Welcome to the Grand Rounds Diversity Edition, Vol. 5 No. 34 - where we celebrate the differences that make the health/medical blogosphere so beautiful and rich.

If this is your first visit to the Health Blogs Observatory, please feel free to look around and explore. Consider submitting your blog to our directory, to gain better exposure and participate in our future research. We are conducting open research of the health/medical blogosphere and would be delighted if you would consider joining us.

We wish to dedicate this edition of the Grand Rounds to Florence Nightingale who was born on this day, May 12, 189 years ago. As you probably know, she is famous for being the ‘Lady with the Lamp’ who devoted her life to nursing and campaigning for better health care and sanitation for all. Her greatest achievement was to make nursing a respectable profession. Florence’s writings on hospital planning and organization had a profound effect in England and across the world, publishing over 200 books, reports and pamphlets. She died at the age of 90 as one of the most famous and influential women of the 19th century. Her writings continue to be a resource for nurses, health managers and planners to this day.

We love you nurses

Since today we celebrate one of the most famous nurses ever, we feel that the only right thing to do would be to start this edition of Grand Rounds with our nurse bloggers. Two of us hosting this edition are physicians, therefor we know just how much important nurses really are. They are our partners, we respect them and don’t know what we would do without them. We love you nurses! There we said it, and we mean it from the bottom of our hearts.

The first post describes it perfectly. So often we underestimate the power of words and compassion and just focus on technology, surgery, and medicine. In the story simply titled “Lisa“, Reality Rounds reminds us that miracles can happen in hospital rooms.

Let’s continue with the article that is as part of a series celebrating nursing sensibilities for Nurses Week. Barbara Olson (@SafetyNurse) explains why a new generation of U.S. healthcare workers should be warmly welcomed.

Keith at Digital Doorway turns our attention towards difficulties parents who work in low-wage occupations might experience with the CDC recommendations regarding swine flue, which mandate seven days of home isolation for any child exhibiting a flu-like illness.

Nurse Ausmed (@NurseAusmed) finds that cellphone TXT messaging is starting to untangle nurse-doctor communication. We too love TXT messages, and use them everyday at work.

Emergency Department

The basic rules of triage instruct us to continue with patients who have the most severe and life threatening conditions. Where do we find these patients? Maybe we can try Emergency Departments in Detroit and Perth.

Emergency physician Jonathan Sullivan has written a truly brilliant and emotional essay at Receiving. blog. He starts by describing the encounter with a scared patient who wants to know if she is okay, and then scares us into questioning if he himself is okay. A great reminder that patients and doctors are the same, just humans after all.

Dr Chris Nickson (@precordialthump) is a registrar training in emergency medicine and intensive care, a blogger, and a talented poet. Go ahead and read his “Tired and afraid” poem based on a recent real patient encounter.

Detective work

Here is an interesting case that had two of our contributors thinking. On April 10, an incident happened at North Shore University Hospital. A female patient’s head was shaved, anesthesia had been administered and she was laying on the OR table but here neurosurgeon, Dr. Paolo Bolognese, never showed up. Chief of neurosurgery, Thomas Milhorat, was then called, but refused to do the surgery because the patient wasn’t his. Eventually the two surgeons got suspended for two weeks. Personal injury attorney, Eric Turkewitz (@Turkewitz) salutes the suspension conduct, but suspects there is much more to the story. Editors of InsideSurgery.com agree that the details of this case remain sketchy, but believe that there is no justification in assigning any blame to Dr. Milhorat who had no ethical or legal responsibility to step in and start the operation on a patient he has not met, nor prepared for.

Investigation continues with a story that has, as Jacqueline (@laikas) said, caused a tsunami. You probably heard about it, you know about Elsevier publishing a fake journal, Australasian Journal of Bone and Joint Medicine, to push Merck products Fosamax and Vioxx. Well, hearing about it doesn’t mean you understand it in a wider context. For an excellent in depth analysis be sure to read Jacqueline’s article at Laika’s MedLibLog.

Interviews

The first Canadian to live in outer space will be a physician! Wow, how cool is that! Pretty cool actually, because the average temperature in space is -270 Celsius or -455 Fahrenheit. Anyway, Sam Solomon (@CdnMedicineNews) talked with Dr Robert Thirsk who will begin a six-month stay on the International Space Station when he takes off on board a Russian Soyuz spacecraft on May 27.

Rich Elmore at Healthcare Technology News has interviewed Dr. Randall Brown, lead author of the report on the Promise of Care Coordination released by The New York Academy of Medicine and the National Coalition on Care Coordination (N3C).

Dr. Val Jones (@drval) is a huge fan of massage. She is such a huge fan that she decided to interview her massage therapist, sort of

Patients and their families

Unless you’ve been on Mars or something for the last four years, you’ve heard about Kerri Sparling (@sixuntilme) and her Six Until Me blog. Kerri has type 1 diabetes for over two decades, and marks her fourth anniversary of health blogging by meeting up with a fellow diabetes blogger.

