Monday, October 31, 2005

Whose bright idea was it?

To revoke daylight savings the day before Halloween?

Between the excitement (Oh, the excitement! Second only, and barely, to Christmas) and the "fall back," my older son was awake at 4:30 a.m. for the day.

Have I mentioned how perpetial lack of sleep is the biggest, most unpleasant shock of parenthood, now well into its eighth year? Oh, I guess I have.

Wednesday, October 26, 2005

Putting Aside Sibling Rivalry

Here's a heart warmer about three sisters who made one baby.

Tuesday, October 25, 2005


I began running when I was in eight grade. Not speedy, I defaulted to the distance events in track, the mile and the two-mile races. Not a racer, I switched to cross country in high school. In cross country only the top five finishers count toward the team's point total. I never earned a point for the team but ran nonetheless, making new personal bests from time to time.

The longest break I have taken from running since eighth grade was two years, during college and again during law school. In between breaks I ran several 5Ks and a 7.5 mile race. I was training for a marathon (longest run ever: 13 miles) when I fell in love and got married instead.

So though I've never been particularly good at it, "runner" is part of my identity. When I was so sick with hyperemesis that I couldn't stand, I raced effortlessly, joyfully, in my dreams.

I never guessed the degree to which running would prepare me for birth. Not physically -- I did not run while pregnant (though mostly because I got out of shape during the nauseous first semester, not from any fear of harming the baby) -- but mentally.

Our cross country coach kept current on athletic training techniques. It was from him that I learned the power of visualization. He would have us lay on mats in the wrestling area behind the bleachers, close our eyes and relax. He would talk us through the race from start to finish, telling us to picture ourselves running strong, staying mentally alert, having the power to surge past an opponent.

More than twenty years later I found myself laying on our futon, relaxed, as my spouse talked me through a labor visualization. I stayed calm, breathed through contractions, listened to my body.

Both racing and birthing followed my mental rehearsals closely. I had power to surge past opponents; I breathed through contractions and listened to my body.

During pushing with my first child, I distinctly remember thinking, "This is like the sprint: Give it all you've got." My body had experienced physical exhaustion before. I was not afraid to make it hurt.

As I've left my childbearing years and returned to running, I find the circle completing: birth is now informing my running.

Without intending to, my mind invariably turns to my sons' births during the times I am running. I am filled with a sense of power, a recollection of the focus and intensity of my efforts then. Those memories alone buoy me. I find new energy as I think I'm tiring; I have certainty approaching hills that might otherwise escape me.

And from watching other women birth, I keep several mantras in mind:

"I can do this."

"This will end when it ends and not before."

Last Friday I was at my parents' home in Milan, where I grew up. I went for a run around the country block they live on. This is a block we ran during cross country training runs. It covers roads I ran during the 7.5 mile race. It goes down my favorite stretch of pavement around the town (which I later took a photo of below...imagine it with golden corn stalks rising on both sides to make a cavern of the road). I was overwhelmed with a sense of place and purpose. I am from here. I return to here with my children. Through it all I run. And through all that I am is birth.

Grand Rounds Vol. 2 Issue 5

Another week's collection of medical and science blogging is available at HospitalImpact. May you find something provoking there.

Monday, October 24, 2005

Blog Updates

I just wanted to call your attention to a few new links I've inserted under "Everything Else I Regularly Visit." I bookmark new blogs and visit them for a few weeks before adding them here. I've been watching 3 purported doula blogs that I'd like to add, but the authors don't really write about birth.

Anyway, Ah Yes, Medical School regularly and humorously writes about the travails of being a medical student. I got sucked in with this post and have been a regular ever since.

Hailey Dai's Daily Dose is not daily, but is at least predictably thematic: "Useful and amusing information about sex, sexual health, sexuality and all things sexy." What's more, Hailey Dai appears to be CANADIAN. Bonus points.


Reason #38 to Avoid a Cesarean

The doctor might be drunk!

