February 16, 2009, 3:35 pm

It’s Grand Rounds, What Do You Think? GOSH!

When I was contemplating hosting Grand Rounds, did I realize that I was hosting a compilation of serious interdisciplinary dialogue relating to the practice of health care?

Did I understand the enormity of the task I had chosen to undertake?

Heck yes I did!

I chose to use a “Napoleon Dynamite” theme anyway as that is pretty much the coolest movie ever made.

If you’ve seen it, you’ll get it. If you haven’t, you’ll think I’m nuts (but I have great nunchuk skills….)!

So grab your coffee, and get ready for a good read!

Or, as Napoleon’s Grandma says, “just make yourself a dang quesa-dilluh!”

Welcome to Grand Rounds…


“What are my skills?” “Well, you have a sweet bike. And you’re really good at hooking up with chicks. Plus you’re like the only guy at school who has a mustache.”

(Napoleon with friends Pedro and Deb. Napoleon assures Pedro he does have skills to run for Class President.)

The Happy Hospitalist takes on relationships and skills in this provocative post on nurse practitioners, PAs and MDs. Check out Dr. Nurse, The PA Perspective, and Your Differential Diagnosis. Be sure to read the entire post and then join in the lively comments section!

Speaking of differential diagnosis, Aequanimitas has some advice for a physician colleague about that exact topic in To the Night-shift A&E Doctor.

Over at In Sickness and in Health, Barbara and Richard discover why they think so differently in MBTI and Illness: Judgers and Perceivers.

We use our skills at resuscitation every day. Mediblog999 wants to know what constitutes A Successful Resus. His conclusions made me rethink my definition.


The Defect in That One is Bleach

(Napoleon wins a medal from the Future Farmers of America by identifying defects in milk, specifically bleach and onions! The following posts look at things that aren’t quite right…)

Walter at Highlight HEALTH sheds some light on Clearing Up Concerns Over Vicks VapoRub. Interesting research with surprising results. It’s not what you think.

Sandy Szwarc at Junkfood Science finds a number of defects in the research touting the Obesity Virus – a New Risk Factor ? Sandy then emphasizes the importance of critiquing research reports vs. media headlines in What You Didn’t Hear About the Latest Study of Sudden and Unexpected Infant Deaths.

Day of the Doc looks at the myth of mental illness and violence in research, as seen through the media and adds some observations/questions of his own in Mental Health Mythbusters: Violence.

And then Doc Gurley takes on the same topic in Mentally Ill Does Not Mean Violent. Bottom line, it’s great news for those of us and our patients who deal mental illness and it the research results need to be disseminated to the general public!

InsureBlog‘s Bob Vineyard explains that newer isn’t always better when it comes to treating mental illness. Gee, could it be a financial issue? Check out Good Money in Mental Health.

Laika at Laika’s MedLibLog observes: “Personalized Medicine has not (yet) fulfilled its promises because there are often no good quality studies that show a clear and strong association with a particular gene (expression variant) that IMPROVES prediction.” Check out Personalized Genetics: Too Soon, Too Little?

What happens when you know the “what” but not the “why”? Canadian Medicine reports: Elevated Cancer Rates Found Near Oilsands, but No Explanation Forthcoming.

DrRich at The Covert Rationing Blog discusses the delicate (t)issue of intestinal screening procedures in Now Wait Just A Dadgum Minute. Hilarious, but you had me at the “David Geffen School of Medicine”! : D



(It looks like brother Kip is the lucky one here, as Napoleon “pulls” him into town on rollerblades. Hey, exercise keeps you healthy. The following posts could do the same…)

Jolie Bookspan, The Fitness Fixer discusses research showing Surgery for Knee Arthritis, Meniscus, Not Needed to Stop Pain, Restore Function.

After pointing out that most neck pain is not serious and will resolve on its own, Dean Moyer of The Back Pain Blog offers a simple checklist readers can use to answer the question, Neck Pain: When to See a Doctor?

Allison at Lemonade Life looks at the reasons “comfortable” may not be a good state of being. Break out of your comfort zone! You can start right here: Uncomfortable.

A new, non-invasive way to monitor the aggressiveness of prostate cancer? Helen Jaques: In Sickness and in Health looks at the research behind the news in Researchers Identify New Prostate Cancer Marker Detectable in Urine.

David at Health Business Blog looks at Another Perspective on the Vaccine/Autism Issue with insights from pediatric neurologist, Michael Segal.

Paul Auerbach gives a great overview of Illnesses and Injuries in Wilderness Athletes over at his Healthline blog Medicine for the Outdoors.


“Build her a cake, or somethin’.”

(Pedro “built a cake” for Summer Wheatly, the cheerleader he wants to take to the dance. Here are some posts whose authors “built a cake” for some of the people in their lives…)

WellroundedType2, in her blog of the same name, talks about her care surrounding a miscarriage in Recovery Room. If I ever need an endocrinologist, I want hers….

Award winning author Laurie at A Chronic Dose, discusses a recent New York Times article in her post Nurses and Patients. The Library Journal named Laurie’s book Life Disrupted one of 2008’s Best Consumer Health Books. Congratulations!

