Revisited: Does this thing work?

Welcome back to retrospective week here at the Doctor Anonymous blog....

So, here is a little synposis of how this little blog got started. As I have probably remarked before, my first exposure to blogging was with political blogs. And, as I did further exploring, I wondered whether there was any blogs about medicine.

I think back then, I typed "doctor blogs" in a search engine somewhere, and one of the first blogs that came up was Fat Doctor. I read every single post she wrote and was captivated by the story telling. Of course, this was in early 2006 when she only had been blogging for a few months.

For the months following, I kept asking myself, "Could I do that? Could I write about myself or write about medicine or both?" Like most bloggers-to-be, I went back and forth.

The next step for me was to go from "blog lurker" to "blog commenter." I remember commenting on her blog and other blogs. And, it was a good time. I was amazed that people were commenting on my comments. The back and forth conversations and banter was fascinating to me. My blog confidence grew, and I knew I had a decision to make. Could I go from "blog commenter" to "blog writer?"

I decided to go for it. For an introverted-type person like me, to risk something like this (for me) was huge. The next step was deciding on a blogger name and blog name. I was reading anonymous lawyer at the time and thought that anonymous doctor would be kind of interesting, but found out the name was taken.

How about the name Doctor Anonymous? I could use "Dr. A" as kind of a nickname. I hoped that it wasn't taken as well. I typed it in, and, Voila! A blog and a blogger are born.

Now, what the heck do I talk about? And, thus comes my very first post on Monday, June 19, 2006 called Does this thing work? It was just four of five lines just to get me started...

I've got to admit off the bat that I'm no techno-expert. This entire sign on process was kind of traumatic. Is this what this blog is going to be about -- whining? Hope not. I'm glad just to be up an running. Don't worry, this sparse blogspace will be filling up soon. Just as soon as a figure out what to talk about...

I was so proud of myself when I hit the "post" button. I had no idea was going to happen. But, I told myself at the time that even if I got zero comments, I had an idea out there in the blogosphere for everyone to read. That concept amazed me then and continues to amaze me now.

It's hard to believe that almost a year has passed since that time. But, I still remember those thoughts like it was yesterday. I'm going to reflect on other posts in the next week during the countdown to my blogiversary. Hope you enjoy this series, because I know I am!

The Sopranos finale

I have to tell you that I have never seen The Sopranos, but in reading the press this morning, everyone was surprised and/or upset by the ending of this series. Here is the Washington Post point of view this morning.

So, in case you missed it, here are the final five minutes of the episode. Watch it now before YouTube is forced to remove it from their database. Personally, I don't get the ending, but, I guess that's how the writer/creator wanted to leave it.

Update: After a couple of hours since the original post, the above video had already been "deleted by the user." I've also seen this message today: "This video is no longer available due to a copyright claim by Home Box Office, Inc." I did manage to find found another YouTube link (for now). If you haven't seen it, click here before this is deleted.

Countdown To Blogiversary

I'm going to continue on this sentimental streak of thinking/writing that I've been having. It started with yesterday's post. Over the next week or so, I'm going to be taking a little bit of a departure from the "usual" Doctor Anonymous style posts.

So, next week is my one year blogiversary. And, over the next seven days or so, I'm going to be re-visiting some past postings and give some perspective of what I was thinking then. I'm actually really excited about it. I've been in a kind of blogging rut lately. I needed something to mix things up - and this is perfect.

BTW, if you haven't had a chance yet, check out the most recent installment of My Three Shrinks where they hear from Dr. Phil. It's a great interview - Hilarious! I'm going to be a guest on their podcast next week. You know, I call myself the "unofficial Fourth Shrink" (that's kind of like The Fifth Beatle - HA!).

For my faithful readers out there, do you have a favorite Doctor Anonymous post, or a post that you particularly remember over the past year? I'm kind of curious if my favorite posts list is similar to yours....

High school graduation

It's high school graduation around here this weekend (image credit), and I cannot help but get a little nostalgic. I guess that tends to happen every year as I get further and further away from my own HS graduation. Why does that happen?

Anyway, way back when, I couldn't wait to get out of there. It's not that I had a bad high school experience. But, like almost all people that age, I was ready to move on to the next step in my life. Some of my friends went into the working world, some of them went into the military right out of high school, and some people went to college. I was in that last group.

But, before that, I remember my last two months of high school like it was yesterday. I went in with about a dozen of my friends to purchase a "class car." It was a beat-up old boat-sized vehicle, but it was ours. We painted the thing; we drove it everywhere; we pushed it to the gas station when it ran out of gas; and we took it to the graduation ceremony as we were dressed in our caps and gowns - Good times!

