If you grew up in the rural South like Doc Gurley, your childhood memories include such everyday events as peeling all the epithelium off both knees and elbows, stubbing the entire top off both big toes, and then sliding into so much dirt with said injuries that the injured skin looked like a new, high-tech version of an organic compost-graft. So what did my Southern Mama do when faced with this disaster? She hauled the budding young Doc into the bathroom, cranked up the tub-faucet to deafening Niagara levels, and held my wet, wiggling injured bits under the pounding water. Everyone’s mother did that. My mother learned it from her mother, and she was a Grandma that could pinch-hit in the child-wrestling department, if necessary, decades after she started putting a little “blue rinse” in her grey hair. Before the age of five, there was enough ceiling blood spatters and screams echoing off tiled walls in my childhood to merit an Emmy for the category of Best Horror Melodrama, Grandmother Starring.
Did it hurt that badly to have my scrapes washed? Well, nah, but why pass up the chance for some trauma-drama? More importantly, now, from the armchair sidelines of adulthood–was the fire-hose of water the right thing to do, medically speaking? We have so many options these days. What should you do when a loved one comes home with a bad case of road rash? Push up your sleeves and don your WWF gold belt, or head to the drugstore for a plastic bottle of hermetically sealed (expiration date unexpired) sterile saline?
Here we have some great practical news (Doc Gurley’s favorite kind) from the world of science. The fabulous people at the Cochrane Review (who spend their lives pouring over tiny numbers while wearing bifocals–imagine watchmakers with a numbers fetish) have compiled, compared, and contrasted all the research on whether it is safe to use drinkable tapwater to clean wounds, compared to uber-expensive sterile saline. The answer is… Continue reading Expensive Sterile Saline, or Tapwater? It’s a Wash!
 Ever feel like even your skin is exhausted? Like your feet are seeping tiredness into the floor? Well, there may be some truth to your sensations. BBC health news today reports on a Proceedings of the National Academy of Sciences (PNAS) article where researchers discovered that each cell of your body has its own [...]
 You’d almost think this article was a follow-up to a Doc Gurley post titled 10 Creative Ways To Get Your Doctor To Wash His Hands. Read the article if you want a review of the issue of doctors and handwashing (or lack thereof). Read the Doc Gurley November 16 post if you want a [...]
There’s only one way to feel about the sudden death of Heath Ledger–what a tragic loss of youth, life, and talent. While we may never know what actually happened, the story about his death raises some important opportunities to learn, and, hopefully, prevent future deaths like this. First point: the medicines that were found in his apartment are a very dangerous combination of pills that can all depress your urge to breathe. Some commentators seem to be downplaying this physiologic fact, even though we should all be aware of it for our own safety. In particular, Valium is the wild card pill–that’s one of the many reasons it’s not commonly prescribed in this country. Valium (or diazepam, its generic name), can last anywhere from 36 hours to several days in your bloodstream. Not only does it hang around forever in your blood (in drug years, that is), but it also, while it’s hanging around, blocks your body from breaking down and clearing out similar drugs–like the sleeping pills and Xanax that were reportedly in Mr. Ledger’s room. That means, if Valium is in your blood, you get much worse, whopping bad side effects from the other pills, even if you take a normal dose. So you could take a Valium on Friday, then pop two Xanax on Saturday, have a glass of wine with dinner, take two Ambien Saturday night, and, depending on your liver, not wake up Sunday morning. Yes, it can be as easy as that. The second tragic factor about what might have happened with Mr. Ledger is the report that, less than three hours before he was found dead, his housekeeper heard him “snoring.” Healthcare professionals across the nation have all probably given a sad shake of the head at that news. Here’s why: “Snoring” is often how non-medical people describe something that emergency room workers would recognize as early airway obstruction. When someone has their urge to breathe suppressed by drugs, it tends to happen is stages. One of the first signs that something is deeply wrong is that the person is unable to do something that we in medicine call “protecting your airway.” Protecting your airway is something that you do, even in your sleep. You have the subconscious urge to cough, to gag, to rustle around. But most of all, protecting your airway means you have the muscle tone in your throat and mouth to keep your breathing tubes open and air flowing freely. Could a trained healthcare provider hear the difference between snoring and early airway obstruction? Generally, yes. Not so much for a housekeeper. Here’s what we’re going to do for our Doc Gurley Health Ledger memorial. In honor of this fine actor, we’re going to review some tips on how to tell if someone is too far gone to protect their airway. So, for anyone who ever had to go home after a procedure with new pain meds, for anyone who worries that their buddy is waaaay too plastered and might not be breathing right, for anyone who just wants to know that the homeless person under the blanket is still breathing, here are some Doc Gurley practical tips on the difference between “snoring” and airway obstruction.
