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Munchausen Syndrome, Volume 79, Issue 4, 2007 |
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Munchausen Syndrome S. Robert Lathan, M.D.
MAA Member Since 1969
After seeing the movie Catch Me if You Can I was reminded of a patient with Munchausen Syndrome that I encountered several years ago while on call for the Piedmont Hospital Emergency Room.
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Managing Anticoagulation Therapy in Patients Undergoing Invasive Procedures, Volume 79, Issue 4, 2007 |
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Managing Anticoagulation Therapy in Patients Undergoing Invasive Procedures
Leslie Dotson Jaggers, Pharm. D., BCPS
Makr E. Silverman, M.D., MACP, FRCP, FACC
Dr. Silverman: MAA Member Since 1978
To bleed or to clot, that is the question.
The peri-procedural management of patients receiving oral anticoagulant therapy is a frequently encountered therapeutic dilemma. Continuation of this therapy during an invasive procedure of surgery may predispose the patient to significant bleeding while peri-procedural withdrawal increases the risk of thromboembolism. Institution of bridging with unfractionated heparin (UFH) or a low-molecular-weight heparin (LMWH) perioperatively can be costly, inconvenient, and may increase the risk of major postoperative bleeding. |
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Best Science and Nature Writing, Volume 79, Issue 4, 2007 |
Best Science and Nature Writing
Sam Gray, M.D.
MAA Member Since 2001
Have you ever wondered whether the near disappearance of the autopsy is a good idea? The Best American Science and Nature Writing 2006 discusses the issue in Buried Answers by David Dobbs. The answer is no. Alan Schiller, chairman and pathology at Mount Sinai School of Medicine in New York, says that “even in today’s high-tech medical world, the low-tech hospital autopsy (provides) a uniquely effective means of quality control and knowledge. It exposes mistakes and bad habits, evaluates diagnostic and treatment routines, and detects new disease.”
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The Other Side of the Table, Volume 79, Issue 4, 2007 |
The Other Side of the Table
Evan Weisman, M.D.
MAA Since 1993
“Evan, it’s Joan. How are you?” It was an afternoon phone call from my sister-in-law from Israel. I had never received a telephone call from her and I dreaded the news. “Can you believe it? Alan had a heart attack – a bad one. He collapsed at someone’s apartment and it took an hour to resuscitate him. He’s alive but on a ventilator.”
Unfortunately, I COULD believe it. My brother was a 65-year-old overweight, habitual cigarette smoker. He had suffered an out-of-hospital cardiac arrest; I knew the odds of survival; they were dismal! This was going to be an exercise in futility! He has moved to Israel 25 years ago. He had left behind 3 unsuccessful marriages and a series of unsuccessful jobs in the food and beverage industry to take a position teaching tennis to children. Our father, a radiologist, used to interpret x-rays at the psychiatric hospital. On its premises was a little used, dilapidated tennis court. Our mother thought it would be nice to take “the boys” to play tennis. We both developed a lifelong love for the sport, but Alan took some lessons and became a college level tennis player.
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Presidents Message: Apathy......Bad Medicine for All of Us, Volume 79, Issue 4, 2007 |
Apathy……Bad Medicine for All of Us
Robert J. Albin, M.D.
MAA Member Since 1991
Apathy. Derived from Greek word meaning without feeling. The dictionary defines apathy as a lack of emotion interest or concern. However, I prefer a more modern connotation – a surefire recipe for disaster as physicians face daily assaults upon the way they practice medicine and deliver healthcare.
I am not naïve enough not to understand and appreciate the modern day plight of practitioners of the greatest profession in the world – the healing arts. I too am overworked, saddled with unending paperwork, engaged in a constant battle to be fairly reimbursed, frustrated by denied diagnostic studies, and concerned by the aggression and disrespect shown by patients and insurers toward doctors and their staff. But I am neither bloodied nor defeated as I survey our present conditions and ponder what may be our future.
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