August 5, 2009, 12:06 pm

With a Little Help From My Friends

push-lucynurseThe week after BlogHer09 was exhausting.

I had traveled across the country two weekends in a row, and was working 12-hour shifts in-between (and after) to make up the time I had taken off. I was doing some writing and had two articles due on a deadline.

Plus, it was my week to host Grand Rounds. Lots of stuff on my plate and if I wasn’t sleeping or working, I was glued to the computer (not that there is anything wrong with that…).

So on Monday, as I finished Grand Rounds and was ready to hit the sack before working the night shift, I noticed a link had been made to Emergiblog from Grunt Doc. I checked it out and it was a “Happy Blogiversary” note.

Oh geeze – Emergiblog WAS four years old on August 3rd and the date had totally slipped my mind! “Wow!” I thought, along with (a) Grunt Doc keeps track of that stuff? and (b) how nice of him to mention it, I’ll have to leave a comment saying “thanks”.

The next morning I got home and, as is my wont, I hit the computer. The “Google Alert” for Emergiblog was in my mailbox and I opened it. Holy cow! There were a bazillion links! My first thought was “oh geeze, what did I do now?”

Well, they were all “Happy Anniversary” posts (including a video from Mike at Dr. Anonymous and a hilarious post by Dr. Rob!)! I nearly fell over! I guess Shane, official “web guy” of Emergiblog, had mentioned the date to a few bloggers. It was like coming home to a virtual surprise party!

(Confirmation of date confusion: fourth anniversary and the beginning of my fifth year of blogging.)

Many, many thanks to all who posted best wishes! I was touched and had a lump in my throat more than once.

A special thank you to Shane who keeps Emergiblog working smoothly no matter how many widgets I ask him to place (and I’m the queen of widgets!), handles my ads and still answers all my questions after four years running.

It goes without saying that this blog would be a web page in the dark if it were not for the folks who read it, so

For all the support, encouragement, commenting (pro AND con) and reading – thank you!


And now for some fun Emergiblog facts (courtesy of my SiteMeter, you can see it at the bottom): as of today, August 5th, 2009….

Average daily number of visitors: 433

Total visitors over life of blog: 470,516 (some perspective on this: NHS Blog Doctor did 500,000 in six months!)

Number of page views: 1,026,888

Most visits by web page (top three): Crass Pollination, the twitter feed for Bojustbo and Code Blog (thanks, guys! : D You can bet I’m right up there on your reader lists, too!)

Top three search words: “Emergiblog”, “Nurse Jackie” (!), “pain scale 1-10” (I cannot believe “Kasey Kahne” did not make the list…)


Now for just some plain old facts:

My blog fathers: Hugh Hewitt and James Lileks

Number of posts: 805 (whoa, that averages out to .55 posts per day, 16.7 per month, 201 per year!)

Number of comments: 7,068

Number of times comments blocked: once (It was my Nurse Jackie post. I mean, I can only take being called a “turkey-on-a-high-horse” so many times : D)

My first link: Circadiana, by Coturnix (aka Bora!) on August 16th, 2005 to this post (originally posted to my old blogspot site).

Number of lattes consumed during blogging: 4,397,777 (okay, I exaggerate)

Number of times I hosted Grand Rounds: 5 (if I counted correctly, themes have been Wallace and Gromit, the Beatles, Nascar, Starbucks and the Emergency Room)


My totally worst experience blogging EVER: My first Grand Rounds (March of 2006) at the old site (which seems to have not made the transition over to this url). I was almost done. There had to be 70 submissions, at least (I may increase the number every time I tell the story). It was late Monday night.

I lost the post. Suddenly it was gone! It disappeared. Vanished off the face of the internets.

I started again, clicked to save the post and it vanished.

Now I am frantic. One is never late with Grand Rounds. I found out the post was too long for Blogger to handle, but managed to get it up somewhere around 0400 or 0500 that Tuesday morning. (Pic thanks to Rita at Supporting Safer Healthcare! From back in 2006!)

I decided right then and there that I would leave Blogger and get my own domain. I do believe that was when Shane entered the picture and this version of Emergiblog was born after that, with my own domain name and, may god bless, a WordPress format!

And never looked back…..until now.

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!

August 1, 2009, 11:39 pm

Nurse Ratched Meets Howard Dean!

Just about the time I’m sitting in a meeting with Valerie Jarrett, our very own Mother Jones, aka Nurse Ratched snags an interview with Howard Dean, no less! I am very proud of my “blog daughter” (and unabashedly envious!). She has given permission to post her interview, in its entirety, here at Emergiblog. It follows as posted at Nurse Ratched’s Place…


howard-dean1I love the Internet. It has a way of bringing people closer together. I saw Governor Howard Dean at a town hall meeting in Washington D.C earlier this month. He’s a dynamic speaker. I wanted to ask him some questions, but the place was packed, so I couldn’t get close to him. Not to be deterred, I emailed Governor Dean in hopes of getting a response to a couple of my questions. He not only responded to my email, he agreed to an interview for my blog. See, the Internet really can bring people closer together. I want to thank Governor Dean for stopping by Nurse Ratched’s Place to talk about healthcare reform.

Question: What is your take on the state of our healthcare system? What do you envision for our system, and how do we get there from here? Can America really afford a public option plan?

Answer: Our system is in disarray. We need a system in which the American consumer has real choices, including allowing people under 65 to sign up for Medicare, which is what the public option will look like. That way people can get affordable insurance which can never be taken away, which can’t be denied, and which will follow them through every job, every loss of job, and every move. We can’t afford NOT to have a public option.

Question: How flexible is the public option: will a person be able to move between the public option and private options as their needs and circumstances change?

Answer: People will be able to move back and forth between the public option and private insurance plans as they see fit, up to once a year.

Question: Given your unique perspective as a physician, can you tell us one aspect of the public option that you like and one aspect that you might not be happy with?

Answer: As a physician I would sign up for the public option at once if it is cheaper than what I have now. I would definitely sign my twenty something kids up; it would give them insurance for life at a reasonable cost no matter what they were doing and where they were living.

Question: One of my nursing coworkers wanted me to ask you this question. How will healthcare reform impact nursing workforce issues? Will we see mandated caps on salaries, and how will healthcare reform impact nurse to patient ratios?

Answer: Workforce issues are not addressed in any of the health care options being discussed in Congress. Most Democrats I know favor nurse/patient staff ratios to protect quality of care.

Question: Preventative healthcare is a key component in the healthcare reform debate. What are your thoughts on a proposal that would make the Chief Nurse Officer of the United States Public Health Service the National Nurse? In your opinion, would establishing the Office of the National Nurse have any impact on health promotion or on healthcare reform?

Answer: As a lot of people know, I am a huge supporter of the Office of National Nurse, and since Congress has been slow to act, I am hoping some changes can be made directly by HHS while we await more complete action by Congress.

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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