Grand Rounds Vol 2 (27)
Welcome to this week’s Grand Rounds, the weekly fest of the best of medical and medically related blogging from round the world. This week, the theme is cricket, the finest sport in the world. Test match cricket is played over five days. For those unfamiliar with the game, here is a thumbnail sketch.
You have two sides, one out in the field and one in. Each man that's in the side that's in goes out, and when he's out he comes in and the next man goes in until he's out. When they are all out, the side that's out comes in and the side that's been in goes out and tries to get those coming in, out. Sometimes you get men still in and not out.When a man goes out to go in, the men who are out try to get him out, and when he is out he goes in and the next man in goes out and goes in. There are two men called umpires who stay out all the time and they decide when the men who are in are out. When both sides have been in and all the men have been out, and both sides have been out twice after all the men have been in, including those who are not out, that is the end of the game.
Got that? Pretty straightforward, really. Before moving on to the intracacies of the game, I digress for a moment to consider the blogs that have been submitted this week.
Dr Crippen’s choice for NHS BLOG DOCTOR Blog of the Week is:
Auspicious Dragon
Potentilla was a frequent, argumentative and trenchant commentator from the earliest days of NHS BLOG DOCTOR. There were discussions, indeed arguments, about drug companies, freedom of advertising and many other topics. Potentilla is Christian Jago.
With her husband Colin, Christian is responsible for Auspicious Dragon, a blog that charts her life, family, job, travels, reading, photography and many other interests. And breast cancer. Wretched, bloody, disseminated breast cancer which is currently occupying a lot of her free time. She writes with wit, humour, patience, and exasperation about the state of the art therapy she is receiving, about the doctors, the treatment, the telephone calls, the logistics and all the ups and downs of dealing with cancer.
__________________
Wat Tyler at Burning our Money has a lot to answer for. It seems a long time ago, but in fact it was only last December that Wat suggested to Dr Crippen that he might start blogging about healthcare. A lot seems to have happened since then. Wat is an economist of stature in the UK. He makes no secret of his right wing politics. He monitors government waste and financial incompetence with relish. He is particularly concerned with health care economics, a subject to which he returns frequently.
Looking at the cost of worldwide healthcare, Wat states that "even though it's already the world's largest industry, it's now growing at about twice the rate of world GDP." And that is the road to disaster.
And we have not learned the lesson the USA learned about the cost of the Olympics. The UK government is to squander billions in the run up to the London Olympics. None other than Michael Johnson, the great American athlete, is critical of the UK Government approach:
_________________
There was a sypathetic response to the article I published on schizophrenia recently and it has been widely quoted. We must remember that this sad, wretched, mis-understood illness knows no boundaries and that we will all encounter it at one time or another.
The doc had just come off a long night shift and was walking home when he passed a road traffic accident. He did his best to help, but he was tired. Find out here about suing the Good Samaritan.
OK boys, we are all getting on now. And some have reached that point in life where the plumbing is not too good. Maybe it's Friday 13th but, for whatever reason, it has finally blocked. But here comes the urologist. Hope she is not superstitious!
We have the technology. Heavens, yes, we have the technology. We never give up. But sometimes, it is time to say godspeed.
Being in hospital is hardly like staying at the Ritz. It seems however that a private room may be cost efficient. I don't know what Patricia would think of that.
Amy is fed-up, and wants all you gynaecologists and diabetologists out there to get your act together and get rid of thrush. And she is not talking ornithology. Alternatively, send her some freebies and she will review them for you.
You may think the price is right. It sounded good to me to. But I did not read the small print.
A strange and distubing man. Dissection for the masses. Media anatomy. Is it just sensationalism, or is it of value? Find out from someone who has been there.
A good doctor-patient relationship is essential, particularly in psychiatry. Shiny Happy Person wonders why there are organisations in the UK which purport to protect patients from their psychiatrists. And there is good news and bad news about depression. The good news is that something really can be done, the bad news is that the media is keeping it secret.
Can you can afford psychoatric care? Still one of the greatest barriers to mental health care is cost. Particularly if you need therapy. What is the answer?