Even though she hates Valentine’s Day, diabetes blogger Kerri at Six Until Me writes a “thank you” to her husband for being such a supportive spouse of a person with diabetes in Mushy Stuff: Diabetes Edition.

MD/PhD student Mudphudder has a mother with an unusual gift for lab coat analysis in Give it Up for the Supernatural Ability of Mom.

Alison of SpinDyeKnit wanted to include a positive post in this GR edition, also, so here is the cake she built for Seven Unknown Heroes.


“They say you’re not allowed to have pinatas that look like real people, but in Mexico, we do it all the time.”

(Poor Pedro. He gets in trouble for making a pinata in the image of Summer Wheatly, who is running against him for Class President. He didn’t know he wasn’t being PC!)

Speaking of politically correct, the ACP Internist takes on PC terminology in Making Medicine Politically Correct. Enough is enough!

While we’re on politics, the stimulus package has funding for EHR. David at Health Blawg notes :“The EHR piece of the stimulus package will bring on one big feeding frenzy. Let’s make sure we spend the money wisely.” Observations and suggestions are found in HITECH Act Part of Stimulus Package Heading to President’s Desk: Steady, Boys!


“The worst day of my life, what do you think?”

(This is Napoleon’s description of his school day. I’m sure we can all relate. Here, Napoleon tries the time machine bought online by his Uncle Rico. It doesn’t work.)

If I had to pick a post that had me absolutely floored, it would be this one by Alison at SpinDyeKnit as she details her desperate attempt to get authorization for her medication in So, Today… There is an afterward to this post that sent me reeling. Alison writes “The end result of this one is that Blue Cross and Caremark delayed getting me that Humira for five days, during which my colon deteriorated greatly. The doctor had tried to order the med after a colonoscopy.  I will never know now whether it would have worked had they gotten it to me the next day like my doctor wanted; the end result is, two weeks ago Thursday, my entire colon had to be removed to save my life.” Oh my.

Neuroanthropology hosts an essay detailing the study of Post-traumatic Stress Disorder by Notre Dame undergraduates as they talk with veterans from all eras who suffer from this disabling syndrome. You’ll understand more, too, after you read Forever at War: Veterans’ Everyday Battles With Post-traumatic Stress Disorder.

Over at The Pink Tee Shirt, there is a post that has made me choke up for a woman I never even knew. Not much I can add to One More…for Dawn.

In his email for this post, Bongi at Other Things Amanzi described this post as “frustrations seen philosophically”. Oh my. I have no words, other than to say my daily frustrations are nothing compared to what Bongi reports in Philosophical.


“Imagine you’re weightless, in the middle of the ocean, surrounded by tiny little seahorses.”

(And so goes Deb’s advice to Napoleon’s Uncle Rico as she takes his photo for the name tag he’ll use as he heads out to sell Tupperware. He’s pretty pleased with himself, don’t ya think?)

The “Sweet!” award for this GR edition goes to Am Ang Zhang over at The Cockroach Catcher for his post on….coffee! Panamanian coffee! Find out the secret at Coffee in Panama: Faking is not All Bad!. I’m up for any taste test between Kona and Panama coffee!

Aggravated Doc Surg takes the “patient” vs. “consumer” debate to a whole new level in The Hard Sell. Act now and you may get a second post for $19.95! Too funny!


“I see you’re drinking 1%. Is that ’cause you think you’re fat? ‘Cause you’re not. You could be drinking whole if you wanted to.”

(Napoleon offers Deb a compliment. Sort of.)

Napoleon may have thought he was just making small talk, but Dr. Deb reminds us that February is Eating Disorders Awareness month in The “F” Word. “Fat”, That Is.

Rachel of Tales of My Thirties also blogs for Diabetes Daily. In Save Me a Cupcake, Elizabeth, she tells us what she thinks of food, Type 2 Diabetes and low-carb dieting.

Nancy at Teen Health 411 asks What is Sexual Harrassment?, and discusses what it is not. On a lighter note, it’s college selection time in College Touring – Oh What Fun it is to Ride!


“You gonna eat your tots?”

(Napoleon stores his tater tots from lunch in his pocket so he can eat ’em while he studies. Wish I had some tots for these studies…)

Allergy Notes reports a relationship I never would have considered in Rhinitis/Sinusitis and Asthma Relationship is a “Two-Way Street”.

Clinical Cases and Images notes a study showing Low Temperatures in Winter Increase Blood Pressure in the Elderly. Check out the comments for what this means for dialysis patients!

Alvaro at Sharp Brains submits commentary on a study whose findings seemed to suggest that acquired characteristics can be genetically transmitted. See A Love Affair Across Generations: A Lamarckian Reincarnation?

Uric acid as the “good guy”? Find out how (and when!) as Rheumination discusses the implications of Darwin’s Big Toe!


“Pedro offers you his protection.”

(Pedro’s tough low-rider cousins help keep bullies at bay as a way to get Pedro elected Class President. Health care and health insurance offer protection, too…)

Dr. Jeff Segal offers an interesting idea on How to Reduce Costs and Improve Quality in Health Care: A Legal Approach, hosted at Getting Better With Dr. Val. Truly a unique vision for health care reform!

