A Very Modern Christmas

The hospital is dotted with Christmas trees: plastic green triangles, some tall and some small, in lobbies and resident rooms and offices. The lights twinkle, golden tinsel glitters, and little angels top the trees. And yet, every posted sign or printed document reads, “happy holidays!”. Easier that way, I suppose. Covers the lot.

Shopping in the neighborhood, I notice that rows of neat little Christmas trees, in shades of pale gray, are standing upright in oblong concrete planters lining the sidewalks. In summer, the planters hold flowers in every color imaginable. Now, in winter, the Christmas season, bright lights are strung around the oddly ethereal trees, shocking pink and blue and purple to contrast with the dove gray branches and silvery bows. From a distance, it looks like an 80s dance floor.

We will have our annual Christmas potluck lunch at work next Monday and food from every corner of the planet, seemingly, will grace the table. Freshly made hummus and pita, spicy fragrant curries and rice, baba ganoush sprinkled with pomegranate seeds, sesame noodles and eggrolls, home made Filipino Pancit, southern fried chicken, red beans and rice, pierogies, baked ham and chicken and salad and cookies and cakes. Well, that’s some of what we had last year I think. We’ll see about this year. The potluck menu rotates because, in a busy teaching hospital like ours, the staff rotates a lot too. It’s a very nice event and a chance to catch your breath during a busy work day, wish others well and a Merry Christmas, and remember just why it is that you chose to practice medicine. You wanted to help people and you wanted to do it in an environment that is warm and nurturing.

Smart Phones and Medicine

Teledermoscopy enables rapid transmission of dermoscopic images via e-mail or specific web-application and studies have demonstrated a high, 91%, concordance between face-to-face diagnosis and remote diagnosis of such images. Further to this, telediagnosis of melanocytic skin neoplasms achieved a diagnostic accuracy of 83% versus the conventional histopathologic diagnosis. Mobile teledermoscopy is the combination of such approaches enabling transfer of images captured with cellular phones coupled with a pocket dermatoscope and preliminary studies have demonstrated the feasibility and potential of its use in triage of pigmented lesions. Such applications are of benefit to physicians in enabling easy storage of data for follow-up or referral of images for expert second opinion and may facilitate a “person-centered health system” for patients with numerous moles and pigmented skin lesions who could forward images for evaluation.

Semin Cutan Med Surg. 2009 Sep;28(3):203-5. Mobile teledermoscopy–melanoma diagnosis by one click?

More data just means more data. Someone – or some thing – has to interpret all of the information generated by new technologies. Too bad we are creating a health care system with all the responsiveness of a snail on downers.

Model that we are creating: A federal bureaucrat commissions a study, to be vetted by a centralized board, to be further vetted by a state panel, to be implemented by a local health care provider, and zzzzzzzzzzzzzzzzzzzzzzz….

Model real-life Millenials will someday use for medical diagnostics: “There’s an app for that.”

I’m exaggerating for effect so don’t get too hung up on the potential accuracy of the prediction. You get the point.

Yell at me in the comments or whatever.