close to home

senseless violence against children-and thanks for children's hospitals

We are all reeling with vivid images of the Boston Marathon explosions. I see the poor 8-year old who was killed flash up on the screen and I cry. that family is irreparably injured, especially because the child's mom and sister were also seriously injured. At the time of this writing, I am aware of 8 other children who have been hospitalized due to the events that occurred during or following the blasts. Somewhere well over 100 others.

Read more

it was a dark and stormy....week

I have written before about being "on service" for a week on the pediatric inpatient unit.

I love it. I hate it. It's fun. It's exhausting. It's happy. It's sad. But mostly its never dull.


This week just past was no exception. Monday though Friday felt like it happened too fast. I was sooo tired by the end of the week, but I felt fulfilled. It was a difficult week. There were many unknowns, and much sadness, but it was totally worthwhile.

Read more

what is meningitis anyway?


When I read something on the internet or elsewhere  about meningitis, or especially about the "meningitis vaccine" it strikes me that the ubiquitous use of the noun without an appropriate adjective could be confusing for most people. Don't misunderstand me, I am not talking about adjectives like "bad," "awful," or "life-threatening." Rather, I am talking about the adjective that indicates the microbiological etiology of the problem--such as "meningococcal meningitis" or "hemophilus meningitis," or "pneumococcal meningitis," or even "viral meningitis"

Read more

dear readers

Dear readers,

I thought you might like to see this article about me that appeared on the Carilion Clinic website 2 weeks ago. It is part of a series aimed at helping folks get to know the leaders at our institution. My apologies to those of you from Carilion Clinic who have already seen it--some of you have even sent me emails to say hello--that was something completely unexpected and truly welcomed.

Read more

isnt' Twitter just for idiots? part 2

So, have you folllowed my advice, and joined Twitter?

Shortly after I wrote the last post I was gifted by discovering this article which had been written about me, and this blog,  and helps describe some of the tweets I share. By reading it you can get a good idea of how I use Twitter to share information, some of the joys in my life (such as when I capture a particularly interesting photo of a bird, other wildlife, a sunset, or snow), or to respond to others who live on the same medium.

Read more

isn't twitter just for idiots?

I hear that question a lot. At faculty meetings, at medical conferences, from my children, my husband, and a wide variety of other folks. Really?


Well, I use Twitter often, and don't consider myself an idiot, at least not for that reason. I welcome other thoughts on the degree of my potential "idiotness" but I hope you have more reasons than because I use Twitter. Feel free to list them in the comments below.


I thought I would share with you what I have learned about using Twitter over the last year-and-a-half, so you could decide for yourself about its potential value for you. I will leave you with instructions on how to get started, in case you decide you would like to try.

Read more

knowing when NOT to do something

Medical costs are out of control. Yet, outcomes are not improving. Why?


Greater minds than mine have grappled with that question, and it serves as the foundation for our ongoing debate about whether, why and how to reform healthcare. Do we limit the tests and procedures that doctors are allowed to order or perform? Do we limit what services or medications patients are allowed to receive? Or do we do something much smarter, and help to guide patients, their families and physicians in having a conversation about how useful certain tests or procedures might be?

Read more

when doctors can't hear

We have discussed child abuse on this blog before, and I promised you more in a series I began last year. This time I want to tell you a story from when I was a medical student--admittedly some of you will consider this ancient history, and perhaps you should. I do not remember the names of my preceptors or the name of the patient. So there is little chance I will tell you anything I shouldn't. In fact, I don't even remember the name of the hospital where this rotation occurred. Yet I remember the patient, her husband, her daughter as if it were yesterday. 

Read more

reflecting on change


In the past we have spoken quite a bit about reflecting in order to get to know oneself better, and in order to find better ways to deal with issues and concerns. We have spoken about how we are using reflective writing in the resdiency program to help identify how well the Pediatric residents are internalizing lessons on professionalism. This post represents a reflection on how well or poorly I am dealing with the unexpected changes to this blog.

Read more