Novel patient, who has a beautifully designed blog, writes about how her chronic illness affects her relationships, especially with her father and how lack of acceptance can drive a wedge between people.

Tim & Alison blog about living with type 1 diabetes on their blog called Shoot Up or Put Up. In the post Alison submitted, she wants to let you know about some of the useful things she learned about diabetes online, and that internet is not all that dangerous when it comes to health information.

Wendy has a beautiful daughter called Adalyne who has type 1 diabetes. She finally got the courage to order her daughter’s medical record, the one that mentions diabetes for the first time. Now she shares her emotions about it with us.

New research has shown Cushing’s syndrome to have a substantially higher prevalence than previously thought and that diagnosing and treating it is sometimes just as difficult as it was 70 years ago. Robin (@staticnrg) at survive the journey knows more.

If you are sick, you need help and compassion from your partner. However your partner is a jerk. OK than. No no no, Barbara Kivowitz (@bkivowitz) has some advice on her In Sickness and In Health blog to try and work things out with your significant other.

Stop for a sec and Learn how to:

• ask a doctor out - Doc Gurley
• feel good, even when it hurts so bad - How to Cope with Pain
• repair a torn earlobe - Suture for a Living (@rlbates)
• treat infection of the external ear canal - Medicine for the Outdoors
• bend right to avoid herniating discs - The Fitness Fixer

Medical research

DrShock (@DrShock) has difficulties learning how to program in the computer language called Python. This is probably because some parts of his parietal lobe and hippocampus used all the adaptation juice and probably still are, so his other parietal parts refuse to adapt very quickly in order to allow him to learn how to program. Go figure, as he presents the latest neuroscience research paper.

There is this thing they do every Monday at the ACP Internist (@ACPinternists) blog called “Medical News of the Obvious“, which is a compilation of recent studies that don’t always pass the “So what?” test. Let us just say two things: 1. being overweight hurts the entire planet 2. asthma and swine flue don’t go well together. Very amusing stuff!

Want to rub some Viagra on your hmmm… skin? Scientists can make it happen. More rubbing at InsureBlog.

“Evolution of patients with nonallergic rhinitis supports conversion to allergic rhinitis” is the title of the research article presented by Dr Ves Dimov (@AllergyNotes).

Marshall Scott, a hospital chaplain, wrote an interesting review and critique of a JAMA article on religious coping and care at the end of life on his Episcopal Chaplain at the Bedside blog.

Is conference attendance and self-directed reading of UpToDate really worth one year of residency as one study shows. Neil Dunavin (@ndunavin), intern in internal medicine shares his view at InternTips.

A little bit of this, a little bit of that

or

Young doctors in debt who feel inadequate are managing misdiagnosed smoking bats suffering from anxiety disorder, instead of worrying about vaginal discharge in teen girls

Louise Norris (@LouiseNorris) suggests that in order to cut health care spending, perhaps one of the things we need to look at is how we train doctors. She thinks that if new doctors didn’t graduate with hundreds of thousands of dollars in loans and work for peanuts for their first few years after med school, maybe they wouldn’t need $250,000 salaries.

Medaholic (@medaholic) is a medical student who has recently been shadowing practicing physicians. This experience was full of emotions like inadequacy and inspiration which Medaholic generously shares with us.

David Williams (@HealthBizBlog) at Health Business Blog thinks that the fact Sanofi-Aventis is trying to get into so-called “disease-management” field is a sign of serious trouble they are in.

What do you do when a colleague transfers a completely misdiagnosed patient to you? Happy Hospitalist (@happyhospitalis), a board certified internist, tries to realize why such mistakes happen, help his colleagues understand that an alternative course of action may have been better, and make sure they never do the same mistake again.

Do you know what Fourth-Hand Smoke is? Hurry up to Clinical Cases and Images Blog to see the answer.

Dr Am Ang Zhang (@croachcatcher) brings some distressing news about bats dying at alarming rates. She wonders about the ecological implications of it all.

Philip Hickey, a retired psychologist writes an extensive and informative article about anxiety disorders. Here is just a little taste of it: “The APA and the pharmaceutical companies have jointly developed this spurious system in which all human problems, including normal reactions to stress, are declared mental illnesses which need to be “treated” with drugs”.

Finally, Teen Health 411 brings the facts about vaginal discharge all teen girls should know.

That’s it

We hope you have enjoyed the Grand Rounds Diversity Edition. Thanks again to everyone who submitted their articles. There were posts from physicians, nurses, patients, librarians, lawyers, MBAs, health insurance professionals and even priests written in the forms of essays, reviews, critiques and surprisingly poems. If this doesn’t demonstrate the beautiful diversity of the health/medical blogosphere, we don’t know what does. The best way to keep enjoying it is to follow Grand Rounds in the future. The next edition will be hosted at Healthcare Technology News.