Just when you thought you couldn’t stomach anymore Thanksgiving goodness, it’s the Thank-You-Kindly edition of Grand Rounds! (Version 2.10, but who’s counting.) Publicized in part by Medscape, thanks!

Unbuckle your belt, folks, and dig right in:

We start out remembering why we’re in this in the first place. The patient. Traci experienced a complication from her hysterectomy , needed blood, a trip back to the OR, and a night in the ICU. We’re thankful you’re okay, Traci.

And next up, we’re thankful for our own pats on the back… that’s right, I’m proud to announce The 2005 Medical Weblog Awards!
Vote early (for me), vote often (for me). And please add category of “Best Third-Year Medical Student Blog In the Bay Area Who Has Been Blogging for Years!” (I like winning.)

And we’re thankful for the technology and progress that continues to improve our health. The Biotech Weblog writes about a new chewing gum that may save our troops trips to the dentist (and may save me 5 minutes in the morning).

We’re also thankful that we aren’t all handsome hospital-conglomerate-running COOs, like the one worth $460 million that Hospital Impact tells us about . We’ve got plenty of self-esteem, and we surely don’t need $460 million to tell us we’re good people. We’re not jealous. Not at all.

If anything, we’re thankful for the sleep that we get. Sleepdoctor informs us of the recent update in the understanding of insomnia ; it’s not just a secondary condition, as it was assumed 20 years previously. (And while many of us aren’t sleeping as much as we’d like, some in the world aren’t able to get restful sleep for months.)

The Rock hits the Hard Place at Healthy Concerns this week; where do our medical concerns meet our political values of freedom of speech? Is it free speech to tell a teenager how to commit suicide? Where’s the line? Thanks for providing such an important ethical dilemma for our moral stew.

Medicine hits another ethical snag this week–where do we draw the line between spending and spending effectively? Should we pay for treatments that have incredibly high number (or cost) to treat? Is the UK right, us, or somewhere in between? Thanks Health Business Blog!

Insurance, regulations, coverage, and billing can be more than one can take–from a physician to a patient to an administrator, and so we’re thankful that there are professors that can make sense of it all. Insureblog’s Prof Stern explains in easy-to-understand language the dangers of “Discount” insurance plans which, like many things, are probably too good to be true.

The FDA has new regulations regarding Wireless Alarms in hospital settings–namely, they’ve just approved them! Medical Connectivity Consulting has the scoop, the gist, and the buzz . Thanks!

In a similar vane, I think one of the best reasons to blog is to take inaccuracies and fallacies to task; in medicine this is of the utmost importance. We thank Red State Moron for covering the topic of vaginal births after cesarean (VBAC) ; he addresses the elephant in the room: “rhetoric does little to advance the discussion over what do we do to decrease cesarean birth rates.”

Polite Dissent attacks another fallacy, with data and might and muster. Is choking on toys really a leading cause of kids’ deaths ? Crying Wolf may be a perfect title.

It’s strike three for fakers, fibbers, and charlatans; Doc Around the Clock tries to uncover and make sense of meth users’ tooth rot . Does it have its own mechanism and pathophysiology?

But wait, there’s more. Go Trent Go! Trent McBride, pathology resident, does a great job trying to set the record straight about Christine Maggiore , the woman who “refuses anti-retrovirals while pregnant and after daughter’s birth, she breastfeeds daughter (a known risk for HIV transmission), and daughter dies [of … ] AIDS-related pneumonia.” Medbloggers got some teeth!

And teeth they have. Thanks goes to Orac, who again takes on the autism-vaccine crowd . Great work. (Are we sure these aren’t budding lawyers? Their evidence is excellent!)

I’m personally thankful for being able to learn about fascinating new discoveries we’re making every day, and The Genetics and Public Health Blog surprised me with this one: researchers may have identified a gene that is responsible for an individual’s level of fear, called stathmin . Thanks Dr. Lei!

And some discoveries are more important than others; GruntDoc’s finding of a *ahem* study *ahem* discouraging the use of tinfoil hats definitely blows a fear gene out of the water. (Sorry Dr. Lei!)

Sometimes we’re just blessed to have been able to share a story, or have a story shared. With Andru’s contribution, he makes the economic and justice arguments for health care reform ; I should be thankful I get to eat lunch. Thanks to Andru for his service to the underserved, as well as everyone else who donates their time toward providing health care or health care reform.

Joy’s post at CodeBlog makes me thankful my loved ones are safe and sound . The story leaves me speechless. I take pause.

Just when I think I’m starting to think I’ll be up for this whole “doctor” thing, Doc Shazam’s stories of the First and Second Ovary make me thankful I’ve got some more time to still say “I’m just a student.”

And tips from those who’ve already been in the field for 27 years are to be thanked as well. Kim at Emergibog gives her take on how to chart effectively, document thoroughly , and even her necessary equipment (“blue and I must have a medium-point, gel-ink pen that does not scratch the page as it flows,” in case you were wondering).

We’re also thankful for fresh ideas. Hippocrates posits that a more transparent medical system (he calls it “Open Medicine”) will improve the information and financial conundrums that plague the current health care system. Take a read, and see what you think.

And Dr. Andy has a fresh take on gifted children –should they have gifted classrooms? Should they be pushed to enter college early? He examines an NYTimes article in-depth. (Me? I just played Oregon Trail all day long when I went to Enhanced Learning.)

If you didn’t see yesterday’s piece on Pharma hiring college cheerleaders to promote their products, look no further than DB’s Med Rants . The site updates us on the work of influence, something very important that we remember as physicians. Thanks DB!

Being a computer geek and having grown up in the Nintendo era, I’m thankful for the entertainment and games we can play. But there’s a darker, more dangerous side, and even I can vouch that the addiction is real. Treatment Online writes about The Challenges of Stopping Gaming Addiction . Ask your patients about these games; a colleague had a patient who said she was too busy playing these online games to get out of the house or exercise.

I am just downright thankful that someone went into depth on the tryptophan/turkey/sleepy issue, as Circadiana did ! (Great minds think alike, you know.) The entry even provides the biochemical pathway! How’s that bring you back to USMLE Step One?

Medicine’s daunting, if nothing else. I don’t care who you are, what your specialty. To keep up with it all, remember the important little details (they’re all important, sadly)? Thankfully we have the Clinical Cases and Images blog, reminding us of the possible complications of an NG tube placement (can you remember them before you click?). Confirm with a chest radiograph, NOT a KUB!

I would imagine that Mr. Kerswell is thanking his lucky stars today after suffering a reporter 28 cardiac arrests . Amazing and thanks, Parallel Universes !

And we’re thankful for statistics. Okay, well, maybe you’re thankful for them, but I’ll be honest… I’m lukewarm at best. That being said, we’re very thankful for Tara Smith, who writes at Aetiology about possible numbers of subclinical infections (that means not bad enough to be seen by a health professional about) and flus in Asia.

Intueri gives us something to ponder, as many of us sometimes forget the mental and psychological side of health care: how do we, or how can we, objectively predict a patient’s possibilty of future violent acts ? Is flawed better than nothing? Thanks!

And finally, thank you to everyone that participated. For sharing your stories, your time, and your concern. Everyone needs a little “me” time; give yourself some each week. MSSPNexus Blog reminds us that we can all experience burnout, especially the most dedicated caregivers around us . If you don’t give yourself a break, you won’t be able to keep on providing care, so make sure you’re breathing, too.

Don’t miss Grand Rounds, next week at The Examining Room of Dr. Charles .

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