Grand Rounds is up at Dr. Charles!

This is the 100^th edition, and he’s done a fantastic job … as usual. Here’s a quote from his introduction:

Grand Rounds Turns 100! Originally conceived by Dr. Nicholas Genes, the weekly linkfest celebrating the highlights of the medical blogosphere has reached its 100th edition. Intended to introduce the wider world to the growing medical blogosphere (doctors, nurses, students, administrators, EMTs, techs, and patients who blog), Grand Rounds has blossomed into a phenomenon noticed by The LA Times, Web MD, and Instapundit to name a few. For this the 100th edition I’d like to throw down a cool 57 links, an inclusive orgy of medical goodness, only tolerable in such gluttonous proportions once in a lifetime. Behold today’s display of medblogging largesse, hereby called Grand Rounds #100, hot off the press.

An email exchange with Dr. Schwab a few weeks ago gave me some wonderful material for thought - and discussion. I’m quite grateful to him for allowing me to use different parts of our emails like this, because some of these ideas just beg to be explored more deeply.

In discussing the rather delicate question of whether suicide would be a personal option in order to avoid the anguish of Alzheimer’s, Dr. Schwab questioned:

“[…] would I rather drop dead in an instant, or have a terminal illness that would allow me time to make plans, make peace, say goodbyes. I’ve seen family members go in each way. What I know is that when an uncle dropped dead at age 65 with no warning, his family was devastated. When a brother in law died slowly, it was miserable, but somehow when the end came it was easier to deal with afterwards.”

Along with Dr. Schwab, I have to question which way would be better. My father died very suddenly of a massive stroke … we were not prepared to lose him. 19 years later, I still mourn him … I still miss him palpably. His death left so many things unsaid, so many loose ends. In contrast, my mother lingered with Alzheimer’s for a decade. I finished mourning her years before her body died. When she went, the anguish ended, rather than began … she was no longer trapped in the empty shell that had once been the woman who raised me, nurtured me, wiped my tears.

I don’t ever want to see someone die from Alzheimer’s again - it was agonizing, long, exhausting … emotionally draining. But … we were able to mourn her fully, to tie up our loose ends. My dad … he was there one day, laughing at our jokes, rubbing his big beautiful rough hands together in glee as he anticipated the fun he was going to have with us and his grandkids since he’d only moved to the area a week before … and then, suddenly, he was gone. The wonderful times we were all finally going to share — went with him.

And so, which is best? Dr. Schwab says he doesn’t know … and I certainly don’t know …

If you could choose the way you were going to die, would you have it be quick? Would you rather know ahead of time, and have the time to make your plans, tie up your loose ends? Get everything said?

What about the death of a loved one … do you think a sudden, unexpected death is better, easier? Or is it better to know that you’re losing someone, to have time to say your goodbyes?

Let the blogosphere know what you think - and why. And don’t forget to vote in the poll in the left sidebar … thank you!

Circumcision? To cut, or not to cut?

* Circumcision is necessary! (18 - 3 Votes)
* I approve of circumcision for those who want it. (53% - 9 Votes)
* I’m completely indifferent, or have no idea. (0%- 0 Votes)
* I think it shouldn’t be done without a reason. (12% - 2 Votes)
* It’s genital mulitation (18% - 3 Votes) * Note that TWO of the three votes were from the same place. :p

Total Votes: 17

Suicide OK When Faced With Alzheimer’s?

* Yes (33% - 5 Votes)
* No (40% - 6 Votes)
* I haven’t decided (27% - 4 Votes)

Total Votes: 15

How do you like your ice cream?

* Like a ROCK! (0% - 0 Votes)
* Hard and cold! (28% - 5 Votes)
* Medium, kinda (17% - 3 Votes)
* Soft (33% - 6 Votes)
* Melting (6% - 1 Votes)
* Nuked!!! (0% - 0 Votes)
* I don’t LIKE ice cream! :p (17% - 3 Votes) * who doesn’t like ICE CREAM??? 0.o

Total Votes: 18

To my delight, I found that my friend in the Philippines, Dr. Emer, has posted a new article about male circumcision on his .Parallel Universes. blog.

This entire series began with another friend blogger - Dr. Maurice Bernstein, of the Bioethics Discussion blog. His first post, “Male Circumcision: Should it Now Be a Crime?” gathered 441 comments, many of them anti-semitic, over-the-top, or holding such extremist views that you had to wonder about the individuals making the comments! Blogger took issue to having so many comments on one thread, and Dr. Bernstein was forced to put up another post to allow the comments to run their course. That post accrued another 58 comments, pretty much in the same vein as those from the first posting.

Dr. Bernstein teaches medical students, and he was going to use those comments to show his students what he was coming to believe was a “main stream opinion” regarding male circumcision. After discussing the subject with several males on my own, I was given a very different impression, and decided to post the question on my own blog, because I felt certain that if I didn’t allow the real extremists to take over the thread, that we would be able to get a better sampling of what the “general population” really thinks. That’s exactly what happened.

In the course of the circumcision discussion, Dr. Emer, a physician in the Philippines, posted a comment mentioning that in his country, an uncircumcised man is looked down on, and ridiculed … as if they were lacking in manhood somehow. I found that idea very interesting, since I’d never heard it before. I understood that there are medical reasons for circumcision, and of course also religious reasons … but I was amazed to read about the social reasons!

Dr Emer has found some excellent articles regarding how male circumcision can help prevent the transmission of HIV from infected women to men by up to 60%. He’s linked to 10 very interesting articles! Those of you who were interested in this conversation before should go over and take a look. It’s not over yet, apparently.

In contrast, I believe that most of my Indian friends who left comments would not circumcise their own sons, but still maintained a balanced view on circumcision. I would love to hear more comments from other cultures … how is circumcision viewed in your country? What are your personal feelings about it?

Please vote in the Poll I’ve put in the left side bar … :o)

Nota bene: I’m going to enforce the same rules on this thread as I did the last time. This is not an open forum for the propounding of extremist views … and anything even remotely snarky won’t remain in the comment thread for more than a few minutes, so don’t bother.

Tony Chen over at Hospital Impact is hosting Grand Rounds this week, and he’s done a really good job.

He framed it as a letter to his newborn son … whose picture graces the top the post. You don’t want to miss it! It’s too cute for words! It reminds me of washing my own three baby boys, and finding out that they can give me a shower while I’m giving them a bath! ;o)

I only got my faced washed by my babies once … and it wasn’t by any of the three boys!

Don’t ask! *LOL*

Seriously though, I keep asking myself if I want to host one of those, and then I go take a peek at the newest one, and I just can’t imagine being clever enough to pull it off. These guys are good!