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Grand Rounds: Being Thankful

*tap tap* Is this thing on? *ahem*


I'd like to welcome you all to the Thanksgiving 2010 edition of Grand Rounds (ok, actually this is Grand Rounds Vol. 7, No. 9 - but who's counting?) - it is VERY gratifying to me that so many of you have contributed, offered support, and generally welcomed me into this traditionally human-only medical blog carnival. At this time of year, I always stop and think about what I'm thankful for, and this year I'd say the medical blogging community is definitely on my list. And the office call drinking game! That, and Starbucks, of course. Triple grande nonfat latte FTW! Oh. Um. Sorry, I got a little carried away. I'm also incredibly grateful that my clinic microscope got tuned up today - I may actually have let the Nikon tech see me do the happy dance, in fact. So...anyway... Here we go!


DrRich at the Covert Rationing blog shares his rather unusual Thanksgiving message - he's thankful for the uninsured. DrRich, you slay me. The rest of you really must go read this insightful piece, because words fail me at this point.


Dr. Bates, who as I'm sure you know does in fact Suture for a Living, is a woman after my own heart. She quilts, I knit. Needlework keeps a surgeon's hands limber, people! Her Grand Rounds submission was, as always, educational. No one enjoys having a patient with a post-operative complication, but Dr. Bates manages to express her appreciation for the graceful way the patient and the surgical center handled this one in her entry entitled "P.O.U.R." Please note she also includes a well-deserved shout-out to the M.I.A. urologist-who-shoulda-been-a-veterinarian blogger, KeaGirl. Anyone know what happened to her? 


There are so many things in life to be grateful for - and some of those things don't seem like something you want, until you need it. Over at In My Humble Opinion, Dr. Grumet blogs about being grateful for hospice, which allows him to keep his geriatric patient population comfortable at home for as long as possible. Seems to me his patients and their families are probably really grateful, too. 


Meanwhile, at Veterinary Mom, Dr. Laura is grateful for her friends, family, and her incredible patients. Not only does Dr. Laura appreciate being able to help these special furry friends, but she also keenly appreciates the opportunity to give back to her community by caring for these animal heroes. I gotta say I feel the same way - every time a working animal (usually for me it's a guide dog or a police dog) comes into my exam room, I feel so grateful that I can help in this way. Some of our non-veterinary readers may not realize this, but the veterinary oath contains a promise to use one's training to promote the public human health, as well as animal health. This can be really difficult, but I think Dr. Laura is on top of it, myself.


Dr. Abston was asked to blog an office call, start to finish - and boy did she ever! Most vets I know are incredibly grateful that we do not have to deal with a lot of the administrative - can I say crap in Grand Rounds? No? Ok, well - administrative DETAILS that Dr. Abston has gone to the trouble of outlining here. This excellent post reminds me why I should be patient with the administrative staff at my own doctor's office, and I hope that Sally's mom was grateful to Dr. A for everything she did to help them.


I don't know if I ever mentioned it, but my dad wears an insulin pump to help control his diabetes. Actually the first time I ever saw one was on a classmate in vet school, and I subsequently encouraged dad to get one, which he finally did, and wishes he had done sooner. He's so grateful for his pump, I bet he'd be even more grateful for a more full-featured artificial pancreas! I was personally grateful to get this submission from Amy at the Diabetes Mine. She does an incredible job laying out the facts about the FDA hearings on approval for an artificial pancreas device. Should it get fast-tracked? Speaking of advancing technologies for treating diabetes, I'd like to express my own gratitude to the many dogs used in the original studies of the "pancreatic extract" developed by Banting, Best, and Collip!


In the Health AGEnda blog, the John A. Hartford Foundation discusses aging, geriatrics, and health care. In A Disastrous Discharge, Nora (a social worker by training) shares a personal story about what happens when social workers fail to talk to the family members of those they are trying to help. Nora's gratitude for the wonderful people at her uncle's assisted living facility may not be what she intended to highlight here, but it shone through. Nora also feels thankful for competent social workers, and special programs like BOOST which are designed to help patients gain access to needed services. Seems pretty plain to me that Nora is also grateful that her uncle has adapted well and is happy in his new home.


Dr. Janet from's Veterinary Medicine section had some questions for us this week. What's your attitude for gratitude?" is what she wants to know! Stop by and let her know how your pets inspire gratitude for or in you. She's already given us a list of ways her pets inspire gratitude! She makes a great point about play time, noting that exercise is good for all of us, and helps keep us at a healthy weight. Are you worried about fitting into your pants on Black Friday? Take your dog for a few extra walks this week, and it's all good! Aren't you glad you have a dog to keep you motivated to get some exercise?


