Wednesday, December 3, 2008

GUEST POST: Trusting your Doctor – Is it the Right Treatment?

Welcome to All Scrubbed Up's 4th guest blogger... Sarah Scrafford! Enjoy her views on the patient-doctor relationships. We think this one may draw some comments...

There are some people who treat their doctors like Gods – they think they can do no wrong, that they can cure any malaise, and that they have their best interests at heart. And then there are others who are extremely reluctant to trust anyone connected to the medical field, who move from doctor to doctor in search of the perfect one they can trust but never find one at all, and who generally prefer to treat themselves unless it’s a life-threatening situation. In my opinion, neither extreme is advisable – while you must trust your doctor to do the best for you, it’s also prudent to exercise caution and do a bit of research before you throw yourself at the complete mercy of a total stranger.

We hear horror stories of medical malpractices that occur because of both negligence and/or incompetency; the victims of these tragedies escape with no lasting damage if they’re lucky, but if they’re not, they could end up with chronic conditions, or worse, die. Medical lawsuits are extremely complicated affairs that end up becoming costly and difficult to prove, which is why it’s best to be prepared and do your homework before going to a doctor to seek treatment:

* Talk to other patients: Before you commit yourself to going under the knife of a particular surgeon, talk to his or her other patients so that you get proper feedback from the right sources. Long time patients are your best bet – they’re the ones who know exactly how competent and how trustworthy your soon-to-be physician is.

* Check the Internet: Some doctors have a web presence, but then again, you can’t believe their own publicity. Run a search to see if people have blogged about their efficiencies or inefficiencies – this being the age of free and available information, most people are not hesitant to air their views from a public soapbox, especially when the medium is as vast and diverse as the World Wide Web.

* Talk to your doctor itself: Some doctors are open to honest communication, and if you’re a good judge of character, you’ll know if you’re in good hands or not.

* Use relatives or close friends in the medical community: People who have close connections to the medical industry are usually in the inner loop regarding doctors and their methods of treatment. If you know someone in the medical community, don’t hesitate to pick their brains and seek their opinion.

* Bedside manner is not everything: Don’t be fooled by the bedside manner of doctors – that’s all there is to some of them. Style over substance never works, more so when it’s a question of your life. So take what doctors say with a pinch of salt, and double check your facts if you want to life a long and healthy life.

--- snip ---

This article is contributed by Sarah Scrafford, who regularly writes on the topic of Radiology Technician Schools. She invites your questions, comments and freelancing job inquiries at her email address:

Thursday, October 30, 2008

Stories from Internship: Elephantitis Man

I'm sure Bongi would agree with me that doctors are only human - and usually have many funny stories to tell from seeing hospital patients - especially during internship. You only have to watch an episode of Scrubs. And yes. Most of the time... Scrubs is true. A lot more realistic than Gray's Anatomy.

This reminds me of a competition that our unit ran for a couple of weeks (between four of us - we left out the two religious interns).

The prize
: Lunch. Paid for while you sit and eat it quietly, the rest of the unit picking up the slack of your ward work. As you can understand, a rare gift as an intern.

The Task: Which of our patients had the largest penis?

Yes, it sounds cruel comparing private vital organs, but you all do it on the Net anyway... We weren't cruel or judging. In fact, you would have been disqualified if you laughed, gasped, or in anyway let the patient know what was going on. We became very inventive at showing skin blemishes in the inguinal area on ward rounds, or asking for a second opinion on a catheter insertion.

Needless to say after two weeks we thought we had a winner. Whilst congratulating him before a morning round, one of our religious interns came to ask about the commotion. We told her about the competition and our winner (and the size of the prize penis - "huge" is a good start).

"Can it be any penis, diseased or not?" she asked.

"Anything. This is a hospital of course".

"Well then you should have included me."

Thinking that there was no way our winner could have been surpassed - and also that we couldn't imagine this small, timid girl taking note of any man's penis, we followed...

She lead us down the long corridor and we gathered around a bed.

"Mr X, we need to see how the swelling is going," she said to the patient and removed the bed sheets.

If there has ever been a time that I have had to stifle a gasp it was then.

The man had elephantitis and the timid Intern got one HELL OF A LUNCH!

Tuesday, October 28, 2008


TLA's (three letter acronyms) are the best. Both in clinical medicine and in the world of medical aids.

They sound intelligent. And mysterious. And that's what Doctors are, aren't they?

My favourite is FOS (full of shit - can be used in psych or gastroenterology).

I once had a patient who was well versed in TLA's and also liked to read files. After examining her and writing notes, I went off to collect some meds (this was in a polyclinic)...

She became all worried after reading her file. The acronym F.L.U stood out. What could it be? A fancy medical term? Fungating Lipo Ulcerations?

When I looked confused, she said that I had used an abbreviation and she was trying to think what it meant - it sounded serious...

I couldn't help but chuckle and tell her she had the FLU and I wasn't abbreviating.

Tuesday, September 30, 2008

Internet addiction

And you think it isn't true...

(SA Doc says: Where your world meets mine!). Har. Har.

Check it out...

I do like the bit about seduction:

The Internet itself is a neutral device originally designed to facilitate research among academic and military agencies. How some people have come to use this medium, however, has created a stir among the mental health community by great discussion of Internet addiction. Addictive use of the Internet is a new phenomenon which many practitioners are unaware of and subsequently unprepared to treat. Some therapists are unfamiliar with the Internet, making its seduction difficult to understand.

Tuesday, September 23, 2008

Manto's Liver

Spotted on a Times blog...

“The Medical Association of South Africa (MASA) herewith informs the Minister of Health, the Honourable Manto Tshabala-Msimang, that should she resign, now, with her 11 Cabinet colleagues, she would not be obliged to return her liver.”

Some humour following the chaos in South Africa today...

Friday, September 12, 2008


Have you got it? Excerpt from Associated Content...

Consider this; the Internet is a pure informational gold mind! You can look up practically anything and get immediate gratification to satisfy curiosities or calm suspicions. But what if you have an abnormal anxiety regarding your health? Commonly known as Hypochondriasis or Hypochondria, the Internet has paved the way for its twenty-first century counterpart - Cyberchondria!

The availability of health information plastered all over the Internet has made it easier for those who worry over illnesses or tend to exaggerate symptoms to justify their fears. A common headache now becomes a brain tumor or a simple upset stomach becomes un-curable cancer! Hypochondria and Cyberchondria are devastating obsessions causing obvious distress to those who suffer from it.

These people are not fakers or malingerers – they honestly believe they suffer from life-threatening diseases or disorders! The trouble starts with the amount of information found on the Net, which provides no scientific validity! Cyberchondriacs view any source of information, from old wives tales to comments from a friend or relative to articles posted on the Internet by complete strangers with no medical background as legitimate, regardless of the lack of medical proof. Frequently a symptom of an anxiety disorder or depression, anyone can be stricken with Cyberchondrosis.

