August 3, 2009, 2:37 pm

A Cracking Grand Rounds!

palsWelcome to the latest edition of Grand Rounds, the weekly compilation of the best of the medical blogosphere!

Our theme this week comes to us courtesy of that loveable, wacky duo, Wallace and Gromit!

Many, many submissions make for a wonderful ‘Rounds and this week is no exception.

Now for Wallace, Tuesday means “porridge”, so if that’s your weakness, grab a bowl (I’ll settle for a cup of tea and a bit of Gorgonzola) and dive into “A Cracking Grand Rounds”!



As Gromit reads up on “Electronics for Dogs”, those of us in the U.S. are trying to keep up with the ongoing debate on health care reform.

Terri at Nurse Ratched’s Place scored a coup this week: an interview with Howard Dean!!! Read it here, at Howard Dean stops by Nurse Ratched’s Place!

Wow, what a great post from Glenna Crooks at Disruptive Women in Health Care! Ms. Crooks discusses how health care policies affect women, and how women view certain elements of health care reform in She’s Not Buying…Healthcare Reform.

Canada’s health care system has been alternately held up as a model and demonized as socialist. How is this affecting the discussion of U.S. health care? Sam Solomon of Canadian Medicine weighs in with Barack Obama Feels the Repercussions of the Chaoulli Decision.

Will plastic surgeons – and their patients – be footing the bill for major health care reform? Henry Stern at Insureblog discovers another case of “cranial-rectal inversion” as he reflects on the proposed taxing of non-essential procedures to finance “deficit neutral” health care reform, aka: the Nip/Tuck/Tax.

This summary was written so well I’m going to use it exactly as written: Steven Weinberger, MD, FACP, ACP Deputy Executive Vice President and Senior Vice President for Medical Education and Publishing, continues his monthly column for Check out Putting Effectiveness Into the Healthcare Equation: Rational or Rationing?

Evan Falchuk from See First notes that trying to adjust health benefits in the private sector is a sensitive subject, so it isn’t surprising that the President is taking a hit for his attempts at reform. Perspective provided at Don’t Mess With My Healthcare.

Barbara at Florence dot com is riled and she takes on health care reform (with a nod to our Canadian neighbors) in Truth, Like Rain, Does Not Care Who Gets Wet and it’s worth reading for this alone “…advertisements portray middle aged men who can’t pee as the next generation of Outward Bound campers”.  But read it context; it’s even better!

I have to let DrRich of The Covert Rationing Blog introduce this post himself: “I have long been one of those unenlightened physicians who thought alternative medicine was evil, but now I’ve seen the truth – ‘medical woo’ is our road to salvation.” So, find out Why DrRich Supports Medical Woo.  It’s….so…logical!


Feathers McGraw under lidLooks like Wallace and Gromit are more than a little concerned about finding the evil penguin Feathers McGraw on their platter!

Child psychologist Catherine Busch at Child Psych notes that Parents are Concerned About Psychiatric Medications following a wave of media reports about rare side effects, and discusses factors that influence the decision to use psychiatric medications in the pediatric population.

Okay, this is a big “Ouch”! Ramona at Suture for a Living describes a condition I never knew existed in Raynaud’s Pheomenon of the Nipple. And, thank goodness, there is a treatment for it!

Psychologist Philip Hickey at Behaviorism and Mental Health looks at non-medicinal approaches to depression and argues for the idea that Depression is Not an Illness. Illness or adaptive mechanism? Weigh in with your opinion.

Wow, it looks like psychiatric medications are a hot topic this week! Louise at the Colorado Health Insurance Insider notes that The Drug Industry Is Dancing as psychiatric medications are prescribed ubiquitously.

Nancy at Teen Health 411 gives us information on a new RWJF program aimed at Ending Teen Dating Violence. The statistics will floor you!


picture_8Ah, Wallace would give the world for a good bit of Wensleydale cheese to nibble with his crackers. It does wonders for his mental health.

The ACP Internist notes that another favorite snack is suspected of improving physical health. You have got to read this! Blue M&Ms Treat Spinal Cord Injuries. (Editor’s note: as long as M&Ms sponsors Kyle Busch in Nascar, I’ll pass on any color!)

