Wardround 29viii8

Why was a rheumatologist asked to see this patient?

The reading this week about the methods magicians use to distract their audience led to some discussion of distraction, its benefits and pitfalls in medicine, the importance of not interrupting the 'rituals' of medicine that doctors use to keep on track and recognising when we ourselves have been distracted from the path.

For next week I would like you to read Why are medical journals so dull by Richard Asher. Originally published in the BMJ in 23 August 1958. Tempted as I am to leave you to get hold of the paper using your own initiative there is a link here if you do not feel like taking up the challenge. The link works for me but if you are unsuccessful I can give you a paper copy (folded in the shape of a dunce's hat!)

As ever the original responses to a paper can be illuminating. It is well worth getting used to reading the letters written to the editor about papers you read.

I was sorry to have been called away before the end of the Gram talks. It sounds obvious but the information Gram pos/negative cocci/bacilli should prompt immediate thoughts: does the patient have features of systemic sepsis syndrome? what do I need to check to further identify the type of organism and the likely spectrum of antibiotic sensitivity. Be sceptical about any comment from someone who has not assessed the patient that an organism could be a just a contaminant. How about clicking the comment button and writing in one sentence about something particularly interesting you found in your reading on the subject.

The talks for next week will be Epilepsy.
I was not able to assign these so it will be first come first served. Click the comment and claim the subject you will take. On offer are:
Epidemiology
Classification
Investigation
What to tell a patient after their first seizure
Treatment

Interesting topics

Lofgren's syndrome (what I was called away to see)


MJM

How weary, stale, flat and unprofitable, seem to me all the uses of this world
Fie on't ah fie! 'tis an unweeded garden, that grows to seed ...
That it should come to this.

Wardround 22viii8

The reading for next Tuesday will be Magician's Hand: How Humor And Misdirection Can Manipulate Levels Of Attention. You may also want to look at this related article.

Please read the articles and give them some thought. Is this relevant to medicine?

The two minute talks this week were the ECG. What is normal and what is not? What do you think was the most interesting or useful point in your talk. Click the comment button and type it in. I put together a little list a couple of years ago that you could revise from.

The two minute talks for next Friday will be mibrobiology 101: what should go through your mind when you get a call that your sick patient's blood cultures have grown:

Gram positive cooci HM
Gram negative cocci SV
Gram positive rods ZB
Gram negative rods HJ

Keep it precise (actual figures not general descriptions) and concise, educate your audience, quote sources, produce a handout and keep to two minutes.

Interesting topics:

Hyperkalaemia...read the handbook
Atrial flutter
Korsakoff syndrome

MJM

Wardround 15viii8

The reading for next Tuesday will be The road to recovery. D Pisetsky. Please read the article and give it some thought.

The two minute talks this week were about common drugs: Furosemide, Coamoxiclav, Enoxaparin. The prize this week goes to HM. What do you think was the most interesting or useful point in your talk. Click the comment button and type it in.

The two minute talks for next Friday will be The ECG. What is normal and what is not? Let's have two minutes on:

P wave HJ
QRS complex
Axis
ST segment HM
T wave SG

Keep it precise (actual figures not general descriptions) and concise, educate your audience, quote sources, produce a handout and keep to two minutes.

The morbidity/mortality meeting is on Thursday 28th August. Time to start preparing now.

Interesting topics:

Fallot's tetralogy

Wernicke's encephalopathy

Dressler's Syndrome

MJM

Wardround 8viii8

On Friday I will talk to you about the training side of the ward work, so you are spared giving a talk until next week.


The reading for next Tuesday will be The minefield of medical morals. D Sokol.
Please read the article and give it some thought.


The two minute talks for next Friday will be common drugs. Let's have two minutes on:

Furosemide HM
Coamoxiclav HJ
Enoxaparin SG
Omeprazole RV
Prednisolone just in case

Remember, the aim of the aassignment is that both you and your audience increase your knowledge or understanding of the topic. Don't waste too much time telling us things we will already know. The time is limited to two minutes and you should practice your talk and timing before the big day. Don't give a five minute talk in two minutes, edit it down to time. Always quote your sources so others know where to go to check things out for themselves. You should produce a single side of A4 handout. This is to illustrate your talk, not to provide a textbook level detailed article. Hand drawn pictures with arrows and signs beat something that looks like a cv every time.

The usual advice is keep your talk precise and concise, educate your audience, quote sources, produce a handout and keep it to two minutes.

Interesting topics this week:

Where to look up complementary medicines
DGRI antibiotic guidelines (I can't make the link work so you will need to navigate to it so it's intranet only. Go to the DGRI homepage, at the top choose select a service, then prescribing support, then click go. The document is listed there).

MJM

Welcome to the new trainees, goodbye to the old.

The reading for thought on Tuesday will be Meeting the ethical needs of doctors. Daniel K Sokol. BMJ 2005;330:741-742.

Welcome to the new trainees. Could I ask you to look over to the right hand side of this page and click on the "Training" link please. There is a little about work on the ward there and a timetable for yourself and me.

There will not be any assigned two minute talks this Friday. What I would like each of you to do is tell us a little about yourself and what you wish to do this year, and after that. The usual Friday rules apply. Only two minutes please.

MJM