bear.

In fact, the moment …

Operating on the hypercritically ill

Sid Schwab, MD

Physician

December 17, 2012

I’m certain that if I hadn’t been just finishing a midnight appendectomy, Daphne would have died. Not fully balancing all the bad luck in her life, she fortuitously chose to exsanguinate when a surgeon and OR staff were immediately available. Nevertheless, vomiting all that blood, she damn near died before she got to the hospital.

Niceties like passing a scope to find …

Read more…

Operating on the hypercritically ill

The loopholes around penalizing hospitals for readmissions

Brad Wright, PhD

Health Policy

December 16, 2012

With notably few exceptions, the American health care system has been financed on the basis of volume rather than value. That means that we’ve been paying providers for everything that they do, rather than paying them for the outcomes they produce. This is not common in other fields.

For example, if you are in an accident and have to take your car to a body shop, you (or your insurance company) …