Our blogger colleague at How to Cope With Pain looks at Using Antidepressants for Pain Disorders. And using an anti-depressant for pain management does not mean it’s “all in your head”

Rita at Supporting Safer Healthcare notes notes “If you are an effective meeting facilitator people may actually look forward to participating in committees that you manage, and in today’s over-meeting’d world, that’s high praise indeed.” She discuses what it takes in Are You A Star Meeting Facilitator?

If Wallace is drinking green tea, he may be better off health-wise! On the Wards explores the question Does Green Tea Prevent Hematological Cancers?

We see a lot of asthma and chronic sinusitis in the ER, Allergy Notes looks at one option for treatment and wonders Does Surgery Help Asthma Symptoms in Patients with Chronic Sinusitis and Asthma?


mean with feathers

Uh oh! Looks like Gromit has about had it with the antics of Feathers McGraw, evil penguin!

Over at the ACP Hospitalist comes advice from the AHA Leadership Summit: How CEOs Can Avoid Getting Fired. To paraphrase Wallace, getting fired can certainly take the bounce out of your bungie!

Amy at Science and Sensibility takes apart the The New GBS Cochrane Review: A Hot Mess! There are more holes in this research than Wallace finds in his swiss cheese! Kudos to Amy for making research an interesting read!

Jacqueline at Laika’s MedLibLog notes that a new aggregator has some major issues in Clinical Reader, a Fancy New Aggregator – But All is Not Gold That Glitters.

Captain Atopic starts a series on the arrogance of some medical students in Arrogance I. Sometime a smirk can come back to haunt you!


Wallace and Wendolene

Wallace makes a connection with super-knitter Wendolene. Looked like a love connection until he found out she didn’t like cheese! Not even Wensleydale!

Rachel at Tales of my Thirties made some connections last week at BlogHer 09 and she looks back in Unlocking Some Doors. It was great meeting you, Rachel! Thanks for the moral support during my panel!

And the blogosphere has reconnected with The Examining Room of Dr. Charles!!! He is back and better than ever, taking look at the Evolutionary Scorecard! Where else can you find appendices, spinal cords and chest hair in one post?

In his inimitable style, Bongi describes the connection he made with a family of American tourists when one became critically ill in Gracious, found at Other Things Amanzi.

Barbara at In Sickness and in Health, makes an unexpected connection with Leonard Cohen in Anthem by Leonard Cohen: Words of Wisdom.

Toni at Everything Health connects with a suprising group of athletes in Prison Tennis!



Gromit is quite the meticulous gardener, assessing his legendary gigantic watermelon.

Speaking of legends, Dr. Rob and I have produced a blog spawn in Max E. Nurse over at It Shouldn’t Happen in Health Care. Max goes on to discuss the Legends of the Past he worked with in his ER days. Such a polite boy – we raised him well! : D

Some of the stories of the dissection room can be quite legendary themselves. The Hippocratic Oaf muses over a summer anatomy session in Dissection: A Brief Reminiscence.

Wikipedia has become bigger than Gromit’s watermelon! Clinical Cases and Images is amazed to find out that Wikipedia Used by 70% of Junior Physicians, Dominates Search Results for Health Queries. Wiki was not acceptable as a source in my research class, I wonder if they back up what they find out with other sources.


gromit catchGromit uses his intuition and a quick set of reflexes to catch a soccer ball before it destroys his greenhouse and almost makes it!

Residents hone their skills daily, developing the intuition they will need as they care for patients. Jaotte, at Dr. Ottematic gives a beautiful description of the process in Resident Physicans. Uh, What are Those?

Clinton, proprietor of Not My Second Opinion recently attended the American Academy of Family Physician’s National Conference. He left with a new way of thinking about primary care in Patient Centered Medical Home…Say What?

Speaking of reflexes, Reality Rounds asks that rhetorical question, Did I Just Pee? And yes, she actually did! Find out why and what she has discovered about perineal integrity along the way! Ladies, listen up!



When they aren’t busy inventing, our hosts Wallace and Gromit enjoy the fun of a seaside roller coaster ride!

Laura at My Favourite Number remembers the night her blood sugar felt like a roller coaster in That Lovely (and Sometimes Illusive) Window of Control or: How to Pass the Time When Your Sugar’s on the Fritz. Let’s hear it for hubbies and board games!

Speaking of seaside, Paul from Medicine for the Outdoors reminds us to follow the U.S. Coast Guard rules for Safe Paddling!

