Grand Rounds in the New Year

Grand Rounds took a break this week, for the first time in its history. We probably should have done it on earlier occasions, but in the past there was no shortage of willing hosts or participants.

Now is a different story. Recent hosts have remarked to me about sparse submissions and a decline in traffic -- it seems to vary week-to-week, and there are notable exeptions, but the trend is unmistakable. One new blogger (and recnt host) asked, "Does blogging even matter anymore?"

I don't have a great answer. It seems like most everyone still has a blog, if only to have something to link back to on tweets. Blog traffic and comments don't seem to motivate writers as much as followers, fans and retweets.

For years I've considered Twitter and Facebook as less flexible, and more lacking in meaningful content, compared to blogs. But it's clear that this is how the vast majority of online readers prefer to learn about quality health writing. And since the mission of Grand Rounds has always been to showcase excellent medical writing and creative writers, we're going to have to do more with these new platforms.

They might be giants

This year, I learned about the death of two physicians that were pretty important to me.

The first was my pathology teacher, Dr. Guido Majno. In addition to just being a tremendous person, kind and curious... He and his wife wrote the best textbook I've ever read.

The second death was that of my pediatrician growing up, Dr. Thomas Peebles.

Funny, although he followed me from birth to high school, my family never knew about his incredible research background. We learned it in the many obituaries.

It's worth reflecting on their accomplishments and the manner in which they conducted their lives and practice -- especially in this era, when doctors are encouraged to develop their social media presence and be proactive about online reviews.

Would they have used these new tools? Would they even have needed them? Would they have found the idea of trading links to medical stories on Twitter to be interesting? Stimulating? Or maybe distressing, or distasteful?

I never thought to ask them.

Time won't let me go

Before the App Store, way back in the spring of 2008, I jailbroke my refurbed first generation iPhone. I claimed it was for the cool native apps but also liked the customization that was possible (even now, animated backgrounds and control over device sounds is not allowed through official channels).

The innovation came at a price -- the phone became slower and more crash-prone.

When the App store was available, I quickly upgraded to the Apple-approved iPhone OS 2.0 and all my jailbreak hacks and apps disappeared.

Except, strangely, one hack.

There must be some kind of bad connection

A reader of my EMPractice LLSA review on paracentesis (still available, buy yours today!) wrote my editor with a question. Not, thankfully, on anything factual in my writeup, but rather on an issue of word usage.

This is picayune but a start. 2010 LLSA 4 paracentesis refers to a \"Z tract\" as a technique to avoid leakage. When I learned this years ago I thought it was Z track-as the pathway (track) left when the needle was removed. I thought using tract was just sloppy language. Checking Roberts for procedures I read Z tract-OK-solved. BUT then Roberts' Illustrative Guide calls it Z track. So, evidenced-based mavens which is it?!!!

Our editor referenced the original NEJM article on which my review was based. The NEJM uses the term “Z-tract.” But further Googling turned up varied usage, and "Z-track" was far more popular.

Is there a definitive answer?

When all is well and well is all

Slate's Juliet Lapidos recently reviewed a new book by Allan Metcalf on the story of OK ("America's Greatest Word").  Key graf:

The only etymology with hard evidence behind it, he says, is that OK began as a joke—a joke so bad, so boring, that I won't cover it in detail. Briefly: In the spring of 1839, the Boston Post ran an article tweaking the Providence Daily Journal, which included the phrase "OK—all correct." Get it? OK started as an intentionally misspelled abbreviation of all correct (oll korrect). It sprang, more generally, from an 1830s fad for abbreviations, like NG for no good and OW for oll wright or all right.

I've heard about this silliness before, and in fact referred to it whenever someone around me bemoaned the spelling of, say, "Gorillaz" or  "Flickr." The current trend in spelling hijinx doesn't portend the end of civilization or reflect a decline in education, but rather, continues a longstanding English tradition. 

But the part about the review that I really liked focused on the inscrutability of "OK" (more below):