tag:blogger.com,1999:blog-82103262011-08-16T20:00:22.614-07:00musings of a psychiatrist in the pacific northwestaafannoreply@blogger.comBlogger6451100tag:blogger.com,1999:blog-8210326.post-1151552603098793082006-06-28T20:42:00.000-07:002006-06-28T20:43:23.110-07:00

...to say goodbye.Like Medpundit, I find that I don't have enough time to devote to this blog.It's been a lot of fun.

aafannoreply@blogger.com30tag:blogger.com,1999:blog-8210326.post-1151299042637394022006-06-25T22:17:00.000-07:002006-06-25T22:33:36.400-07:00

"Could you forgive the unforgiveable?" Kate Kellaway, in the Observer: "The Forgiveness Project...has no religious or political agenda. It has no agenda at all apart from the brave, unfashionable wish to turn the blame culture on its head, to share the stories of people who, in extremis, have discovered that 'the only way to move on in life is to lay aside hatred and blame'. It tells of victims

aafannoreply@blogger.com5tag:blogger.com,1999:blog-8210326.post-1150908274175926672006-06-21T09:41:00.000-07:002006-06-21T09:49:19.993-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Grief, originally uploaded by creativity+. ...for Pfc. Tucker and Menchaca.

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1150702712911565212006-06-18T23:44:00.000-07:002006-06-19T07:25:30.766-07:00

"The president?" The patient's eyes grew wide. She was ninety-two years old, and her memory was "not the best, dear." We had just met. I'd quizzed her gently, and she'd responded with bemused indulgence...until now. She looked directly at me, and scowled. "Here it comes," said her daughter. Here it came, indeed! A stream of bitter disapproval...It was 1998, and we had all just heard of

aafannoreply@blogger.com5tag:blogger.com,1999:blog-8210326.post-1150699439122344332006-06-18T23:37:00.000-07:002006-06-18T23:43:59.126-07:00

Michele G. Sullivan, in Clinical Psychiatry News: HENDERSON, NEV. — Treating medication overuse headache involves a three-pronged approach of patient education, teaching pain coping skills, and addressing psychological issues that put patients at risk for relapse, Alvin E. Lake III, Ph.D., said at a symposium sponsored by the American Headache Society.Most patients don't understand that excessive

aafannoreply@blogger.com6tag:blogger.com,1999:blog-8210326.post-1150581230817092872006-06-17T14:53:00.000-07:002006-06-18T23:24:49.546-07:00

...you showed us how to cheat. Forbes.com:Last fall, Bentley College management professor Tony Buono taught a class on corporate scandals with colleagues pitching in from finance, accounting and even the philosophy department. The four picked through the cases of Enron, WorldCom, Tyco and Shell.At the end of the semester, the number of students in a simulated trading room who were caught in

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1150258067384988242006-06-13T21:07:00.000-07:002006-06-13T21:10:15.356-07:00

Joel imagines a cafe that brings diners into a "bipolar experience."1. You would be surrounded by frowning people. 2. The food would be hospital food. If you did not eat it, they would not let you go home until you did. 3. The food would make you constipated or dizzy or wanting more and more and more... 5. The waiters would take notes on your behavior. 6. Voices would tell you

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1150255236403286732006-06-13T20:20:00.000-07:002006-06-13T21:13:49.230-07:00

I've made a rule here: "No medical advice is given on this site." But suppose that a commenter says: "To taper a med, do A, B, and C." Does that violate my rule? Should I delete the comment?And if another commenter states that such a taper is unwise or even dangerous, what then? Is that medical advice? Why does it matter? Each day, people ask Google about "stopping meds." Each day, Google

aafannoreply@blogger.com13tag:blogger.com,1999:blog-8210326.post-1148090354105367922006-06-13T18:38:00.000-07:002006-06-13T20:46:55.863-07:00

This can be terribly difficult. But it can be done. (Note updates!)I note Dr. Stephen M. Stahl's "dosing tips": "For patients with severe problems discontinuing paroxetine, dosing may need to be tapered over many months (i.e., reduce dose by 1% every 3 days by crushing tablet and suspending or dissolving in 100 ml of fruit juice and then disposing of 1 ml while drinking the rest; 3-7 days

aafannoreply@blogger.com22tag:blogger.com,1999:blog-8210326.post-1150175575121527142006-06-12T22:12:00.000-07:002006-06-12T22:12:55.270-07:00

A clear winner of the Most Regrettable Bedside Manner Award. In the New Yorker:Your husband was admitted with extreme pain in the abdomen, which is obviously not our fault...We didn’t want to rule anything out, so we opened him up.There were no multi-hundred-pound tumors; that’s the good news.However, it’s a real mess in there. There’s a lot of intestinal tubing squishing around—what you call “

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1150173411734589072006-06-12T21:36:00.000-07:002006-06-12T21:43:07.916-07:00

Some patients are discovering that their Medicare Part D drug coverage has a gap, and stops paying when a limit is reached. For some who qualify, coverage resumes later. The gap in coverage is called the "doughnut hole." Timely advice from OnThePharm: "Yesterday I had my first customer come talk to me about his medicare coverage. He spends quite a bit of money in the pharmacy, but he had opted

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1150171665405564732006-06-12T21:07:00.000-07:002006-06-12T21:14:54.733-07:00

From a multiple-choice pathology exam: 36. The poet Yeats wrote: An aged man is but a paltry thing, A tattered cloak upon a stick, unless... A. He finds a younger woman, has a fling, And then yells out, 'I never will confess!' B. He takes Viagra pills, to boldly bring To his beloved his mighty manliness. C. He uses Rogaine, and by next spring Has hair regrowth that's certain to impress.