While we are on the topic of recreation, Dr. Shock,MD notes that Computer Games at Work are Good For You! They are supposed to facilitate relaxation. Obviously the researchers have never tried to play “Typing Maniac” on Facebook!

The Cockroach Catcher also goes to the sea (and has some stunning diving photos) as he discusses Sea Slugs and Ships: Memory and Biodiversity.



Our guys are looking pretty spiffy in their fancy clothes!

Maybe they are thinking about the medblogger track at BlogWorld/New Media Expo 09, being held in Las Vegas in October? Information on registration can be found here and rooms are available at the Venetian at a discount! Be there or be totally square!

And that ends this edition of Grand Rounds.  Many thanks to Dr. Val Jones at Better Health and Colin Son for keeping the carnival up and running and to Nick Genes for starting it all way back when!

Our next host will be DrRich himself, at The Covert Rationing Blog!

Thanks for reading!

Have a cracking good day!


  • rlbates

    August 3, 2009 at 3:24 pm

    Great edition! and Happy Blog Anniversary!

  • […] While there, check out Grand Rounds […]

  • Reality Rounds

    August 3, 2009 at 4:53 pm

  • Adrienne Zurub

    August 3, 2009 at 5:55 pm


    Your Blog is always great reading.

    Happy Blog Anniversary!!!

  • Grand Rounds @ Emergiblog

    August 3, 2009 at 8:01 pm

    […] medical blogging, and one of the best ways to get reconnected with great medical writers is through Grand Rounds, hosted this week by Kim of Emergiblog.  It’s also her 4 year blogging anniversary, and she’s brought together a wealth of […]

  • Rita Schwab

    August 3, 2009 at 9:44 pm

    Wow, nearly 40 entries and you still managed to post a bit early. Your blog energy is impressive!

    Nice job.

  • Jessica Otte

    August 3, 2009 at 10:44 pm

    Thanks for including me; Wallace and Gromit are an excellent pair to make the Grand Rounds a cracking one indeed!


  • […] blog birthday to Emergiblog, run by Kim, an ER nurse from San Fran. She just published a lovely Grand Rounds – and managed to include my “ Resident Physicans. Uh, What are Those?” […]

  • Am Ang Zhang

    August 4, 2009 at 4:08 am

    Thanks for a grand Grand Round. I have just managed to read through the varied selections.

    The Cockroach Catcher

  • […] Vacation time, and still able to compile such a wonderful Grand Round overnight (!), excisting of al… […]

  • […] Grand Rounds at […]

  • hgstern

    August 4, 2009 at 4:39 am

    Outstanding job, Kim! That’s a LOT of info, but easy to follow.

    Thanks for hosting, and for including our post.

  • tammy swofford

    August 4, 2009 at 7:38 am

    A day late weighing in, but congratulations on reaching the milestone of five years of continuous blogging! smile

    Best regards,


  • Toni Brayer, MD

    August 4, 2009 at 8:20 am

    Great Grand rounds and happy happy blogging anniversary to you!

  • Barbara Olson

    August 4, 2009 at 10:07 am

    Love it. Forget that I said it’s like being in a Fellini movie!

    And thanks for including my “meanest post ever”!

  • On The Wards

    August 4, 2009 at 6:03 pm

    Great job with the skillful integration of a Wallace and Gromit theme with this week’s medical grand rounds! I had an amusing time reading the commentaries.

  • […] extensive grand round with a lot of posts in a funny theme on Emergiblog: Our theme this week comes to us courtesy of that loveable, wacky duo, Wallace and Gromit! Many, […]

  • […] Rounds, a medical-blog carnival, is published at Emergiblog this […]

  • Dr. Vikram

    August 5, 2009 at 11:13 am

    Great article, but was too lengthy, eyes got tired while reading, but it was interesting, keep blogging and Happy Blog Anniversary!!!

