Edwin Leap/physician-writer discusses medicine, family, and culture

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MedBlogs Grand Rounds 29 July, 2008. ‘Why do we do it?’

Posted on July 29, 2008 by Edwinlea

Welcome to Grand Rounds! This is my first time hosting, so thanks for your patience as I stumble through. And thanks to everyone who submitted! There are some extremely insightful folks out there, and I’m grateful to showcase their thoughts.

Here’s how I’m setting this up. As I said when I called for submissions, my theme this week is ‘Why do we do it?’ That is, medicine being what it is, many providers (nurses, physicians, PA’s, NP’s, etc) are dissatisfied and frustrated. So why is it that all of these good people keep coming back? Why do docs like me return to the packed, over-burdened, understaffed emergency department, day after day, year after year? Why do surgeons operate at all hours on the injured and dying, aging too quickly and leaving their families at home? Why do family doctors care for so many complicated and ungrateful individuals…at a financial loss? Why do students sacrifice so much of their lives to become physicians? Why do nurses endure the hours and patient ratios, the annoying physicians and the pesky families in order to care for the sick? Why do we do it?

It’s a question I think about quite often, so I wanted everyone else’s thoughts as well.

Now, here’s the layout. The first section will contain links that address the theme. Following that will be some comments from non-bloggers who had something to say after reading my question. They don’t blog, so I’ll be posting their insights here.

The second section will contain links to topics that are not on our theme, but still contain useful, important information that were submitted by people who deserve our attention.

Let me explain section three. Section three will contain links that are basically advertisements. As a free-market capitalist, I’m fine with advertisements as long as we know that’s what they are.

Now, finally, if I mess this up, it’s entirely my fault. Please forgive me if I get something wrong. I’m really not very good with computers, blogging, websites or any of that stuff except the writing itself.

Section One: Why do we do it?

Here’s what I think. We do it for so many reasons. Because it’s exciting, because we love challenges. Because we have families to support and need the money. We sometimes do it for prestige, we sometimes do it for power and control. But what matters to each of us is not why ‘we’ do it, but why ‘I do it.’

I do it for a few reasons. First, because I believe God called me to it. I never intended to be a physician. I wanted to be…lots of things. That wasn’t on the short list when I started college. But it became very important to me, and it has become such a wonderful life, such a great job, such a rewarding experience that I know the hand of the Creator was in it. But more than that, I think he puts the desire to help into our hearts.

We care, not because humans on their own do, but because the need to help the helpless, to heal the sick, is God’s gift to us, and God’s extension of his own hand into our world. Modern health-care requires nothing less than a divine initiative to keep us going, caring for both the best and the worst of humanity, in difficult situations, and often for little earthly reward.

Second, I do it because it’s my way to support my family. The children and wife I was blessed with need things. My work as a physician is an honest way to provide what they need. And a way to show my children that parents provide by working. They need to see me going to and coming from work, and doing my work well and with honor.

Third, I do it because it’s a great laboratory for writing. Patients show us many things as writers, from nuances of language and dialog to the soaring and diving emotions of human experience. Let’s just say, I carry a notepad.

Finally, fourth, and most important, I have come to see that I do it because I love wallowing around in humanity. I love knowing that I’m caring for people as broken and messed up as I am. I love touching them, hearing them, being intertwined, however briefly, in their lives. I love using my hands and brain simultaneously.

I love learning to love them. Medicine, brothers and sisters, is poetry in flesh and blood. Learn the meter and you’ll see more than you ever imagined.

That’s why I do it.

Now, onward and upward!