At least with a vaginal birth, the mother can control whether the person in charge of getting the baby out (i.e. herself) is doing so under the influence of alcohol. Sadly, that is not always insurance enough to keep birth a sober and safe experience.

Thursday, October 20, 2005

and I consider myself informed!

Our paper carried an AP article yesterday on how the market for premature baby clothes and products is growing. Why? Because the rate of premature births in the U.S. has grown from around 9.4% in 1981 to over 12% in 2003.


Zoinks! Where have I been? I knew that March of Dimes is focusing its biggest campaign on premature birth and that there is much discussion of how to prevent preterm labor. But I did not realize that the rate was increasing.

I've spent an hour on-line looking for explanations for the rise. Apparently THAT is the question researchers are seeking to answer. The National Academy of Sciences is sponsoring a project that seeks to identify causes of prematurity. Among its goals is to, "Review and assess the various factors contributing to the growing incidence of premature birth, which may include the trend to delay childbearing and racial and ethnic disparities."

Hmmm...not much to go on.

So if you have some money you haven't already earmarked for the kids' college accounts, Christmas, a well-earned vacation, hurricane relief, winter heating bills or Amnesty International, why not share it with March of Dimes?

November is Prematurity Awareness Month

Yo Hospitals: Your Customer's Experience Does Not End With Birth

My officemate brought in her new baby today. You can guess that I barely let her set down the baby carrier before I asked if she would tell her birth story. It was a good story. A first-time mother, she arrived at the hospital at 5 cm; was 9 cm several hours later and had the baby in another hour and a half. No drugs, no IV. The birth she'd wanted.

Her face was radiant as she talked about the birth. Then the shine vanished and she said, "But after the birth? It was horrible." She delivered at the newly opened Family Birth Center I critiqued in an earlier post. My complaints then were with the labor and delivery unit. I forgot to remark about the postpartum piece.

This hospital used to have LDRPs (Labor Delivery Recovery and Postpartum rooms) where you spent your entire hospital stay. When they renovated, they changed to LDR rooms. That means that now, after women "recover" from delivery -- which apparently takes only an hour -- they are moved to rooms in the Mother/Baby unit. Some of the rooms are private, but many are semi-private. They are closet sized and the shower is down the hall.

My officemate said her spouse wanted to spend the night with her and the baby. The only chair in the room did not recline, so they shared the hospital bed. Some of her family had to stand in the hall when they came to visit because only three people can comfortably stand in the room at one time.

She expected to receive some breastfeeding support, but got nothing beyond a periodic check-in from nurses who would note whether the baby was feeding or not.

She also thought someone would bring a wheelchair for her when it was time to leave. Instead, the nurse cut off the ID tags from her and the baby's arms, handed her the discharge papers and walked out of the room. After waiting a while for someone to come back, my colleague shuffled out the door and down the hall, carrying her baby. She had a second-degree tear with stitches.

My own experience at this hospital was similar. My second night the "code" button kept malfunctioning and I was repeatedly awakened from cherished sleep by a crew of doctors and nurses bursting in to resuscitate me; this ended only after a crew of maintenance workers came in a 4 a.m. and did 1/2 hour of drilling and rewiring above my head. A nurse came at 2 a.m. my first night to bathe the baby (I declined) and 5 a.m. to take the baby for his hearing test (I declined).

I have heard similar complaints from clients who have delivered there.

How can a hospital do a multi-million dollar renovation, bill the new product a "Family Birth Center," and yet facilitate none of the elements of a successful post-partum period? No concerted breastfeeding support. Sleep interruptions. Lack of privacy and lack of space for family bonding.

Postpartum doulas take note! There is an unmet need here. Hospitals are washing their hands of MotherBaby care as soon after delivery as possible. Yet as you all know, that is just the beginning of many families' most challenging period.