On a more academic note, Diana Gitig over at the Highlight Health blog shares a study from the Journal of Nutrition, which shows that blueberry extracts improve insulin sensitivity in obese adults! Now, I don't know about you, but I am all about those blueberries. They used smoothies in the study, but I'm thinking muffins (that could be because it is late, and I'm hungry, but whatever). Of course, that assumes that you already had some type of muffins in your diet, and are just adding the blueberries, because if you add in the muffins when you weren't already eating them, well, that's not going to help anything, but - well, anyway, this is very exciting news, because it really does look like it was the blueberries that worked in this case, and I am grateful to Diana for explaining this study in a down-to-earth, straightforward kind of way. 


I don't know about you, but I love it when bloggers share a truly personal story. I'm pleased to offer you Dr. V's Grand Rounds submission, Give Thanks, in which she shares with us her visit to the veterinary radiation oncologist with her dog, who unfortunately has malignant melanoma. The specialist in turn shared a story with Dr. V, which raises a lot of questions. Go on, read it, and see what I'm talking about. Then come back and let me know what you think - are my specialist colleagues wasting their careers? Or is it ok to be grateful for advancing specialties in veterinary medicine? Leave me a comment. I'd love some feedback on that one.


The Happy Hospitalist, who blogs at his eponymous site, is often good for a laugh, and this post about free medical advice is no exception. Happy is grateful for the armchair consults his colleagues graciously provide in the doctors' lounge. He's also pretty grateful for being able to take advantage of HSA stacking, and free food, and hey, can you blame him? Happy's point about taking advantage of the, well, collegiality of our colleagues is not lost on me. In my profession, I frequently find myself with a patient who simply CAN NOT be referred to a specialist for financial reasons. I too am grateful to have specialist colleagues who will take time from their busy day to discuss a case, with no expectation of compensation, except maybe a small Starbucks gift card come holiday season :)


Speaking of giving, without expectation of receiving...Dr Dan from the eVet Clinic wrote this week about someone who seems only to receive, but in the end turns out to be an endless source of giving. Do you wonder who this character could be? Mosey on over and check it out in his aptly-titled post, Thanks for Giving.


When I'm looking for a slice-of-life ER story, I always head straight to, and ERP's Grand Rounds submission, You're My Hero!!! is a classic. This story highlights the gratitude of the nursing staff when the attending doc comes through in a big way. I love a good smackdown myself, and can DEFINITELY relate to the patient (in my case, it would be an owner, but still) using *cough* COLORFUL language *cough*. Here's hoping this was an eye opener for ERP's patient, and that one day the patient himself will look back with gratitude to ERP for helping him take the first step in his recovery. Oh come on. I can hope, right?? Deep inside my highly shellacked coat of cynicism is the soft tender heart of an idealist, people.


Dr. Shock blogged this week about gratitude, too. What a coincidence! Ha. Specifically, he submitted Gratitude Among Married Couples. Apparently, studies have been done, and it's pretty clear that "to feel higher level of gratitude is more important for marital bliss than one’s tendency to express gratitude." I'll keep it in mind. Not that I have any marriage plans. That I know about. I mean, the holidays are coming up, and you never know what other people are planning, but, well. Anyway. Moving on...


My old friend Pat Mahaney, who's gone and gotten certified in veterinary acupuncture like a REAL Californian (dude!), submitted  a sweet piece about his own pup's recovery from IMHA and his appreciation, on many levels, for the health of his beloved Cardiff, who actually has his own blog, too! IMHA basically sucks, so I'm glad Cardiff is doing so well. I gotta ask Pat for some details about this Chinese therapy he's incorporated into Cardiff's treatment plan! So far I haven't strayed beyond the bounds of western medicine in my own practice. I just don't know anything about TCM (or TCVM). I'm grateful for the opportunity to learn, though!


I'm not a mother, but I often feel like I can relate to things posted by the Mothers in Medicine. Gizabeth, a pathologist, wrote about how being a pathologist is sometimes like being Homecoming Queen. Funny thing, I know JUST how she feels! Gizabeth is grateful that her phone was ringing off the hook with calls from people who value her expert opinion. That DOES feel good, doesn't it?


Still with me? We're almost done! Dr. Huston blogged about what pet owners and veterinarians have to be grateful for - and believe me, there's a lot of things to be grateful for. I know, we all love to sit and snark about the worst in people, but there really is a lot of good out there too. I love that she brought up the One Health initiative. I've said it before and I'll say it again: many species, one medicine. Herd health is not a concept limited to my large animal practice colleagues, people. All living things are part of a giant herd, and I'm grateful to live in a time when we can recognize the interconnectedness of people and animals on many levels.


The talented StorytellERdoc, on his blog's first anniversary, is grateful for the support of his readership, who helped him win the best literary medical weblog of 2009 award - and this post makes me REALLY grateful that *I* do not work out at his gym!


And finally, FullyVetted's Dr. Khuly reminds us all to stop and smell the puppy breath when things get a little overwhelming. I don't know about you, but I love the smell of puppy breath in the morning!


If you're still reading this, a big THANKS to you for sticking with it. I hope you enjoyed today's Grand Rounds, and that you'll stop over next week at  Colorado Health Insurance Insider for the next edition!