Edwin

In this post, Anesthesioboist tells, without telling, the shear joy of her work and in the ‘not telling,’ explains why she keeps coming back. This is the way good writing works, friends.

http://anesthesioboist.blogspot.com/2008/07/tales-from-saint-boonies-songs-in-or.html

It isn’t just people who directly care for patients who ask ‘why do we do it?’ Here’s a post from Colorado Health Insurance Insicer, on improving reimbursement for physicians using electronic transfer of billing data. Wait, you do it to help us make more money? Then you’re my hero! Keep up the good work.
http://www.healthinsurancecolorado.net/blog1/2008/07/24/electronic-prescription-transmittal/

Although this post, by South African surgeon Bongi, is not openly related to the theme, it addresses it. Sometimes we do what we do through shear will-power and professionalism. Next time I whine, I’ll have to read this post again. I salute you, doctor. I couldn’t do what you’re doing.

http://other-things-amanzi.blogspot.com/2008/07/im-on-my-way.html

An interesting twist; this blogger addresses ‘why we do it,’ by reminding me why he blogs: to spread the news about coping with pain. In this post, we are treated to a look at the therapeutic benefits of the Wii. Do NOT show my children this post! It would only validate their desire fo a Wii.
http://www.howtocopewithpain.org/blog/194/wii-chronic-pain/

From Hope for Pandora, a middle of the night post on ‘Why?’ Those night-time thoughts are often the best, though sometimes I used to come off of night shifts with the keys to fixing everything, and insights that approached enlightenment. But then, I went to sleep and forgot them. Maybe it was the bacon I ate. Still, this post makes beautiful connections on purpose.

http://hope-for-pandora.blogspot.com/2008/07/typing-my-way-through.html

Some physicians find meaning in moving from medicine proper to larger arenas of interest. Here’s a post from Canadian Medicine on a physician whose interest in climate change is driven by his interest in patient welfare.

http://canadianmedicine.blogspot.com/2008/07/interview-dr-pierre-gosselin-physician.html

This post addresses ‘why we do it’ by showing the results. A well-known and highly respected dietician, she points out how a congressman benefited from proper diet and exercise. Trimming the fat from a congressman seems to have worked well. Now, how about trimming the fat from congress?

http://www.healthline.com/blogs/diet_nutrition/2008/07/way-to-go-congressman-ric-keller.html
From chaplain, English professor and ER volunteer, Susan Palwick, a reflection on why she teaches medical students. Not an easy task, I can tell you. I hope she keeps it up. Medicine without humanity is a terrifying prospect.

http://improbableoptimisms.blogspot.com/2008/07/score-one-for-narrative-medicine.html

Dr. Zhang reminds us, with Yucca plants, Tarantulas and healthy skepticism, that we do what we do out of interest!

http://cockroachcatcher.blogspot.com/2008/07/psychosis-plant-talks-back.html

At last, a reason to become a physician that invokes the power of Star Trek! I love this post. And as a long-time fan of Star Trek, I completely agree…Thanks Dr. R!


http://mymedjokes.blogspot.com/2008/07/my-trek-to-medicine.html

Why we do good things matters. But we must also ask, ‘why do we do evil things?’ This post, from J.C. Jones, MA, RN, asks how psychiatrist and war criminal Karadzic moved from medicine to evil. We may never know the answer, but the question is always relevant.

http://www.healthline.com/blogs/healthline_connects/2008/07/medical-doctors-and-genocide-dr.html

P J Geraghty tells us, not how we providers are special, but how some of our patients families are remarkable. Like those looking through tragedy to organ donation. Why do they do it, I have to ask? Or more to the point, how?

http://evelgeraghty.wordpress.com/2008/07/22/the-ghosts/

Dr. Auerbach gives us National Estimates of Outdoor Injuries. I guess, if you’re going to hike, snowboard or ski, you should do it indoors?
http://www.healthline.com/blogs/outdoor_health/2008/07/national-estimates-of-outdoor.html
Dr. Dee tells us, candidly, that the mountain of debt threatening to fall on him keeps him coming back. I know the truth. It’s what he later tells us; he just likes it! Well, if you like it, you’ll get the debt paid off without even realizing it!

http://www.nzou.com/2008/07/26/why-i-do-it/

I love the answer from Dr. Chan at Rural Doctoring: but I’ll let you read it for her great ending, which sums up what so many physicians feel, and so few can articulate as eloquently.
http://www.ruraldoctoring.com/2008/07/case-metastatic-cancer-week.html

Dr. GC George loves what he does because he is constantly learning from that most amazing of all texts; his patients. Here is a man writing with humility and a great heart. His mother’s prayers, apparently, continue to be answered.

