I didn’t do an adequate job of pushing my agenda to talk about surgery and charity, but at least I had an excuse to put up a picture of Bono.  Really, the charitable part of this Grand Rounds is the contribution made by all of you to the medical blogosphere.  Thanks to all of you for your submissions.  Hope you enjoy!

Physician’s Corner

Buckeye surgeon relays a once in a lifetime case of mesenteric ischemia, not to mention a great review of gastric vascular anatomy.  He also reminds us that anything is possible - even necrosing a stomach.

In light of Halloween, and in the spirit of pumpkin carving, Suture for a Living reviews fingertip injuries, including classification of the injury and techniques for repair - very thorough with fantastic demonstrative drawings.

White Coat Rants helps out the linguistically challenged in “I Don’t Speak French” when he teaches us another name for the plafond fracture.  Find out what a plafond fracture is and why it’s also known as a “Don Juan” or “lover’s fracture”.

Just when you thought Hallway Four was gone, her ghost returns as a guest host at Ten Out of Ten.   Hallway Four talks about a surgical hernia case encountered in the ED…or is it really a hernia? 

Science-Based Medicine thoroughly explores the advantages and disadvantages of circumcision in “Circumcision: What Does Science Say?”  A good read for both physicians and parents before deciding what to do for their patient or son.

If you’re worried that a spreader-graft widens the nose, Beverly Hills Rhinoplasty Surgery Blog tells us that unless you’re a robot, the difference can’t really be noticed…what is noticeable is the improved breathing and improved aesthetics.

The Scalpel’s Edge writes why she isn’t so hard on her “stupid” burn patients anymore after her son’s incident with some hot porridge.  “The other side of the waiting room” reminds me of an old book by Dr. Edward Rosenbaum, "Taste Of My Own Medicine: When the Doctor is the Patient".

Odysseys of George gives a radiology quiz that reminds us the importance of history taking skills...I could see this being a House episode where Dr. House tells his team for the 100th time, “the patient is always lying!” 

The Online Cancer Blog discusses individualized treatment strategies for patients with renal cancers and why a nephrectomy even for localized tumors might not be enough…depending on the patient.

Written by a patient, every nurse and surgeon should read The Orton Family’s story of how patients should NOT be treated post-operatively.

Delhi With Avinash & Friends writes a fascinating article on the differences between near death experiences and out of body experiences, including a discussion of neuro-scientific theories to explain such phenomena.

http://delhiwithavinash.blogspot.com/2008/11/life-after-death-part-xxiii-has-science.html

Ethics & Surgery

Respectful Insolence discusses the fine line physicians must walk to lead and sometimes persuade patients to make the right choices, while also respecting their autonomy.  The article is based on  Orac’s quite comical story of an emergency physician who gives new meaning to the term “informed consent” when he bluntly details what will happen to a young patient who refuses emergency surgery.

Chloroform Rag carefully and thoughtfully discusses the problem of drug addiction among anesthesiologists in “One-Strike-Your-Out”.  The article sheds some light on why denying a second chance at anesthesiology might be the better way to provide a second chance at life.

Thanks to Chloroform Rag, I’m reminded of a book by Dr. Abraham Vergehese - The Tennis Partner: A Doctor’s Story of Friendship and Loss. It is a moving account of the author’s personal encounter with a fellow friend and physician who succumbs to a drug addiction.  It’s definitely worth reading.

Read this article about a transplant surgeon accused of hastening a patient’s death for the purpose of organ procurement.  Who knows, but it’s seed for thought about the ethical boundaries transplant surgeons are faced with on a daily basis.

Other Things Amanzi gets caught up in Pretoria gossip and rumors without saying a word and shares why it’s never worth it to participate in work place gossip.

The Online Nursing Degree Guide posts a hundred resources for educating yourself on the issues surrounding health data privacy and security in the electronic information age.  The articles are categorized according to: opinions, HIT, HIPAA, CCHIT (Certification Commission for HIT), EHR/EMR/PHR Information, Patient Safety, Privacy and Empowerment, Health Care Law and Policy Blogs, Specialty Health Law, eHealth, and Helath 2.0.

Surgery in the Media

Plastic Surgery 101 sheds some light on recent media coverage of nipple sparing mastectomy techniques – why make things more complex than they need to be?

An article in the Jordan Times about pyloric stenosis.  It’s the result of a Family Health Project conducted by the partnership of Jordan Ministry of Health, USAID, and John’s Hopkins University.

Patient Corner

Tales From My Tiny Kingdom shares about her 24 year journey from Harrington rods to jazzercise. 

Stephanie from How to Evict Your Useless Colon gives a pictorial account her most recent fight against ulcerative colitis – a colectomy with ileostomy.  Her blog is a great resource for patients with inflammatory bowel disease, and interestingly, note in the comments section that there is a clinical trial to test the efficacy of online nursing care for ostomy patients. Great idea!

Colon of Carmen chronicles her ileostomy takedown and J-pouch procedure starting with the day before surgery through post-op day 3.

UC to J-pouch story provides a photo diary of living with an ostomy bag and actually has some great tips for how to hide the bag.  You’d never know he lives with one.  Thanks for sharing, Mark. Really, his entire blog is another fantastic resource for patients living with IBD.

Money Blue Book shares his experience with Lasik Eye Surgery and his story is a great resource for those who are considering Lasik.

World Dental discusses the various treatment modalities for oral cancer – surgical and otherwise.  It’s a useful link for those patients and families dealing with oral cancer.

And Women’s Health Zone explains Metabolic Syndrome.

Training & Education

Monash Medical Student reflects on how he might choose a specialty.  Needless to say, I’m a little disappointed that he didn’t even mention emergency medicine!  With sincerity, please keep us posted! And for those trying to decide what specialty to pursue, this is good food for thought.

The Sterile Eye, a medical photographer and videographer, shares some of the challenges of working in the surgeon’s domain, but then shares why it’s worth it – all you need to do is to watch some of his videos – a diagnostic endoscopic ultrasound, a transhiatal esophogectomy, and esophageal stenting.  Videography has tremendous educational value.

Saif, a premed student at UC Davis who is abroad for a Latino health internship, tells a story about shadowing a surgeon in Mexico City, and the comedy of errors that happen for a student in a new place, different culture, and speaking different language before he finally gets to where he wants to be – in the OR for a vertebral fusion surgery.  Way to be persistent Saif!

Training to be, or interested in becoming a midwife? USPharmD+ posted 100+ Essential Online Resources for Midwives.

Surgeon or not, elearning gurus suggests we drop our backpacks and take a look at the compilation of internet tools available to enhance our e-learning experience with regard to research, studying, teaching, and organization.  I especially like the free bibliography tools listed under “writing tools”.

Bonus

Be a plastic surgeon without the six to seven years of training.   All you have to do is pay $9.95.  Sweet.

SurgeXperiences is a blog carnival about surgical blogs, wherein surgical experiences are shared. It is open to all (surgeon, nurse, anesthesia, patient, etc) who have a surgical blog or article to submit. The next edition of SurgeXperiences (211) will be hosted by The Scalpel is Mightier than the Sword on 23 Nov, 2 weeks from now. Be sure to submit your post via this form.