Monday, March 15, 2010

Set your phasers on hilarious

My peds rotation has brought me to the conclusion that tazers are a bit barbaric when a long range tickle machine would most assuredly accomplish the same thing.


Julie said...

Dr. Meat,

Off topic, but if you could give me an answer to this, it would be GREATLY appreciated. Is the information provided by the NCBI a good online resource? Is there a better resource that would address the increases or decreases in mortality and morbidity with different surgical treatments of the same disease?

I have lots of docs as friends but this sort of question (when asked by a friend) would prompt, "Why do you want to know?" And I don't want to go there...

Thanks...Julie of the Internet

Meat, M.D. said...

Hey Julie of the internet, I think this is a great question and I would love to give a longer answer, so I will. but right now I'm studying for a shelf exam and don't have time to do it the justice it deserves which is, like, a lot of justice. but I also feel like you may need an answer quickly, so...
that's a great resource, but it requires you to be able to sift through the MASSIVE amount of primary papers out there, evaluating each for their study design, results, power, etc. not an easy task. in fact a task so difficult, some people spend the better part of their career doing just that. Also, for something like a surgical procedure, it's tough to get good complication rates because they aren't very common, and if they are, the patients are very sick. So you really need someone to distill it down for you. What you need is a resource that does just that for you. There is one that all the doctors use, called uptodate, but unfortunately it's not open to public use (god forbid people get real information). so you have a few options: use NCBI, and specifically PubMed to find a review article on the subject. Downsides: you can't always find what you want for this, it takes a good deal of searching, and they aren't necessarily up to date, and the number one problem (drum roll) even if you have a pubmed user id, you can't get have the shit, so all you can read is the abstract. so helpful.

Medline plus will get you links to good information. is probably my favorite. they have good distillation of current research and it seems to be written by doctors. this is going to sound terrible, but wikipedia is an awesome resource. because it is open source, world experts look on it and are like, "what, that's bullshit! you don't treat it like that. honey, boil me some tea, i have some editing to do!" But they rarely have extensive treatment discussions, especially if it's something on the more rare side. it's better for explaining the disease.

Almost none of those will get you actual percentages, but that's because you have to go to the primary studies for those (back to pubmed), and again, it's too hard with surgery complications to take any one primary paper as a reliable source.

my overall recommendation for finding out about a disease and treatment: wikipedia, then mayoclinic, then a review article search on pubmed for some real numbers.

hope this helps and more to come (although that's basically what im going to say, just more well thought out).


Julie said...

You are THE best.

If you ever need a personal reference...I am SO there.

Julie said...

OK, I've thought about it. I feel much more indebted than just telling you how super duper I think you are. (If you knew the details you would understand).

Therefore, if we can work out some way for me to pay for a nice dinner for you and a buddy of any persuasion, I am committed. Even though I live far, far away, I have done this sort of thing for my daughter in the past, so I know it can be done.

Just let me know when and where (hopefully in some sort of private fashion so I am not paying for just anyone) and it's done. Only restriction is no Le Bec Fin. I would have done this privately but I don't know how. Sorry.

Oh, if you would rather have a really big starbucks gift card (or any gift card), we can do that, too.

Really, thank you. I mean it.

Meat, M.D. said...

Julie. Jules. J. . Absolutely not. I really appreciate the offer, and as much as I do love the dinner scene around here, it all goes on the ol' loan tab. I am truly glad that some of my garbled drivel helped, but I am in no need of a tangible thank you. Just pay it forward Julie, pay it forward.

And I think you have prompted me to provide some kind of contact info on here, although I need to make some decisions about how traceable I want this site to be. The last thing I need is to be sitting in the interview seat and have residency director going, "so you really hate the parking patrol so much that you would gladly see them with c. diff? my husband heads the parking patrol. and before that, he programmed the formatting section of excel. and before that, he added raisins to cinnamon swirl bagels."

Julie said...

St. probably just had a holy shit moment. Your first intuition about tracing is completely justified. Start deleting and protect yourself. I'm telling you this as a mother. I have advised my own daughter to have no LinkedIn accounts, etc. safe. I will consider that my gift to you...weird as it is.

Meat, M.D. said...

Oh i've been very aware of it since I started. i'm not too worried, i actually want to make stuff like this a part of my career and don't feel particularly anxious about hiding it. i think there is plenty of room for comedy to meet medical information, hence the purpose of this site. but i appreciate your motherly concern. peds has given me a very keen sense of its value.

Julie said...

Yo…I was in Philly for the long weekend and had a need to do a return at Fresh Grocer. While standing in line I thought, “Hey, I can buy Saint Meat a gift card while I am here and he can just present a photo ID to Customer Service and pick it up whenever…easy peasy lemon squeezy.” I mean, there had to be something in FroGro you could use.

However, given that it took 3 copies, 7 stables, 5 passes of some super-duper security card to open the cash register, 2 signatures, 1 manager approval and 20 minutes to get my $5.41 back, I thought that maybe there was a better place where I could execute this same idea the next time I am in Philly.

Remember, it’s the thought that counts. AND don’t say, “don’t”… ain’t not happening.