Wednesday, October 19, 2005

Instinct vs. Prescription

In another example of common sense proving wiser than scientific advice, mounting evidence is reversing many of the baby feeding "rules" we were all given by our doctors:

...rice cereal may not be the best first food. Peanut butter doesn't have to wait until after the first birthday. Offering fruits before vegetables won't breed a sweet tooth. And strong spices? Bring 'em on.

I remember having my five-month old son at a picnic and someone saying, "give him some of this watermelon to suck on." I was mortified. We were only just introducing strained carrots, the first non-cereal solid, to his diet.

As parents of multiple children can appreciate, by the time our second son came around, he got much more of his solid food right off our dinner plates. We "pre-chewed" it if it was something tough, but otherwise, let him gum his way through things.

The experience of breastfeeding was similar. The first time around I tried to remember all the specific, and often competing, guidelines: nurse the baby every 2-3 hours; don't let the baby sleep through a feeding; don't wake a sleeping baby; feed 10 minutes on each side; empty one breast completely before switching.

When my second was born, they kept coming in at the hospital to do breastfeeding assessments. They'd ask when his last feeding was, how long he ate, etc. I made up answers to get them to leave as quickly as possible. He ate when he ate. He did fine.

I know it happens at all levels. Postmenopausal women are told to take hormone supplements, then told they should not take supplements. Butter is bad for you; butter is better than the alternatives.

I don't blame the doctors. But when it comes to these all-knowing pronouncements, especially ones that run counter to what I as a surviving product of thousands of years of natural selection would instinctively do, I am becoming increasingly skeptical.

Grand Rounds Vol. 2, Issue 4

I was occupied yesterday with a child who was too feverish to go to school but too well to lay in bed, so I did not get a chance to link to Grand Rounds. Here it is. Included are four reproduction-related posts (under the OB/GYN heading).

Monday, October 17, 2005


Courtesy of Bookworm: list five of your idiosyncrasies. Do you really want to know this?

1. Scarves and mittens. I was reminded by our recent cool weather that I am particularly sensitive to cool air on my neck and hands. Hence, if it's below about 65 degrees, you will see me with my neck wrapped and hands covered.

2. Parades. I cry at them. Don't know why. Some combination of excitment, pageantry, pride and idyllism (? word?).

3. Vaporizors. The sound, the cool mist on my face. My favorite way to read for fun is with a vaporizor humming and vaporizing right beside my head.

4. Shopping Carts. Still like to ride on them.

5. "Consumer Feedback." I am an incorrigible letter writer, 1-800 number dialer and survey answerer. Recent example: I popped a bag of microwave popcorn over the weekend that took a disasterous turn. I put the charred bag in the trash and the box, with its "Satisfaction Guaranteed" promise and 1-800 number, in my bag to take to work today. My hope is always a coupon for a free product. But at the least I want the satisfaction of telling a company their product did not satisfy. This is not limited to perishibles. I am polishing a letter at this moment to the Milan School Board shaming them for excluding The Chocolate War from the freshman English curriculum. My spouse thinks this is Quixotic (and annoying); I think it is a moral imperative.

I'm tagging Milliner's Dream with this one.

Thursday, October 13, 2005

Preparing for the Unexpected

When one works with pregnant women, it pays to prepare for birth outside the expected parameters. Every day you read about babies born in cars or as unplanned home births. Here is a recent example (I love it that the nine-year-old passed the paramedic a note that said, "Stay calm).

Ever since T$ had a client deliver in her own driveway, I've kept a few special items in my doula bag:

--bulb syringe (to clear mucus from a baby's airway if necessary)
--cord clamps (to, well, clamp the umbilical cord)
--sterile gloves
--"blue pads" (those really absorbant and plastic-lined pads that help control fluid spread)

These tools are backed up by a few emergency maneuvers that I hope I'll never have to use, but that I also hope work if I do have to use them:

--"Gaskin Maneuver" (to help free a stuck shoulder)
--"Summersaulting" a baby with a too-tight nuchal cord
--Flexing the head of a breech baby by letting it "dangle" (assuming it's anterior) just prior to delivering the head

I also keep the phone number of the local homebirth midwives' practice in my cell phone. In the event of a precipitous birth with complications, I would call 9-1-1 and then call them to talk me (or the birth mother's partner) through the delivery. I have to think they'd know more how to handle an emergent birth situation than the 9-1-1 dispatcher.