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1150170863847758872006-06-12T20:54:00.000-07:002006-06-12T20:54:52.910-07:00

Or rather, don't heckle the student. I'm too late:

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1150170604614924192006-06-12T20:46:00.000-07:002006-06-12T20:50:04.746-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } DSC_0002, originally uploaded by shrinkette. Can't let it go. Sorry.

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1149831703301371532006-06-08T22:38:00.000-07:002006-06-08T22:51:05.616-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } DSC_0059, originally uploaded by shrinkette. ...and the world can't wait to see my vacation photos, right? I thought so! This is the Napali coast of Kauai, where I completely and utterly forgot about the rest of my life..

aafannoreply@blogger.com7tag:blogger.com,1999:blog-8210326.post-1148722176156007662006-05-27T02:26:00.000-07:002006-05-27T02:29:36.163-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Honolulu, originally uploaded by Mikey720. Greetings from Oahu. We needed a break! We'll be hiding out here for about a week. Blogging will be very sporadic for awhile...

aafannoreply@blogger.com10tag:blogger.com,1999:blog-8210326.post-1148394293118409262006-05-23T07:24:00.000-07:002006-05-23T07:37:52.886-07:00

Dr. Emer hosts this week's Grand Rounds at Parallel Universes. Note: Pediatrics has its own weekly roundup. This week, it's hosted by Blog, MD. And what's this? Indian Cowboy is starting a psychblogging carnival (coming June 1). Must think of something to submit. Looks like I'll be extremely busy...

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1148235199551564762006-05-21T11:00:00.000-07:002006-05-22T22:43:37.846-07:00

She's been our leader, our "doyenne," since 2002. We can't let her go without a send-off, can we? Come on in, I'll take your coat. Glad you could make it!The guest of honor is here. (She looks...happy. Relieved, perhaps?) We have quite a gathering. DB and GruntDoc are here, and Dr. Emer is relaxing on the deck. Dr. Choi brought his lovely family. Help yourself to our lavish buffet! Can I

aafannoreply@blogger.com6tag:blogger.com,1999:blog-8210326.post-1148194330791306412006-05-20T23:52:00.000-07:002006-05-20T23:56:58.386-07:00

Barry Bonds ties Babe Ruth's record, but there is no joy in Mudville. Mercury News:...maybe that's the one positive we can take from this whole sordid steroids scandal. If nothing else, Bonds is a living, breathing, tortured, tormented illustration we can point to when we tell our kids, 'You know, when you cheat, you're only cheating yourself.'Bonds has cheated himself out of the adoration and

aafannoreply@blogger.com5tag:blogger.com,1999:blog-8210326.post-1147927837256361932006-05-17T21:50:00.000-07:002006-05-17T22:23:50.623-07:00

This news is...huge."I no longer have the time needed to devote to (the blog). The phrase 'declining reimbursement and rising overhead,' is repeated so often in medicine that it seems a cliche, but it's also a reality. I'm spending longer hours at work and seeing more patients to support my office and my family. The 1-2 hours a day it takes to keep up the blog are no longer there. I don't have

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1147918719527876652006-05-17T19:18:00.000-07:002006-05-17T19:33:22.206-07:00

New Scientist Technology Blog:How'd you like to see yourself 30 years from now? It sounds terrifying to me, but if you fancy looking at an artificially haggard and gnarled version of you then pop over to this site. All you have to do it upload a picture of yourself and they promise to use 'facial transforming software' to age you 30 years or so.Should I try it? Er...you go first!

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1147917216735525812006-05-17T18:53:00.000-07:002006-05-17T19:32:08.060-07:00

Dr. Dinah would like to blog about "pet goats and ducks, as service animals for the emotionally distraught." But she can't. She's laughing too hard! The comment thread is priceless: ...And if the service goat flies for free, then my service spouse should fly for free, too. Roy, I'm gonna need a note.ClinkShrink said... Given a choice between sitting next to a service goat versus a

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147916387393413522006-05-17T18:39:00.000-07:002006-05-17T18:39:47.406-07:00

New Scientist:"The world's most popular fruit and the fourth most important food crop of any sort is in deep trouble. Its genetic base, the wild bananas and traditional varieties cultivated in India, has collapsed." (Yes, yes, I know. In the last post, I was restrained. And this post is about...bananas. However, this is a pure and wholesome blog! Do you suppose that my Id is getting feisty

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147758689691393242006-05-15T22:51:00.000-07:002006-05-15T23:00:08.330-07:00

Staff demonstrate for - and on - Dr. Maria. I've had this training, too. It's remarkably easy to take me down. A team of five staff can flip me like a flapjack. The leather cuffs go on, they're locked, and I'm down. (I don't try to resist!) Here's Maria: "And so it began—and it happened much more quickly than I had anticipated (although time may simply pass faster when one is actively

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1147757865635723162006-05-15T22:37:00.000-07:002006-05-15T22:39:44.480-07:00

...the flowers that were to be tossed at American liberators by grateful Iraqis. Dr. Stanley Renshaw, at Political Psychology Blog, observes:The expectation that American soldiers would be greeted as “liberators,” with flowers and sweets was reasonable enough. After all, Iraqis had been savagely brutalized by Saddam’s domestic rein of torture, terror and sadism. Robert Kaplan recently wrote that

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147754397394894082006-05-15T21:39:00.000-07:002006-05-15T21:39:57.396-07:00