Louise at the Colorado Health Insurance Insider notes: There are plenty of people who advocate a free market approach to health care, and are complaining that the government shouldn’t be allowed to dictate that a particular treatment isn’t cost effective. But private health insurance does exactly the same thing… Get the whole picture at Government Research and Health Care.

Protection. Restraints and seclusion can be used for protection of patients and staff. Rita, at Supporting Safer Healthcare looks at the regulatory side of in Restraints and Seclusion – A Hot Topic for Hospitals. She also writes a wonderful post on hanging in there as we go through the Culture Change in Healthcare – Weathering the Storm.


“… I love technology, but not as much as you, you see… But I STILL love technology… Always and forever.”

(I can’t say much about that quote without giving away a great part of the movie. Napoleon loves to draw Ligers, saying “It’s pretty much my favorite animal. It’s like a lion and a tiger mixed… bred for its skills in magic.” Well, I don’t know about the magic, but I couldn’t resist this shot of my man, Steve Jobs!)

And I do love technology, the technology that makes fun projects like Grand Rounds possible.

Many thanks to those who submitted, who shared their wonderful work and put up with my silly theme!

Also, props go out to Colin Son and Dr. Val for keeping the foundations of Grand Rounds up and running and to Nicholas Genes for starting it all way back when!


And while Deb here solicits sales for her boondoggle keychains, Peggy at The Blog That Ate Manhattan will be soliciting submissions as she takes the hosting duties for Grand Rounds next week.

Check her site for details.

(Don’t forget, Grand Rounds now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available.)


  • rlbates

    February 16, 2009 at 4:16 pm

    Very nicely done!

  • Healthcare Today

    February 16, 2009 at 4:19 pm

    It’s Grand Rounds, What Do You Think? GOSH! // Emergiblog…

    This week’s Grand Rounds, with a Napoleon Dynamite theme!…

  • medic999

    February 16, 2009 at 4:22 pm

    Who would have thought…..Grand Rounds meets Napoleon Dynamite???
    Nicely done and thanks for the mention!!

  • Grand Rounds at Emergiblog! « Medicblog999

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  • Dr. Val

    February 16, 2009 at 4:42 pm

    I LOVE Napoleon Dynamite – what a great theme, Kim. Hilarious!!! 🙂

  • Doc

    February 16, 2009 at 7:22 pm

    Looks like all of the medical blogosphere participated this week! Nicely juggled and organized, Kim. Excellent theme. Bravo!

  • issa

    February 16, 2009 at 7:38 pm

    i loooooooooooove “Napoleon Dynamite”! =) excellent theme & awesome wrap up of the best out there. next time!

  • AlisonH

    February 16, 2009 at 8:40 pm

    A small correction that will be important to nobody but me, but, it was a Friday not Thursday that they operated. Oops.

    The funny part about you choosing Napoleon Dynamite as a theme? That top picture? (The least distinct one, so I guess I can read more into it.) That one is the spitting image of my husband when he was in high school. To a T.

  • Dr Am Ang Zhang

    February 16, 2009 at 9:00 pm

    Wow! How sweet indeed. It is an amazing job! Great theme.

    The Cockroach Catcher

  • […] Rounds 5.22 – Napoleon’s Dynamite – GOSH! 17 02 2009 Ever heard of Napoleon’s Dynamite? Ever seen Napoleon’s Dynamite? According to nurse Kim… am I glad she announced the Grand Round as follows […]

  • hgstern

    February 17, 2009 at 5:59 am

    Dynamite job, Kim!

  • Aggravated DocSurg

    February 17, 2009 at 6:09 am

    This was so great, I caught you a delicious bass! You must be my “soul mate,” AKA LaFawnda, because I have a little talking Napoleon Dynamite statue on my desk! Nice job.

  • Dynamite Grand Rounds | Doc Gurley

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  • Barbara K.

    February 17, 2009 at 7:32 am

    Great job, Kim. Napoleon Dynamite is a hoot! Thanks for including my post.

  • Kerri.

    February 17, 2009 at 2:10 pm

    AWESOME Grand Rounds, Kim!!! (I did the Napoleon Dynamite dance in celebration.) 🙂

    Thanks for including me!


    February 17, 2009 at 2:40 pm

    Flippin’ sweet!

    (How much do I LOVE Napolean?)

  • mudphudder

    February 17, 2009 at 3:44 pm

    This has to be my favorite edition of Grand Rounds yet. Thanks for taking the time to make it so inclusive–and fun! Oh, and my mom is also a Registered Nurse…So, maybe the whole “supernatural abilities” thing is actually a nurse thing and not necessarily a mom thing??? 🙂 Regardless, both are phenomenal groups of people.

  • Deb

    February 17, 2009 at 5:43 pm


  • […] It’s Grand Rounds, What Do You Think? GOSH! […]

  • laurie edwards

    February 18, 2009 at 7:59 am

    Great job, and thanks so much for including the link, and adding the kudos 🙂

    Love the theme! I got a talking Napoleon Dynamite pen in my stocking one Christmas, and every now and then I laugh to myself when I click “I caught you a delicious bass.”

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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