Archive for July, 2009

The whole post is a good read, but the following caught my eye:

A reflection: Is our national medical obsession with chest pain a manifestation of our national anxiety and fear of uncertainty? Of our national terror of death, or our collective unease even in the face of relative security and prosperity? Is it because we’ve subsituted faith for pharmaceuticals?

via edwinleap.com | Sunday morning in the ER.

My answer: yes.   More specifically, we have substituted Science as the religion, humanity as supreme, and have found both sorely lacking.

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The evidence has been mounting for some time, and people are starting to notice.  TechCrunch recently posted about the problems with AT&T, and the article is also a good collection of references:

Since I switched to AT&T from Verizon just over 2 years ago to get the iPhone (which, of course, AT&T has exclusively in the U.S.), there have been no shortage of shortcomings by AT&T. But as of late, I’ve been noticing things getting much, much worse. And I’m hardly the only one. And so it’s time to call out AT&T on those failures. And plead with Apple not to renew its exclusive contract with AT&T when it expires next year.

via AT&T Is A Big, Steaming Heap Of Failure.

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This is almost old news already, but I think it deserves some attention, as well as a permanent (relatively) spot on the web.  When did Lebron turn into a big baby?  Between his playoff run-and-hide and now this, where he can’t handle someone dunking on him.

This is absolutely no fun, and it falls right in line with a batch of childish behavior from LeBron James recently. And I’m not in line with those who are letting James slide for this or James’ refusal to meet the media or congratulate the Orlando Magic last month because “he hasn’t done anything wrong yet.”

They’re confusing “not doing anything wrong” with “meeting and far exceeding the hype that preceded his NBA career.” We should applaud his game, but to applaud him for merely not being a dingle berry doorknob is ridiculous. Nearly as ridiculous as substituting “dingle berry doorknob” for a curse word.

via LeBron James, and the Tale of the Never Seen Dunk – Ball Don’t Lie – NBA – Yahoo! Sports.

Everyone was willing to make an excuse of the playoff thing, but this is just dumb.  I know Nike has made some statement amount “no videos” or something like that, but many witnesses say that they had no problem with the filming until Lebron got dunked on.

I really don’t get it.  Lebron certainly appears to be more relaxed and fun-loving this.  Is he getting uptight?  Maybe this just shows that maybe NBA players should go to college and mature a little.

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An essay column in the New York Times discusses a personal reflection on money aspect of practicing medicine by Dr Sandeep Jalhar:

To meet the expenses of my growing family, I recently started moonlighting at a private medical practice in Queens. On Saturday mornings, I drive past Chinese takeout places and storefronts advertising cheap divorces to a white-shingled office building in a middle-class neighborhood.

I often reflect on how different this job is from my regular one, at an academic medical center on Long Island. For it forces me, again and again, to think about how much money my practice is generating.

via Essay – A Doctor by Choice, a Businessman by Necessity – NYTimes.com.

I sympathize with the feeling that one may have entered medicine hoping to not worry about money. Unfortunately, those days are gone… the age where doctor’s are paid enough so that they can just practice and not worry about money have been gone for a couple decades now.

I do think that the current fee-for-service system is sick, and really needs to be fixed.  I know HMO’s got a bad name in the late 80s, early 90s, but I do feel that they are a much better financial structure than the system we have now.  Obviously, I’m a little biased.

I’m pretty sure doctors in general will be happier that way.  I know that there was a survey of Canadian doctors which showed surprisingly high satisfaction scores when compared to their salary.  I’ll need to dig up to reference, I’ll update this post when I find it.

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An article trying to interpret behavior while speed dating and making evolutionary interpretations.  The epidemiologist part of me just cringes at the statement below.  The method (randomization) is meaningless unless you have some grasp of the inclusion criteria and the potential biases introduced there.  Specifically, are the type of men and women who speed-date different from the general population?

I think it is fair to say that most people have never speed-dated in their lives.  If I could hazard a guess, I would also say that men who go speed-dating tend to be more shy, and women who speed-date tend to me more extroverted than average.  (I know someone is going to hate me for making generalizations).   I don’t know if these assumptions are true, but any report on science should at least acknowledge that the study has very little to do with “evolution” and is more something that is limited to speed-dating behavioral dynamics.

In recent years, the emergence of speed dating has given psychologists, economists and political scientists new ways to test this and other hypotheses about mating. Because participants can be randomly assigned to groups and have no prior information about other participants, three-minute speed-dating sessions are about as close to a controlled experiment as researchers are likely to get.

via Testing Evolution’s Role in Finding a Mate – NYTimes.com.