BigMamaDoc is blogging again. What an ordeal she had!As I was wheeled back to my ER room, Dr. Resident said, "Well, you've had several more strokes. I count at least 8 new lesions. Maybe more. This is very interesting. Let me repeat some of the physical exam. "Oh, so who's the faker now, buddy?The Neuro ICU is a strange place to be when you don't feel particularly ill. Strapped down by IVs and

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147620956549582572006-05-14T08:33:00.000-07:002006-05-15T23:06:58.810-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Mother's Day, originally uploaded by Donna C.. I'm on call again. If your Mother's Days are rough, Dr. Serani has a post for you.Must get to work now!Update: Dr. Flea observes that the translations are a bit mangled. I

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1147553183564114612006-05-13T13:36:00.000-07:002006-05-13T20:43:39.066-07:00

The patient is furious. What should I say? Every word will be subpoenaed. Think, Shrinkette. Think some more...okay, a question:"Why are you suing your doctor?""Because I needed him, and he was not there for me!"(Afterthought: am I there for my patients? Am I there for this patient? I'm thinking about how I'm going to be subpoenaed...)

aafannoreply@blogger.com8tag:blogger.com,1999:blog-8210326.post-1147497148760336502006-05-13T13:15:00.000-07:002006-05-13T13:18:23.376-07:00

A Flickr group pool. It's filled with shots of "our parents, before we knew them." The mystery of mom and dad! An irresistible topic (for me, anyway). Here are some moms, before they were moms:.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Prettiest Bride Ever, originally

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1147411710257770952006-05-11T22:28:00.000-07:002006-05-11T22:28:30.260-07:00

It's a novel medicine for smoking cessation. Cigarettes just aren't as satisfying when you take this twice a day. From the FDA website: "The U.S. Food and Drug Administration (FDA) today approved Chantix (varenicline tartrate) tablets, to help cigarette smokers stop smoking. The active ingredient in Chantix, varenicline tartrate, is a new molecular entity that received a priority FDA review

aafannoreply@blogger.com18tag:blogger.com,1999:blog-8210326.post-1147411150073188002006-05-11T22:19:00.000-07:002006-05-11T22:22:05.053-07:00

She's had some strokes, and she's had some procedures. The latest word from her blog: She is doing fine, we should be heading home Friday. I will let her tell the story as only she can.Mr. Mamadoc What can she be going through right now? Hope she's okay...

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147410936519867152006-05-11T22:15:00.000-07:002006-05-11T22:15:36.520-07:00

A blog is deleted, and its author has an insight. The Blog That Ate Manhattan is no more. (Doctor, if you ever want to guest-blog over here, just let me know!)

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1147410405886543372006-05-11T22:06:00.000-07:002006-05-11T22:10:56.670-07:00

Peta Thornycroft blogs from Zimbabwe:With Zimbabwe’s official inflation now at 913 per cent, (international accountants say it is closer to 1500 percent,) it’s a pain going shopping. A decent sized whole chicken cost nearly a million Zimdollars this week.It’s hard getting enough money to pay for a couple of baskets of basics as there are long queues in banks, and the automatic cash machines are

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1147409504188960202006-05-11T21:51:00.000-07:002006-05-11T21:53:27.416-07:00

Neurologist Dr. Greg P., on the Emory "Dread" study. Suppose you knew that something bad was going to happen, and that you couldn't prevent it. Would you simply wait for it? Would you suffer more, and sooner, just to get it over with? Suppose we did imaging studies of your brain, while you chose and responded. What would we learn? Is this a good model for dread, and for responses to dread?

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1147156901031681762006-05-08T23:22:00.000-07:002006-05-08T23:41:41.236-07:00

A warm welcome to the newest psychiatry blog. Drs. Dinah, Clinkshrink, and Roy have created "a cyberplace for psychiatrists to talk." Here's Dr. Dinah: It was a hard winter. It started even before that, perhaps in October, right before I left to work in Baton Rouge-- one patient had a serious suicide attempt, several were in crisis, even the patients who were fine were having trouble getting

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1146942772918515262006-05-06T12:09:00.000-07:002006-05-06T22:09:32.520-07:00

He's 150 years young today. Mind Hacks has a round-up of interpretations. Who wants to analyze Freud? Times Online tries: Although his writings were not scientific in any rigorous sense, and although he was not the lone pioneer that he claimed to be, supposedly charting a completely unknown psychological continent, there is no doubt that it was he who made us aware, in a straightforward and

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1146715834124374492006-05-03T21:08:00.000-07:002006-05-03T21:11:46.550-07:00

Trick-cycling for Beginners: Allow me to tell you about some of the side effects I have experienced over the years.One drug made me sleep for up to 20 hours a day.One caused violent headaches and nausea if I forgot to take a single dose.One made my mouth so dry that no amount of water or chewing gum could prevent my lips and cheeks from constantly sticking to my teeth from lack of saliva.One

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1146715061818154042006-05-03T20:57:00.000-07:002006-05-03T20:57:41.830-07:00

Just posted: "Greetings from a Friend of Bigmamadoc. I'm here to pass along an update for the good lady. Here goes:"The procedure last night terminated early once they saw how goopy things were in those brain arteries. (Pardon my non-medical translation.) The new plan is to stent the artery on the right side Thursday and the left side on Friday or Monday. She'll be in the Neuro-ICU unit over the

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1146714592395424592006-05-03T20:49:00.000-07:002006-05-03T20:52:49.090-07:00