http://www.gcgeorge.net/2008/07/27/why-do-we-do-it/

Why we do it is closely allied to ‘how do we do it?’ and ‘how will we afford it?’ This post by DrRich explores how much money we spend in our attempts to do the right thing.

http://covertrationingblog.com/general-rationing-issues/is-treating-cancer-worth-it

Kerri ,at Six Until Me, explains why she does it. Does what? Keeps moving on, keeps finding happiness despite medical annoyances and set-backs. What’s not to love about a ceramic blue-bird?

http://sixuntilme.com/blog2/2008/07/blue_bird_of_happiness.html

From friend and co-worker Loon1900, a discussion of what motivates an intelligent, capable young man to work as a nurse in an ER full of difficult, ungrateful patients. (And speaking as someone who works there, quite a lot of nutty physicians!) His answer is just what I would expect from someone of his character. Well done.

http://www.xanga.com/loon1900/667910565/item.html

Psychiatrist doctor dymphna, aka Dr. Cordes, loves her work and considers it a ministry. I think she’s absolutely correct in that assessment.

http://drdymphna.wordpress.com/2008/07/28/why-do-i-do-what-i-do/

My friend and former roommate John has an excellent, inspiring, post on why he is still a physician:

http://www.lightalongthejourney.com/?p=688

I have included notes from non-bloggers, who happen to read my blog and want to comment:
Here’s a note from ‘Dr. in training’ Ye, who gives us a most eloquent, lovely, and candid look at the path she took to medical school. I’m glad God directed her in the path she took. (And Dr. Ye, the desire to be useful is a wonderful reason for pursuing medicine!)