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Some well reasoned advise regarding the recent federal advisory committee report on acetaminophen published in the New York Times health blog.  I think the key points include the very low level of incidence, and the comparitively high level of side effects (although still low compared to how much it is used) of NSAIDs and Aspirin.

Few drugs are more ubiquitous than acetaminophen, the pain reliever found in numerous over-the-counter cold remedies and the headache drug Tylenol.

But last week, a federal advisory committee raised concerns about liver damage that can occur with overuse of acetaminophen, and the panel even recommended that the Food and Drug Administration ban two popular prescription drugs, Vicodin and Percocet, because they contain it.

The news left many consumers confused and alarmed. Could regular use of acetaminophen for pain relief put them at risk for long-term liver damage?

via Well – Reasons Not to Panic Over a Painkiller – NYTimes.com.

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Article from Ars Technica, discussing the move to digital archiving.  Personally, I would love it if people would stop sending me dead trees and just give me an option for online subscriptions for my journals…

Last week, the head of the US branch of Oxford University Press noted an event that was striking, if unsurprising. When grading an assigned paper, a Columbia University professor found that the majority of his students had cited an obscure work of literary criticism that was roughly a century old. The reason? Because the work was in Google Book Search, while much other (more recent) work was not.

The relative invisibility of offline information has an impact on almost all areas of life, but it’s felt especially acutely in the academic world, where work builds on the existing body of knowledge. Getting all of that dead-tree information onto the Internet (or into archives like J-Stor) would be of tremendous utility to scholars and students, but convenience isn’t the only reason for digital distribution of academic work. A recent decision by a prominent academic publisher to switch to digital-only distribution was apparently motivated by simple economics: print no longer made financial sense.

via Science moves from the stacks to the Web; print too pricey – Ars Technica.

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A Day in the Life of 3G – PC World.

Finally, a good article that tests 3G networks across multiple cities in an objective manner.  Of course, you can still have some local street-by-street variation and indoor-outdoor variation, but I am impresed by their methodology.

And the results?

chart - 3g speed and reliability results by city

Testing Results in a Nutshell

In Novarum’s tests for us, Verizon Wireless demonstrated a good mix of speed and reliability. Across more than 20 testing locations in each of the 13 cities we tested, Verizon had an average download speed of 951 kbps. Verizon demonstrated good reliability, too; the network was available at a reasonable and uninterrupted speed in 89.8 percent of our tests.

Sprint’s 3G network delivered a solid connection in 90.5 percent of our 13-city tests. Sprint’s average download speed of 808 kbps across 13 cities wasn’t flashy (at that speed, a 1MB file downloads in 10 seconds), but dependability is an important asset. The Sprint network performed especially well, both in speed and in reliability, in our test cities in the western part of the United States.

The AT&T network’s 13-city average download speed in our tests was 812 kbps. Its average upload speed was 660 kbps. Reliability was an issue in our experience of the AT&T system: Our testers were able to make a connection at a reasonable, uninterrupted speed in only 68 percent of their tests.

Somewhat surprisingly, our testers also found that the “bars of service” readings on their phones were rarely an accurate predictor of the quality of the ensuing connection. In most places and with most wireless providers, the “bars” did little more than indicate whether the phone had access to some service or to no service. (See “What Do Bars Say About Your Connection?“)

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Everyone who uses the internet leaves some sort of footprint, even if it’s just a string of visited addresses. This presence is magnified if you’ve ever been in the news, been listed on a website (e.g., as faculty), or if you write a blog. Social networking sites such as facebook and Twitter add a whole new dimension of online presence. Everyone should be concerned about what their online presence says about them (if your public Amazon wish list is full of sex toys, for example…) but physicians should have special concerns which fall into some broad categories. First, we’ll briefly discuss types of online presence.

via Doctors and the potential pitfalls of an online presence : White Coat Underground.

I well written article reviewing some of the concerns of medical blogging.  I know that I write this blog fully aware that a patient or potential or current employer may see it.  I don’t mind them seeing that I can be silly, but you have to be careful want you rant about…

It helps to have a pretty common name….

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These are really cool. They’re acapella versions of Michael Jackson’s songs. It’s like listening to MJ in a totally new way. My personal favorite is definitely “I’ll Be There.” His older stuff sounds amazing.

link to Buzzfeed.  With a hat-tip to Bing Shen through his Google Reader Shared feed.

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