Dr. Deborah Serani: "...if you're like most people, the triangle that is rotated more from the vertical position is the one that is suffering more. The triangle that is vertical, standing on point is stronger."In a recent study, Pavlova and her colleagues[1] found that imbalance or instability in a picture of static objects is what leads individuals to attribute emotion to them. In a

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1146635836339592342006-05-02T22:57:00.000-07:002006-05-02T22:58:02.406-07:00

Her latest post:Greetings from UCSF Medical Center, room L872, where I was admitted Friday night with several new strokes, bilateral frontal lobes this time. Turns out my bad mood was nothing but poor perfusion; a few intracranial stents this afternoon should do the trick. Please forgive the brevity of this message. Typing is a challenge with limited use of my left hand.Our thoughts and prayers

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1146457588152003142006-04-30T21:26:00.000-07:002006-04-30T21:29:30.680-07:00

4/30/magazine/30wwln_q4.html">NYT: Deborah Solomon interviews Carlos Fuentes.At 77, do you think much about age and mortality?I don't think about it at all. What will come will come. I have two children who died before reaching 30, so who am I to complain about being alive?You've had more than your share of sorrows.Most of all not having my son around. I was very proud of him. He was a very good

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1146457010968519472006-04-30T21:16:00.000-07:002006-05-02T23:22:30.790-07:00

...for a NYT article. Men's life expectancy is increasing; good-bye to the "merry widow!" Dr. Helen is having none of it: "In this pathetic excuse for an article, the theme appears to be that because men are living longer, this might put a cramp in women's lifestyles." Was it Dorothy Parker who said: "This is not a book to be taken lightly. It is to be hurled against the wall with great force

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1146456144217196952006-04-30T21:02:00.000-07:002006-04-30T21:02:24.406-07:00

NYT Magazine: "On the day after Hitler arrived in Vienna, a gang of Nazis stormed into Freud's apartment, at 19 Berggasse. They ransacked the place and made off with a fairly large sum of money. ('I never got so much for a single session,' Freud, never at a loss, observed.) They only left, it is said, when the old man, trembling and frail, appeared from out of his consulting room and fixed them

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1146346393253015742006-04-29T14:33:00.000-07:002006-04-29T14:43:45.466-07:00

Dr. John Horgan, psychologist, at an anti-terror conference:"It will not work. It means different things to different people and there is the wrong assumption that if we can identify the traits of known terrorists we can move into predictions."The terrorists are not a homogenous population and we simply do not understand why some move from legal activities to illegal."Too much is based on a

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1146334072819841382006-04-29T11:07:00.000-07:002006-04-29T11:56:51.906-07:00

A junior psychiatrist rants. "I feel for you. I understand why you feel so bitter." At Trick-cycling For Beginners:A nurse in our meeting, a senior nurse, the head of the community mental health team, who has never met this patient, gave us this very helpful and thoughtful recommended treatment plan (I quote her, verbatim):"You need to turf her - a waste of space like that."All through the

aafannoreply@blogger.com18tag:blogger.com,1999:blog-8210326.post-1146030680328990112006-04-25T22:46:00.000-07:002006-04-25T22:51:20.343-07:00

Adam Christian in Slate: Sarah Hepola's confessional piece on her recent decision to shut down a long-running blog prompted fraysters to share their own struggles of addiction...TheNate discusses the successive stages of his own detox: "My nine months as a blogaholic ended in August. It was a gradual withdrawal that began with accepting a higher media than myself and ended with me carrying the

aafannoreply@blogger.com7tag:blogger.com,1999:blog-8210326.post-1145746737788149472006-04-22T15:58:00.000-07:002006-04-22T16:01:02.376-07:00

SobekPundit: "In this urn, we see the potato figure again, but this time in a more stylized form than at Lascaux. Recent discoveries on the island of Crete have created a near-consensus that this urn represents an ancient myth, in which Zeus transformed himself into a tuber of some sort, in order to seduce the Minoan Queen. The fact that three such potatoes appear has led some to speculate a

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1145745813121587682006-04-22T15:34:00.000-07:002006-04-22T15:43:33.180-07:00

...is that it never causes any adverse effects. Whatever physical or emotional symptom is present, it's always due to "something else." At least, that's what some patients tell me. Example:"I'm hungry all the time. I've gained 8 lbs this month." Are you still smoking medical MJ daily? "Yes, but that has nothing to do with it."And: "I can't get out of my chair, I have no energy and I can't

aafannoreply@blogger.com14tag:blogger.com,1999:blog-8210326.post-1145730736756890272006-04-22T11:32:00.000-07:002006-04-22T11:32:16.926-07:00

Bora explains:Every now and then a blog shuts down. There are as many reasons as there are bloggers, ranging from getting bored, through getting Dooced, to dying. Every blogger goes about shutting down the blog in different ways. I tried here to put down, in more or less systematic way, the dos and donts of shutting down a blog. If you disagree with some of the points or have additions, please

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1145674850336593792006-04-21T19:42:00.000-07:002006-04-22T08:39:10.793-07:00

"Sometimes things intended to make us safer may not make any improvement at all to our overall safety, and in rare instances they may actually make us less safe. The human tendency to take risks may trump all the efforts of the safety engineers." Cynthia Wood, at Damn Interesting:"Dr. Gerald Wilde of Queens University in Ontario proposes a hypothesis he calls risk homeostasis. In a nutshell it

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1145673525245340172006-04-21T19:38:00.000-07:002006-04-21T20:20:51.793-07:00

this? Yes, says BBC News: It's "rich in Vitamins B and C, and has ten times more iron than cow's milk." Can't wait for the marketing campaign.

aafannoreply@blogger.com7tag:blogger.com,1999:blog-8210326.post-1145594018735766652006-04-20T21:33:00.000-07:002006-04-21T12:04:23.216-07:00

"I'm astral travelling, and I don't like it."

