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Another side of brain death

A few days ago, I wrote a post about the ordeal and complexities faced by the family of Jahi McMath, and the issues of brain death in a pediatric patient. While this scenario is playing out in California, there is another drama playing out in a hospital in Texas, where a dead pregnant woman is being supported over the objections of her husband and the father of the unborn child who at this point is a 19-week old fetus; too young to be able to survive outside the mother's womb.

According to the Associated Press story,

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What is death?

I fully intended my first blog post of the year to be upbeat and full of promise for the new year. However, I am so disturbed by the events taking place in Oakland, CA, and the confusion over the situation that I felt compelled to write about death today, when my first "to do" of the new year popped up as "write blog post."

Can you define death?

Or do you feel that is a preposterous question? Afterall, we know it when we see it, no? Could there ever be a situation in which a person was dead, but didn't look dead?

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when being more efficient may not be better

We are always looking for efficiency, aren't we?

Trying to go faster, get more done in less time, take fewer steps to accomplish a task.


It has been drummed into our heads since we were little. We must be more efficient. Well, I am not so sure that is always the case.

A couple of examples have come to mind this week from real life experiences that have made me realize that being less efficient can sometimes be better--or at least have some important offsets.

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Does your doctor have bad habits?

Of course she does

He may be a nose picker or nail biter, or she may be a smoker or over-eater, but that's not exactly what I mean

Do you think your doctor is able to change practice habits just because evidence shows that those habits are bad for the patient or society?

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It's ready; come and get it!


It's just mid-September.

We have had a couple of days that have hinted of fall, with some cool nights and pleasantly warm, sunny days. Winter seems like a long time away. Yet you are already seeing advertisements about flu vaccines and are being urged to get vaccinated.

You know how I feel about flu vaccine.

I write about it every year. You know I will get my vaccine, and that I will encourage you to get yours and to also get your children vaccinated.

I often don't write about this until October or later. Why now?

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the perils of progress

Over the past couple of months I have received a number of emails, notes and verbal shout outs wondering why folks couldn't "find the blog" or whether I had stopped linking to the Carilion site, or whether I had hidden my content somewhere undiscoverable.

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is experience really such a great teacher?

We have all heard the expression about how great a "teacher" experience is.

Yet in medicine we also are constantly encouraged to practice "evidence-based medicine" and not rely on experience in medical decision making.

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how to cure poverty

Think for a moment of poverty as a disease, thwarting growth and development, robbing children of the healthy, happy futures they might otherwise expect. In the exam room, we try to mitigate the pain and suffering that are its pernicious symptoms. But our patients' well-being depends on more, on public health measures and prevention that lift the darkness so all children can grow toward the light.

Those words were written by Dr. Perri Klass, in the NY Times Well Blog on May 13.

Do you believe them?

I do.

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drink lemonade, make miracles

It's getting hotter out there.


Summer is a great time for lemonade

Libby, one of our "miracle kids" is helping raise awareness of how hosting a Lemonade stand, and buying lemonade from such a stand can help your children's hospital--OUR Children's Hospital

Follow the links below for two short videos of our darling miracle child helping to make more miracles happen

Helping Carilion Clinic Children's Hospital keep YOUR miracle child Close To Home

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week of the nurse: one physician's tribute to all nurses


You make me look good,

.....and I forget your name

You comfort my patient and their family,

.....and go home late to YOUR family

You help my student do the right thing,

.....and I never say "thank you"

You remind me of my duty,

.....and I yell at you for overstepping your bounds

You spend much time saying "yes"

.....when you'd rather say "no"

You find a wrong order,

.....and you call to correct it before the patient is harmed

You stand at the bedside of a dying child,

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