Normally it develops in the twenties or thirties and often follows the illness of a close family member or friend however, an illness in the family is not a prerequisite. This obsession of serious medical problems begins to interfere with daily routines. And the quest for justification cost millions in unnecessary medical tests and treatments every year! This disorder causes its sufferers to become obsessively aware of common sensations most people often ignore. These complaints become a central part of their personalities, as he/she honestly believes they are always a serious threat to their overall well-being. Cyberchondriacs tend to concentrate on hard-to-diagnose, vague symptoms, such as fatigue, general muscle aches and strange physical sensations. And surfing the Net provides validation, especially when his/her primary physician may dismiss worries or simply not supply a diagnosis that soothes the anxiety.

We've told you before.. Google Health just ain't, well, good for your health.

Monday, July 28, 2008

UK. Aphthous Fever. Bah.

The bloody brits... What will they chain-letter next :)


Department of Health
Minister for Health
Victoria Quay
Walsgrave Hospital

COVENTRY, July 23, 2008


Subject : New contamination possible in most Towns

Recent studies conducted on "aphthous fever" (for which we have just received conclusive results) indicate that in certain cases this can be transmitted to humans. We foresee a possible contamination in most Health Board areas. Cases have been reported in Norwich, Stevenage, York, Birmingham, Barrow-in-Furness, and more recently in Leicester, Durham and Nottingham.

It was observed that the subjects examined were regular consumers of wine and spirits. Most (97.6%) of the subjects would encounter serious problems with their vision when having gone without alcohol for 1 to 2 days on average.

Extended periods without alcohol would seriously affect the individuals reading capabilities. The subjects would also feel a trembling sensation. In extreme cases, individuals would start to hallucinate and see coloured specks when staring at an object for extended periods.

If you encounter any such patients having these symptoms, please contact the Crisis Centre in Coventry immediately.

Our research to date has resulted in a cure, consumption of alcohol every day for 3 months!!!

Friday, July 11, 2008

Special announcement from the Department of Health & Welfare

Department of Health & Welfare
Minister for Health

P.O Box 69
Cape Town

Cape Town, June 19, 2008



Subject : New contamination possible in most Provinces

Recent studies conducted on "aphthous fever" (for which we have just received conclusive results) indicate that in certain cases this can be transmitted to humans. We foresee a possible contamination in most provinces. Cases have been reported in Gauteng (31), Mpumalanga (24), Western Cape (1,145), Northern Cape (10), Kwazulu-Natal (23) and more recently in the Eastern Cape (15).

It was observed that the subjects examined were regular consumers of wine and spirits. Most (97,6%) of the subjects would encounter serious problems with their vision when having gone without alcohol for 1 to 2 days on average.

Extended periods without alcohol would seriously affect the individuals reading capabilities. The subjects would also feel a trembling sensation. In extreme cases, individuals would start to hallucinate and see coloured specks when staring at an object for extended periods.

If you encounter any such patients having these symptoms, please contact the Crisis Centre in Cape Town immediately.

Our research to date has resulted in a cure, consumption of alcohol every day for 3 months with plenty beetroot and garlic!!!

Please pass this document on to everyone you believe at risk!!!

Yours sincerely,


Special Advisors:
Mr Johnny Walker
Captain Morgan

Monday, June 30, 2008

MindBullet: Take 2 Aspirin and We'll Google You in the Morning...

Excellent MindBullet from They're weekly doses of futurism - health related in this instance...

SA Doc's analysis
. It could happen - give it a couple of years. In South Africa, we're in a little bit of a pickle though. No online consultations are allowed - HPCSA law dictates you have to "touch" a patient in order to provide a medical service.

Monday, June 23, 2008

Neurotics and Psychotics

The difference between a neurotic and a psychotic is that, while a psychotic thinks that 2 + 2 = 5, a neurotic knows the answer is 4, but it worries him.

Thanks to Medical Jokes on Geocities.

Saturday, June 21, 2008

Doctor Chart Bloopers #1

Found these at The Doctor's Lounge. Not from real Doctor's. Obviously. Well. Maybe.

*The lab test indicated abnormal lover function.

*The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.

*Exam of genitalia reveals that he is circus sized.

*She stated that she had been constipated for most of her life until 1989 when she got a divorce.

*The patient was in his usual state of good health until his airplane ran out of gas and crashed.

*Rectal exam revealed a normal size thyroid. (Long fingers?)

*Between you and me, we ought to be able to get this lady pregnant.

*A midsystolic ejaculation murmur heard over the mitral area.

*The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.

*Both breasts are equal and reactive to light and accommodation.

*She is numb from her toes down.

*Exam of genitalia was completely negative except for the right foot.

*The patient was to have a bowel resection. However, he took a job as stockbroker instead.

*When she fainted, her eyes rolled around the room.

*Examination reveals a well-developed male lying in bed with his family in no distress.

*She has no rigors or chills but her husband says she was very hot in bed last night.

*She can't get pregnant with her husband, so I will work her up.

*Whilst in Casualty she was examined, X-rated and sent home.

*The patient states there is a burning pain in his penis which goes to his feet.

*On the second day the knee was better and on the third day it had completely disappeared.

*The patient has been depressed ever since she began seeing me in 1983.

*I will be happy to go into her GI system, she seems ready and anxious.

*Patient was released to outpatient department without dressing.

*I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.

*The patient is tearful and crying constantly. She also appears to be depressed.

*Discharge status: Alive but without permission.

*The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.

*Healthy-appearing, decrepit 69 year old male, mentally alert but forgetful.

*The patient has no past history of suicides.

*The patient expired on the floor uneventfully.

*Patient has left his white blood cells at another hospital.

*Patient was becoming more demented with urinary frequency.

*The patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.

*She slipped on the ice and apparently her legs went in separate directions in early December.

*The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary oedema at home while having sex which gradually deteriorated in the emergency room.

*Patient has chest pains if she lies on her left side for over a year.

*He had a left-toe amputation one month ago. He also had a left-knee amputation last year.

*By the time he was admitted, his rapid heart had stopped, and he was feeling much better.

*The patient is a 79-year-old widow who no longer lives with her husband.

*The patient refused an autopsy.

*Many years ago the patient had frostbite of the right shoe.

*The bugs that grew out of her urine were cultured in the Casualty and are not available. I WILL FIND THEM!!!

*The patient left the hospital feeling much better except for her original complaints.

Friday, June 13, 2008

A second penis?

Founds this on

A baby boy was born with a second penis — on his back. The rare condition is called fetus in fetu. He was rushed to Tianjin Children’s Hospital in China’s Henan province on May 27. The second penis has been surgically removed.


Tuesday, May 20, 2008

Who do you let die?

Interesting article on Yahoo Answers.

Who should MDs let die in a pandemic? Report offers answers

By LINDSEY TANNER, AP Medical Writer Mon May 5, 12:14 AM ET

Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Now. That's quite a thing. We've known for ages that there are systems of selection in medical environments and situations. I suppose just a little scary to see it in print.

Article goes on to say...

_People older than 85.

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer's disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

... as examples of how detailed this report gets.

What do YOU think?

There are too many humans. Perhaps life isn't quite as sacrosanct as before...

