Welcome to Grand Rounds - Vol. 4, No. 29

Welcome to the Medical Blog-o-sphere's weekly edition of Grand Rounds! Today we'll take a decidedly (well, what else?) cardiovascular bent. I appreciate all who contributed their talents to this week's edition. Many thanks must be bestowed on Nicholas Genes, MD, PhD, the grandfather of Grand Rounds and the great Keeper of the Schedule, for his patience and guidance during my maiden voyage into the ranks of the truly gullible "grandly" hosts of this weekly event.

All 36 (or so) posts have been included, and have been assembled by their appropriate cardiovascular term.

So grab a cup of coffee, sit back, relax and enjoy this week's Best of the Medical Blog-o-Sphere!

Legal thuggery is sure to make a medical blogger's heart stop. Eric Turkowitz over at New York Personal Injury blog links to the buzz created by New Hampshire blogger Kathleen Seidel of Neurodiversity.com, and her remarkable post entitled "The Commerce in Causation." Ms. Seidel is a level-headed, well-researched citizen-journalist who has tirelessly investigated the pediatric medical research conducted by Rev. Lisa Sykes, Mr. Clifford Shoemaker, and their colleague Dr. Mark Geier; their efforts to compel removal of mercury-containing antimicrobials from FDA-approved vaccines; and their "judicial advocacy" campaign. After sharply criticizing Shoemaker's legal incentives, she received a subpoena within four hours from Mr. Shoemaker, the plantiffs' council, demanding "bank statements, cancelled checks, donation records, tax returns, Freedom of Information Act requests, LexisNexis® and PACER usage records. The subpoena demands copies of all of my communications concerning any issue which is included on my website, including communications with representatives of the federal government, the pharmaceutical industry, advocacy groups, non-governmental organizations, political action groups, profit or non-profit entities, journals, editorial boards, scientific boards, academic boards, medical licensing boards, any 'religious groups (Muslim or otherwise), or individuals with religious affiliations,' and any other 'concerned individuals.'...."

Not intimidated, Ms. Seidel subsequently filed this well-targeted motion to quash the subpoena. It's an incredible story exposes the underbelly of a potential new legal tactic that could be imposed against bloggers anywhere: issuing malicious subpoenas to quell bloggers' free speech.

More likely, as Orac points out in his "important rant," Ms. Seidel will be vindicated by a Streisand effect.


Not Totally Rad reviews the radiologic imaging of sex. It seems it's all about the angle of the dangle. Hey, if this doesn't give you palpitations...

Vitum Medicinus describes his pap smear on a man. Getting lightheaded yet?


It would be laughable if not so true: Dr. Rich at Covert Rationing Blog discusses the implications of the 196-page smoking cessation guidelines (Brady) and their implications for the 7.5-minute outpatient office visit (Tachy).


Really, when it comes down to it, for gay teens "nothing again will matter." (Thanks to Nancy L. Brown, PhD from Teen Health 411 for submitting this lovely poem).

At Med Students Down Under we get a glimpse of a med student's worse nightmare: flunking boards. More importantly, we also learn of the remarkable strength and fortitude it takes to recover from such an event and the lessons learned along the way.

TBTAM over at The Blog That Ate Manhattan demonstrates beautifully what happens when doctors start to think about the tough stuff in healthcare.

Imagine. Finding you could no longer lift your child or swallow. Pearls and Dreams discusses the paradox that lies between the ability of medicine to tackle difficult diseases, like Myasthenia Gravis, and the challenges of ongoing care affter being diagnosed.

The Sterile Eye reflects on the gnosis of diagnosis by biopsy.


Dr. Val notes this is what some orthopedic surgeons sound like during academic lectures. You gotta love those orthopods!


Lisa Emrich at Brass and Ivory outlines the blocks to qualifying for drug-assistance programs when you're a "tweener:" not yet on Medicaid, but struggling with the long-term costs of medications.


