OK, I'm back. Took a while, I know. But hopefully the wait's been worth it.Here we go again. 

Dashing MD

Episode 28: Podcast 2.0

The way this blog is posted and served is absolutely free. Unless you value the time it takes to do it...this post was finished almost a week ago, but took a long time to successfully upload.So that's the excuses section.Anyway, Episode 27 is up at last. Enjoy, and let me know what you think!D, M.D. 

Episode 27: Whither and Whence

Well folks, I'm back again. And reading from the mailbag, where Amanda writes in with some great questions about naturopathy.Also, in the podcast, I mistakenly refer to graduates of Osteopathy schools as ODs. This is what's known, in this political season, as a gaffe. They are actually DOs. Apologies.Here are some associated links, if you want more:Here's a Wikipedia article on Naturopaths...it's interesting for some basic information on naturopathy, and it's also a fascinating exploration of how Wiki articles are made and debated about, if you look at its associated discussion page.And an article on placebos.The good folks at South Park have addressed this issue, too.This week's case (an exercise that I'll make a regular feature if you guys like it):An 88 year-old woman with a history of advanced breast cancer 30 years ago, and a bad history of high blood pressure and osteoarthritis complains about her right hand, which is turning white. Her primary care doctor can't find a pulse, but he sends her to a vascular surgeon who can find a signal of a pulse using a doppler. He tells her to come back in a month. What do you tell her?Enjoy! And keep in touch!D, M.D. 

Episode 26: Sometimes it's all in your head.

You responded to Episode 24 with aplomb, I have to say. Tons from the mailbag -- enough to form an entire episode. We hear from Moof on why I should be a doctor, ZeroRocker on why he wants to be one too, and another emailer with some compelling questions on transplants. In 26, look for a diagnostic puzzle...coming soon(ish)!Until then, enjoy, and keep the conversation going!D, M.D.P.S. In this episode, I talk about how altruistic liver donation doesn't happen in the US. Turns out there are a few programs starting up, slowly, and with a lot of trepidation. 

Episode 25: A Conversation on the Frontlines of Medicine

I know, I know...You could argue, rightly, that I already went. But hey, I'm back, and glad to be here. No drama, no amnesia, no fugue state in which I woke up months later washing dishes in a diner in New Mexico, no kidnappings or secret missions. Just a lot of living, and then, towards the end, some technical difficulties.But I'm back, and here is Episode 24. And here is the link to the article from the NYT that I talk about therein. Keep in touch. I'll do the same. 

Episode 24: Should I Stay or Should I Go?

Hi All,First, a very happy New Year to you all! I'm really excited about where this podcast is headed, and about this first episode for 2008.This episode is in three parts:Part 1: The story of a recent tragedy, and what it makes me remember and consider.Part 2: A look at a couple of recent issues that have appeared in the mainstream media that have direct implications on surgery. The first is a story from This American Life about a heart transplant recipient who comes to know her donor's family...I have a few thoughts on what a bad idea that is.The second is an article by Atul Gawande that appeared recently in the New York Times, telling a story about the latest example of research methods and research ethics failing to agree on what's best for patients. A really interesting read.Part 3: I've been struggling to figure out where the podcast is headed. Now, I'm also struggling to figure out where I am headed. Which, at the very least, gives me a sense of some things to talk about in the weeks to come.Enjoy! As always, look forward to hearing your thoughts! 

Episode 23: Looking back, looking forward

So...summer was great. So great that I didn't really get to the podcast much. That, and some technical difficulties. But I'm back now, with some great listener mail. Episode 20 hits some big topics: - Medical school for non-traditional students- Universal healthcare, and my feelings about it- Coping with bad daysHope you enjoy! I'm glad to be back.Keep your thoughts and questions coming! 

Episode 20: The End of Summer

Here's the story of how a young doctor-in-training learns to keep standing...and at what cost.As always, I love hearing your thoughts.New to the podcast? Want to subscribe? You do? Great! Click the button below: 

Episode 17: You Grow Accustomed To The Smell

Here's Episode 16. We start with some letters from the Listenership, then take a quick trip to the newswires, where we check on the medical accuracy and completeness of recent stories about Tony Snow's cancer diagnosis and Jon Corzine's car accident. Then, at long last, we arrive at the stated topic: questions you should ask your surgeon before having an operation, and things you can do in the hospital to be sure that you're getting all the treatment that you should.Of course, I'm not your doctor, and you should take my medical advice the way you take any advice from a complete stranger who won't tell you his name...For convenient reference, I'll put the main points here: 1. Be sure your attending is going to be in town while you're recovering, not heading to the airport from your operating room. 2. Is your attending surgeon going to see you every day while you're in the hospital? I used to take that for granted. No longer. 3. What's the patient to staff ratio going to be? If you're going to be in ICU, will you have 1:1 nursing, or at least 1:2 nursing? And what sort of physician coverage is going to be present at night and on the weekends? Will there always be a senior-level doctor in house, or are the interns sometimes left to their own devices? 4. How many cases like yours has your attending done - AS AN ATTENDING? 5. When you get to the hospital, ask about the following...and keep asking: a. Prophylaxis against Deep Venous Thrombosis (DVT) b. Peri-operative antibiotics c. Beta-blockers (not everybody needs them, but be sure your team is thinking about it)Hope this proves a useful reference. If you have things that you think should be added to this list, please, let us know!! 

Episode 16: Questions you should ask

As I finish a three-week rotation in the Intensive Care Unit, three patients with three families stick in my memory. Not so much for their individual cases, though each was memorable and heartbreaking in its way, but for how their needs and ours worked together - or failed to. Also, a trip to the mailbag for more questions from Nancy! Enjoy! 

Episode 15: Three Patients, Three Families

In this week's episode, I go to the front pages of the last week, trying my hand at a little bit of political commentary from the medical perspective and trying to put some scientific sense into our reading of news headlines.The two issues I talk about are based on articles about Dick Cheney's blood clot and the Walter Reed Scandal.As always, I can't wait to hear your thoughts on this week's episode! 

Episode 14: From the Newswires

In which a young surgeon-in-training reflects on things that happen to him, and perhaps others do as well. And the questions of children and curious adults are answered, too!

hubhopper

Dashing MD

hubhopper