Thursday, May 8, 2008

GUEST POST: - Amazing Emergency Room Stories

Welcome to All Scrubbed Up's 3rd guest blogger...! Enjoy their fine fare of humorous anecdotes...

Amazing Emergency Room Stories
Every day hundreds of thousands of people all over the world are rushed to different hospitals emergency rooms. All of them with real injuries and physical complaints but with different reasons as to why they had to be hospitalized. Here are some funny emergency room stories. Whether or not they’re true events is up to you to decide but stranger things have happened. Or?

Tricky Contacts
On a regular Tuesday evening a local emergency room in Pennsylvania gets a visit by a man that can’t remove his contact lenses. Under the obvious influence of alcohol the man complains of his head aching and abnormal pains in his eyes. Explaining to the nurse that he has been trying to remove his without any luck. The contacts will only come out halfway before popping back in. The nurse then uses a suction pump to get the lenses out but with no result.

When the doctor finally examines the man he quickly realizes that the man has in fact not contact lenses but has being trying to remove the membrane of the cornea. Hence the pain in the eyes.

Don’t Ride An Ambulance in San Francisco
After answering a 911 call from an elderly woman paramedics are rushing back to the local San Francisco ER. While driving up an incline ambulance personnel witness how the back doors of the ambulance suddenly fling open. The stretcher with the resting woman flies out the back and rolls down the hills at a horrifying speed. Rolling through a crossing missing ongoing cars by mere inches the stretcher finally comes to a stop and tips over. The woman is found to be without any physical injuries but clearly chocked.

Bungee Jumping With A Foot Loose

Arriving to the emergency room of Tacoma, Washington, Kerry Bingham had spent the night drinking with his friends. After about the 5th pitcher somebody told the story of a friend of a friend of a friend who had bungee jumped from a nearby bridge during rush hour.

Inspired by the story Kerry and his friends decided to follow this dared devil’s example and too bungee jump from the very same bridge. Well there they realize they have no bungee jump cord, a minor detail according to Kerry who is drunk as a skunk by now.

Several minutes later Kerry’s left foot is strapped and secured to a coil of lineman’s cable and he makes the jump only to fall 40 feet before the cable stretches, feel his left foot being torn of his leg and tumble into the cold river beneath.

Miraculously Kerry survives the fall and is picked up by two fishermen and rushed to the local ER. He later thanks god for keeping an eye out for him and swears never to drink again.

Sunday, May 4, 2008

Hospital pecking order...

Okay, okay - so I'm "adapting" another thing from Medical Jokes on Geocities... hope they don't mind, but this was way too good to pass up.

The Surgeon...
Leaps tall buildings in a single bound
Is more productive than a train
Is faster than a speeding bullet
Walks on water
Talks with God

The Resident...
Leaps short buildings in a single bound
Is more powerful than a switch engine
Is faster than a speeding BB gun
Walks on water if the sea is calm
Talks with God if special request is approved

The GP...
Leaps short buildings with a running start and favourable winds
Is almost as powerful as a switch engine
Can fire a speeding bullet
Walks on water in an indoor swimming pool
Is occasionally addressed by God

The MO (Medical Officer)...
Barely clears a picket fence
Loses tug-of-war with a train
Can sometimes handle a gun without inflicting self-injury
Swims well
Talks with animals

The Intern...
Makes high skid marks on a wall when trying to leap buildings
Is run over by a train
Is not issued ammunition
Dog paddles
Talks to walls

The Med Student...
Runs into buildings
Recognizes a train 2 out of 3 times
Wets himself with a water pistol
Cannot stay afloat without a life preserver
Mumbles to himself

Lifts buildings and walks under them
Kicks trains off the track
Catches speeding bullets with her teeth and eats them
Freezes water with a single glance
The Sister IS God

Friday, April 18, 2008

Modernising the Medical World.

In the wake of the official Google Health launch (check it out - looks interesting). Got some comment from SA Doc on modernising the medical world...

I used to work in a practise that was - for lack of a better word - archaic. You've heard of paperless offices. Now try a paper-filled practice. Everything was done in the old fashioned method of pen to paper - the invoices, the patient notes, even the list indicating the link between family name and file number.

Email? Email who? The only computer visible (under the masses of paper) is an old 486 running Windows 3.1. I actually had to relearn how to use that OS.

No matter how I tried to convince the partners to modernise they could not see the advantage. The idea that you could access any information from complete, LEGIBLE patient notes with a CTRL F was beyond them. The idea that billing and ICD10 coding could be done with a couple of drop down choices didn't compute either (pardon the pun).

I love the idea of systemising patient records and details. It makes things simple. It correlates data very well (no more missing lipograms when a page from the file goes missing). Yikes.

More doctors should organise their patients details and medical information. It makes it easier when you practice, it makes it easier for locums, it makes it easier to recall patient illness details when you need to discuss them with another doctor, it makes it easier to correlate lab results and it makes it easier to bill.

From the other side of the fence now (my crossover into the dark side of managed health), I immediately can notice when a doctor is using a system. They can give me detailed information, email me motivations / lab results. They also tend to bill more appropriately and thus (big tip here!)... have their claims approved faster!

It's a pleasure to work with them! Catch a wake up Docs. It's the 21st Century.

Thursday, April 3, 2008

Medical... Aids...

Unfortunate wording of an ad that appeared on All Scrubbed Up. No real alternate option though if you think about it... Medical SCHEME doesn't sound too great. Neither does Aids.

Shouldn't really be making jokes about this, should I?

Wednesday, April 2, 2008

Zuma vs Google

Har. Har.

Try searching for Idiot who thinks a shower cures AIDS. It doesn't work anymore. Updated index or fudged funny. Still hilarious though.

Use Buzzfuse* to easily rate, review, and share this item

Tuesday, April 1, 2008

WTF Medical Aid Funding Requests #3

What is a reasonable request from your medical funder? This All Scrubbed Up series looks at funding requests - from the sublime to the ridiculous.

Just remember. A medical aid funder is allocating money to all their members for REAL medical reasons.

Part 3. Your other lips.

Like most medical aids, we don't cover cosmetic surgery. But believe it or not - we always give people the benefit of the doubt. So when a request comes in for something that is seen as plastic surgery, we always ask the member for a doctor's motivation as to why this procedure is NOT cosmetic, thus repairing a functional impairment.

Labial Reductions.

(That means reducing your "other" lips in size - to look good when the lights on. You know.)

Sometimes there are "functional" reasons for this procedure to take place. For instance, the labia are so large, the person can't straddle a horse. I'm not joking.

The best application we received recently was for a member who's motivation for reduction was: she sprayed in every direction when she peed.

Girl's sit on toilets (I think?). HOW is that a problem? I am a Doctor. A Girl Doctor. I'm sorry - I would not want my pink bits operated on to that extent. We all know that mole removal scars hurt for weeks (and everytime in gets cold!). Can. You. Imagine.

Tuesday, March 25, 2008

GUEST POST: Lobotomy Revisited (by Brian Carty)

The second guest post from Brian Carty of Hot Medical News, covering the... well, less-covered side of medicine! Enjoy "the history of the lobotomoy"! There's a great video that goes along with this post. Watch it here.

