Jun

14

Bread and Circuses, Water and Sewage

June 14, 2009 | 21 Comments

Customer Disservice
There are days when I explain to the family of a 98-year-old customer, in terror of the the inevitable end, that today is not that day and while the odds of their mother living another month are close to zero, she’s alert, reasonably comfortable, and they have some time to say what they want [...]

Jun

2

Anabasis

June 2, 2009 | 16 Comments

Marching Up Country
(With Apologies to Xenophon)
The campaign draws to a close and will end like many such expeditions do; in a victory of sorts for I have certainly marched into and through the Empire of Medicine with my fellow mercenaries, outwitting the enemy on many occasions, laying waste to his crops and orchards when necessary, [...]

May

22

Edumucation and Other Things

May 22, 2009 | 11 Comments

Perspective
While driving through the downtown of our small but not insignificant Midwestern city (there are corn fields five miles from the city center but we do have the state capital and a handful of miniature skyscrapers) I noticed a fat brown squirrel scampering down a tree and bounding across the street in the halting but graceful manner [...]

May

9

Panda-emic

May 9, 2009 | 8 Comments

“I got the Swine”
I’m hoarse from explaining influenza to my patients, the numbers of whom showed a small but significant increase over the last two weeks as Swine Flu hysteria grew, peaked, and then receded.  Everybody wanted a pill for “The Swine” for which, unfortunately, there is none except an essentially useless anti-viral that works [...]

Apr

23

Can’t Touch This…

April 23, 2009 | 13 Comments

Actual Patient Conversation:
“Man, that Dilaudid didn’t even touch my pain.”
“Uh, Okay.  Your CT was negative so you’re fine to go home.  I’ll ask your nurse to come discharge you.  Come back if you get light headed or start to vomit but otherwise, just take Motrin for your headache and you should be fine.”
“Can you give [...]

Apr

16

More Random Reader Questions and in Which I Give Some Real Medical Advice Without Fear of Being Sued

April 16, 2009 | 16 Comments

(Actual questions from actual readers. -PB)
I know you don’t like chiropractors but what are we supposed to do for chronic back pain?
For chronic back pain I recommend back strengthening exercises, instruction in correct lifting and posture, weight loss, physical activity, judicious use of NSAIDs, and occasionally just sucking it up.  For serious back pain which [...]

Apr

13

Don’t Forget….

April 13, 2009 | 4 Comments

A short post today, my apologies, but I want everybody who can to attend their local “Tea Party” on April 15th.  As you may recall from American history, back in 1773 American colonists irate over increasingly oppressive duties and tariffs imposed by the British disguised themselves as indians, boarded British Merchantmen in Boston Harbor, and [...]

Apr

11

47 Million Uninsured My Ass

April 11, 2009 | 7 Comments

(With apologies to Deborah Peel -PB)
So I had this uninsured patient with a chronic medical problem that was being addressed at The Big Academic Medical Center Sixty Miles Away who came to the department with worsening symptoms from her chronic medical problem, a problem that was competing, I might add, with several others that were [...]

Apr

5

Ask Yer’ Uncle Panda: More on Mid-Level Providers and other Topics

April 5, 2009 | 42 Comments

(In which I answer several random questions submitted to me by readers. -PB)
Hey, Panda, I’m not sure what specialty I would like to do and am considering going to PA school because Physician Assistants can easily move between specialties.  Your thoughts?
I often hear the ease of movement between specialties touted as a benefit of being [...]

Apr

1

1001 Ways to Die

April 1, 2009 | 6 Comments

1001 Ways to Die
There has got to be a better way to die and surely the patient at the center of our frantic activity couldn’t have wanted this one.  I arrived at his room with a code in progress although, as the patient was still alert, most of the activity involved throwing towels on the [...]

Mar

28

Old School and Other Things

March 28, 2009 | 12 Comments

Old School
I admire the physicians of yesterday who practiced at a time before medicine became so technical but I don’t necessarily accept the premise that they were better doctors.  Certainly their physical exam skills were better honed than ours are today as this was often all they had to establish a diagnosis.  They also had [...]

Mar

24

Skin in the Game and Other Things

March 24, 2009 | 22 Comments

Skin in the Game
I had the privilege to work with one of the specialists in town for the last couple of weeks, a gentleman who still takes call for the Emergency Department but only for one week a month after which we have to ship the emergency cases in his particular area of expertise a [...]

Oct

22

Welcome to the Pandaverse

October 22, 2008 | 21 Comments

(The Student Doctor Network has been kind enough to host the archives of my blog and have asked me to write a little introduction. I’m sort of retired as a blogger so in lieu of a post I thought I’d just answer a few questions that people often ask me. I may from [...]

May

15

There Are Days…

May 15, 2008 | 144 Comments

My Good Friends and Patient Readers,
I’ve decide to stop blogging. Although I have enjoyed writing this blog and mightily appreciate all of you who have taken the time to read and comment upon my many articles, keeping the blog going has taken an appreciable toll on my sleep, studying, and even on my family time. [...]

May

12

No, I haven’t Disappeared…

May 12, 2008 | 13 Comments

Just taking a break from blogging for a couple of weeks. If you want something to read need I remind you, oh my regular readers as well as those who have accidentally arrived at my blog after a fruitless Google search for “stuffed panda bears” or “panda bear mating habits,” that my archives, [...]

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