03 December 2009

Not dead yet

I've a lot to say, but haven't had the time or energy lately to blog -- work, family, real life, they so get in the way of my idle amusements.  I've a few things on tap, but for the moment I'll content myself with simply linking the more interesting things I've read recently.  In no particular order:

Life in the Fast Lane, an Australian Emergency Medicine blog, has been on fire recently with some of the greatest medical posts I've seen in years.  Notable recent posts include the worst imaginable complication of chest tube placement -- must be seen to be believed -- and an excellent educational post with the most improbable title, "Code Blue in the Mortuary."

Dr Val writes about her father-in-law's ER visit and work-up for chest pain.  The ending is a happy one, but Val totally misses the point in her post-event musings:

George was right - he was getting old. The nurse was right - there was nothing emergent going on.

The ER doc was wrong - George didn’t have an aortic dissection. And I was wrong - there was nothing actively wrong with his heart.

I feel badly that I contributed to a waste of healthcare resources.
No, Val, the ER doc was not wrong.  You are committing the logical fallacy of ex post facto reasoning.  The CT scan was clearly indicated based on the presenting symptoms because the doctor did not yet know there was no dissection.  Carl Sagan once wrote of the TV scientist who sadly lamented a "failed experiment" because it did not produce the expected results.  That's the exact opposite of science!  Any scientific investigation in which the outcome is known in advance is a waste of time.  The test was successful because it provided useful information, and while the outcome was negative, the assay was by no means a waste.

Dr Rob writes that he's also struggling with real life, and we're all hoping that he gets distracted right back into blogging soon.  Until then, I have dibs on the Llamas!

Dr Bryan Vartabedian writes at Better Health about doctors blogging anonymously:
Anonymity is a fantasy. It’s remarkably difficult to achieve. With small thoughts you can hide – in fact, no one cares who you are. If you offer anything worth hearing people will ultimately find out who you are.
So terribly true.  I was amazed, the first time I got picked up on Reddit, how quickly some clever commenters were able to figure out my identity.  Since then, I've only kept up a very slight fiction of anonymity, all the more transparent when I got cited under my real name in some national publications.  The only qualification I would add to this is that I keep my name and that of my hospitals off the blog, since I don't want patients to Google me after seeing me in the ER and immediately find the blog at the top of the search list.  Not that it'd be hard to make the connection, but I don't want patients I have cared for to find the blog and have the fear that "he's going to write about me." And yes, I do fictionalize every patient story on this blog extensively.  Bottom line: don't post anything on line that you'd be uncomfortable listing on your CV!

Speaking of patient stories, there is a promising new ER blogger in town: StorytellERDoc.  I like what I've read so far very much, and will be watching eagerly to see if he can keep up the challenging pace he's set for himself.

One another note, I liked Roger Ebert's cranky and petulant rant in the Sun Times about politicians inserting non-science-based beliefs into their public policy positions.  I'd complain about the tone of the piece, but Ebert's clearly on the side of the angels on this matter, so I'll let it be.  Hmm. That "angels" metaphor doesn't really work in this context, does it?

OK, gotta pick up #2 son from school now.  More real medicine stuff coming soon, I promise.

7 comments:

Dr. Val said...

Well, omniscience would be nice to have... Could save us a bundle in healthcare costs. Perhaps it would have been more accurate to say that my hypothesis was proven wrong by my appropriate choice of tests? :)

shadowfax said...

Yeah, my crystal ball just doesn't work. Me, I'm still waiting for one of those cool medical tricorders that Dr McCoy had in Star Trek.

precordialthump said...

G'day!

What ER docs in the US don't have omniscience? You guys are so far behind us...

;-)

Glad you're enjoying 'Life in the Fast Lane'.

Cheers, Chris

precordialthump said...

... at least you have punctuation - should've been a comma or question mark or something after 'what'...

sandnsurf said...

Thank you for your kind words regarding the Life in the Fast lane blog.
The team have been working overtime to create a mix of humorous, insightful and educational posts for the blog and recognition of this feverish activity is greatly appreciated.
As the UCEM develops the concept of waiting room medicine to its maximal potential we hope to continue to bring more weird wonderful and educational posts into the medical blogosphere.
Your humble servant….

fnyc said...
This comment has been removed by the author.
fnyc said...

Life in The Fast Lane is definitely on fire. A fine example how Physicians et al in Medical field can incorporate social media with a sense of humour which reaches out to all.