And, then, for the rest of June, there was graduation party after graduation party. Little did I know that would be the last time that I would see some of those people -- because hardly anyone moves back to this economically deprived area. For a lot of my friends, it was time to move on to bigger and better things.

For me, I had a feeling of accomplishment that I finished high school. I was going to miss my friends, but I knew it was time for me to move on as well - to the next step in my life. I was excited, yet a little scared of what was to come - namely college.

Thanks for this quick stroll down memory lane. Maybe I'll have more to blog on this later. Any fun high school graduation memories out there?

Blogblast for Peace

Don't be surprised if you see this graphic in a lot of places on June 6, 2007. I'm posting this a little early because I'm afraid that I'll forget tomorrow....

The message is pretty simple: Peace on Earth. Were you there on November 7, 2006 when this first happened? You can read all about it here. The idea came when Mimi saw a plane.

Outer peace (meaning world peace) always must start with inner peace. And, I gotta tell ya, trying to organize and trying to control my life has been really difficult lately. So, as I go forward on this special day, I know that the only way that I can be of any impact to anyone else is to look in the mirror first.

Finally, kudos to Mimi Lenox, who appears to have made it her passion to spread this message to so many people in the blogosphere. I hope to see many more peace globes around blogland as compared to November. Great job Mimi!

Grand Rounds

Grand Rounds 3.37 is now up and running at Inside Surgery. It's a pretty no nonsense and straightforward format this week. About 30 links which are easy to navigate and read. Great job and thanks so much for including my post...

People in the News
Doctor Anonymous writes on the Kevorkian Effect

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science?

Next week, GR moves to Dr. Val & The Voice of Reason. What an interesting name for a blog. Want to submit to GR for June 12? Click here and read on....

Pass the chips, or not

Here's the weight loss tip for 2007 - Stop watching television. I know what you're saying - like, duh, Dr. A, we knew that. Well now there's scientific proof, and it involves late night television.

I'm a Letterman guy myself (image credit). Not that there is anything against Leno. But, being in high school in the late 1980's meant one thing to me - staying up until 12:30am to watch Late Night with David Letterman. What do these guys have to do with a weight loss study? Read on and find out...

According to this Reuters article, researchers at the Smell and Taste Treatment and Research Foundation in Chicago (no joke) took people, potato chips, and television and developed a experiment around it.

Forty-five volunteers ate as many chips as they wanted during five-minute intervals over three-week periods while they watched monologues by late-night talk show hosts David Letterman and Jay Leno.

They also were given chips to eat when the television was off. [Alan] Hirsch [neurological director of the Smell and Taste Treatment and Research Foundation] found people ate an average of 44 percent more chips while watching Letterman and 42 percent more while viewing Leno, than when they did not watch TV.

My question is what potato chips were they using. Because, for me, I'm partial to the BBQ flavor - and maybe salt and vinegar. But, other flavors, not so much....

At each session, volunteers were asked to concentrate on the sensory characteristics of the food such as taste and smell. Researchers say these sensory clues, in addition to internal body changes, signal satiety.

But when distracted, a person does not pay attention to either the body's sensations of feeling full, or to the sensory characteristics of the food. Many studies have linked obesity to watching television and that link is likely due to inactivity, Hirsch said. But perhaps entertaining shows are also contributing.

"If you want to lose weight, turn off the television or watch something boring," he said.

Something boring? I wonder what that means. I'd make some suggestions, but then, I know that dozens of Hollywood attorneys and television producers would be attacking my blog. *cough* Happy TV watching everybody!

Go Cavs!

Congrats to the Cleveland Cavaliers who are on their way to the NBA Finals. This is the first chance in a long time for Cleveland to win a major sports championship in decades. From the Associated Press, this pretty much sums up what's going on in Cleveland this morning. Good luck in the Finals!

As his teammates danced and carried on while wearing baseball caps and T-shirts proclaiming "Champions," LeBron James walked around in a daze with a smile etched across his face. "This is like a dream," he said, shaking his head. "This is probably the best feeling that I've ever had in my life." An entire city felt the same.

For the first time in a long time, championship-starved Cleveland has something to feel good about. The Cavaliers, once the punch line to jokes and Michael Jordan's favorite foil, are Eastern Conference champions — and on their way to the NBA finals.

TB Double Standard?

Last week, I was only peripherally following the case of Andrew Speaker. He's the guy who flew to Greece to get married and it was found out that he had a form of drug-resistant tuberculosis. There was a lot of media coverage about who was exposed on the airplane, and the process of contacting all these people. Apparently, Friday, he went on national television to apologize.

Right now, Speaker is under US government quarantine (the first since 1963) while he is undergoing further evaluation and treatment. His medical plan is to stay in a Denver hospital for possibly two months to receive antibiotics and possibly surgery.

