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Hello and welcome to this edition of Grand Rounds!

As I contemplated the possibilities for a cheeky theme and racked my brains for something pithy or unique, my thoughts consistently fell on the fact that tomorrow is Veterans Day in the United States. Veterans Day is simply a day off for some. For others it is a day in which we take the opportunity to show those, who sacrificed greatly for the freedoms we enjoy, appreciation.

Tomb of the Unknowns
Arlington National Cemetery
Photo Credit: Emily McGee

What does this have to do with an international edition of a medical carnival?

Without Freedom of Thought, there can be no such Thing as Wisdom; and no such Thing as publick Liberty, without Freedom of Speech.

—Benjamin Franklin

Freedom of thought, and freedom of speech is what blogging is all about. I am not only proud of my Army service, but am grateful to those who wore the uniform before me, making sacrifices so I can spend my evening writing my own words without fear of reprisal or censorship.

I am honored to present to you every entry I received. Please enjoy this edition, and take the time, either publicly or privately, to reflect on the freedoms you have, and what it took for you to possess them.

Bongi—you couldn’t have given me a better transition if we planned it! On his blog “other things amanzi” he shares a time in which the freedom of his speech helped solidify his legendary status. Yes, even more legendary then he is to us!

Freedom of speech doesn’t end with sentences and paragraphs. Apparently, a few of my favorite bloggers embarked on a Haiku quest this past week. My two favorites? So glad you asked!

The first is from Ramona over at “Suture for a Living.”

Haiku #2

Too big , too small, sad

Cut, sew, reduce, augment, lift

Happy, happy girls

The second is from Laika at “Laika’s MedLibLog.”

Haiku #8

Wishing he was dead,

Paralyzed from neck down,

Nothing he can do.

Apparently Dr. Rob was in the middle of the Haiku insanity, but who does that surprise?

Having the nerve to discuss mistakes, many times, is difficult to come by. Dr. Joseph Kim tackles not one, but two tough topics his post, Doctors and mistakes: big and small on the blog “Medicine and Technology.”

Healthcare lawyer David Harlow, on “Healthblawg,” digs a bit more into free speech, taking on the subject of Twitter spam, and the use of social networking by drug companies to promote off-label uses of medications to the lay person.

The US healthcare system and insurance debate were tackled as well.

One of the best submissions for this edition came from “Insureblog.” Sandi’s plight highlights how our current medical insurance system was successful, but how it could also fail. Follow that entry up with Dr. Rich’s post, New Jersey, What Were You Thinking? and you will have both a system and an individual view of the debate.

To round out the submissions covering the US healthcare/insurance debate, we have two posts. The first, a podcast and transcript in which David Williams interviewed Peter Lee who is co-chair of the Consumer-Purchaser Disclosure Project. Why does the system perpetually seem doomed to failure? IMHO, lawsuits have a huge chunk of the blame. In the second post “ACP Internist” has a great entry covering the basics related to lawsuits in the post, “Which patients sue for malpractice?”

How else does the system lose money? Errors. Error Prevention Strategies: It’s not “Sophie’s Choice” folks is up over at Florence dot com. The situation isn’t helped, however, when things like counterfeit versions of the flu vaccine are being sold, further degrading trust in the system. Go read the post “Drug Wholesaler Found Peddling Mystery Medicine as Flue Vaccine (Pharmacy Liability),” and you will be even more concerned.

Some of my favorite posts were related to the clinical side of medicine. Medication For Pain Series 2009: Antidepressants is part of a series over at the blog “How to Cope with Pain.” The post Baby it hurts: birth practices and postpartum pain on the blog, “Science and Sensibility” keeps the same theme, but proves what a wide topic pain can be.

Have you ever been grossed out by something you see another practitioner do? Next time you cringe when you see a man’s tie dangle over a patient, consider the possibility that it could be germ resistant! “ACP Hospitalist,” in the post Ties that bind, and make you gag talks about this new option for neckties, and also covers an even more scary side of ties—-the perpetuation of tacky prints!

The post which I would give my “Favorite Clinically Based Post” award (if there was such a thing!) to is from Paul Auerbach, M.D. who highlighted a published case study about Recombinant Factor VIIa for Rattlesnake Envenomation. As far fetched as this happening twice seems, about the time that crosses my mind, I will be flying the anti-venom, the Factor VIIa AND the patient to the big hospital in my area!

Rounding out the submissions are posts covering a wide range of subjects. Resources for Sexual Minority Youth made me realize I wouldn’t have even known where to begin looking for information about the topic had a patient asked. I also didn’t realize that those old school fitness tests may have been all for naught! Find out more in the post Fitness Tests – Do They Do What They Claim? And, from our friends to my immediate north, the blog “Canadian Medicine,” in the post Canada is looking out for your health, brings a collection of short topics covering topics such as Solubilize, nebulize, die, and Consumable entertainment.

When I host Change of Shift, I usually save my favorite post for last. Most times it is the post which had the most emotional impact. This edition did not disappoint.

T.
“Notes of an Anesthesioboist”
Glimpse Into a Marriage

Thanks for heading my way for this edition and thanks to Colin for giving me the opportunity to tackle this last minute edition!

Grand Rounds Vol. 6 No. 8 will be @ Health Insurance Colorado on 17 November 2009.