Grand Rounds Vol. 4 No. 21: The Valentine’s Day Edition

Happy Valentine’s Day (almost), and welcome to Grand Rounds, "the weekly rotating carnival of the best of the medical blogosphere," hosted improbably this week by — horrors! — a health care lawyer and consultant.  I’ve organized this edition around themes related to Valentine’s Day, which is coming up real soon, on February 14.  (Last call for those of you who still haven’t figured out what you’re doing for that special someone.)  If this is your first visit to HealthBlawg, I hope you’ll stick around and read a few posts beyond today’s edition of Grand Rounds, and maybe even come back now and again.

Thanks to all of the medbloggers out there who submitted posts that stuck with the previously-announced categories.  High honors go to two bloggers for going above and beyond (details below).

Chaucer: for the birds

For our initial orientation to the themes of the day, we turn to the New Advent Catholic Encyclopedia:

The popular customs associated with Saint Valentine’s Day undoubtedly had their origin in a conventional belief generally received in England and France during the Middle Ages, that on 14 February, i.e. half way through the second month of the year, the birds began to pair. Thus in Chaucer’s Parliament of Foules we read:

    For this was sent on Seynt Valentyne’s day
    Whan every foul cometh ther to choose his mate.

For this reason the day was looked upon as specially consecrated to lovers and as a proper occasion for writing love letters and sending lovers’ tokens.

So let’s begin with posts touching on birds and love.

A couple of lovebirds dealing with each other’s illnesses is the topic of Barbara Kivowitz’s post at In Sickness and In Health; hers is chronic, his is a new cardiovascular issue.  An interesting look at the sick role, the caregiver role, and changing roles in a long-term relationship.

How often do you see "folie a deux" and "Q-Tip" in the same post?  Tip of the hat to Liana at Med Valley High for this tale of two strange birds.  (Would someone kindly page Oliver Sacks?)

Ken Cohn, blogging newbie at the Healthcare Collaboration Blog loves the collaborative feedback he gets from his teenage daughter.

Dr. Anonymous is blogging about "the love hormone" and will have a Valentine’s Day edition of his BlogTalkRadio show — which Dr. Val tells us will be an "estrofest" featuring several women medbloggers.

We’re not supposed to throw rice at weddings anymore — to save the birds, you know — but this week Christine Miserandino at But You Don’t Look Sick tells us love can be a rice ball.

Matters of the heart

Since the heart was long thought to be the seat of emotion, and Valentine’s Day is associated with matters of the heart, this segment of Grand Rounds is open season on anything cardiovascular.

Let’s begin with volunteer ED chaplain Susan Palwick’s poem inspired by watching a patient having an echocardiogram, at her Rickety Contrivances of Doing Good.

The Blog That Ate Manhattan highlights a long-overdue fix to the risk disclosures regarding blood clots accompanying the contraceptive patch.  High honors go to the blogmistress of TBTAM, for tendering her URL on the back of twenty-dollar bill, as requested.  Demerit points awarded, however, for making that merely a JPEG of the back of a double-sawback, and not the genuine article. 

David Williams introduces us to iCardiac Technologies at his Health Business Blog.  Among other things, this company is working on personalized medicine, so that drugs with risks for some can be marketed to others, rather than being kept off the market.

Speaking of drugs and risks, see Vreni Gurd’s post on cholesterol, heart-disease mortality, and cholesterol-lowering drugs at Wellness Tips.

Two of my personal favorite approaches to ensuring cardiovascular health have gotten a ringing endorsement from Danish researchers: drinking (in moderation, of course) and exercising.  Clinical Cases and Images points to the study (as does Time magazine).  My poisons of choice: red wine, single-malt scotch and bicycling.  (For more on the latter, see my posts on biking in the Pan-Mass Challenge, and consider sponsoring me this year.  The poison of choice for many of my fellow-riders seems to be beer; for the carbs, they say.)

And don’t forget this little tip from the NY Times: in case you were wondering, using a stunt double for video of cardiovascular workouts just doesn’t cut it (especially if your name is Jarvik and you’re selling Lipitor).

Maybe it was the roses . . . .

Now if we look back a little further through the mists of time, we’ll find that there may have been three different saints named Valentine, but they had to buddy up on one saint’s day.  Trusty Wikipedia tells us:

The saint’s feast day was removed from the Church calendar in 1969 as part of a broader effort to remove saints viewed by some as being of purely legendary origin. . . .  Prior to the creation of the new calendar, the church in Rome that had been dedicated to him observed his feast day by, among other things, displaying his reputed skull surrounded by roses.

Could our saint be the ur-Deadhead?  I don’t know . . . .  In any event, we now turn to posts of skulls and roses.

