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Confessions of an American clinical anatomist.
The American Association of Clinical Anatomists (AACA) is a diverse group that includes practicing clinicians, some of whom work outside the academic realm, and other clinicians and basic scientists whose primary responsibility is to patient care, publication, and teaching. This essay pointedly examines why our professional activities often do not lend themselves to the personal and professional realizations for promotion, tenure, and prestige enjoyed by most research-oriented colleagues. Thus the issue of how we can thrive as a distinct group of academic professionals warrants sincere dialogue. Most of the scholarship contributed over the past 2 years to Clinical Anatomy has come from investigators outside the AACA, and only 11% of the AACA membership have published in Clinical Anatomy during this time. A self-examination and analyses of the issues that may bear on these findings are discussed in the hope that they may prompt introspection and encourage development of individual and association strategies that promote increased membership support of the AACA and its journal.
Treating obese patients with poorly controlled diabetes: confessions of an insulin therapist.
How to treat the obese, poorly controlled patient with diabetes is a common and vexed question. Using insulin without giving thought to ameliorating the inevitable weight gain will cause desperation in the physician and despondency in the patient. Novel attempts at dietary manipulation before commencing insulin can be beneficial provided there is close scrutiny of short-term changes in weight and metabolic parameters. Combinations of insulin and metformin can also be helpful at an early stage. It may be helpful to use insulin as a therapeutic trial provided the goals of therapy are agreed with the patient at the outset. Above all it is important to avoid therapeutic nihilism - a minority of fat people may be jolly but few are truly happy.
Radial is not radical, but is it practical? Confession of a nonuser.
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Compliance and quality of life: confessions of a difficult patient.
Noncompliance has been treated as a deviant behavior. This paper argues that nonadherence is more complex and is the expression of independence and a judgment about the utility of any medical, surgical, or rehabilitation intervention. The quality of one's life is a personally defined concept and so too are the reasons why a patient refuses to do what is recommended. Appropriate health behavior should be thought of as a behavior that meets the person's goals and achieves some mutually definable outcome.
Lymph-vascular space invasion in endometrial adenocarcinoma: confusion, confessions, and conclusions.
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Call me Doctor? Confessions of a hospital philosopher.
Accustomed as many of us have become in the era of clinical bioethics to the idea of a "hospital philosopher", on reflection the historical novelty of the role is astonishing, as are its ambiguities. As a result of considering my own experience I found myself writing this miniature intellectual autobiography. In the course of this essay I raise two specific questions: what can the Western philosophical tradition contribute to the clinical setting; and (a question that is rarely asked), what are the implications of this experience for that tradition?
Unconscious reasons for husbands' confessions to their jealous wives.
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Confessions of a neobehaviorist.
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Psychology of false confessions.
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Confessions of a bioenergy advocate.
Feedstocks that deserve serious consideration for fuels and chemicals are sugarcane, corn, trees and algae. Commercialization of biomass refining is imminent but the wild claims of those who think that bioenergy can replace much of our dependence on foreign oil are appalling. It is naive to view biomass as the panacea for the coming energy crisis because there is not enough in practical locations and the costs involved in retrieving and refining it will be relatively high. The world will not run out of energy, but cheap energy might disappear, with its economics clouded by a myriad of subsidies for the competing energy sources and by world politics. This assessment of biomass supply and conversion technologies provides global perspectives and exposes some alternatives to be so impractical that they are almost fraudulent.
Psychological analysis of confession statements.
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The color of reflux: confessions of a skeptic.
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Confessions of a former nurse manager.
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Epidemiology on trial--confessions of an expert witness.
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Confessions of a condom lover.
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