Hi!
Your question – ‘why do it’ was interesting, perhaps because not only do I like listening to other people’s reasons for going into med school/becoming a doctor, but because it’s something I spent a couple of years trying to figure out, and even now, my reasons continue to change and make themselves clearer.
Granted, I’m only in my first year of medical school [and in Australia], so I suppose I’ll be forgiven for being a little idealistic.
I can’t really remember when I first decided I wanted to be a doctor. When I was young, I’d read encyclopaedias and be particularly interested in this picture of a baby inside a mother’s womb – the translucency of the skin and the baby, so perfect, really called to something in me. I’ve always liked pretty things, after all.
Then in high school, it sort of just was the thing to say. With parents who put a lot of pressure on me to do very well, and the two ‘proper’ accepted answers when someone at church asked ‘what do you want to be’ was either a lawyer or a doctor, I always said I wanted to be a doctor, without really thinking about it. [My father had been involved in law, and I'd known from a young age that really, I wasn't interested.] I’d always liked science and maths, and in Year 12, I discovered a love for chemistry, and as it was a prerequisite for most medical courses, I figured [naively, I know] it was predestined.
When the time for interviews came, that was the question everyone knew would be asked at every interview at all the schools. By then, I’d had that dream for a long time, and I believed that God that wanted this for me. I still couldn’t explain it – just that I really, really wanted to. [Admittedly there was the fear of disappointing my parents, but was I going to tell the examiners that? No.] Perhaps getting into medicine represented for me just another success in my life – something akin to walking along a relatively easy, straight path where my future was so clear and so obvious to me. [I tend to plan my life out, many years in advance.] However, I didn’t see a small branch in the road until I came to it, and at the crossroads, I was blown onto its path.
To sum it up in a word, bewilderment.
I actually got accepted into law. Basically, I hadn’t done well at the interview – my marks and UMAT score were not particularly high, but high enough. My parents were disappointed, but not unduly concerned. After all, I’d gotten into law, which was good enough – it would ensure financial security, and wouldn’t be a waste of my schooling. I don’t think my mother understands to this day why I chose to defer and re-sit the UMAT again, so I could re-interview, and apply again to medical school. To be quite honest, I’m not sure I do, either.
Maybe it was just pure stubbornness – it sounds so petulant, but I’ve always gotten whatever I’ve truly wanted. I suppose they weren’t that great achievements; getting into a selective school, getting a project featured in the school magazine. I couldn’t believe that I hadn’t gotten in, especially as I’d prayed so hard, hadn’t asked God for much, and I’d worked hard for my marks. I was also afraid what this would do to my father – who wasn’t of good health anyway, and stressed about the littlest thing. Even if I didn’t stress, he would, so I’d wanted to get in, so that he would stop worrying.
But really, I couldn’t stomach the thought of doing a course in law. So I declined my arts/law degree places and decided to sit the UMAT again. My friends thought I should defer, just in case, but once faced with the decision, I knew I couldn’t do it – so why hang onto a place I wasn’t going to accept anyway, while robbing someone else’s who might really want it? Besides, I thought that if I left that option open, there was the possibility of weakening and doing something I knew I’d hate. I had doubts about what God wanted for me – did he want me to do law, instead? But there was no vision, no future when I imagined that, and I wanted to study medicine so badly that I prayed that I’d get into medicine, even if I was to combine my degree with a law degree later. I tried so hard, that year, for His will to be done, but I also thought – please let His will be that I do medicine and not law.
During that year, I learnt things. I had much more time on my hands, and I did study hard for the parts of the UMAT I’d done badly on. [I did much better the second time around ^^] I learnt, when I wasn’t allowed to give blood, that one had to be healthy themselves to be able to look after other people. I learnt, when one of my closest friends moved countries, that people and circumstances change, and that I can’t control everything in my little world. I learnt, while working at my parents’ store, that there are many different types of people in this world – arrogant, annoying, rude, those without integrity, those who are immature, those who are thoughtless. However, I also found that those people were only significant in their rareness – most people, when talked to for even just a minute, became a 3-D persona who were pleasant, easy to talk to, and most of all – kind. It was a little bit of a culture shock – I realised how cloistered my school life had been – filled with similar-minded people, who were all intelligent and smart. I learnt really, how hard it was to get into medicine. But I think the biggest shock of all was learning that I was not infallible. That things didn’t always go how I wanted them to, when I wanted them to.
Even I think that it sounds arrogant – a 19-year old girl thinking that she could accomplish anything. However – it had always been like that. My parents were always away at work, and tried to give us the things they could afford, that we wanted. Especially for me, who didn’t like to ask for money and did without unless they asked. That way, I’d known that if I’d really wanted something, my father, if not my mother, would get it for me. I’d always been intelligent, having been taught well from a young age by my parents who understood the importance of education. And I liked school, so I studied. Good grades came easily to me, especially at a small, local primary, then high, school.
Near the time when results came out, I was terrified of praying to God – I did pray that He’d change my feelings, that I would want what He wanted, but oh, no, I didn’t. I still wanted to do medicine – I clung onto that idea as if it was the last reliable thing on Earth. But this time, I was accepted.
I was happy – but I couldn’t believe it. I spend those holidays alternating between feeling insanely happy and smug and wonderful and wondering what I’d do if my name wasn’t on the enrolment list, if they’d made a mistake, if they’d let me in anyway [because after all, it was their mistake - don't ask about the logic]. Even after enrolment day, when my name was on the list, I spent the first couple of months of school checking and re-checking the class lists and allocations, just in case my name wasn’t on it. It was only after the midsemester exams that I figured, they really have accepted me, I’m really in med school. And by then, I couldn’t even be completely euphoric, due to that horrid exam, but I did spend a couple of days going around with a smile stuck on my face.