By Brian Carty, MD, MSPH
March 25, 2008

Do you remember Rosemary Kennedy, John F. Kennedy's sister? Maybe not, since she spent most of her life hidden away in an institution in the Midwest. She had a lobotomy, a brain operation for mental illness, in 1941 when she was 23. Her father, Joseph Kennedy, arranged the operation. The procedure left her mentally incapacitated. Whether she was mentally ill, mentally retarded, or both, is unclear, but her disruptive behavior led to the operation and its unfortunate outcome. She died of natural causes on January 7, 2005 at the age of 86.

The lobotomy, also called leucotomy, was devised in 1935 by the Portuguese neurologist Egas Moniz for the treatment of various psychiatric disorders. In this procedure, holes were drilled in the skull and a blade was used to cut nerve fibers from the frontal lobes (the front of the brain, just behind the forehead) to the rest of the brain. The term lobotomy came to include a variety of surgical procedures on the frontal lobes which were performed for psychiatric disorders.

An estimated 50,000 lobotomies were performed in the US in the 1930s and 40s. Although electroconvulsive therapy was introduced in the 1930s, it is useful mainly for the treatment of depression. Otherwise, before effective psychiatric drugs were available in the 1950s, the only other treatments for the severely mentally ill were incarceration and physical restraint.

By today’s standards, conditions in the mental hospitals of the time were unimaginable. Many patients were severely agitated, extremely violent, and incontinent. The hospitals were dirty, overcrowded, and understaffed.

Many severely ill patients benefited from lobotomy with decreases in violence and agitation. However, lobotomy often caused serious adverse effects, including disturbances of mood and personality, euphoria, poor judgment, impulsivity, loss of initiative, intellectual deficits, and seizures.

For many patients, however, a decrease in agitation and violence, even when accompanied by neurologic injury from frontal lobe surgery, was understandably considered an improvement. When the first effective antipsychotic drug, Thorazine (chlorpromazine), was introduced in the US in 1954, the number of lobotomies performed plummeted.

Surgery for psychiatric disorders is still performed rarely today. The procedures have become more selective and less extensive and now include deep brain stimulation with implanted electrodes. Similar surgical procedures and deep brain stimulation are sometimes done for movement disorders and chronic pain. Surgery for psychiatric disorders is still controversial and, when performed, is most often used for treatment-refractory obsessive-compulsive disorder (OCD). OCD is a disorder characterized by obsessive thoughts and compulsive behaviors such as repeated hand washing or checking to see if doors are locked. OCD can severely affect functioning and quality of life.

It is worth noting again that surgery for psychiatric disorders must be judged with reference to conditions which existed at the time the procedures were introduced. Although lobotomy is viewed by many as barbaric, the operation gave many patients a limited improvement which was otherwise unobtainable. The wisdom of hindsight should be applied sparingly; newly introduced medical treatments often cause unintended harm. The history of lobotomy should remind us that future generations will inevitably view our current best treatments as primitive.

Tuesday, March 18, 2008

GUEST POST: Are Ya Juicin' It? Anabolic-Androgenic Steroid Abuse

Welcome to our second guest poster on All Scrubbed Up... Brian Carty of Here's an indepth look at the effect of steroids in body builders. Chilling stuff.

By Brian Carty, MD, MSPH
March 14, 2008

Irritable, angry, aggressive, but feeling strong and invincible, Mr. A, 32, a bodybuilder and prison guard, stopped at a convenience store to call his boss. Car trouble on the way to work.. He would be late.

Bodybuilder and enhanced performance

[With permission of Steve Michalik. Mr. Michalik, a former Mr. America and Mr. Universe, once used steroids and suffered as a result. He is now an energetic and outspoken opponent of steroid abuse.]

Mr. A was taking his fifth cycle of anabolic-androgenic steroids (abbreviated in this article as "steroids"), and he was "stacking," combining high doses of several different steroids, sometimes referred to by the slang term "juice." The woman working at the convenience store noted his uniform and joked, "You officers use my phone so much, I ought to start charging for it." Mr. A was strangely disturbed by this remark. He felt that the woman had criticized and demeaned him, and he was obsessed by the remark that afternoon and throughout the night. He slept poorly. His wife could not reassure him.

'Roid Rage
Later, he said that he wanted to "scare the lady in return for that remark she made to me." In the morning Mr. A drove back to the convenience store and forced the woman into his car. She fought back, biting his hand and grabbing his revolver which fired through the windshield. Although he subdued her and drove away, when the car stopped she bolted from the car. He shot her in the back as she fled, leaving her permanently paralyzed. Mr. A was later arrested, tried, and sentenced to twenty years in prison. After his arrest and withdrawal from steroids, he developed major depression which resolved in a month.

This case and several other cases of homicide or near-homicide by anabolic steroid abusers are presented in an article by Dr. Harrison Pope, Jr., and Dr. David Katz in the January 1990 Journal of Clinical Psychiatry.

Read more on this subject at Brian's site here (continuation of article)...

Monday, March 10, 2008

Have a Happy Period!

Never know whether these things are true or not. But bwhahahaha. Funny nonetheless! I'm a boy, and even I cringe at the medical marketing.

This is an actual letter from an Austin woman sent to American company Proctor and Gamble regarding their feminine products. She really gets rolling after the first paragraph. It's PC Magazine's 2007 editors' choice for best webmail-award-winning letter.

Dear Mr. Thatcher,

I have been a loyal user of your 'Always' maxi pads for over 20 years and I appreciate many of their features. Why, without the LeakGuard Core or Dri-Weave absorbency, I'd probably never go horseback riding or salsa dancing, and I 'd certainly steer clear of running up and down the beach in tight, white shorts. But my favorite feature has to be your revolutionary Flexi-Wings. Kudos on being the only company smart enough to realize how crucial it is that maxi pads be aerodynamic. I can't tell you how safe and secure I feel each month knowing there's a little F-16 in my pants.

Have you ever had a menstrual period, Mr. Thatcher? Ever suffered from the curse'? I'm guessing you haven't. Well, my time of the month is starting right now. As I type, I can already feel hormonal forces violently surging through my body. Just a few minutes from now, my body will adjust and I'll be transformed into what my husband likes to call 'an inbred hillbilly with knife skills.' Isn't the human body amazing?

As Brand Manager in the Feminine-Hygiene Division, you've no doubt seen quite a bit of research on what exactly happens during your customers monthly visits from 'Aunt Flo'. Therefore, you must know about the bloating, puffiness, and cramping we endure, and about our intense mood swings, crying, jags, and out-of-control behavior. You surely realize it's a tough time for most women. In fact, only last week, my friend Jennifer fought the violent urge to shove her boyfriend's testicles into a George Foreman Grill just because he told her he thought Grey's Anatomy was written by drunken chimps. Crazy!

The point is, sir, you of all people must realize that America is just crawling with homicidal maniacs in Capri pants... Which brings me to the reason for my letter. Last month, while in the throes of cramping so painful I wanted to reach inside my body and yank out my uterus, I opened an Always maxi-pad, and there, printed on the adhesive backing, were these words: 'Have a Happy Period.'