Wow, for a minute I thought I was being Rickrolled by Doc Gurley, but it seems the American Heart Association wants us to do CPR to the beat of disco. "Stayin' Alive," to be exact. Another time reentered, indeed. I'm just not sure I want to stay alive to listen to this, but the cadence is catchy...


Sam Solomon over at Canadian Medicine reminds us of the power of doctors' poetry. After losing my father last year, I was struck by this one which appears among the many links he provides.

The Fitness Fixer links to a funny, yet disquieting, video on the sedentary-mindset of our society.


Med Valley High describes food-related references in medicine. Shoot on over and add any he's missed.


Quit coffee? Nah. It's just afib... What's a little coffee among friends? (Kerri - I feel your pain!)

Sandy Szwarc, RN at Junkfoodscience exposes the irregularities of the study design in a recent New England Journal of Medicine study that claimed fat pregnant women outstay their welcome in hospitals compared to their slender counterparts.

Colorado Health Insurance Insider discusses another irregularity: the profit in non-profit hospitals. Well, given that 60% of hospitals are non-profit, maybe this is not so irregular after all.

While on the subject of irregularity: Chronicles from the Middle of Nowhere describes the challenges doctors encounter when they second-guess treating family members.

And if defibrillator hacking wasn't enough, Clinical Cases and Images discusses a new nightmare: hacking blogs.

Did you have an endoscopy in Las Vegas, Nevada between March 2004 and Jan. 11, 2008? Reused syringes and improperly cleaned endoscopy equipment are just of the few irregularities that occurred at the Endoscopy Center of Southern Nevada. Healthline Connect's JC Jones, RN has where to call to get help.

Ian Furst over at Wait Time and Delayed Care looks at his blog stats to suggest an explanation why certain countries (like England) have longer wait times for patients.

Vreni at the Wellness Tips Blog discusses the history of the refined carbohydrate vs. saturated fat debates in the genesis of obesity.


Rita Schwab over at MSSPNexus blog brings us back to normal rhythm as she discusses the real reason doctors should attend educational conferences.

Amy Tenderich of Diabetes Mine makes it easy to teach patients how to count carbs with her handy-dandy mnemonic.

InsureBlog's Henry Stern shares his personal catharsis about caring for aging parents, making often painful decisions, and offers encouragement and suggestions to those in the "sandwich generation."

Who makes the bigger contribution to mankind, an organ donor or a clinical trial participant? The Health Business blog's David Williams thinks he knows.

When Joshua Schwimmer can The Efficient MD, efficiently announce his new book deal with the American College of Physicians and then spin over and tell us about a new bioartifical kidney on the horizon at Tech Medicine. Dude! So efficient! (But normal? Hmmmm... I have enough trouble keeping up one blog...)

Barbara Kivowitz at In Sickness and In Health discusses the fun that can be had by eavesdropping on others in the waiting room. HIPAA? What HIPAA?

Dr. T. over at Fruit of the Womb (great name for an OB blog, by the way) does a nice job explaining how smoking can confound certain prenatal tests for Trisomy 13/18 and Trisomy 21 (Downs Syndrome). Even this cardiologist learned something! Now, where can I apply for CME?

Paul Auerbach, MD at the wilderness medicine blog, Medicine for the Outdoors, reflects on his week working in a hospital in Guatemala where people make due with much less than the US and manage quite nicely, thank you.

Laurie Edwards, a celiac disease patient at A Chronic Dose, discusses why she never ventures to the center of a grocery store.

And finally, How to Cope with Pain proves what I've come to learn preparing all of these posts: computers can be painful. Amen!

Well that wraps up another exciting collection of posts for this week. Thanks again to all who donated a bit of their time, energy and effort to making the field of healthcare just a little bit more accessible to all.

Next week's Grand Rounds will be hosted by Women's Health News.

So now, here's what's left:


May I rest in peace.

-Wes