I initially wanted to do medicine because it was the only acceptable answer. I’ve only got a semester of medical school behind me, but now my reasons for wanting to do medicine are different. I still like the science part of it. But I realise that I want to do something practical, even if it’s measuring someone’s blood pressure with a mercury sphygmometer, or talking to patients and hearing stories. I also figure that doctors will always be needed, and it’s nice to be useful. Learning the subject is absorbing, even if it’s intimidating that there’s so much to know. But even that’s exciting, because there’s so much to look forward to. Ultimately it feels as if it’s myself I’m learning about, which is also interesting, but what draws me to medicine the most is the utter fascination I feel for it. The various factors that influence patients in coming to see a doctor, the various biochemical reactions in the body that manifest and appear as different symptoms, and the fact that I will [hopefully] be able to do something, even if it’s little. Because to me, being helpless and being able to do nothing to contribute or help is a situation I don’t ever want to find myself in. I’m not sure that the lessons I learnt last year were all that hugely notable, but I still believe that God has a plan for me, something He wants me to accomplish. So now, while I can, I’ll revel in my idealism, letting it shape me. For I think that making my ideals a reality is something that I can always work towards – I’ll never accomplish it.
Oh gosh, that’s long. Thank you, if you’ve read all this, and I hope it was worth your time…and not too uninteresting.
Now, insights from the other end, after medical school. This is from an emergency physician in the Midwest, well into practice:
I am 10 years out of residency and work at 3 different hospitals because I enjoy the cross section of society that I see by working in 3 distinctly different EDs.Isn’t that what emergency medicine is about? And I stick with it because I know I am good at this(10 years of experience is considered by many residency directors(ie Carey Chisholm) as the peak of our career. I am experienced, triple boarded and generally love what I do. To get through my shifts I pray before each shift, God help me to love my patients and colleagues, and protect me from malpractice. And my prayer is answered daily! I love my work and my patients! It is the threat of malpractice and the experience of 2 suits(unsuccessful for the plaintiffs but stressful nonetheless) that has me planning my retirement/chance to leave medicine at age 50(9 years and 5 months from now). The anticipated further erosion of respect, and decreasing reimbursement adds to this. I have not decided what I will do when I am 50 but it most certainly will not involve working all night, not getting paid by a significant proportion of patients that I see, being verbally abused and physically threatened and lied to by patients to whom I am giving free but top notch care, and functioning under the daily cloud of the malpractice threat. So I do it for the reasons stated above and because the end is in sight: my physician husband and I have saved aggressively for retirement, so as of 2017 ….I am outta here!!From my friend and emergency medicine mentor Tom:
Thats a great question. Why do we do it? Is it because we invested all our early lives, substantial money and hours, to enter a field where we help people, and despite the fact that we work longer, harder hours for less and less, it still boils down to that–we WANT to help people? For the most part, I think so. Sure, we have become jaded by the drug seekers, the stupid parents, the drunk drivers maming the innocents, domestic violence, and the fact that “all patients lie.” We are told every year we will get paid less and less by the lawmakers that then vote themselves raises or the insurance company CEOs who take their huge bonuses. But all that starts to fade away with the smile of one child in pain that you know you have made comfortable. It goes away when, even when you have lost a patient, their family thanks you for all you did. It goes away when you have the privilege to see the miracles we (and God) perform on a daily basis with the upgrades in medicine (or sometimes, just God on his own!). It goes away when we see patients that we used to see die now living on a regular basis. It goes away when a hospital CEO comes up to you and thanks you for the good job you do. And occasionally, every so often, you are PROUD of what you do every day and know that despite what you say, how much you want to quit at times, you never could. Because down deep you know it is a blessing to be a physician and God gave you the gift to be one, and that is what he intended for you. To throw that away would be a sin.
My friend Vicki, a compassionate and kind PA, has this to say:
I vividly remember as a 3 year old having the calling to go into medicine – but I knew I did not want to a doctor or a nurse. Those were the only two medical professions that involved direct patient care that my simple mind could embrace. Thus, I searched somewhat randomly looking for my niche’ is various medical research settings always coming up empty-handed. Finally, in 1989 I discovered my career path as a physician assistant.At that time I was doing what most people would do when they’ve just learned their loved one, in my case my 29 year old sister with a barely 2 year old daughter, was diagnosed with stage 4 lymphoblastic lymphoma. I was accompanying her to her numerous visits and ultimate admission to Fred Hutcherson Cancer Research Center (FHCRC) in Seattle.All of her day to day care was administered by incredible PAs and I knew that was the career I had been searching for. So I began the cumbersome process of applying, interviewing and praying for admission to PA school. My training was extremely challenging because my oldest child was 3 and my baby was 8 months old when I started PA school. Frequently I would ask myself “Why am I doing this?”The answer came years later during the end of my PA training while I was in my last rotation at none other than FHCRC. My first day at the hospital was my sister’s birthday, the first room I rounded in was the room she was in and my first patient died the same day she did. What are the odds of those “coincidences”?It was then that I realized why I “do” medicine. The fundamental of my calling is wrapped up in this – all of life is precious no matter what stage, it is an honor to walk into someone’s life at perhaps their most vulnerable moment and be able to provide excellent medical care, but more importantly, a drink of “Living Water” and the privilege to witness a miracle that I am positive medicine did not prepare me for or create in most humbling.I am deeply honored and privileged to practice medicine!

