Saturday, October 27, 2007

Following a Birth on Twitter / Flickr

making progress, originally uploaded by merlinmann.

Robert Scoble and (now) Merlin Mann have both followed the birth of their children on Flickr and Twitter.
View's getting prettier; Ribsy's getting closer.

Head down, strong heart, and looking awesome by all accounts.

We've also had independent reports of a fontanelle and a sighting of a head of hair.

Friday, October 26, 2007

"Professionalism and the Psychopathology of Everyday Life"

This is an email sent to the Department of Medicine at Columbia by Donald Landry, Acting Chair of Medicine (and one of my mentors).

I've reproduced it here because it's one of the strongest and best arguments for handwashing that I've read.


Re: Professionalism and the Psychopathology of Everyday Life

Consider the spectacle of surgeons who argue with JCAHO
inspectors rather than mark an extremity prior to lateralized
surgery, or pediatricians who object rather than wash their hands
prior to examining a child. How can we understand such behavior
described by witnesses as “bizarre”, “inverted”, and “strange”?
How can we understand hyperintelligent internists who, as
a group, adhere to elementary hand washing protocols only 50-60% of
the time, despite constant reminders?

A potential explanation: some physicians perceive in the new
required practices an almost mortal threat. But why? Imagine a
physician whose entire life is devoted to providing the highest
quality of care, a prideful physician admired by patients,
respected of peers – imagine such a physician who now hears that
his or her sterling practices of the last few years or decades are
flawed, dangerous, substandard, unprofessional. To accept this
pronouncement is to see the edifice of a lifetime's work leveled in
a moment. How could such a physician react, except with denial and
defensiveness? And from this wellspring comes the contradictions
that we witness with wonder.

I see only one productive course. We must surrender. We must
surrender in terms of our conduct and our disposition. Only from
the most open posture can we rapidly assimilate and incorporate the
best practices to which we all aspire in moments of quiet

The care of our patients must transcend every other concern.
Failure to commit radically to this principle breaks faith with our
patients and invites sanctions from external observers...

Full disclosure: I can recall a time when I failed to wash my
hands 100% of the time. My practice consisted solely of ICU
patients and I was wearing new gloves for each patient, so why wash
hands? But I was wrong and admitting this was the necessary first
step to change. And so if you are fully compliant, wonderful. But
if not I strongly advocate unconditional surrender...

Many thanks for your help and for your commitment to our

Don Landry

Friday, October 19, 2007

Wow, their Radiation Detectors are Sensitive

Just saw a patient who relayed this story. She was buying coffee at Starbucks at Newark Airport. Two homeland security personnel were standing next to her when the suddenly glanced at each other, then at her. The radiation alarm on their hips had gone off. "Have you recently had a nuclear stress test of the heart?" they asked. "Why yes," she answered, "...three days ago."

42nd Street Up Close

42nd Street Up Close, originally uploaded by KidneyNotes.

Wednesday, October 17, 2007

Dinner with Sermo's CEO, Dr. Daniel Palestrant

Update: For notes on the dinner, see Tech Medicine.

I'll be at an informal dinner tomorrow (Thursday) with Sermo's CEO and founder, Dr. Daniel Palestrant. If anyone has particular questions they'd like me to ask (time permitting), please leave a comment.

Sermo is the largest online community for physicians. I discussed Sermo at my talk on "Health 2.0" at the 5th Annual Healthcare M&A and Corporate Development Conference.

I'm also planning to post observations from the dinner live on Twitter. (Which reminds me -- are there other physicians out there who use Twitter?)

Friday, October 12, 2007

"How to Cite Blogs" by the NIH / National Library of Medicine

For anyone who's wondered how (or even whether) to cite blogs in formal academic medical papers, the National Library of Medicine / National Institutes of Health now provides a style guide. They used Kidney Notes as one of the examples. I'm honored. [blog on the Internet]. New York: KidneyNotes. c2006 - [cited 2007 May 16]. Available from:

Thursday, October 11, 2007

Hilarious Journal Articles #88: Random Neuronal Firing Causes Mistakes

Via Neuron:
The resting brain is not silent, but exhibits organized fluctuations in neuronal activity even in the absence of tasks or stimuli. This intrinsic brain activity persists during task performance and contributes to variability in evoked brain responses. What is unknown is if this intrinsic activity also contributes to variability in behavior. In the current fMRI study, we identify a relationship between human brain activity in the left somatomotor cortex and spontaneous trial-to-trial variability in button press force. We then demonstrate that 74% of this brain-behavior relationship is attributable to ongoing fluctuations in intrinsic activity similar to those observed during resting fixation. In addition to establishing a functional and behavioral significance of intrinsic brain activity, these results lend new insight into the origins of variability in human behavior.
Thanks, BoingBoing.

Monday, October 8, 2007

A Stanford Medical IT Specialist Inteviewed by Robert Scoble

Via Scoble:
This 47 minute conversation is very interesting. Why? Well, he’s working with Google on a personal healthcare site. We cover a LOT of ground about technology trends inside the medical industry... we cover the various “personal healthcare services like Microsoft HealthVault” at about minute 41 and also cover some of the fears of giving services like these your health care data. Don’t miss that part of the interview, especially around minute 44 where he explains what these new health services could do for you.

Sunday, October 7, 2007

I'm an Editor at

The good folks at made me an editor! So I'll be intermittently posting there, too -- because, you know, I have so much time.

Doctors and Medical Students on Twitter

I'm surprised more physicians and medical students don't use Twitter. It's a useful tool — for example, see the sidebar of this blog, this post on Medicine 2.0, and this post on Clinical Cases and Images.

Update: To improve performance, I'm transferring the Doctors on Twitter feed to the Doctor's Room on FriendFeed. Please visit, and join the room. If you're a doctor or medical student, please
  1. Click on "Share Something."
  2. Click "Import your stuff."
  3. Import your Twitter feed, blog feed, etc.
The following is a list of doctors and medical students on Twitter:If you'd like to add your name to the list, please post a comment.

Read about the Doctors on Twitter Feed here.

Adam Bosworth Returns

Via his blog:
Well, as some seem to know, I’ve left Google. And now that I’ve left, that old entrepreneurial fever has struck me again and I’m off working on a startup. Google is a wonderful company and I had a great time there and had a lot of fun building something I really believe in, Google Health, which I think has a great potential to change the way consumers manage their health when it launches. Still, for me, it is time to start a new company and I’m off and running.

Thursday, October 4, 2007

42nd Street From Afar

42nd Street From Afar, originally uploaded by KidneyNotes.