Are you fu*ing kidding me? What I mean is, does any part of your tiny middle-manager brain really think happiness - actual smiling, laughing happiness is possible during a menstrual period? Did anything mentioned above sound the least bit pleasurable? Well, did it, James? FYI, unless you're some kind of sick S&M freak, there will never be anything 'happy' about a day in which you have to jack yourself up on Asprin and Kahlua and lock yourself in your house just so you don't march down to the local Walgreen's armed with a hunting rifle and a sketchy plan to end your life in a blaze of glory.

For the love of God, pull your head out, man! If you just have to slap a moronic message on a maxi pad, wouldn't it make more sense to say something that's actually pertinent, like 'Put down the Hammer' or 'Vehicular Manslaughter is Wrong', or are you just picking on us?

Sir, please inform your Accounting Department that, effective immediately, there will be an $8 drop in monthly profits, for I have chosen to take my maxi-pad business elsewhere. And though I will certainly miss your Flex-Wings, I will not for one minute miss your brand of condescending bullsh*t. And that's a promise I will keep. Always.


Wendi Aarons
Austin , TX

Thursday, March 6, 2008

Medical Quotes #2

More quotes... Some philosphical. Some, er, not...

- - - - - - - - - - - - - - -

Medicine is the only profession that labours incessantly to destroy the reason for its own existence. ~James Bryce, 1914

It is not a case we are treating; it is a living, palpitating, alas, too often suffering fellow creature. ~John Brown

The patient does not care about your science; what he wants to know is, can you cure him? ~Martin H. Fischer

Medicines heals doubts as well as diseases. ~Karl Marx

A physician is obligated to consider more than a diseased organ, more even than the whole man - he must view the man in his world. ~Harvey Cushing

Medicine sometimes snatches away health, sometimes gives it. ~Ovid, Tristia

As it takes two to make a quarrel, so it takes two to make a disease, the microbe and its host. ~Charles V. Chapin

Disease is war with the laws of our being, and all war, as a great general has said, is hell. ~Lewis G. Janes

Until a physician has killed one or two he is not a physician. ~Kashmiri Proverb

No man is a good doctor who has never been sick himself. ~Chinese Proverb

Only one rule in medical ethics need concern you - that action on your part which best conserves the interests of your patient. ~Martin H. Fischer

To me the ideal doctor would be a man endowed with profound knowledge of life and of the soul, intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere presence. ~Henri Amiel

Medicinal discovery,
It moves in mighty leaps,
It leapt straight past the common cold
And give it us for keeps.
~Pam Ayres

When you no longer know what headache, heartache, or stomachache means without cistern punctures, electrocardiograms and six x-ray plates, you are slipping. ~Martin H. Fischer

It is easy to get a thousand prescriptions but hard to get one single remedy. ~Chinese Proverb

Never forget that it is not a pneumonia, but a pneumonic man who is your patient. ~William Withey Gull

It is said to be the manner of hypochondriacs to change often their physician. ~William Cullen, Practice of Physic

The road to medical knowledge is through the pathological museum and not through an apothecary's shop. ~William Withey Gull

A Short History of Medicine
2000 B.C. - "Here, eat this root."
1000 B.C. - "That root is heathen, say this prayer."
1850 A.D. - "That prayer is superstition, drink this potion."
1940 A.D. - "That potion is snake oil, swallow this pill."
1985 A.D. - "That pill is ineffective, take this antibiotic."
2000 A.D. - "That antibiotic is artificial. Here, eat this root."
~Author Unknown

When a lot of remedies are suggested for a disease, that means it cannot be cured. ~Anton Chekhov, The Cherry Orchard

A half doctor near is better than a whole one far away. ~German Proverb

No doctor is better than three. ~German Proverb

I will lift mine eyes unto the pills. Almost everyone takes them, from the humble aspirin to the multi-coloured, king-sized three deckers, which put you to sleep, wake you up, stimulate and soothe you all in one. It is an age of pills. ~Malcolm Muggeridge, 1962

Man may be the captain of his fate, but is also the victim of his blood sugar. ~Wilfrid G. Oakley

Faith and knowledge lean largely upon each other in the practice of medicine. ~Peter Mere Latham

Each patient ought to feel somewhat the better after the physician's visit, irrespective of the nature of the illness. ~Warfield Theobald Longcope

Who ever thought up the word "Mammogram?" Every time I hear it, I think I'm supposed to put my breast in an envelope and send it to someone. ~Jan King

Never go to a doctor whose office plants have died. ~Erma Bombeck

You may know the intractability of a disease by its long list of remedies. ~Alonzo Clark

Here's good advice for practice: go into partnership with nature; she does more than half the work and asks none of the fee. ~Martin H. Fischer

Varicose veins are the result of an improper selection of grandparents. ~William Osler

If you are too smart to pay the doctor, you had better be too smart to get ill. ~African Proverb

When you treat a disease, first treat the mind. ~Chen Jen

Symptoms are the body's mother tongue; signs are in a foreign language. ~John Brown

The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease. ~Thomas Edison

Oh the powers of nature. She knows what we need, and the doctors know nothing. ~Benvenuto Cellini

So many come to the sickroom thinking of themselves as men of science fighting disease and not as healers with a little knowledge helping nature to get a sick man well. ~Auckland Geddes, The Practitioner

Where a man feels pain he lays his hand. ~Dutch Proverb

The doctor is often more to be feared than the disease. ~French Proverb

Despite all our toil and progress, the art of medicine still falls somewhere between trout casting and spook writing. ~Ben Hecht, Miracle of the Fifteen Murderers

The Lord hath created medicines out of the earth; and he that is wise will not abhor them. ~Ecclesiasticus 38:4

A drug is that substance which, when injected into a rat, will produce a scientific report. ~Author Unknown

Cancer is a word, not a sentence. ~John Diamond

The medicalization of early diagnosis not only hampers and discourages preventative health-care but it also trains the patient-to-be to function in the meantime as an acolyte to his doctor. He learns to depend on the physician in sickness and in health. He turns into a life-long patient. ~Ivan Illich

Patients may recover in spite of drugs or because of them. ~J.H. Gaddum

He's the best physician that knows the worthlessness of the most medicines. ~Benjamin Franklin

Physiology is the stepchild of medicine. That is why Cinderella often turns out the queen. ~Martin H. Fischer

The field of Western medicine has become literally nothing but medicine. Doctors are on their way out, to be replaced by self-serve pharmaceutical vending machines. ~Grey Livingston

The fact that your patient gets well does not prove that your diagnosis was correct. ~Samuel J. Meltzer

Man is a creature composed of countless millions of cells: a microbe is composed of only one, yet throughout the ages the two have been in ceaseless conflict. ~A.B. Christie

Our profession is the only one which works unceasingly to annihilate itself. ~Martin H. Fischer

On J-Day our profession will have a lot to answer for! We might at least have withheld our hands instead of making them work against God. ~Martin H. Fischer

The doctor may also learn more about the illness from the way the patient tells the story than from the story itself. ~James B. Herrick

Don't think of organ donations as giving up part of yourself to keep a total stranger alive. It's really a total stranger giving up almost all of themselves to keep part of you alive. ~Author Unknown

Most of those evils we poor mortals know
From doctors and imagination flow.
~Charles Churchill

Men are not going to embrace eugenics. They are going to embrace the first likely, trim-figured girl with limpid eyes and flashing teeth who comes along, in spite of the fact that her germ plasm is probably reeking with hypertension, cancer, haemophilia, colour blindness, hay fever, epilepsy, and amyotrophic lateral sclerosis. ~Logan Clendening

Don't take your organs to heaven with you. Heaven knows we need them here. ~Author unknown, attributed to both Dan and Barbara Hladio and Thomas Boyadjis, Sr.