May these preparations remain unnecessary!

Wednesday, October 12, 2005

AAP: Back to Sleep, Back in the Crib

Monday the American Academy of Pediatrics issued a revised policy on SIDS prevention. Among the recommendations:

  • Babies should be put to sleep on their back only; no side positioning
  • Babies should be encouraged to sleep with pacifiers
  • Babies should not sleep with, though should sleep near, parents

Their concern with side sleeping is that the baby can still roll or squirm on to her belly. I am curious to know if that is the case even with the little sleep positioners, which we used with both of our boys. [In looking for information, I came across this hugely depressing site where parents recount how their children died due to malfuntions of baby devices. You can click story to story...but I urge you not to, especially if you still have young children]

The academy acknowledges that pacifiers can interfere with establishing breastfeeding and recommends parents wait until the baby is a month old before using pacifiers.

As for co-sleeping, the statement says:

Bed sharing is not recommended during sleep. Infants may be brought into bed for nursing or comforting, but should be returned to their own crib or bassinet when the parent is ready to return to sleep. However, there is growing evidence that room sharing (infant sleeping in a crib in parent’s bedroom) is associated with a reduced risk of SIDS. The AAP recommends a separate but proximate sleeping environment.

I wonder what elements of room sharing benefit babies that the family bed or separate room sleeping do not? I guess if we had all the answers, SIDS would not still cause 2,500 deaths a year in the United States.

Tuesday, October 11, 2005

Grand Rounds, Vol. 2 Issue 3

This week’s PSA (courtesy of drdeborahserani):
National Depression Screening Day was October 6
World Mental Health Day was yesterday, October 10


“A feller wiser than myself once said, 'Sometimes you eat the bar, and sometimes the bar, he eats you.’” –The Big Lebowski

This week’s Grand Rounds is meditation on symbiotic relationship between law and medicine. I mean, without medicine, what would lawyers do? And without lawyers? Well, probably some aspect of medicine would be worse off than it is now.

Editor’s Picks

Sound sets the tone for this week’s Grand Rounds with Under Promise and Over Deliver: Why Patients Sue Doctors. He writes, “I think part of the cause of malpractice is the public's need to believe in their doctors, and their disappointment when bad things happen. The lack of transparency and communication between physicians and patients only adds to the size of the gap that devastates the family when outcomes are poor.”

Insureblog submitted a post about which questions insureds should ask about their premiums; I prefer to link to this slightly older post, which gets us thinking about an ethical (and legal) question: “When one donates money on behalf of a specific person (or cause) is it wrong if that money is diverted to something (or someone) else?”

Interested Participant gets double points for submitting a post that is both on topic AND has a Canadian theme (Happy Thanksgiving. I am listening to k.d. lang’s Hymns of the 49th Parallel in honor of the occasion!): Unsatisfied Canadians heading to the U.S. for surgery because they can get appointments 18-24 months sooner than in their native country. Could they bring some of those low-cost meds with them?

Docket Review

In a lesson many Justices and judges could learn from, DB’s Medical Rants shows how to separate one’s personal philosophies from application of constitutional law. He argues that Oregon’s right to legislate approval of physician assisted suicide should remain a state- and not a federal-level decision, no matter how ethically deplorable he finds the practice to be. The end does not always justify the means.

Newcomer PharmaGossip keeps us posted on the Vioxx trial, with only a wee bit of snarky commentary: “was there some sort of LOTTO draw and good ole Briggs was the winner/loser/hero/patsy (delete as appropriate)?.”

Two writers, Kevin, M.D. and The Mommy Blawger, react to the JAMA’s article on “Implications of Cerebral Palsy Litigation.”