I took my son for a drink here and ended up with a bill for $80,000. Trouble is now, in the USA it's the same everywhere you go.
Dr Crippen's grandmother always said, "Well, it must be true, I heard it on the radio." Actually, she did not quite say that. She said "I heard it on the wireless". Now they are all around us in medicine. But are they really helpful?
And on a serious note, the background worry for all doctors, perhaps particularly family doctors. We do not want to see this. But Jon did here
A touching tale of breast asymmetry. We may hear more of this. And asymmetry may be diagnostically significant.
Sort your diet out with a simple questionnaire? Maybe it is not quite as easy as that. A diet to solve all the problems in the world? Dr Crippen has his doubts. See what you think.
It was Seneca who said, "Whom God wishes to destroy he first makes mad." A contemporary Greek commentator, resident in the UK, finds an unusual use for a Jet Engine.
How do you tell the sex of a butterfly? Not easy. But you would except a learned and respected organisation like the British Medical Association to get it right. They failed. And we have to look after butterflys like this because a shortage of them in Australia is going to have a devastating effect.
Those most in need of preventative medicine are the least likely to seek it out. It was always so. And it remains ever frustrating.
Dr Crippen always advises patients who are going to the USA to make sure they have good health insurance. Most of them do not worry about mental illness. They should! If you are going to go potty on holiday in the USA, pick the state with care.
Looking for a job which pays lots of money? Then move on from here. How about one which involves years of training, unsociable hours, lots of stress and very poor pay. You would have to be mad. Who would do that for a living? It has to be a vocation.
And you are always on the front line. If someone dies, you have to pick up the pieces. Literally.
Cricket at LordsYou have two sides, one out in the field and one in. Each man that's in the side that's in goes out, and when he's out he comes in and the next man goes in until he's out. When they are all out, the side that's out comes in and the side that's been in goes out and tries to get those coming in, out. Sometimes you get men still in and not out.When a man goes out to go in, the men who are out try to get him out, and when he is out he goes in and the next man in goes out and goes in. There are two men called umpires who stay out all the time and they decide when the men who are in are out. When both sides have been in and all the men have been out, and both sides have been out twice after all the men have been in, including those who are not out, that is the end of the game.
Got that? Pretty straightforward, really. Before moving on to the intracacies of the game, I digress for a moment to consider the blogs that have been submitted this week.
Dr Crippen’s choice for NHS BLOG DOCTOR Blog of the Week is:
Auspicious Dragon
Potentilla was a frequent, argumentative and trenchant commentator from the earliest days of NHS BLOG DOCTOR. There were discussions, indeed arguments, about drug companies, freedom of advertising and many other topics. Potentilla is Christian Jago.
With her husband Colin, Christian is responsible for Auspicious Dragon, a blog that charts her life, family, job, travels, reading, photography and many other interests. And breast cancer. Wretched, bloody, disseminated breast cancer which is currently occupying a lot of her free time. She writes with wit, humour, patience, and exasperation about the state of the art therapy she is receiving, about the doctors, the treatment, the telephone calls, the logistics and all the ups and downs of dealing with cancer.
Christian JagoLife in the slow laneChristian particularly draws your attention to a recent post here and I commend it to you, but spend some time roaming the whole site. Essential reading for both doctor and patient.
I have secondary cancer. I was probably going to die in 2003. That's why I'm retired in my early 40's and have time to write content for personal websites.
I retired from a busy job in a (then) global fund management company. This site was originally conceived as a way of communicating with the many kind people in 8 countries who wanted to know how I was doing. I got bored with sending out messages to enormous email groups saying, er, well, I'm still here. Look at the medical pages if you want more detail. There are also some rather stream-of-consciousness ideas on coping with cancer, in case they are useful to anyone.
Apart from that, the Cookery and Thoughts pages belong to me, and the Flora & Fauna pages to both of us.
