My first–and hopefully, only–experience as a hospital patient occurred several years ago when I needed a minor surgical procedure performed. Although I would not want to repeat this experience, it was interesting to observe the delivery of medical care from the patient’s standpoint. It was pleasant to receive the attention and respect of the medical staff following my case. I also felt pampered by the ancillary services who did the cooking and cleaning. Regardless of how tempting it may have been to just move in, I was much more eager to leave.

The hospital can be a fairly inhospitable place. The most drug-resistant pathogens wander the halls. Noisy neighbors and their noisier visitors inevitably occupy every other room. Let us not forget the infiltrated IV lines that trigger endless alarms or the monotonous beeps of the telemetry monitors. There are the mass-production renal-cardiac-diabetic diets and bareback paper-thin cloths called “gowns”. As for the hospital odors that permeate throughout the premises? Unique. Then, there is the constant interruption by the army of medicine: phlebotomists, patient care assistants, nurses, nursing students, social workers, medical students, residents, fellows, and attending physicians.

Please don’t get me wrong. The goal of this post is not to lambaste the hospital system. As a cog in the American health care machine, I am endlessly devoted to the promotion and improvement of hospitals. I just continue to be amazed how some truly ill patients can endure their pain, discomfort, and the often unfriendly environment, yet exhibit enormous patience when I awaken them at some odd hour before dawn to do my pre-rounds. My hat goes off to them.

Note: I realize the image shows a building of the University of Michigan Health System. I have no affiliation with the institution and did not target them in this post. Any similarities between this post and a patient’s experience there may be more reflective of hospitals in general and not of the University of Michigan. I have no intention to denigrate any institution or anyone.

Dr. George Lundberg, a pathologist by training and Editor-in-Chief of Medscape General Medicine, presents an intriguing method for treating seborrheic keratosis. He terms the procedure “fingernail surgery”. Dr. Lundberg also provides a helpful hint on how to differentiate seborrheic keratosis from other skin lesions, such as cancer.

Please remember that information from the Internet, including this site, cannot replace the professional opinion of a licensed physician. Consult your medical doctor when you notice a questionable skin lesion, especially if it has irregular borders, non-homogenous appearance, or changed in any way.

Happy 2007! First of all, I wish everyone an enjoyable and rewarding new year. Although the transition from one year to another is essentially an artificial designation, it is accompanied by near-mystical fanfare. Celebrations include fireworks, music, and champagne galore. The new year also compels the general human psyche to reflect on the past and make resolutions for the future.

For many of my colleagues, work continues without skipping a beat. EMS still drives in the gunshot victim at 11:59 PM on New Year’s Eve. Two minutes later, a patient complains of sharp substernal chest pain that radiates to the shoulder. For admitted patients, hospital day 2 becomes hospital day 3.

As for myself, I was lucky to have gotten the day off. This gave me time to reflect on a myriad of thoughts, including the future of OnTheWards. The project is nearing its one-year anniversary, yet the amount of content here is only worthy for a month-old blog. I have not become the prolific blogger as I had originally hoped. Given my myriad of professional and personal responsibilities, I have also had to reassess whether this would be a worthwhile project to continue. And the verdict is … yes.

OnTheWards started as an experiment of sorts. It was my first entry into the blogging world. With some reflection on the past and inspiration from the future, I feel that it will continue to be a fun and educational endeavor for a long, long time. I look forward to sharing useful and interesting tidbits, while working to enrich this blog. Happy New Year!