'Tis not always in a physician's power to cure the sick; at times the disease is stronger than trained art. ~Ovid

And lo, The Hospital, grey, quiet, old, Where Life and Death like friendly chafferers meet. ~William Ernest Henley

For the most part, Western medicine doctors are not healers, preventers, listeners, or educators. But they're damned good at saving a life and the other aspects kick the beam. It's about time we brought some balance back to the scale. ~Claire Todae

A sweating ovary or a sick prostate explains most history. ~Martin H. Fischer

The only weapon with which the unconscious patient can immediately retaliate upon the incompetent surgeon is hemorrhage. ~William Stewart Halsted

The public blabbers about preventative medicine, but will neither appreciate nor pay for it. You get paid for what you cure. ~Martin H. Fischer

To save a man's life against his will is the same as killing him. ~Horace

Nowadays the clinical history too often weighs more than the man. ~Martin H. Fischer

Hypochondriacs squander large sums of time in search of nostrums by which they vainly hope they may get more time to squander. ~Mortimer Collins

One doctor makes work for another. ~English Proverb

Doctors are just the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you, too. ~Anton Chekhov, Ivanov

Let the young know they will never find a more interesting, more instructive book than the patient himself. ~Giorgio Baglivi

Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic. ~Thomas Szasz, The Second Sin, 1973

Wednesday, March 5, 2008

Tooth gives man his sight back


Wat die donder?

27/02/2008 21:16 - (SA). AFP

Dublin - An Irishman blinded by an explosion two years ago has had his sight restored after doctors inserted his son's tooth in his eye, he said on Wednesday.

Bob McNichol, 57, from County Mayo in the west of the country, lost his sight in a freak accident when red-hot liquid aluminium exploded at a re-cycling business in November 2005.

"I thought that I was going to be blind for the rest of my life," McNichol told RTE state radio.

After doctors in Ireland said there was nothing more they could do, McNichol heard about a miracle operation called Osteo-Odonto-Keratoprosthesis (OOKP) being performed by Dr Christopher Liu at the Sussex Eye Hospital in Brighton in England.

The technique, pioneered in Italy in the 1960s, involves creating a support for an artificial cornea from the patient's own tooth and the surrounding bone.

The procedure used on McNichol involved his son Robert, 23, donating a tooth, its root and part of the jaw.

McNichol's right eye socket was rebuilt, part of the tooth inserted and a lens inserted in a hole drilled in the tooth.

The first operation lasted 10 hours and the second five hours.

"It is pretty heavy going," McNichol said. "There was a 65% chance of me getting any sight.

"Now I have enough sight for me to get around and I can watch television. I have come out from complete darkness to be able to do simple things," McNichol said.

Will have to wait for SA Doc to get back from her managed health care world and explain to me the differences between enamel and eyes. :)

Thanks Toby Shapshak for the story...

Monday, March 3, 2008

Medical Quotes #1

I'm in a quotes phase. Don't know why. But found these beauts. Two part series. Original post here.

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In nothing do men more nearly approach the gods than in giving health to men. ~Cicero

My doctor is nice; every time I see him, I'm ashamed of what I think of doctors in general. ~Mignon McLaughlin, The Second Neurotic's Notebook, 1966

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated. ~Plato

Body and soul cannot be separated for purposes of treatment, for they are one and indivisible. Sick minds must be healed as well as sick bodies. ~C. Jeff Miller

In the sick room, ten cents' worth of human understanding equals ten dollars' worth of medical science. ~Martin H. Fischer

It is a mathematical fact that fifty percent of all doctors graduate in the bottom half of their class. ~Author Unknown

Restore a man to his health, his purse lies open to thee. ~Robert Burton

I got the bill for my surgery. Now I know what those doctors were wearing masks for. ~James H. Boren

A hospital should also have a recovery room adjoining the cashier's office. ~Francis O'Walsh

Did God who gave us flowers and trees,
Also provide the allergies?
~E.Y. Harburg, "A Nose Is a Nose Is a Nose," 1965

I learned a long time ago that minor surgery is when they do the operation on someone else, not you. ~Bill Walton

It is a wise mans part, rather to avoid sickness, than to wishe for medicines. ~Thomas More, Utopia [sic]

I wondher why ye can always read a doctor's bill an' ye niver can read his purscription. ~Finley Peter Dunne

You have a cough? Go home tonight, eat a whole box of Ex-Lax - tomorrow you'll be afraid to cough. ~Pearl Williams

To array a man's will against his sickness is the supreme art of medicine. ~Henry Ward Beecher

A doctor whose breath smells has no right to medical opinion. ~Martin H. Fischer

Surgeons must be very careful
When they take the knife!
Underneath their fine incisions
Stirs the Culprit - Life!
~Emily Dickinson

It is a good thing for a physician to have prematurely grey hair and itching piles. The first makes him appear to know more than he does, and the second gives him an expression of concern which the patient interprets as being on his behalf. ~A. Benson Cannon

A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment. ~Author Unknown

One thousand Americans stop smoking every day - by dying. ~Author Unknown

A hypochondriac is one who has a pill for everything except what ails him. ~Mignon McLaughlin, The Second Neurotic's Notebook, 1966

The art of medicine consists in amusing the patient while nature cures the disease. ~Voltaire

A doctor must work eighteen hours a day and seven days a week. If you cannot console yourself to this, get out of the profession. ~Martin H. Fischer

It is sometimes as dangerous to be run into by a microbe as by a trolley car. ~J.J. Walsh

Every disease is a physician. ~Irish Proverb

God heales, and the Physitian hath the thankes. ~George Herbert, Outlandish Proverbs

Drugs are not always necessary. Belief in recovery always is. ~Norman Cousins

I firmly believe that if the whole materia medica could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes. ~Oliver Wendell Holmes

There is no curing a sick man who believes himself to be in health. ~Henri Amiel

Doctors think a lot of patients are cured who have simply quit in disgust. ~Don Herold

The only equipment lack in the modern hospital? Somebody to meet you at the entrance with a handshake! ~Martin H. Fischer

The worst thing about medicine is that one kind makes another necessary. ~Elbert Hubbard

When you are called to a sick man, be sure you know what the matter is - if you do not know, nature can do a great deal better than you can guess. ~Nicholas de Belleville

