Backlog

I've got a pile of old unpublished posts in various stages, and just promised a regular reader I'd be finishing them up soon. Until then, here's Lileks, on his new book Mommy Knows Worst:

It’s a compendium of archaic child-rearing advice, going back to the 1920s, when parents were urged to give their kids sunburns and linseed enemas. It’s perhaps the only book I will ever write that devotes a substantial chapter to the greatest problem of the 1940s: CONSTIPATION. You have no idea how slow the bowels of American children moved in the forties. Dads will enjoy how stupid and useless they were made to look in the 50s; Moms will enjoy the detailed how-to-give-birth-at-home section from the WW1 era, and everyone will love the 1960s pamphlet on dealing with home stresses via industrial tranquilizers. It’s the usual retro-fest with many ads, laden with unfair commentary, and attractively priced; perfect for everyone who’s ever had a kid or a mother. I think that covers it all.

I think Lileks is downplaying the size of the constipation crisis among infants of the 40's, and even today. If there's one thing I remember from medical school pediatrics, it's that constipation causes a surprising number of hospital visits (a second fact springs to mind: parents aren't often satisfied with the diagnosis of constipation).

Now that I think about it, I should buy this book in preparation for my peds month in December. One or two of those chapters may come in handy on the floors.

Decay

She came in with their teenage son to see him. She was about forty-five or fifty, with makeup and earrings and a nice blouse. I didn't recognize her at first -- she wasn't what I expected.

When my patient told me his ex-wife would be coming to visit, I simply imagined someone like him. I tried to picture his home; the squalor and decay that I associated with a pathology like his.

I overheard her at the front desk, asking, "Why can't anyone tell me where he is?"

I looked up from my charting and saw her. "I'm sorry," I answered. "I'm taking care of him. I spoke with your son on the phone. We just moved him to isolation -- it's right this way."

I led them to him and opened the door. Her face contorted and her posture stiffened, then she went inside. Their son followed.

I stayed outside, by the desk, writing my chart. I had a lot of questions I wanted to ask her, about his medical history, his alcoholism -- but it could wait until they were outside again.

I didn't want to go back in there.

She emerged a few minutes later, and took a moment to adjust her outfit and take a few deep breaths. She briskly walked toward me.

"When is he going to surgery?" she asked.

"Hopefully within the hour."

She thought carefully for a moment about her next question, and asked slowly, "What is that godawful smell in there?"

In a moment, I tried to imagine their divorce, maybe a few years ago, as his drinking got worse. Was there an ultimatum? A custody battle? In the end, maybe she felt she there was nothing more she could do -- so she took their son, and hoped that somehow her husband would turn it around, by himself.

He didn't, and now it had come to this: asking the emergency department intern about the smell.

I pursed my lips and looked into her eyes. "It's the foot," I said. "His right foot is just dead tissue."

Celebrity Skin

It's October, 2005, and I'm continuing to coast on all the writing I did last year.

A few days ago, the Wall Street Journal mentioned blogborygmi in a piece on medical blogs (reprinted here). It looks like the reporter read though some of my archives, which is really nice. But she listed me as anonymous -- maybe because I requested that my hospital affiliation not be disclosed. Or maybe she thought "Dr. Genes" was a pseudonym (though the last time I was quoted in the WSJ, my name was the topic).

I also was interviewed by Dr. Kent Bottles of SoundPractice.net, as part of his series on medical bloggers. It's really a wonderful thing he's doing, recording the thoughts of early medblogging pioneers like MedPundit and Dr. Centor -- I'm really honored to be listed among them.

A few hours after doing the interview, I sauntered into work, my head still a little big from the attention. Internship can be a long slog, and sometimes it gives me a warm fuzzy to know this medical blogging scene is taking off, and I'm a part of it.

One of the seniors greeted me excitedly.

Resident: "Nick! You just missed all the cameras! The network was here. Our attending is going to be on that makeover show! They just swooped in and took her away."

Me: "Really? Dr. B? But she's so..."

Resident: "Pretty? Yeah, but she felt she had kind of lapsed a little bit since she started here. Anyway, they filmed in the ED, they got a shot of all of us, I'm going to be on national TV!"

Me, smiling to myself: "That's really... great..."

I guess, despite all the progress, medblogging still has a ways to go.

Diamond in the Roughage

I often wondered which medical blogger would first make it onto Blogger.com's "Blogs of Note" first... would it be the news and views from mighty Medpundit? The rich examining-room tales of Dr. Charles? The heartbreak and introspection from The Cheerful Oncologist (you know, before he moved off blogspot).

As far as I can tell, none of these fine, erudite blogs have been featured. But this one is: Ah Yes, Medical School. Ah yes, they've chosen to spotlight the bawdy writing from a still-adolescent twentysomething male, preoccupied with breasts, poop jokes, and whining about work.

It's really funny.

It looks like he's labored without much recognition for years, before finally getting some attention this month. I wonder how many others are out there like him. Maybe now with google's blog search, it'll be possible to find more of these hidden sites.