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1145594000657947012006-04-20T21:21:00.000-07:002006-04-20T21:47:20.360-07:00

Primary Care Doc is on the line. Three times, he has sent his patient to ER with suicidal ideation. Three times, the patient told ER he was fine, and was sent home. "He's back in my office, and what do you suppose he's telling me...again? I'm no good with psych patients. I don't know what to do with them! Now the ER's asking if he's bipolar."I've had him on Zoloft, Prozac, Effexor, you name

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1145593163681358352006-04-20T21:19:00.000-07:002006-04-20T21:19:23.683-07:00

...the first real life Barbie is a 24-year-old graduate of Kent State University School of Performing Arts called Erin Coors. She was about to accept a minor role in a fringe production when Mattel selected her as the one to bring Barbie to life....Barbie will be travelling across America for the best part of a year, stopping off at 80 small towns, and the occasional large one, to perform the

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1145592751097516292006-04-20T21:12:00.000-07:002006-04-20T21:14:22.580-07:00

Los Angeles Times:Probably the most promising recent discovery has been that of the role of a gene called "sonic hedgehog" in hair growth. The gene (which is indeed named after the Sega video game) is known to be vital to the development of organ systems in embryos. In adults, one of the few "organs" that continues growing and relying on the gene is hair.Curis Inc., a Cambridge, Mass.-based

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1145344341986789402006-04-18T00:12:00.000-07:002006-04-18T00:12:22.153-07:00

Fat Doctor hosts our weekly roundup of medical blogging. Don't miss it!

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1145287212495241942006-04-17T08:02:00.000-07:002006-04-17T09:44:10.050-07:00

...or, as we call it: "our hospital, at Easter." Match each hospital area to its treats: ICU Emergency Room Cardiac Unit Information Desk Psych Unit Med-surg Unit _____Chocolate bunnies_____Marshmallow peeps_____Jelly Beans_____Chocolate-covered marshmallows_____Foil-wrapped designer chocolates_____Easter-themed cupcakes_____Miniature chocolate bars_____

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1145136475473159632006-04-15T14:27:00.000-07:002006-04-15T15:15:39.550-07:00

.flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } From Me To You..., originally uploaded by **Anna. Flickr Easter clusters: here. (Who is that model who's wearing nothing but marshmallow peeps?) Flickr Spring clusters: here. And have you seen Laura's gorgeous flower

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1145136188915156552006-04-15T13:59:00.000-07:002006-04-17T09:40:50.876-07:00

Very Important Doctor is on the line. "Sure, go ahead!" He speaks quickly. Better write this down. He must want a consult.The patient is in her 60's. He's known her for years. She had pain. He started a pain med. She got dizzy and sleepy. She fell. She had a fracture. She had surgery...then complications. They were bad complications..."How awful," I say.Pause. Silence. He goes on:

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1145138271535104522006-04-15T13:56:00.000-07:002006-04-15T21:37:57.563-07:00

Professor Batty:Workers in veterinary clinics have a name for it: "Exploding Cats." No quite as gruesome as it sounds, but a spectacle to be sure. When a cat has lived in isolation, never having seen a dog or other animal before, it is quite liable to "explode" in a fury of clawing, writhing and spitting. In the wild, it is an effective survival technique....Sometimes the human animal has its

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1145134331727406432006-04-15T13:50:00.000-07:002006-04-15T14:41:20.246-07:00

New Scientist: "Evidence from a clandestine lab in eastern Europe suggests that gangs are trying to hide cocaine by incorporating it into a host of innocent-looking transparent plastic consumer products, such as fish tanks, DVD cases or light fittings for cars. These could be imported en masse with no customs officer giving them a second look."The trick came to light after police searched an

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1144814908070564642006-04-12T00:01:00.000-07:002006-04-11T23:08:31.726-07:00

The Cheerful Oncologist, on a study of near-death experiences:“A new study finds that people who have had near-death experiences are generally more likely to have difficulty separating sleep from wakefulness.”"Oh, no…don’t tell me that after years of reverent admiration of those souls who stand at the shining gates of heaven, toothbrush in hand, and are told that it was not their time, then

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1144822518376174202006-04-11T23:15:00.000-07:002006-04-11T23:15:18.380-07:00

Advice that's making the rounds:1. DO NOT commit suicide, and stay extremely calm if you have missed the rapture. There will be a period of total chaos, suicides, and heart attacks. People all over the world will be in total chaos. Please understand the fact that you who remain here have missed the rapture, and are living in the tribulation period, and nothing you do can change that fact. Listen!

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1144821820009050822006-04-11T22:46:00.000-07:002006-04-11T23:03:41.406-07:00

"The urge to eat crayons.""The psychology of Spongebob.""Gonzo Emergency Medicine" (Strangely, the Cheerful Oncologist doesn't have the top spot. He should have it.)"Blogging creates communities."And:"Psychiatrist blog."(I'm so proud!)

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1144819649328536182006-04-11T22:27:00.000-07:002006-04-11T22:45:37.866-07:00

This week's roundup of health-care blogging (aka "Grand Rounds") is up! Our host: "Anxiety, Addiction and Depression Treatment Blog." Featured bloggers: GruntDoc, Kevin MD, Dr. Charles, Difficult Patient, The Blog That Ate Manhattan, and more. Go there at once!