Advisory Memos

RedStateMoron highlights the SorryWorks! coalition and their efforts to mediate the malpractice crisis we’re mired in, but questions whether legislation is the right tool for the problem.

Without calling it “patient rights,” Joan at Oasis of Sanity, has a lot of suggestions for improving patients’ understanding of their situation in “the problem with labs:” “I’m referring to the labs, or laboratory reports, that list a bunch of incomprehensible words and acronyms, along with a bunch of equally incomprehensible numbers, that delineate exactly what was found in a blood sample.”

Barbados Butterfly doesn’t say it can help dodge a lawsuit, but nonetheless points out the difference experience makes in a surgical team’s ability to transact urgent business without alarming the patient:
“Surgical Registrar to Anaesthetic team: How are you going up there?
Junior's interpretation: The surgical reg values my contribution to this operation and wants to exchange greetings.
Senior's interpretation: Something's wrong. Probably some blood loss.”

Tired of illegible, incomplete or absent patient drug records, Over!My!Med!Body! has taken matters into his own hands and created a website where patients can list, track and print out a list of their medications. Med!Body!, please be careful the Good Samaritan in you doesn’t hang you out to dry in the liability department.

What happens when you can get a gallon of milk, one hour photo developing and a rapid strep culture all in one place? Aggravated DocSurg considers the possibilities, big box malpractice suits among them.

Approaching Ripeness

Trent McBride, writing at Catallarchy, takes on individuals who deny AIDS is caused by HIV.

Clinical Cases and Images directs our attention to a video post from Medscape General Medicine that calls medical blogging “anarchy.”

Amicus Briefs

Kim at Emergiblog shares her story of nursing burnout and offers a few tips to others for avoiding it. Further examples are available from ImpactEDNurse, who discusses “deep nursing” and on-the-job techniques for mindfulness, meditation and meaningful caregiving.

The Health Business Blog reconsiders the wisdom of consumer directed care after reading that multiple gestations persist in the IVF business despite the medical, ethical and financial “wisdom” of restricting the number of implanted embryos.

And what about consumer directed prevention? Parallel Universes hopes the plain monetary cost of smoking will serve as a deterrent.

A Difficult Patient writes from experience on Domestic Abuse.

Political Calculations tells us how U.S. blood donations are faring in the wake of hurricane Katrina.

Docaroundtheclock directs us to an article on health care, childbirth specifically, during the Brezhnev era in communist Russia.


Orac at Respectful Insolence shows his stripes on the issue of “alternative medicine” in “How to Succeed at Quackery.”

Relatedly, GruntDoc shares tips on how NOT to act in the ER if you’re there to scam some drugs.

Healthy Concerns reflects on gender and reactions to a promised phone call that never comes.

The Cheerful Oncologist delivers a death allegory that is beautiful, and more than a little unsettling.

Res Gestae

doulicia asks that you visit this post at SageFemme to see what legislation and malpractice threaten to take away – at least from women who prefer to birth in the hospital.

Mea Culpa

To all the excellent bloggers whose posts I omitted this week, please continue writing and submitting. When I volunteered to host, I had no idea I would receive so many submissions, all of them excellent. I tried to present a collection of pieces that resonated with the theme or with each other. That meant not including some stellar posts. If yours was one, I appreciate your sharing it with me. I promise to be similarly empathetic when I’m left off Grand Rounds.

Next Week

Grand Rounds will be hosted by Diabetes Mine.

Monday, October 10, 2005

A Sign Your Spouse Has Been a Student Too Long

Tonight my spouse was included in the guest list for dinner with a visiting speaker from his department. As he prepared to leave, he kissed our boys goodbye. The younger son, age three, eyed him suspiciously, then pointed to his neck.

"What's that?"

"It's called a tie."


"Did you get married?"

Close only Counts in Hand Grenades and Horseshoes

I'm embarassed to link to USA Today, but they had a fair article yesterday on the differences between Near-Term and Term babies.

