Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Saturday, July 23, 2011
    A Pain Chart for the Real World

    You know those silly pain charts that are used in hospitals and nursing homes, the one you point to to show your level of pain? Go read this. She's developed a much better one.


    Friday, July 22, 2011
    Dots on a Map

    Lately I seem to spend a lot of my online time on Mapquest. I look up the small towns where my parents grew up, revisit the parts of Philadelphia I remember from college and medical school. I spend a lot of time virtually wandering California's Central Valley, heading north on Route 99 and zooming in on the small farm towns that dot the valley floor. Some of these towns are only a few blocks long. I eyeball the bar scale at the bottom of the map, trying to estimate their dimensions: are they half a mile wide? Less?

    Then I wonder what it would be like to live there. Hellish, no doubt: if these towns were thriving they would be bigger, plus the farm economy isn't doing well these days. Not to mention that the Central Valley is hot as hell in the summer. Nevertheless I can't keep myself from daydreaming about retiring there. On the map every one of these tiny little towns is an idyll. Everyone knows one another, it's peaceful there, there's a little high school with a scrappy football team that the whole town supports. Folks sit on porches and drink iced tea.

    In real life, the denizens of these towns are probably either dead-eyed clerks at the local convenience store/gas station or toothless geezers who cook up meth in their spare time. I don't want to chance my fantasies being shattered, or ending up like Janet Leigh in the Bates Motel, so for the foreseeable future I'll confine my travels to Mapquest. And when I drive through California it will probably continue to be on boring Interstate 5.

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    Thursday, July 21, 2011
    Head Meets Desk

    Annnnnnnnnd today, we have the patient who needs approval for life insurance, whose insurance company faxed a form marked "urgent" in sixteen different places, who hasn't had a physical since MARCH 2008. FAIL.

    Give her credit, when I called to explain she was horrified and offered to come in right away, but still.


    Wednesday, July 20, 2011
    Don't Read This Post While Eating

    Medicine has long been apostrophized as a field in which its practitioners shield themselves behind a layer of fancy words, and rightly so. Sometimes though the words serve a useful purpose: if you have to discuss bodily functions, it helps to use a word that won't gross people out. A case in point is a word I came across in a gastroenterologist's report today: "scybalous." As in, "The patient passed a scybalous stool with mucus."

    What the hell does that mean? I wondered. Wormy? Skinny? Scythe-shaped? My imagination ran riot, and I was forced to look it up immediately. Turns out that scybalous is defined as "composed of hard feces" or "pebbly feces." Not an attractive thought to be sure, but using a word like "scybalous" distances the reader from the concept a bit. Gets your head out of the toilet, so to speak.

    My search led me to an online medical dictionary, one of those books it's impossible to stop reading. You may find me at that site for the forseeable future.

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    Thursday, July 14, 2011
    Consider the Following.

  • Setting up the shot took nearly an entire workday - before they were even ready to begin filming.

  • Culver City was operating under a water shortage.

  • He wasn't feeling well, in fact was running a temp of 101° F. The director told him to go home, but he refused and wanted to try one take.

  • They hadn't choreographed the dance except for the "start" and "end" marks, essentially, he IMPROVISED THE WHOLE THING.

  • That first take was the take they used for the film.

  • So now, ladies and gentlemen, I present to you: Singin' In the Rain.