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The Most Disgusting Hand-Shake Ever

Shaking hands is not really such a good idea, especially in a hospital where there are all sorts of nasty bugs floating around, seeking whom they may devour. So generally I do not shake hands unless the patient absolutely insists and I think the cultural slight may be more than he can bear. But one incident highlighted to me the reason you generally don’t want to shake hands so well it could just have well been written all over the hospital in bright neon lights.

I was on call that night so it fell to me to evaluate and treat the patient in casualties which the casualty officer said had a perianal abscess. I approached the bed and introduced myself, but I made a point of positioning myself in such a way that the patient wouldn’t be able to greet me with the traditional handshake. Experience had taught me that this was one case where this cultural idiosyncracy was patricularly ill-advised.

I asked what the problem was. without saying a word his hand moved to his gluteal cleft in one smooth motion. Moments later I found myself staring with morbid fascination as he pulled his butt cheeks apart and started prodding what was clearly an abscess with his finger. It had already broken open slightly so there was a thin stream of pus oozing out and following the natural pull of gravity. The patient’s grubby finger scratched, prodded and poked this poor stream of sepsis, completely disrupting its attempt to soil the bed linen. Read more »

*This blog post was originally published at other things amanzi*

Medical Treatment Of Ingrown Toenails: 1908 And 2009

Flipping through the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD I found at an antique store last month, I came across the section on ingrown toenails. The causes of ingrown toenails were much the same as one hundred years.

This is a condition in which the edge of the nail, usually of the great toe, by its too close contact with the flesh beneath causes irritation, ulceration, or suppuration. There has been much discussion as to whether the nail or the flesh is the more at fault. This discussion is without profit. It is much better to study the normal conditions, and see what can be done to restore them. Read more »

*This blog post was originally published at Suture for a Living*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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