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1144734786941201732006-04-10T22:53:00.000-07:002006-04-10T23:25:06.536-07:00

"...more frequently than men think about sex." So says Times Online, citing a British magazine's survey of 5,000 women. Note: "...29 per cent worry about their size and shape every waking minute." (No word on study design or selection criteria, though. Too bad!) Of those questioned in the poll, nine out of ten said that they dieted, with 41 per cent saying they were constantly on a diet. Half

aafannoreply@blogger.com12tag:blogger.com,1999:blog-8210326.post-1144608037599879612006-04-09T11:08:00.000-07:002006-04-09T17:17:32.020-07:00

(Scene: a simple stage. Spotlight on three dubious characters.)Id: I want to blog!Superego: Quiet. We're busy now.Id: I don't care. I like blogging.Ego: How can we blog now? Taxes...unfinished charts...what's this "alternative minimum tax," anyway?Superego: Right, just blog about how we can't get anything done, because we're blogging. Brilliant.Enter Giraffe.Giraffe: Will you three pipe

aafannoreply@blogger.com10tag:blogger.com,1999:blog-8210326.post-1142807205496044712006-03-19T14:26:00.000-08:002006-03-19T14:26:45.516-08:00

It is entirely too busy here.

aafannoreply@blogger.com10tag:blogger.com,1999:blog-8210326.post-1142234751210199432006-03-12T23:25:00.000-08:002006-03-12T23:27:18.603-08:00

Dr. Michael Hebert: "I was just covering for the weekend. 'Just covering' means doing a lot of dancing on thin ice."Room 441 looked easy. DNR was written loudly on the chart, telling me that the patient and family recognized that the end was near and were requesting that no resuscitation measures be taken...I went in, and found myself surrounded by anxious family members. My stomach told me

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1142195015422376912006-03-12T12:23:00.001-08:002006-03-12T12:27:29.243-08:00

On "This Week with George Stephanopoulos:"STEPHANOPOULOS: Our voice this week, Art Buchwald. The Pulitzer Prize winner is best known for his razor-sharp columns published in more than 300 newspapers. And now, Buchwald is scripting his final days. Refusing dialysis, the 80-year-old author has decided it's time to die. From a bed in his Washington hospice, he tells us why.(BEGIN VIDEOTAPE)BUCHWALD:

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1142189826557435932006-03-12T10:57:00.000-08:002006-03-12T11:38:29.950-08:00

In the Telegraph: an extract from Martin Gayford's forthcoming book, The Yellow House. Gauguin and Van Gogh shared a yellow house in Arles. Van Gogh suffered bizarre symptoms (reviewed here). Gauguin was overwhelmed. Van Gogh asked: are you planning to leave? Yes, said Gauguin. ...Later in the evening, around 10.30pm to 11pm, he took the razor with which he sometimes shaved his beard

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1142139032420226222006-03-11T20:48:00.000-08:002006-03-12T11:43:43.326-08:00

1. What did Shrinkette spill on her computer keyboard this week, rendering it inoperable?A. Chateau de Beaucastel Châteauneuf du Pape, 2001B. "Cosmic Elixir" (dewdrops collected from the leaves of 12 endangered plants)C. Infusion of virginal tea leaves harvested from the shady side of the Himalayas during a full moon (-via the C.O.)D. tap water2. Which blog fodder went unposted, due to a soaked

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1141784832475030932006-03-07T18:27:00.000-08:002006-03-07T18:37:40.140-08:00

I was halfway through a post about my recent experiences on call. Then I realized: it's almost identical to this post, and this.You see the rhythm of my life.

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1141281427896899452006-03-01T21:55:00.000-08:002006-03-02T07:20:53.593-08:00

Thank you for the kind wishes! The eye drops are doing their job. This isn't my first eye injury. The windows to my soul are frequently smudged and scratched by diverse foreign matter: dust, sand, cinders (in London!), cigarette ashes (in Chicago). Eye shadow (two hours before my wedding! My groom brought me to the ER, and I sat there, cringing, in my wedding gown.) Cat's paws, baby's

aafannoreply@blogger.com12tag:blogger.com,1999:blog-8210326.post-1141023800520335742006-02-26T23:01:00.000-08:002006-02-26T23:03:20.546-08:00

It's blurry. Just came back from ER.Doc says I have a corneal abrasion.Does. Not. Feel. Good.More later...

aafannoreply@blogger.com13tag:blogger.com,1999:blog-8210326.post-1140915220404414232006-02-25T16:53:00.000-08:002006-02-25T18:49:55.836-08:00

Missbhavens is a videoblogging Labor & Delivery nurse. What happens when she eats White Castle burgers?With apologies to vegetarians everywhere, I have to say that I can't get enough of that mini-burger stuff. I eat them so infrequently (for obvious reasons) that when I finally do get my hands on one (or six) I find myself overcome with a joy that can best be expressed through the power of The

aafannoreply@blogger.com7tag:blogger.com,1999:blog-8210326.post-1140675839619576702006-02-22T22:23:00.000-08:002006-02-22T22:40:46.386-08:00

In the New Yorker: a review of Dr. Jonathan Haidt's “The Happiness Hypothesis," and Dr. Darrin McMahon's “Happiness: A History.” Once you get past the reviewer's fable of "Ig and Og," it's quite interesting.One of the key questions—going straight to the heart of the Enlightenment ambition for us to be happy here and now, in this life—is whether happiness is a default setting of the brain. That is

aafannoreply@blogger.com14tag:blogger.com,1999:blog-8210326.post-1140372093862616992006-02-19T08:50:00.000-08:002006-02-19T12:11:58.856-08:00