  • […] extensive grand round with a lot of posts in a funny theme on Emergiblog: Our theme this week comes to us courtesy of that loveable, wacky duo, Wallace and Gromit! Many, […]

  • […] I close, I must draw thy attention to my blog mum…she has just celebrated her 4th blogiversary and prod… Keep up the good work […]

  • […] found Glenna’s article in Grand Rounds, hosted this week by Kim at […]

  • aqua

    August 9, 2009 at 12:16 pm

    Hi Kim,
    In support of all the people struggling with mental illness, and in particular, MDD, I just have to respond to the Philip Hicky article, “Behaviorism & Mental Health: “depression is not an illness”. My response is long and wordy, but I fear Mr H will not post this resonse to him on his website, and I worry people with MDD might end up there and think their illness is their fault. That is how I felt reading his piece.

    Here goes:

    in response to Philip Hickey’s “depression is not an illness:

    For me severe depression really did just pop out of nowhere. There was nothing wrong with my life during these episodes…I had a great life. It was the depression that stopped me in my tracks, not the other way around.

    When you wrote, “When things are going well in our lives, we feel good”…I understood immediately that you misunderstand MDD. The sad thing about MDD is that even if things are going well this illness destroys a person’s ability toi feel good.

    I find it difficult to understand how you treat people with depression when you place so much distance and dogma between yourself and your patients. When you say,

    “Many of these individuals lived on a diet of soda pop [I can count on my hands the numer of sodas I have drank in the last 5 years], cigarettes[don’t smoke], and salami sandwiches[I think the last salami sandwich I ate was in high school…I’m 44]. Others drank enormous quantities of alcohol [I used to drink periodically…like many other happy people I know…until I got as severely depressed as I am now. In which case it drove me to drink more to try to help my symptoms]. Few ate vegetables regularly[ was did well here]. Many stayed indoors almost all the time [see my above list of favourite and common activities]. Physical activity was almost always minimal [ditto]. Purposeful activity – i.e. activity directed towards some kind of goal – was seldom present [university? , and good honest, open relationships almost non-existent…[great frienships?]…

    …Chronically depressed people, however,are individuals who have been neglecting these areas for years. They spend the vast majority of their lives indoors, watching television and eating snack food. They are often over-weight, have no goals other than the next TV show, and although they may have many acquaintances, they do not share their concerns and worries in an open and honest manner”

    …it struck me that you believe very strongly that “we”are so very different from you. We just don’t try hard enough to be happy. If only “we” would try harder, “we” could be as happy as “you”.

    Have you ever really worked with someone with clinical depression? Contrary to your statement that we are indoorsy, crappy food eating, inactive, solitary, lazy, unfocused, fat, slobs.. [actually slob is my word…it’s how i sense we seem to you) people with MDD are a wide range of people…some of us even active, outdoorsy, friendly and friend supporting, anti-t.v., fit and interested and interesting people.

    It becomes clear you have never understood what it is to be depressed when you state, “Depression or despondency is not as acute a sensation as pain”. In the past I broke both my elbows at the same time, had a severe case of CMV related hepatitis that required hospitalization, have broken my leg, my ankle, my wrist, had three concussions, was injured in a car accident, had a doctor drill into my leg bone for bone marrow, basically have suffered a lot of physical pain.

    NOTHING is as painful as severe and chronic MDD. When I broke my elbows I had just come out of the hospital after having ECT. For the first time in years I felt mentally well. I REFUSED any pain medication for my physical pain, for fear that my psychic pain would recur. NOTHING hurts like mental pain…NOTHING.

  • Intransigentia

    August 17, 2009 at 3:00 pm

    Aqua, I felt the same way when I read his post, and honestly I was a little surprised that he was included in the Grand Rounds. I mean, on the one hand there are interesting questions around the neurochemistry of depression; the old serotonin hypothesis doesn’t seem to work and yet antidepressants do seem to help people. All sorts of good research to be done there. But going off about how depression is just a sign that you need to get your $h!t together already? Really?

  • Kim

    August 17, 2009 at 3:17 pm

    A quick note from the hostess here: when I host Grand Rounds, it is extremely rare that I exclude a submission. I will disagree, from time to time, with the opinion of a blogger, but I put it out there and let the discussion take off.

    Each Grand Rounds host does things a bit differently; you will find hosts that are all-inclusive and those who edit the submissions via content. I’m 99.9% inclusive – I’m not really a fan of flat out sales pitch sites.

    And, for the record, I firmly believe you can have all your, uh, $hit together and still suffer from depression – been there, done that! : )

  • Intransigentia

    August 18, 2009 at 8:56 am

    Thanks for the clarification, I appreciate it.

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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