They're not quite full term, but they're not that premature. They're "near-term" babies, born roughly four or five weeks before their estimated due date.

They typically have normal Apgar scores, used to evaluate newborns' physical condition. Their birth weight is in the normal range. They usually go home with Mom. Most people think they must be healthy.

And generally they are. But research suggests that appearances might be deceiving in some cases. Though near-term babies on average are healthier than preemies, they may not be quite as healthy as full-term babies.

I feel like I've read about this somewhere before -- heck I probably blogged about it and forgot! Anyway, as interesting to me as the relative immaturity of near-term babies, is the motivation for studying them:

Pediatrician Marvin Wang says he became interested in studying near-term babies a few years ago after an obstetrician colleague asked about the merits of scheduling cesarean sections before the 37th week of gestation, when babies are considered full-term.

It's rumored that some celebrity moms have asked to deliver their babies via C-section a month before their due dates to get a head start on slimming down, says Wang, co-director of the newborn nursery at Massachusetts General Hospital.

He says celebrities aren't the only mothers asking for C-sections before 37 weeks. Indeed, research suggests that "patient-choice" C-sections are on the rise. Wang says comments he has heard suggest that some might be scheduled too early so Mom can fit maternity leave into her work schedule.

What needs to change in our culture for people to accept birth as a process we can't control? The same mindset that leads some women to ask for an elective surgical delivery at 36 weeks' gestation is the same one that leads other women to sue when an unhealthy baby is delivered.

There are no guarantees in birth. Quite the opposite in fact. Birth is an unpredictable and sometimes risky proposition.

But so much is made of our ability to control reproduction -- its prevention and occurrance, the starting and ending times of labor, the pain associated with labor, early determination of the gender and genetic profile of the baby -- that the "natural" (i.e. unpredictable, unforecastable) aspect of pregnancy and childbirth is forgotten.

This reminds me of a family in the town where I grew up. They had a pet cougar. They had raised it from infancy and had it declawed. Their yard had a high fence, through which you would see the adults wresting with the cat in play. You would also see them rubbing it, much as you would a cat. Then one day it saw the neighbor boy running in his back yard, jumped the fence, and nearly chewed off his leg before they got the boy away. I babysat him. His leg is scarred for life.

Now this could have happened to the boy anyway. If he was hiking in the west, say. It would be sad no matter the circumstance. But it was more shocking for the friendly situation suddenly turning violent, the animal you've petted and fed suddenly ripping muscle from bone.

We need to keep in mind that pregnancy may be profiled and measured, labor started and stopped, but the process still has teeth and will occasionally bite people. There is no way to avoid it. Premature babies will be born; congenital defects will happen. But we can avoid creating bad situations by respecting reproduction's wild and natural origins.

Thursday, October 06, 2005

Catching Your Grandchild

This year I took up the ACNM on their offer of a "friend of the college" membership. I get the Journal of Midwifery and Women's Health delivered to my door and read it cover to cover. It contains articles and research written by nurse-midwives on research subjects near and dear to the natural birth community (e.g. "A Description of the Outcomes of Vaginal Birth After Cesarean Birth in the Homebirth Setting").

My favorite part of the subscription, however, may be reading the personal notes in the back of Quickening, their organization newsletter (I propose a name change). Usually there are several birth announcements in which nurse midwives not only announce the birth of their children, but also thank the midwife (CNM and CM) teams that supported them in labor.

The best ones of all, however read like this, "Mary Durante (CNM) and Carl Matice are pleased to announce the birth of their daughter, Maria, born into the loving arms of her granmother, Joan Durante (CM) on June 4, 2005."

Can you imagine catching your own grandchild? It gives me goosebumps just to think of it.

Wednesday, October 05, 2005

Whine Whine Fuss Fuss Redux

At the last birth I attended, we were blessed with two great labor nurses. Rita arrived during transition and stayed through post-partum transfer. I smiled the moment I saw her. She had been a fantastic source of perspective and encouragement for the client of mine whose birth experience was the worst I have witnessed so far.