Won't some child psychiatrists come forward, to answer this post...and this one? I've posted on adult ADHD before, and my views haven't changed. (These are my personal views. I can't speak for my profession.)I note Dr. McClellan's comments, in this online discussion at WAPO:Alexandria, Va.: Not only has there been a rise in children diagnosed with Bipolar but also with ADHD. I'm not sure I

aafannoreply@blogger.com23tag:blogger.com,1999:blog-8210326.post-1140323268466303662006-02-18T20:27:00.000-08:002006-02-18T20:52:00.583-08:00

It's not a Monty Python sketch. Details: here. Also struck off: "a nurse who put a patient's glass eye in a ward sister's drink." Shhh...listen. Do you hear that sound? That's Dr. Crippen, tapping at his keyboard...polishing his post about these nurses...

aafannoreply@blogger.com6tag:blogger.com,1999:blog-8210326.post-1140158001251357232006-02-17T00:33:00.000-08:002006-02-16T23:42:39.620-08:00

The headline is misleading, but it's great Friday blog-fodder. Psychologists ask: at what point does conscious thought become detrimental to problem-solving? When is it better to...stop thinking? In the Guardian: "Tough problems best left to the unconscious mind"Here's a suggestion for the next time you need to make a complicated decision: stop thinking. According to a new study, thinking

aafannoreply@blogger.com11tag:blogger.com,1999:blog-8210326.post-1140161929904187122006-02-16T23:00:00.000-08:002006-02-16T23:38:50.000-08:00

I wandered off with my watercolors for a bit, painting the flowers on my desk (they're like Spring - you should see them!). Now, checking in, I find more than 20 amazing comments to this post! Some are like essays. Bardiac asks why docs feel devalued... that topic could occupy a series of posts. (Managed care is only part of the answer.)Most docs actually want their patients to be well

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1139985128826571552006-02-14T22:32:00.000-08:002006-02-15T09:39:09.970-08:00

From the archives of NHS Blog Doctor:Patients often bring Dr Crippen articles from newspapers or from the 'Daily Mail'. He just doesn’t know how he would manage without them. He only spent six years at medical school with four years post-graduate training and then another twenty years in practice, so obviously he cannot be expected to know everything.It so refreshing therefore that helpful

aafannoreply@blogger.com28tag:blogger.com,1999:blog-8210326.post-1139984500060056412006-02-14T22:21:00.000-08:002006-02-14T22:27:16.283-08:00

At WebMd Blogs: "Sexual Addiction: Real or Invented?" Here's Dr. Louanne Cole-Weston, PhD:"I hold the viewpoint that the concept of sexual addiction was created by factions of the mental health community who were personally uncomfortable with robust sexuality and who possibly also wanted to create a new way of attracting therapy clients. The problem is, those who 'treat' sexual addiction, by

aafannoreply@blogger.com6tag:blogger.com,1999:blog-8210326.post-1139983371242632952006-02-14T22:02:00.000-08:002006-02-14T22:18:45.230-08:00

Via the Difficult Patient blog. Dr. Barron H. Lerner, MD, writes: It is not easy to delineate the characteristics that make a patient difficult. First, different physicians have different reactions to various types of behavior. In other words, behavior that one physician might find annoying, another might find to be particularly challenging or even endearing. Second, the characteristics of a

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1139982851447403292006-02-14T21:54:00.000-08:002006-02-14T21:58:14.526-08:00

From the new intern at Realspace:I mean, it's happened before, when we were students in our med rotations, and certainly when I was doing palliative care, but this is the first that I've had a hand in arranging things for, following up, that I saw almost every day.. Heck, he'd been in this hospital longer than I had. He was quite young too, hadn't even made 50 years old. He always had a smile for

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1139935398666281202006-02-14T08:43:00.000-08:002006-02-14T08:43:20.283-08:00

...isn't it? Scott Adams, on his Valentine's Day offering to his sweetheart:I cleverly bought some flowers a day early in order to beat the Valentines Day rush, and also so I could get the “good stuff” before it was gone. What I learned is that smarter guys bought all of the “good stuff” at least TWO days ago. I couldn’t go home empty handed, so I picked the best of what was left. It was grim.I’m

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1139931574212977132006-02-14T07:39:00.000-08:002006-02-14T07:39:34.340-08:00

is up, at Dr. Maria's blog: Intueri.Welcome to the personal ads of Grand Rounds. It’s Valentine’s Day and you’re looking for that special someone—or just some stimulating entertainment. Skim the personals below and if any tickle your fancy, don’t be shy—that click could be the sound of a love connection.

