Friday Funnies- malfunction

from Close to Home by John McPherson

Shameless self promotion

Epocrates is sponsoring the 2008 medical weblog awards at Medgadget, and they are currently taking nominations.
As you should already know, the medical blogosphere is stuffed full of great blogs, but if a certain neuroscience, medicine, doctor, spirituality, Mormonism, philosophy, psychology, brain, neurology blog happens to be your thing, too bad. That’s not a category.

–However, best new blog might be a possibility. (wink, wink, nudge, nudge, know what I mean, know what I  mean.)

   In any case, head on over here to nominate your favorites.  The more voices the better.

Science and Salesmanship

Medicine often finds itself in a quandary as a profession.  Like any profession, it offers an important service.  In a sense, patients are customers and consumers.  Physicians do compete to some extent with naturopaths, homeopaths, nutritionists, acupuncturists and all who hawk their latest miracle cure or millennia old natural remedy on late night television infomercials.  We try to separate ourselves out from these with science, evidence base, and therefore increased credibility.  While this credibility is very important to patients, the truth is they just want to feel better.   The conflict is this, as a scientists, doctors are trained to be skeptical of all medical claims so they can be rigorously evaluated.  Yet, as healers, it is critically important to believe that what you are doing is, in fact, best for the patient, as the patient needs to believe in the treatment for it to have any effect as well.  In a very important sense, we have to sell what our recommendation is to the patient.  

On the Benefit and Perils of Youth

Choosing on a medical specialty involves learning your own answers to a series of questions?

-Do I enjoy patient interaction or not?

If no, consider Pathology or Radiology

-Do I like surgery and procedures more, or medicine and clinical reasoning, or both?

note- Anesthesia is a procedure and OR specialty, sort of surgery-lite.

Both- Ophthalmology, Orthopedic Surgery (well peds ortho anyway), ENT, Ob-Gyn, and Emergency medicine for procedures

-Do I prefer general, broad knowledge or limiting to one area or system, Primary care or specialist?

This is often a question of knowing a little about a lot, or a lot about a little.  However, It also involves whether you prefer relatively healthy patients or relatively sick.

-Do I do I prefer to see kids, adults, or both? (remember you can do almost anything for kids that you can for adults.)

The last question was easy for me.  From my point of view, pediatric care is superior to adult medicine in so many ways.

Phenomenal Cosmic Powers

We live in an age where our understanding of life is far beyond what our forefathers could have dreamed. We have cracked the genetic code. We have to capability to splice and dice. We have an entirely new field, bioengineering dedicated to the proposition that we can literally, “engineer life” to suit our needs. The breakthroughs we have made are astonishing. We have sequenced the entire genome of mankind. We have the power to modify species at will.

In a sense we have been at this for a very long time. We have domesticated the dog and the cat. The grains that we rely on to feed mankind are all a product of manipulation of one seed with another, keeping the ones that grow the “best” crop. Rice, wheat, corn are all essentially artificial and manmade in a sense. I find it a little ironic those that will look at genetically altered agricultural produce with fear and disdain when by definition, agricultural products are manmade. Whether we select genetic traits in a lab or in the field, the fact is we alter them.

Fixing cracks in the system.

    America has a love affair with blame.  When tragedy hits, do we ask what we can do to help, what we may have done to add to the problem, or other such pedestrian nonsense.  Heavens no, we want to know who screwed up and we want them to pay.  Who let this happen, we ask.  Journalists make it their only question.  Headlines wring out for weeks.  Politicians will find someone to throw under the bus.  People will go into defensive mode.  If we run out of proper candidates, we then pile it on God.  Hand wringing is everywhere, but actually identifying and solving a problem, now that is rare.

April fools, Grand Rounds, Encephalon, Giblets and assorted fun

   For All folks who care to know the week in medicine and healthcare blogging, The very long April 1st edition of Grand Rounds is out starting at GruntDoc and taking one wild, winding, twisting, turning ride through several blogs, strangeness, mutants, and valley girls until it reaches Emergiblog, capped off by the 11th hour submission by yours truly, many thanks for slipping me in, courageously killing the theme and the fun to let others learn about a touching and all too serious subject. 

    In Brain and neuroscience news, afficiandos will be excited to learn that Paris Hilton is hosting Encephalon at Of Two Minds and its totally “Hot.”   There is also some prurient airing of ScienceBlogs dirty laundry as Adventures in Ethics and Science angrily calls it quits.  I am still wondering if there is a little repressed venting going on, April first aside.  I guess we will have to hold our breath to see if she is still there tomorrow.

     Around the LDS bloggernacle, By Common Consent has a very special guest post appearance by Lars glenson, (or is it Glen Larsen, or perhaps the dearly missed Languatron) for all the mad Battlestar Galactica ranting you could ever need or want for your April 1st perusing pleasure, and  the Snarkernacle has announced open nomination for categories in the Giblets in parody of the ongoing Niblet award voting. 

Also I hereby declare today MSB day in honor the best medicine, neuroscience, lds, mormon, spirituality, disability advocacy blog in the universe.  Please celebrate by stroking my ego ad nauseum in the comments.  Its a highly specialized market, but those who really, really need to find their mormon brain, medicine, spiritual, disability, philosophy fix, where else you gonna go.  Your long and tireless search is over. 

All Fool’s Day indeed, enjoy.   

Placebos and the mind-body connection

One thing that consistently amazes me about the human mind is its intricate relationship to our health and well being. In anxiety, your muscles remain constantly tense and flexed, burning your energy supply, leaving you exhausted. Panic attacks can feel identical to heart attacks, as your body is flooded with stress hormones.

Every specialty has their own somatoform disorder. These are real physical symptoms that occur as a result of an outside stressor. They can include headache, irritable bowel syndrome, wheezing and trouble breathing, nonepileptic seizures, paralysis, chest pain, rashes or a host of other symptoms. Despite the tendency to claim, “It’s all in your head,”all of these conditions are very real and lead to the consumption of a lot of physician’s time.
Unfortunately because they are intricately related to the mind, they tend to be written off by doctors. We tend to see conditions as either physical or mental when the truth with any disease is that there are always strong components of both.

So where does this prejudice stem from? Oddly enough, I think it is rooted in our scientifically useful proof of the mind body connection, the placebo.