Most recently, Rita was promoting the merits of arnica oil to ease crowning. She turned a blind eye to the laboring mother's consumption of solids. She saw me mixing an Emer-gen-C and asked if she could try one. She helped set the mother up in a squatting position for pushing.

I heart Rita.

I can use Rita's name because she is no longer working as a labor and delivery nurse. She is no longer working as a nurse at all. We were talking after the delivery and she told me that she had accepted a job as a pharmaceutical rep. Did she have a burning desire to distribute promotional enema dolls? No.

She said she was leaving nursing because she couldn't do the part of the job she loved any more: working with women.

The hospital she worked for switched roughly a year ago to a paperless records system. So every notation the nurses make is entered into the computer through a combination touch-screen and keyboard. I have watched doctors and nurses use this system. They come in to take a temp or BP and then they have to go touch through several screens to get the vital signs page, where they then type in the time, their name, the vitals. Then they touch over to the heart tracing page and put in a notation there that they took vitals. Can't the computer integrate these things? Same procedure for medication, interventions, etc.

Compare this to the paper charting still done at the other hospital: the nurse comes in, takes a temp, writes it down on the chart and leaves. Or, better yet, asks the mother if she'd like some juice, or offers to get a sandwich for the partner. Or just sits and holds the mother's hand.

Rita said she loves birth -- she had her 3 children naturally. She loves supporting unmedicated birth. She can hold her own with the doctors.

We have lost her to technology.

Do I really want to go to nursing school if this is what the future holds?

What is Grand Rounds, exactly?

So asks Linda. Thank you for the opportunity to explain.

Grand Rounds is a weekly collection of medical-related blog posts. As the original submission guidelines note, "the target audience here is NOT other medical bloggers, or people in the health care industry. It's the educated but nonmedical readers coming from general-interest blogs."

And who can submit to Grand Rounds? As the original guidelines answer in the FAQ section:
I'm a doctor / nurse / researcher / student / EMT / health care economist / patient who writes mostly about gardening / dating / reality television. Will you link to my post? Maybe. I'll certainly look at it, if it's medically related. And very few blogs are 100% medicine.

So what I hope to put up here next Tuesday is a collection of stellar posts related to the world of medicine and composed by health care providers, analysts, cricits and recipients.

For more explicit guideslines, please continue reading:

  • Submissions are due by 8:00 PM EST Monday night 10/10/05
  • Grand Rounds will posted on Tuesday 10/11/05 at 9:30 AM
  • Send the link to your post, the title, and a brief description
  • One entry per blogger
  • Recent posts between 400 and 1000 words are preferred
  • Posts are to be written for a general audience. Potential topics include:
    --Patient encounters
    --A profile of someone in medicine
    --Medical education
    --Implications of a new basic science discovery
    --Commentary on a new study
  • Commentary on health care delivery
One final note: It is the host's discretion as to what gets included. This will no doubt provide me, a midwesterner through and through, with many minutes of lost sleep if I can't use all submissions. Please know in advance I love you all.

Tuesday, October 04, 2005

Grand Rounds

Is up here.

I'll be hosting next week. Please send submissions to by 8:00 p.m. (EST) next Monday, October 10.

Life Is Like a Box of Chocolates...

...and last night mine was full of dreams Tim Burton would be proud of.


Monday, October 03, 2005

More news from the world of midwife education

Last week I vented about my personal frustration with the particular nursing program I have access to. It is good to be reminded that there are many nurse and nurse-midwife programs out there, and people are getting great things from them.

This year the Frontier Nursing Service celebrates 80 years of operation. Originally founded to train midwives and other health care professionals to work in truly rural areas, it continues its distance teaching and learning today. The midwife who caught my younger son did her schooling through FNS. There's a nice profile of of the organization and its history here.

As European midwifery programs continue to protest the admission of men, one Spanish student, enrolled in England, conveys a true midwife spirit as he witnesses his first birth.