Continue reading Was Heath Ledger Snoring? Or Was It Something Worse?
 Dr. Judah Folkman died this week in Boston. News organizations used the occasion to report on his decades-long cancer research career. Given his status as a distant, non-celebrity, non-Nobel surgeon, you may be asking yourself why you, personally, should care about his death. Here’s why.
We were in our second year of medical school, feeling the growing pressure of clinical years just around the corner, when we would be thrown into the hospital system. For now, we had lectures in a large hall with 130 students sitting in chairs that sloped down to a stage. Professors came with presentations and handouts and complex diagrams. The immunology lectures were continuous strings of letters and numbers, with only the occasional verb, impossible to decode as human speech without months of training. Every tissue, every disease, every human physiologic function was discussed, down to the sub-molecular level. After hours of these lectures, the air would get stale and backs would ache and the squeak of weight shifting in chairs would become a metronomic beat marking out time that seemed to pass endlessly.
Then, one day, Dr. Folkman walked on stage. He asked us to put down our pens. He said he was going to teach us something that no one else would ever discuss, much less teach. Continue reading How To Break Bad News
 The Doc Gurley post on using a mood-altering computer game is included in this week’s grand rounds of medical blogs. This week’s host, Alvaro Fernandez, of www.sharpbrains.com did an awe-inspiring job of reviewing 40 sites. He lists each with a fun, catchy one-sentence summary. Talk about setting the bar high! If you’re looking for [...]
Typically, health news is a litany of faux fears. You know what I mean, alarmist stuff that makes it seem like an act of insurance-revoking foolhardiness merely to leave the house without a respirator, a bottle of thermonuclear disinf ectant, and a NASA-approved re-entry pod. In a surprising twist, here is a truly alarming bit of bad news that seems to have been, in contrast, glossed over by the press. Researchers in San Francisco have discovered that multi-drug resistant Staphylococcus Aureus infections, also known as MRSA, are transmitted sexually. All I can say is, OMG. First tip-off that this is truly bad news–MRSA is also known as the “superbug.” You’ve probably heard of it because recent estimated numbers of deaths from this germ are greater than those from AIDS. Outbreaks have also made the news, one of which killed a healthy young athlete on the East Coast. So how and why was this new “superbug” information glossed over? Continue reading Yeowza! Important Bad News!
For all you loyal Doc Gurley website visitors (yes, all two of you), you may be thinking this is another article about Dave Barry. But nooo. Just to prove how fickle my fantasy stalker-affections are, I’m outing myself right here, right now, on international Internet, as being obsessed yet again–only this time with a face. Who is this person? I have no  clue. What does he do? I have no idea. When it comes to his opinions, politics, or personality, I got nothing. He’s frozen in time, with one two-dimensional expression on his face. For all I know, one second after the camera clicked, he drooled. None of that diminishes my affections. So how did I even find him? By sacrificing myself to the greater good. On behalf of my readers, I went online to investigate a scientifically-supported positive mood-enhancer that was designed based on neuro-psych research. I (gulp–this is hard for someone over 40 to admit)…I played a computer game. Yes, I’m exposing my innermost, tenderest feelings of vulnerable obsession to all of you as a warning. Unless you want to be an object of teenage mockery (but then again, what mom isn’t?), beware. Here’s the cautionary tale: Continue reading Okay, I’m Obsessed
We here at Doc Gurley know what question keeps you up at night, fretting and pondering–can you, with minimal effort, and no side effects, have a better stool? Can you, by doing so, even avoid disease? Well, boys and girls, the answer in the health news this week is a resounding no s#*t. You [...]
If so, check out the audio version of the Doc Gurley New Year’s Resolution article. You can go to your own, personal, leather-seated, ladder-racked, mahogany-paneled library of Doc Gurley podcasts on U.K.’s Global Local Radio just by clicking http://www.canstream.co.uk/copperbeech/index.php?cat=DocGurley. Bookmark the site, let your family and friends know where it is (in case you [...]
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About The Author  Doc Gurley is a Board-certified Internist physician and the only Harvard Medical School graduate to have been awarded a Shoney’s Ten-Step Pin for documented excellence in waitressing. Find out more.Doc Gurley Library of Medeos
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