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1139785501992946242006-02-12T15:05:00.000-08:002006-02-12T15:13:32.146-08:00

...for your (much appreciated!) reaction to my recent posts about med-induced weight problems:The truth is, health and appearance are absolutely, 100%, forever intertwined. How many of us have looked in the mirror and felt 'depressed?' How many of us have avoided working out because we worry about what we'll look like at the gym? How many of us stay in unhealthy relationships because we worry

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1139784461359803692006-02-12T14:47:00.000-08:002006-02-12T14:58:50.466-08:00

...to this post, about a patient's rapid, severe, iatrogenic weight gain. (That miserable black hole of a post, from which I have not yet found escape!) Here's Sera, who blogs at A Safe Place: The weight gain associated with psychiatric meds sucks. It's a pain in the butt...and the hips, and the knees and the back. But the reality is that the giant spiders that used to hang out on my ceiling,

aafannoreply@blogger.com3tag:blogger.com,1999:blog-8210326.post-1139558773329280922006-02-10T12:09:00.000-08:002006-02-10T00:16:00.136-08:00

The bloggers and commenters have spoken. They aren't letting me get away with this! I accept cultural stereotypes about female beauty. I'm appalled that this teen gained 42 lbs in less than a month, during treatment for psychotic symptoms. When I protest that "health" is my main concern, and that appearances aren't important, I'm kidding myself. How I've been forced to re-examine myself!Using

aafannoreply@blogger.com14tag:blogger.com,1999:blog-8210326.post-1139465977059374932006-02-08T22:10:00.000-08:002006-02-08T22:19:37.080-08:00

"...is a documentary film profiling nine older women as they talk about themselves, sex and love in later life," says the physician at The Blog That Ate Manhattan."Still Doing It tackles the stereoptypes and preconceived notions about sex (or the lack of it) and aging. The women profiled are thoughtful, insightful and brutally honest as they talk about their aging bodies, their needs for intimacy

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1139387857163883882006-02-08T00:37:00.001-08:002006-02-08T16:55:45.996-08:00

...is up, at Science & Politics. Don't miss it!(...And what's this? Bora also tends a chronobiology blog: Circadiana.)

aafannoreply@blogger.com0tag:blogger.com,1999:blog-8210326.post-1139386147195444002006-02-08T00:09:00.000-08:002006-02-08T00:22:50.010-08:00

Imagine being forced to make this terrible choice. Alexander Linklater, in the Prospect:...one morning, Nia was transformed. She left her bedroom, came to meals, had normal conversations with staff. Her face filled out with ordinary human expressions. A day later she was even laughing. A young woman, an intelligent teenager, had reappeared; the psychosis seemed to have left her. To see a

aafannoreply@blogger.com18tag:blogger.com,1999:blog-8210326.post-1139114036184036872006-02-04T20:33:00.000-08:002006-02-04T20:37:29.106-08:00

NYT: The study of deception. Dr. Jennifer Vendemia discusses her work with event-related potentials: ...This brings us into sci-fi territory, into the realm of mind reading. When Vendemia has a subject in an E.R.P. cap, she can detect the first brain-wave changes within 240 to 260 milliseconds after a true-false statement appears on a computer screen. But these changes are an indication of

aafannoreply@blogger.com5tag:blogger.com,1999:blog-8210326.post-1139112759136430702006-02-04T20:12:00.000-08:002006-02-04T20:12:39.210-08:00

Should self-harmers be given clean blades, to minimize infection? Times Online: "The motion to be debated at the RCN (Royal College of Nursing) Congress has been put forward by the mental health nursing forum, an RCN division. It states: “Safe self-harm — is it possible? That this meeting of the RCN Congress discusses the nurse’s role in enabling safe self-harm.”According to proposers of the

aafannoreply@blogger.com24tag:blogger.com,1999:blog-8210326.post-1139086899640125922006-02-04T13:01:00.000-08:002006-02-04T19:40:29.810-08:00

Scott Adams at The Dilbert Blog: The biggest relationship mistake you can make is to assume that because you have some special training or knowledge on a topic, that your opinion should be extra important. You could be the world’s most respected expert on insects, for example, but if your mate insists that caterpillars grow into chipmunks, there will be no talking him or her out of it...So forget

aafannoreply@blogger.com4tag:blogger.com,1999:blog-8210326.post-1139077071718478992006-02-04T10:17:00.000-08:002006-02-04T10:19:11.306-08:00

...is up, at Joel's Pax Nortona. "This first Carnival of the Bipolars is my take on the electronic ties that dissolve the isolation that many bipolars feel from spending their lives in their living rooms, terrified of going out while in episode, scared of the “normals” who mock them and make sport of their fast-talking, their racing thoughts, the shaking that ripples from the tops of their heads

aafannoreply@blogger.com2tag:blogger.com,1999:blog-8210326.post-1139076706390621142006-02-04T10:11:00.000-08:002006-02-04T10:11:46.556-08:00

A patient gives a gift that's wrong in every conceivable way. Then it's carried off by Katrina! Dr. Hebert reports on why he misses the worst gift ever given:My desk and my office took on 8 feet of water after Hurricane Katrina, so I only have my memory of it; but my memory in this rare case is perfect: It was a 5-inch tall gray ceramic skull, a Halloween trinket, glazed to a high gloss...It

aafannoreply@blogger.com1tag:blogger.com,1999:blog-8210326.post-1138953318864979762006-02-02T23:52:00.000-08:002006-02-02T23:55:18.870-08:00

This week, a patient told me that she wanted "express service" for her problems.I imagined myself at a drive-up window, smiling, wearing a paper hat...asking about symptoms and side effects...

aafannoreply@blogger.com8tag:blogger.com,1999:blog-8210326.post-1138952256352264332006-02-02T23:37:00.000-08:002006-02-03T13:10:13.823-08:00

The frustrations of the waiting room, and why doctors are late. Dr. Rod Moser blogs at WebMD:People are complex. When you schedule a woman for a routine pap smear, this is what you are planning to do. However, when you enter the room, you are faced with a crying, depressed individual in a paper gown. Clearly, a pap smear is not her main issue today. You patiently listen to her version of the

aafannoreply@blogger.com8