Section Two: Assorted links to important topics

Falls: A topic important to me as an Aikido student! As my Sensei says, we’re only born with one fear: the fear of falling. Most Aikido students spend a long time learning to fall, and a longer time learning to make other people fall. But how do we keep the elderly from falling? And most importantly, how do I keep from falling when I get old? That break-fall may not work at 95!


http://neuroanthropology.net/2008/07/21/fall-prevention-in-older-people-stephen-lord-at-hcsnet/

Finding the truth can be elusive when the media gets involved. Ironic, huh? When I was in journalism school, however briefly, we were told that we were ‘gatekeepers of information.’ At the time it sounded heady and cool; now it sounds creepy. Here’s a post on the way the media affects public perception of insurers.

http://insureblog.blogspot.com/2008/07/caitlins-story-jumps-shark.html

Last week I was reading Slate magazine and saw an article on a death in an ER, which occurred while a psychiatric patient was awaiting a bed. I had issues with the conclusions the writer made. I’m glad someone else did as well. Thanks to Emergiblog for this honest, and critical, look at the Slate piece.

Although I confess to little knowledge of it, ADHD is always in the news, and certainly a diagnosis many patients carry. Here’s a much viewed post on a relevant topic.
Looking for healthy links? Ways to make yourself more fit, or make fitness less painful and more fun? A post and links from fitness fixer!
http://www.healthline.com/blogs/exercise_fitness/2008/07/new-fitness-fixer-index.htmlFeel like some coffee? Liver feeling ‘out-of-whack?’ Grab some Joe. Pity I hate the stuff. You coffee drinkers may have yet another reason to celebrate your icky, bitter nectar of life. Here’s a post on coffee and liver cancer.http://www.highlighthealth.com/diseases-and-conditions/increased-coffee-consumption-associated-with-lower-risk-of-liver-cancer/

Traveling Doc takes us on a teaching adventure in Borneo. Heck, I’m not sure I ever want to practice anywhere but South Carolina! Thanks for letting us adventure vicariously through you!

http://borneo-breezes.blogspot.com/2008/07/trip-up-mountain.html

From Clinical Cases and Images, here’s an interesting look at whether or not medical bloggers are doing the right thing, and how to do it better! Ouch, maybe I need to go back and do some self-evaluation. A relevant question we should all ask, even as we brush up on our First Amendment rights!

http://casesblog.blogspot.com/2008/07/content-of-weblogs-written-by-health.html

Allergy Notes updates us on giving ARB’s to patients with ACE-inhibitor-related angioedema.


http://allergynotes.blogspot.com/2008/07/can-you-prescribe-arb-to-patient-with.html

As physicians and administrators struggle to mend the safety-nets across the country, The Plain Dealer online medical editor Chris Seper decides to take some action and propose solutions for MetroHealth, Cleveland, on a website devoted to just that topic.

A discussion of herniated discs, ‘Are they caused by age?’ This piece is by Dean Moyer of The Back Pain Blog. My answer? Back pain is caused by putting together Grand Rounds in an inexpensive desk chair, after your children climb all over you in the pool.
Dr. Trofatter, from nearby Greenville, SC, discusses Elevated FSH and Aneuploidy. Herein he reminds me that emergency physicians have a very limited fund of knowledge, and almost never use the word Aneuoploidy when discussing Lortab with drunks. And reminding me yet again why I respect all of you smart doctors so much.
http://www.healthline.com/blogs/pregnancy_childbirth/2008/07/elevated-fsh-and-aneuploidy.htmlThe gracious and insightful Dr. Val interviews former Surgeon General Antonio Novello about creating a Health-care Navigation System for cancer patients.
http://www.revolutionhealth.com/blogs/valjonesmd/dr-antonia-novello–15028

Dr. Shock with advice on how much of ourselves we should disclose to patients. Hint: they don’t need to know your last cholesterol, or how unhappy your parents made you!


http://www.shockmd.com/2008/07/25/patient-doctor-relationship-self-disclosure/

Monash Medical Student uses an episode of House to refresh our memories about Echovirus, echovirus, echovirus, echovirus.