Throw physic to the dogs; I'll none of it. ~William Shakespeare

I recently became a Christian Scientist. It was the only health plan I could afford. ~Betsy Salkind

Poisons and medicine are oftentimes the same substance given with different intents. ~Peter Mere Latham

In the nineteenth century men lost their fear of God and acquired a fear of microbes. ~Author Unknown

Symptoms, then are in reality nothing but the cry from suffering organs. ~Jean Martin Charcot, translated from French

I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form. ~Jerome K. Jerome, Three Men in a Boat

Diagnosis is not the end, but the beginning of practice. ~Martin H. Fischer

The physician should look upon the patient as a besieged city and try to rescue him with every means that art and science place at his command. ~Alexander of Tralles

Physicians and politicians resemble one another in this respect, that some defend the constitution and others destroy it. ~Author Unknown

A smart mother makes often a better diagnosis than a poor doctor. ~August Bier

When fate arrives the physician becomes a fool. ~Arabic Proverb

Medicines are not meat to live by. ~German Proverb

Treat the patient, not the Xray. ~James M. Hunter

God and the Doctor we alike adore
But only when in danger, not before;
The danger o'er, both are alike requited,
God is forgotten, and the Doctor slighted.
~Robert Owen

Financial ruin from medical bills is almost exclusively an American disease. ~Roul Turley

The hospital is the only proper College in which to rear a true disciple of Aesculapius. ~John Abernethy

A man who cannot work without his hypodermic needle is a poor doctor. The amount of narcotic you use is inversely proportional to your skill. ~Martin H. Fischer

Better to hunt in fields, for health unbought,
Than fee the doctor for a nauseous draught,
The wise, for cure, on exercise depend;
God never made his work for man to mend.
~John Dryden

Saturday, March 1, 2008

All Scrubbed Up - Looking for contributors!

Wanna get under our blog?

All Scrubbed Up is looking for contributors... Drop us a comment with your email address if you're keen to get involved with writing on South Africa's leading medical blog. Share of ad revenue to your posts - part of the package baby!

We want to expand - are you it?

Tuesday, February 26, 2008

Medical Confessions

Har. Har. Pretty funny read...

Ever wondered if doctors are frightened of catching what you've got? What their notes really mean? Or how to get round their receptionist? We asked five doctors to spill the beans

Check it out here.

Monday, February 25, 2008

Remembering the old days... Black Eyes & Baragwanath

Being in managed health care is just... not as dangerous.

For some reason, I thought of this old gem the other day...

It was a dark, stormy night. Aren't all the nights in Bara dark and stormy. Or at least dark. When the lights go out. That's another story.

Was working in Ward 20. Having seen the 1 000 00th TB patient, I got called to case where the patient was tired to a stretcher. This can only mean two things.

One, the patient is dangerous. Two, the patient is psychotic. Both aren’t preferable. And the combo package is even worse.

This particular patient had post-ictal psychosis (for the layman out there, translation: have fit, become psychotic). On trying to get close to her, the poor lady screamed like a banshee and struggled against the restraints. At one point, she managed to slip free of the bonds that held her, requiring two (big manly) doctors to hold her down. My job? Flank and approach armed with large dose of Benzo’s. Unfortunately, she got her arm free and took a nice big swing.


I’ve barely been in a catfight, but before I knew it – I was knocked flat back on my ass. 1 x Well connected shot to the jaw. I left. Ego and jaw bruised, and not particularly caring anymore.

On the ward round the next day, we came across the same patient, who was now lucid and no longer psychotic. She was, however, spoting a nice black eye. Eyes turned towards me. The consultant had heard about the punch.

“Did YOU do that?!” he said.

“No,” I replied. But I wish I had.

Goes to show. Always the bloody doctors who get blamed!?

Tuesday, February 19, 2008

Zuma and his HIV Shower... the jokes #2

Dredging more out the archives - Zuma jokes. Aren't politicians meant to be good at spinning stories?

For our international readers - our State President to be got embroiled in THIS fantastic farce...

Tuesday, February 12, 2008

WTF Medical Aid Funding Requests #2

What is a reasonable request from your medical funder? This All Scrubbed Up series looks at funding requests - from the sublime to the ridiculous.

Just remember. A medical aid funder is allocating money to all their members for REAL medical reasons.

Part 2. No time to eat.

Middle Aged Male has a feeding tube because of oesophageal cancer (a feeding tube is a tube straight into your stomache, allowing food to be syringed in).

Request is for a feeding pump. One that provides feeds at a continuous rate throughout the day. Reason for needing a pump? Male travels from Pretoria to Johannesburg every day. Spends approximately 4 hours per day in the car. Doesn't have the time to feed himself.

Join the club mate.

Friday, February 8, 2008

WTF Medical Aid Funding Requests #1

What is a reasonable request from your medical funder? This All Scrubbed Up series looks at funding requests - from the sublime to the ridiculous.

Just remember. A medical aid funder is allocating money to all their members for REAL medical reasons.

Part 1. Eye are not wearing glasses.

Middle age male requests payment in full for laser optic surgery. Male has optical limit, as with most benefits. Reason for requesting full payment: He currently feels that he cannot do occasional activities of daily living, like volleyball and playing with his kids while wearing glasses. In a motivation, the middle aged male said: "They might come off or get broken!".

Further information was volunteered. "I can't wear contact lenses, because I couldn't imagine sticking something in my eye."

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Monday, February 4, 2008

Ready! Aim! Operate on my back please!

Working for a managed care company, I am observing the high number of spinal surgeries that take place in the market (and just think that, what a funder sees is only a fraction of what is actually happening in South Africa...)

South Africa is known to have a low threshold for doing spinal surgery. In the UK, you would have to go through a lot of conservative therapy and years of waiting... AND have severe disease in order to get an op. Here, we see many neurosurgeons going in to do fusions or disc replacements sometimes without severe disease, sometimes even without conservative treatment!

Is this due to the patients who put so much pressure on surgeons to do something about their pain? Sometimes I think these people fit into their own subset, and should be defined by psychiatry for a new personality disorder. We get a constant stream of calls - all exactly the same personality types - fighting tooth 'n nail to get a surgery for disease that is very mild on their MRI.

OR. Is it due to monetary greed on the part of certain local surgeons (believe me... when we're looking at funding requests, we see large subsets from the SAME neurosurgeons, and the SAME areas of the country). Sniff sniff. I smell a pattern.

Back surgery is dangerous... not necessarily curative, and often leads to repeat surgeries. Yet in South Africa, it's itchy trigger fingers all round. I think South Africa (neurosurgeons, medical schools and possibly funders) need to have a serious look at the indications for doing back surgery.

Or before long, we'll set a precedent that could rather have been controlled by Celebrex.

(PS. The surgeons in this picture were ripped straight off the Internet and have NOTHING to do with this article! If you're a back surgeon, send All Scrubbed Up your picture... We'll post your picture up with dollar signs. For free.)

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Thursday, January 31, 2008

Manto's Liver to Little Johnny: Thank You!