Hard at work in those skulls are all sorts of stresses, and the amazing neurochemical coping mechanisms our species has evolved.  Thanks to Gregory Kellett at SharpBrains for laying them all out for us.

In the numbskull category, we have Amy Tenderich’s explication of the  ACCORD study results — and the inability of the mainstream media to get it right — over at Diabetes Mine.  (Amy was kinder, labeling the post cardiovascular.)  For a more personal reaction to the ACCORD news, see Rachel Baumgartel’s Tales of My Thirties.

Reading "skull" broadly as an invitation to jump into orthopedics, Hank Stern at Insureblog gives us his brother-in-law the orthopedic surgeon explaining the advantages of anterior hip replacement surgery.

Speaking of orthopedic surgery, Bongi shares a tale of a leg amputation and a (relatively brief) discussion of same with a student rugby player visiting the OR, at Other Things Amanzi.  He titled this post Callous.

For a post on Rose, we turn to Running a Hospital and Paul Levy’s appreciation of a long-term volunteer named Rose, and ruminations on the folks each of us looks to as a moral compass. 

Lupercalia

Peering even further back to an earlier age, we see that Valentine’s Day is one of those Church festivals intended to replace an earlier pagan festival. (Religious groups through the ages have tried to claim sacred space and time from other religious groups, sometimes more peacefully than others).  Lupercalia was a pagan festival honoring the she-wolf that suckled Romulus and Remus, mythic founders of Rome.  The main event involved Luperci, or "the brothers of the wolf," clad only in goatskins, sacrificing goats and a dog, smearing blood on foreheads and running about whipping girls and young women with goatskin thongs to ensure their fertility.

Thanks to the Luperci, we can now delve into recent posts touching upon goats, wolves, dermatology, hematology and fertility.

Our own modern-day rituals concerning courtship and marriage would probably seem as odd to the pagans as theirs do to us.  Kerri Morrone shares her tale of a bridal gown fitting with a twist at Six Until Me.

The goat-biotech connection is such old news that nobody submitted any current posts on the subject.

In the fertility sphere, How I Spent My Nursing Education shares a little more than we really needed to know about PMDD, or "über-PMS."

On the dermatology front: First, here’s the lowdown on rituximab and eczema, courtesy of Allergy Notes.  Second, A Sterile Eye tells us of a case of photodynamic therapy for skin cancer that makes a grown man writhe.

On hematology and, well, the skull again:  At the intersection of the base of the skull and the circulatory system, it’s time for another look at chiropractic and cervical artery dissection.  Walter at Highlight HEALTH lets us know that the latest study says it’s really not a problem, though folks with other risk factors for dissection should probably avoid chiropractic.  (On a personal note: I’m entirely open to complementary therapies, including chiropractic and acupuncture, both of which have worked for me.)

Anyone who’s tracked animals can tell you about scat.  Beth at PixelRN shares her own scatological obsession — an occupational hazard, one might say.  (I indulged my younger son’s interest in that department last weekend, as we mucked goat stalls at a local model farm.  If that ain’t love . . . .)

JC Jones ruminates on Heath Ledger’s untimely demise at Healthline Connects, and introduces us to a couple of "wolves in white coats," MDs peddling scrips for controlled substances.  Doc Gurley comments on a new study and poses the question: Artificial Sweeteners–A Wolf In Goat’s Clothing?  (I kid you not.)

My brother at the bar, Bob Coffield, provides the latest installment in the Paris, Texas anonymous blogger case at his Health Care Law Blog.  Is the blogger a wolf in sheep’s clothing? A sheep in wolf’s clothing?  This round, the First Amendment keeps the blogger’s identity cloaked.

Straying away from the vulpine: One day, the phrase "kill the skunk" will be synonymous with "do the right thing," and you’ll be able to say you remember the day you read Sam Solomon’s seminal medical ethics skunk post at Canadian Medicine.

And finally, here’s Jolie Bookspan’s unusual Valentine’s Day tip.  Forget dancing with wolves; The Fitness Fixer says: do push-ups with a friend.

It’s a wrap!

High honors go to Nancy Brown, for working a mention of every one of today’s themes into her book review of Can’t Buy My Love: How Advertising Changes the Way We Think and Feel at Teen Health 411.

Parting is such sweet sorrow . . . .

Well, even if the immortal bard didn’t have us in mind while penning those words, we’ve come to the end of another edition of Grand Rounds.  Thanks for visiting HealthBlawg, and I look forward to having you drop by now and then. (You can leave the goatskin home, though.)  Thanks to Nick Genes and thanks again to all the medbloggers who contributed. 

Next week’s Grand Rounds will be hosted at DailyInterview.  See you there.

— David Harlow