The Happy Hospitalist on a topic dear to all our hearts: allegations of patient ‘dumping.’
Vitum Medicinus looks at a wonderful patient enduring a crappy situation. If only we all could look at people the way this Canadian medical student does, the way so many medical students do, we’d be a sight better off as physicians.
Section Three: Advertisements and reviews
This post is part advertisement, part advice on obtaining health insurance. Plenty of interest in that these days!http://www.besthealthinsurancebook.com/blog/2008/07/25/cant-get-medical-insurance-move-2/For those of us with children who will, one day, go to college (I’m crying already!) a review, by Nancy Brown, PhD, of a book on how to prepare them. Prepare them? How do I prepare me! I’ve got to go tuck someone into bed!http://www.healthline.com/blogs/teen_health/2008/07/book-review-launching-years-part-1.html

Well, dear friends and colleagues, that’s all for this week. I hope I didn’t disappoint. I tried to be fair to all. I hope you enjoyed.May God ‘bless you real good’ today, as a wise man once said to me.Sincerely,Edwin Leap

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12 to “MedBlogs Grand Rounds 29 July, 2008. ‘Why do we do it?’”

  1. jeff says:
    July 29, 2008 at 11:05 am

    great stuff. fascinating read. thanks for including my submission. :)

  2. Dean Moyer says:
    July 29, 2008 at 12:36 pm

    Wow! A lot to read here. Great job! Thanks for including my post as well – even if it was off-topic. :)

  3. hgstern says:
    July 29, 2008 at 12:56 pm

     
    WoW! That is an AMAZING ‘Rounds!

    Thank you for hosting, and for including our post.
     

  4. Chris Seper says:
    July 29, 2008 at 6:12 pm

    Thanks for including our site. A comprehensive list to say the least!

  5. travelingdoc says:
    July 29, 2008 at 6:41 pm

    An interesting approach. Well done. Lots of good reading.

    It is the first time I have seen a “commercials” section. I agree it is needed, although I would include some other bloggers, such as the Healthlines folk and wasn’t sure why you included the two that you did. Maybe it will spark some interest in the topic. Great job.

  6. Wild Rose says:
    July 30, 2008 at 12:12 am

    Great Job. I bet you worked late on this one. You are awesome.

  7. John Hollandsworth, M.D. says:
    July 30, 2008 at 1:39 am

    Ed,
    thanks for all the hard work. I know it took A LOT of time to put all that together.

    John

  8. TBTAM says:
    July 30, 2008 at 11:32 am

    Wow! That is a GRAND rounds! Thanks for all your hard work.

  9. Jay Norris says:
    July 30, 2008 at 6:48 pm

    Well done Ed! And I still haven’t finished reading the whole thing…

  10. Am Ang Zhang says:
    July 31, 2008 at 9:54 am

    Thanks for hosting. There is such a lot to go through. Thanks for including my post. Medicine could be fun.

    The Cockroach Catcher

  11. Myriam Díaz, MD says:
    August 7, 2008 at 4:59 pm

    Dear Edwin
    I can’t agree more with everything you wrote. While I read it I felt like if I was reading my feelings and thoughts about my own work. I am an Internist, working in the ER of one of the government’s Hospitals in Guatemala, Central America. With our very, very limited resources here, many times one have to face the sufferings of this patients with any on hand but hope. What a powerful word! I am so grateful to God for calling me to serve others with this amazing profession. You are a great example for all of us.
    Thank you
    Myriam

  12. NIKITAKTAK says:
    February 23, 2010 at 2:46 am

    Good design blog. Author fellow, will be your constant visitor. I learned many interesting thanks.



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