Welcome to this weeks 41st Grand Rounds. Reading Grand Rounds
always impresses me with the diversity, richness and good writing that
comes from folks in the many areas in health care, and today is no different. This offering
ranges from the clinical to psychological to business to the
regulatory. Here are today's submissions.

Craig at The Cheerful Oncologist
sent me his post first, and receives the honor of leading us off this
morning with a post on how cigarette smokers rationalize their years of
pure smoking pleasure with their newly diagnosed lung cancer. Here's (Cough) Looking at You, Kid is a brief study of human nature we can all learn something from.

Things are not always what they seem when Dr Tony steps in for second opinion. Fortunately the outcome is a happy one (and good for a surprising laugh) in A Post-Surgical Complication.

At Polite Dissent, you can get a reality check in the form of Brief Advice for Interns.
Its always interesting to look at key lessons in a field and consider
what parallels there my be in your own field. While I do sometimes have
to deliver bad news, sex is never a topic of conversation.

The medical field attracts some pretty amazing characters, from practitioners like Patch Adams or entrepreneurs like Michael Cudahy to, well, ventriloquist and inventor Paul Winchell. In this post on the artificial heart, MedGadget
weaves a brief history of both the development of the artificial heart
and Paul Winchell's career. Really, they do go together!

First Tom Cruise had his say regarding psychiatry during his interview with Matt Lauer on the Today show. In this post from Shrinkette,
the molecule Seratonin (just Seratonin, you know, like Cher or Madonna)
provides a scientific counterpoint to Mr. Cruises, ah, point of view.

Hospitals all do the same things; diagnosis, therapy, surveillance and
care. Yet throughout my career, I've always been struck by the variety
of practice in hospitals. Kidney Notes has an interesting post on variations in ICU practice titled, The View from the ICU. One of these approaches certainly provides better patient flow, and probably delivers better outcomes.

As a health care consumer, winding one's way through the labyrinth of
today's health care system can be daunting. Freshman blogger, Healthy Concerns tells the story of a single woman looking for maternity benefits in, Covering pregnancy: Does it matter if you're married? Read and learn.

Doc Shazam, of Mr. Hassle's Long Underware, submits her first post after a big three shifts as a fresh attending in Memoirs - day 2. Can't say this sounds much different then residency.

Doc Grunt weights in with a post on the impact tort reform's had on Texas physicians, in If you Fix It, They will Come. Yes, but how many trial attorneys have they lost as a result?

Hey, look at this sick patient (CT images included)! Aggravated DocSurg likens an abdomen to a box of chocolates (you never know what you're going to get) in this post, When "Free Air" Isn't "Free".

Orac Knows
gets righteous about medical misinformation in, Mercury and autism: More Huffington Post nonsense.
Ms. Huffington is right up there with Rollingstone Magazine (which also
published an ill conceived article on the same topic) -- not really
worth reading except for the laughs.

On a more serious note (you might actually squirm reading this), Interested Participant highlights a new anti-rape device that hasn't gotten much press.

Ever wondered what it would be like to practice at an extreme sporting event? Dr. Andy is here to report his experience at the Western States 100 Mile Endurance Run. Crazy.

When I first bought our Sony Playstation 2, my wife razzed me
mercilessly. Guess who spends the most hours playing? She does. Well
here's some good news for here an other gamers reported by Dr Elmer in Good News for Video Gamers.

Dr. Charles is proof that physicians can have real lives. Here he recounts his experience at Life 8 in Philly.

Different River tries to keep conventional wisdom intact in the face of a study on obesity
reporting that it's better to just stay fat rather than run the risk
(and increased mortality) of losing weight. I feel much better now!

Did you know that the NEJM offers RSS feeds and podcasts of content
(that's an audio recording of journal content for you non-techies)? Clinical Cases and Images Blog has all the details in NEJM Audio Trial - Listen to Full-Text Articles for Free.

A narcotic related respiratory arrest and intervention is described by Far From Perfect in From Arrest to Discharge.

The Rest of the Story tells us about tetracycline and "the most gratifying of all chlamdial diseases to treat", in I Just Love This Stuff.

In a fascinating discussion of the difference between "science based" and "evidence based" medicine, Red State Moron considers the article The Bell Curve recently published by the New Yorker. The post is titled, "The Bell Curve" and evidence based medicine."

Should Medicare pay for impotence drugs? Trent McBride of Catallarch
describes how he's changed his mind on this topic noting, "a surprising
small part of our health care expenditures actually go toward
increasing life expectancy (or decreasing mortality)." His post: Lifestyle Medicine.

David Williams of the Health Business Blog laments the sad state of customer service, in this post oh to be an animal.
Hmm, just who is the customer in today's hospitals, the referring
physician or the patient? Regardless of the answer, this pithy post
asks a thought provoking question.

And to continue the business theme, The Stalwart, explores the topic of investment opportunities in The Case for Healthcare IT. And he doesn't use the word "bubble" even once!

Insureblog leads with an
item about the possibility of eliminating the tax deduction for group
medical insurance as a way of driving down costs and increasing
availability. A Radical Idea? explores ways our health care system might be reformed to make it more market driven.

And just barely squeezing under the wire, Tony of hospital impact, provides a review of preventive health care in popular culture. His post is titled An ounce of prevention...

Be sure to check here at the Grand Rounds archive to see who's hosting next week's medical Grand Rounds.

UPDATE: Next week's host is Shrinkette. Submissions can be emailed to shrinkette01@earthlink.net.