As I was reading this story, there were aspects of this that sounded kind of familiar to a previous post that I wrote. Then, it hit me. I wrote two months ago about Robert Daniels (pictured above - image credit) and his ordeal in Arizona.

Daniels moved from Russia to Arizona and it was found out that he has drug resistant tuberculosis. Reports state that he refused treatment or even to wear a mask. For these reasons Daniels ended up in jail and is still there to this day (Read TB patient in jail for more details and an interesting comment section).

I started asking myself: How can one guy be under federal quarantine and placed in a hospital, and another guy be under state/local quarantine and placed in jail? As I did more research, I found this article on MSNBC/Newsweek.

Robert Daniels has been confined to his small, cinder-block room for nine months so far and he doesn’t know when his confinement will end. He has one barred window that is frosted over so little light shines through, a metal toilet with a metal sink and he spends most of his day in bed. He hasn’t had a hot shower since his detention and has to bathe with sanitary wipes, since he has only been allowed out of his room once. But Daniels is not a criminal, and has not yet been charged with any crime. Instead he is a tuberculosis patient who was quarantined at the Maricopa County hospital in Phoenix last July after failing to wear his mask in public.

While tuberculosis patient Andrew Speaker, at the center of a media storm this week, was the first person since 1963 to be quarantined by the federal government, some others, like Daniels, are detained by local and state officials.

[A]fter Speaker's case went public, [ACLU attorney Linda] Cosme says she will be filing a motion to move Daniels' case to federal jurisdiction. "Speaker's treatment is much better," Cosme says. "While Robert acknowledges that he should be quarantined, he should be allowed out to exercise his legs and be in the sun." As long as he’s wearing that mask.

Is there a double standard here with one quarantine in a hospital and the other quarantine in a jail? Well, the ACLU is going to make an argument for this. Do I agree? If these cases where similar, then I would say, yes, there has to be consistency here.

But, I think there are more differences than similarities in these two cases. Daniels was pretty adamant about not wearing a mask in public, lied about not wearing a mask, and didn't follow other public health recommendations. These choices landed him in jail.

Meanwhile, Speaker was already in Europe when he learned of his disease state. Granted, he ignored health official recommendations not to take a long flight home, but I'm willing to give him a pass on this (I'm starting to hear the hypocrite chants) because the guy was scared and thought he was going to die. Plus, since getting home, he states he's been feeling guilty about taking those long flights and has been apologizing to anyone who will listen.

Is there a double standard going on here? Am I being a hypocrite here? Well, you be the judge (and I know you'll let me know). These cases will be more and more interesting as they continue to unfold.

Flea thoughts

I just want to warn you right now. There are going to be no new relevations in this post. If you're looking to see if I have this uniquely new spin on this situation, then just click on to whatever you were going to read next. This post is going to be just rambling thoughts....

Over the past two days or so, I've been reading and reading and reading all the reactions and analysis on this situation. There are very emotional posts, there are blame directed posts, there are self-righteous posts, over what? Over a guy who got called out on having a blog...

This just happened to be a great media moment because it happened on the witness stand. Just wait, one of the fall season premiere episodes of Grey's or House or whatever medical TV show, is going to have this moment....

Some people out there in blogland are proclaiming that this case proves that there is no such thing is anonymous blogging. Heck, I could have told you that - and I have - here, here, and here....

There are even some out there who say that either any docs who blog anonymously are cowards and should blog under your real name anyway (they say this case proves that). Or, still others who say that medical bloggers should make up a set of rules and stick by them. Uh, yeah, that's a great idea (I don't think so).

Just from my personal point of view (i'm not speaking for anyone but myself), if I wanted to blog under my real name, than I would from the beginning. It took the realization about six months ago that anyone out there can find out who you are, where you are, and any kind of personal information that they want to. This really freaked me out, but I kept blogging nonetheless.

About a set of rules, I think this is great for people who use their real name blogging. I also think it's ok for those who feel the need that medical bloggers need some kind of credibility and legitimacy. However, I think this sets the bar higher than it needs to be. Just another reason for enemies to come after you and your blog.

I'm all for patient privacy, but to put all of your credentials out there, for me, I'm not sure about that. If you "anonymously" blog, if you put your credentials out there that some of these rules say, why not just use your real name anyway.

Are there any huge ramifications to the medical blogosphere because of this case? I continue to stand by my past statements in which I've said I'm concerned about the continued growth of the medical blogosphere from the grassroots. Many of these blogs will continue to go private quietly and other potential bloggers will be discouraged to even start.

You know, Flea is probably out there right now, watching all of this happen, and laughing at us for all the attention that we're giving this case. He's probably started a new blog, with a different name, with a different identity, and blogging about anything but medicine. All the best to you, Flea.