__________________
Wat Tyler at Burning our Money has a lot to answer for. It seems a long time ago, but in fact it was only last December that Wat suggested to Dr Crippen that he might start blogging about healthcare. A lot seems to have happened since then. Wat is an economist of stature in the UK. He makes no secret of his right wing politics. He monitors government waste and financial incompetence with relish. He is particularly concerned with health care economics, a subject to which he returns frequently.
Looking at the cost of worldwide healthcare, Wat states that "even though it's already the world's largest industry, it's now growing at about twice the rate of world GDP." And that is the road to disaster.
And we have not learned the lesson the USA learned about the cost of the Olympics. The UK government is to squander billions in the run up to the London Olympics. None other than Michael Johnson, the great American athlete, is critical of the UK Government approach:
"As American athletes we were often envious of the support you get in Britain but at the same time it can hurt you because these athletes have the celebrity status and the sponsorship and all the things we have to work so hard for in America."Read the full article here.
_________________
There was a sypathetic response to the article I published on schizophrenia recently and it has been widely quoted. We must remember that this sad, wretched, mis-understood illness knows no boundaries and that we will all encounter it at one time or another.
The doc had just come off a long night shift and was walking home when he passed a road traffic accident. He did his best to help, but he was tired. Find out here about suing the Good Samaritan.
OK boys, we are all getting on now. And some have reached that point in life where the plumbing is not too good. Maybe it's Friday 13th but, for whatever reason, it has finally blocked. But here comes the urologist. Hope she is not superstitious!
We have the technology. Heavens, yes, we have the technology. We never give up. But sometimes, it is time to say godspeed.
Being in hospital is hardly like staying at the Ritz. It seems however that a private room may be cost efficient. I don't know what Patricia would think of that.
Amy is fed-up, and wants all you gynaecologists and diabetologists out there to get your act together and get rid of thrush. And she is not talking ornithology. Alternatively, send her some freebies and she will review them for you.
You may think the price is right. It sounded good to me to. But I did not read the small print.
A strange and distubing man. Dissection for the masses. Media anatomy. Is it just sensationalism, or is it of value? Find out from someone who has been there.
A good doctor-patient relationship is essential, particularly in psychiatry. Shiny Happy Person wonders why there are organisations in the UK which purport to protect patients from their psychiatrists. And there is good news and bad news about depression. The good news is that something really can be done, the bad news is that the media is keeping it secret.
Can you can afford psychoatric care? Still one of the greatest barriers to mental health care is cost. Particularly if you need therapy. What is the answer?
I took my son for a drink here and ended up with a bill for $80,000. Trouble is now, in the USA it's the same everywhere you go.
Dr Crippen's grandmother always said, "Well, it must be true, I heard it on the radio." Actually, she did not quite say that. She said "I heard it on the wireless". Now they are all around us in medicine. But are they really helpful?
And on a serious note, the background worry for all doctors, perhaps particularly family doctors. We do not want to see this. But Jon did here
A touching tale of breast asymmetry. We may hear more of this. And asymmetry may be diagnostically significant.
Sort your diet out with a simple questionnaire? Maybe it is not quite as easy as that. A diet to solve all the problems in the world? Dr Crippen has his doubts. See what you think.
It was Seneca who said, "Whom God wishes to destroy he first makes mad." A contemporary Greek commentator, resident in the UK, finds an unusual use for a Jet Engine.
How do you tell the sex of a butterfly? Not easy. But you would except a learned and respected organisation like the British Medical Association to get it right. They failed. And we have to look after butterflys like this because a shortage of them in Australia is going to have a devastating effect.
Those most in need of preventative medicine are the least likely to seek it out. It was always so. And it remains ever frustrating.
Dr Crippen always advises patients who are going to the USA to make sure they have good health insurance. Most of them do not worry about mental illness. They should! If you are going to go potty on holiday in the USA, pick the state with care.
Looking for a job which pays lots of money? Then move on from here. How about one which involves years of training, unsociable hours, lots of stress and very poor pay. You would have to be mad. Who would do that for a living? It has to be a vocation.
And you are always on the front line. If someone dies, you have to pick up the pieces. Literally.