KevinMD.com

December 18, 2012Dec 18, 2012237

"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…

“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 …

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A gun owner responds to Sandy Hook

Physician voices

Honor the memory of the Newtown children by taking action

Claire McCarthy, MD

December 18, 2012Dec 18, 201215

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…

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 …

Physician voices

Why physician led pain care is important for patients

American Society of Anesthesiologists & Stanley W. Stead, MD

December 18, 2012Dec 18, 20123

, 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…

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 …

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Conditions and diseases

Sandy’s wrath is no match for nurses’ strength

Barbara Ficarra, RN, MPA

December 18, 2012Dec 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…

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 education

Medical eponyms and their connection with Nazi crimes

Ilana Yurkiewicz

December 17, 2012Dec 17, 201212

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 …

Conditions and diseases

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

Jennifer Middleton, MD

December 17, 2012Dec 17, 20126

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…

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, …

Conditions and diseases

Grief is not a disorder and should be considered normal

Eric Widera, MD

December 17, 2012Dec 17, 20122

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 …

Physician voices

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

Jeffrey Parks, MD

December 17, 2012Dec 17, 20125

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…

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 …

Drugs and prescribing

Saving the world from unnecessary prescriptions

David Gelber, MD

December 17, 2012Dec 17, 201211

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.…

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 …

Physician voices

I wonder about the mental effects of amplified noise

John Mandrola, MD

December 17, 2012Dec 17, 20122

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…

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 …

Physician voices

Do we make gun ownership a fifth vital sign?

David Mittman, PA

December 17, 2012Dec 17, 201210

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…

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 …

Physician voices

How a psychologist explained Sandy Hook to his children

Dominic A. Carone, PhD

December 17, 2012Dec 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…

In fact, the moment …

Physician voices

Operating on the hypercritically ill

Sid Schwab, MD

December 17, 2012Dec 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.…

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 …

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Operating on the hypercritically ill

Health policy

The loopholes around penalizing hospitals for readmissions

Brad Wright, PhD

December 16, 2012Dec 16, 20127

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…

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

Physician voices

Newtown, CT will not be the last time tragedy strikes

Mike Sevilla, MD

December 16, 2012Dec 16, 20129

I will say this up front: Newtown, Connecticut will not be the last time tragedy strikes. For good or bad, in this age of social media including twitter, it is easier to track the coverage of this story and people’s opinions about it. I have been thinking about this constantly today, and talking with my friends and neighbors about what happened this morning.

Outlining the problems setting up this tragedy …

Physician voices

Take back some of the richness that life can offer

Matthew Gibson, MD

December 16, 2012Dec 16, 2012

As I was driving to work this morning, I was thinking about how I wish I had time to exercise more. It's my 7th week as an intern, and I have only gone on a run once in that time…

As I was driving to work this morning, I was thinking about how I wish I had time to exercise more. It’s my 7th week as an intern, and I have only gone on a run once in that time (a 2.5 mile run last week in 25:30 — pitiful considering that two months ago I was running 8-10 miles at least once a week). I got to thinking about …

Physician voices

How can we as a society honor the dead children?

Claudia M. Gold, MD

December 16, 2012Dec 16, 20123

For the families who lost children, their world as they knew it has effectively ended. Yet somehow the sun rises again and the next day is here. For the rest of us grieving along with these families, the only way to move forward is to take what President Obama called “meaningful action.” I interpret this to be action that is radical and significant enough that it will somehow give meaning …

Physician voices

Locum tenens prepared me to volunteer in undeveloped countries

Renée Volny, DO, MBA

December 16, 2012Dec 16, 2012

For the majority of physicians in the U.S., taking their skills abroad and providing care via medical missions in undeveloped countries is usually not an option. For me, that was always an option. I am an OB-GYN who works as a locum tenens, a traveling physician who temporarily fulfills the duties of another. This has provided me the flexibility to have …

Physician voices

It is almost midnight: Can this day be over soon?

Miranda Fielding, MD

December 16, 2012Dec 16, 2012

"As flies to wanton boys, are we to the gods. They kill us for their sport." -King Lear, Act IV There are certain days that everyone will always remember. People of my generation uniformly remember where they were and what…

“As flies to wanton boys, are we to the gods. They kill us for their sport.”
-King Lear, Act IV

There are certain days that everyone will always remember. People of my generation uniformly remember where they were and what they were doing the day that John F. Kennedy was shot. My children’s generation will never forget 9-11. For my parent’s generation, images of Pearl Harbor, D-Day, Hiroshima and Nagasaki were burned …

Conditions and diseases

MKSAP: 65-year-old man with headaches and blurred vision

mksap

December 16, 2012Dec 16, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications.

On physical examination, temperature is normal, blood pressure is …

Real physician voices, twice a week

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