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Five Deadly Sins

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I roasted coffee for many years. Kaladi Bros Coffee, in Denver Colorado was a job that was much more than a job, in many ways. Since the day I started working at KBC, in August of 2003, I have been a daily coffee drinker. Perhaps the number of days without coffee, or, at least caffeine of some kind can be counted on one hand. Out of all the vices available for perusement in the world, coffee drinking, if even a vice, would the one I would least want to be rid of. These days there are not many other vices I have either the time nor the capacity to indulge in. In the hospital, the consequence of a given vice are glaringly apparent. This is less a discussion of the psychology and pathology of how a person is given to a certain vice, but a frank examination of the disease processes that I deal with as a direct consequence of the small, but powerful list below. Gluttony Definitely the most widely engaged in deadly sin, and usually the one with the most hard to hide consequences.

I See You? Si Si You! Knee Cue? Pack You!

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A resident physician's life is broken up into four week chunk. And just like this post, residency seems like it could go on forever. These four weeks find me in the ICU. My fourth year of medical school was spent thinking I wanted to be an intensivist; a fancy term for the doctor who runs the ICU. I was keen on going through an internal medicine residency then match into a critical care fellowship. Many intensivists make their way via a pulmonary-critical care residency. In the ICU, I am reminded why I was so intrigued by critical care medicine. I am also reminded why I am not planning on a career that involves the ICU. Rare is the Family Medicine doc who would manage a patient in the ICU, these days, anyway. It important to see and gain experience managing diseases at all points in the spectrum.  Managing a patient at the beginning of their liver failure journey patient takes on a different urgency once seeing what the ending looks like.  Cancer. Renal failure.

From Mastication to Defecation: The True Story of One Kernel of Corns Rebellion

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Turned 40 a few weeks ago. Over a month ago, I guess. I mean, basically I may as well be 50. At that point retirement is looming. Golden years.  Do you know many 40 year olds who still have two grandparents around? Well, I do. Both of my maternal grandparents are alive, but this past week almost saw that number halved.  My grandmother had another small bowel obstruction, and from what I've heard from my Mother, there was a suspicion of volvulus -- a twisting of the bowel on its axis. Imagine a tootsie roll, how the ends are twisted, it's like this. You may think, well, big deal, so what if the guts twist around? The blood supply is cut off when this happens. When blood supply is cut off, death is close behind. Gett'n ahead of ourselves, though.  This, the sixth edition of Doctor, Doctor, Give Me The News will address something near and dear to my heart, and that is small bowel obstruction (SBO.)  We'll use this for a jumping off point to discuss how to manage