Manto wishes to thank the Johannesburg Transplant Unit for her new liver. She's sorry little Johnny didn't get the liver instead. And would like to make a toast to all those out there who supported her cause. Cheers! Glug.

Sunday, January 27, 2008

The ethics of liver transplants for alcoholics...

Read an article on the front page of the Citizen, about Discovery Health (Bongi's favourite) refusing to fund a liver transplant on what seems like suspicion of alcohol abuse.

So I want to debate transplants. And the ethical eligibility to receive one. Liver transplants spring to mind.

Many conditions cause end-stage liver disease that would then require a liver transplant for survival. Livers are a scarce resource that do not become available everyday. For instance, in the UK, 17000 people are waiting for a liver transplant. If you're lucky, between 50 and 200 become available every year.

So, how do you allocate organs appropriately and fairly?

Do you want to give a liver to a person, who through large consumption of alcohol caused cirrhosis? Or do you want to give it to a child, who through no fault of their own, has biliary atresia. Or to a woman who developed auto immune hepatitis?

Most international guidelines say that for a person who has alcohol-induced liver failure to become eligible for a transplant, they need to have shown a period of abstinence and/or a period of rehabilitation. Usually 6 months.

After this period - does that make them deserving of a liver transplant? Should the guidelines be abolished as people who are alcoholics have a disease "that they are not in control of"? Even if you will continue to drink and destroy your new liver?

Should self-induced liver disease be deserving at all (taking into account the more deserving children and adults out there, who have had no control of the cause of their liver failure)?

What do you think?

Personally, I will tell the Organ Donation Society NOT to give my liver / organs to anybody who has not been substance abuse rehabilitated. Full stop.

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Wednesday, January 23, 2008

Live Surgery #1 - Open Heart Surgery

Who would've thunk it? The world's video viewing spot of choice, YouTube, has live surgery.

Lock away the kids!

Thursday, January 17, 2008

Vitality. Is it vital?

Question. What does everyone out there (South Africans) think of Vitality? We've just joined. Got our super cheap gym, earning points like crazy. Blah. Blah.

What do you think? Marketing gimmick? Or a real loyalty programme based on a healthly lifestyle?

Tuesday, January 15, 2008

Private Practice comes to South Africa

Shudder. This just CAN'T be good.

Some background from IMDB.

A highly regarded neo-natal surgeon and a fellow of the American College of Surgeons, Addison is also a board certified OB-GYN with fellowships in maternal-fetal medicine and medical genetics. She also completed two years of study on cystic fibrosis. In addition, she is also one of only a handful of surgeons in the world who knows how to separate fetal blood vessels. She is increditably wealthy but it was never clearly implied if she was weathy to begin with or if she had to work for her success. Addison met her future husband, Derek Shepherd, in medical school and completed her residency under the supervision of her now good friend, Dr. Richard Webber, whom she, at one point, avoided for almost a year after he taught her a valuable lesson about not getting too close to her patients by putting her on a case in which the patient would inevitably die.

Addie and Derek became extremely successful in their respective fields and each began their own practice in New York. This strained their marriage. After she was caught cheating with Derek's best friend, Mark Sloan, he moved to Seattle to get away from her. There, he met Dr. Meredith Grey with whom he started a relationship. Addison then arrived in Seattle at Richard's behest, and confronted Derek on his affair by introducing herself to Meredith as his wife.

After a period of antagonism between her and Derek (in which he continually referred to her as "Satan"), Addison decided to stay on as head of neo-natal surgery at Seattle Grace, signing a lucrative two-year contract after she and Derek decided to make an effort to work things out, but Derek was still in love with Meredith. After finding out that her husband slept with Meredith at the hospital-sponsored prom, however, Addison (in a drunken haze) called Mark Sloan to Seattle.

She and Derek then agreed that their marriage was over and started divorce proceedings. She asked Mark to go back to New York, but he stayed, expressing his desire to continue their relationship. Addison rebuffed him.When the divorce was finalized, Addison dropped the "Shepherd" from her last name. Wanting to make a fresh start, Derek happily relinquished most of their shared properties (their Brownstone in Manhattan overlooking Central Park and a residence in The Hamptons) to her believing that she deserved it under his initial impression that she only had a one-night stand with Mark while he carried an affair with Meredith.

Later, Addison divulged the whole truth regarding her infidelity to him which led to an emotionally painful encounter in which Derek told her to get out of his life. Addison is believed to have had a good relationship with the Shepherd family, in particular Nancy Shepherd (McBitchy), but, pending Derek's revelation of the true extent of Addison/Mark's relationship, her closeness to the Shepherds is in doubt.

Since arriving at Seattle Grace, Addison has made many friendships with other characters, most notably Callie Torres and Miranda Bailey. Callie and Addison often discuss their current relationships and love lives, which has ultimately led to a very close friendship between the two. Addison is also very good friends with fellow attending, Preston Burke. She has a strained friendship with Mark Sloan and doesn't have a strong friendship with any of the interns, with the exception of Alex Karev, but that friendship is reminiscent to that of hers with Mark Sloan. She has a father-daughter bond with Richard Webber, and is often portrayed to be very close to him. A possibility of a relationship between her and Alex Karev has been hinted at, when she kissed him in Joe's bar. Even after he rejected her affections, she continued to lust after him.

She has (along with Mark) decided to abstain from sex for 60 days. If Dr. Sloan completes the challenge, she is willing to try a real relationship with him; however, it is she who fails. She engages in a sexual encounter with Alex at the hospital and Mark learns of this after witnessing them stumbling out of an on-call room. She is spared from confessing, however, when Mark lies to her by telling her he had broken their promise long before.

According to many of the show's allusions, Addison then decides to pursue Alex Karev. Her advances are once again rejected, however, hinting at the potential departure of Addison though she has expressed immense interest in being the next Chief of Surgery. Addison visited her college friend Naomi in a Private Practice is Los Angeles to get pregnant. It turns out that Addison't cervical count is 2 and she can't become a mother. Dr Pete Finch kisses her to "remind her that she's not dried up"...

Sigh. It sounds truly awful. Has anyone seen it? Thoughts?

Friday, January 11, 2008

Best Of All Scrubbed Up (Part 2)

Not enough bloggers take the time to go back in the archives and rehash some of their best material... Egotistically speaking of course.

But we're different.

WELCOME TO PART 2 - The Best of All Scrubbed Up

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The World famous WHAT IS THAT?!? Competition

Ah. Nothing draws crowds like a bit of guess-the-gross-thing-on-the-operating-table. This series of posts probably ranks as the most popular we've ever written for All Scrubbed Up. Read Part 1 of the competition here - or click here to browse through all the posts and their respective answers (reveals!).

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HIV people CAN have children...

And then a heart-warming piece about an experience SA Doc had with some HIV patients. We must never forget our empathy - especially being South Africans, living in the health environment we do.

Aids is not a disease. It's a human rights issue.

- Nelson Mandela, 2005.

Read the post here.

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And there ends the lesson. What do you think of the BEST OF selection? Let us know in the comments...