Surgical Diversions

A brief account of getting SSL working for IMAP, POP, and SMTP on a Leopard Server Mac mini after two frustrating days, resolved by following Panther-era instructions from Joel Rennich with only a minor workaround for the serial file.

A reposted tutorial covering Apache mod_rewrite, explaining how to transform messy dynamic URLs into clean, human-readable ones using basic redirects, regular expressions, trailing-slash rules, and match modifiers.

A short announcement that the blog has been migrated to WordPress, with MarsEdit configuration and hosting transfer still pending but the initial switch going smoothly.

A reaction to a UK government plan to ban the traditional white coat and restrict clothing to reduce hospital infections, arguing the policy lacks research support and that consistent hand-washing would produce far better results.

A doctor explains why the iPhone cannot yet replace his Treo 650 for on-call use due to insufficient alert volume, and offers a five-point wish list of notification improvements that would make it viable for medical professionals.

A cautionary case note on the dangers of using TPA in a trauma patient with a bullet wound crossing the liver, which led to three trips to the OR before Factor VII controlled the bleeding and the abdomen was finally closed about 36 hours later.

A walkthrough of using DisSpam with SpamAssassin in a cron job to filter POP3 spam before it reaches an iPhone, including a custom patch that checks headers against a hash file first to dramatically speed up processing of large mailboxes.

A follow-up citing a BBC report that Fidel Castro refused the colostomy procedure, confirming the prediction made in the original post about the root cause of his surgical complications.

A surgical analysis of Fidel Castro reported acute diverticulitis and multiple operations, arguing that skipping the standard Hartmann procedure in favor of immediate bowel reconnection was a critical error that caused all subsequent complications.

A brief note about using sed to inject verification meta tags into the head section of a freshly rendered HTML page, with a candid admission that sed is powerful but not quick to write.

A warm, brief birthday greeting to daughter Sophie, noting how fast she is growing up.

A California Superior Court ordered the Medical Board to grant the American Board of Cosmetic Surgery specialty board equivalency after it met all 19 regulatory requirements, a win that lets cosmetic surgeons advertise board certification and raises quest…

A recommendation for 1Passwd, a Mac app that leverages the system Keychain to manage web passwords with support for multiple logins per site and responsive developers.

The family has headed to the islands for the rest of the summer, leaving the author at home alone for about a month with a mix of longing and reassurance that they will have a wonderful time.

A short account of being accused of harming someone else Google ranking, requiring a moment of genuine reflection before concluding that no individual blogger has any influence over how Google ranks pages.

A pointer to a blog series demystifying the maze of medical coding and reimbursement for a general audience that has little understanding of how physicians actually get paid.

A quick birthday note to son Jonathan on his 11th birthday, with the real celebration deferred to the coming weekend.

A reaction to a BBC report about a surgeon held responsible for the death of a self-stabbing patient, arguing that removing a penetrating chest object is inherently risky and that personal responsibility should fall on the patient, not the surgeon.

A brief recap of a great snowboarding trip to Utah where the weather was beautiful, Jonathan did well on the board, and everyone returned home thoroughly sore.

A quick note about heading to Park City for a family snowboarding weekend organized by brother Alan, bringing all the siblings and their kids together at The Canyons resort.

A surgeon and independent contractor recounts a dispute with his former employer over ownership of a domain and website he built unpaid on his own initiative, revealing at the end that the former employer is his father.

Guy Kawasaki commencement speech highlights are shared as a top-ten countdown of life lessons, ranging from cherishing family and obeying absolutes to pursuing joy rather than mere happiness.

An announcement that the blog has been quietly switched from Radio UserLand to Squib, a Ruby on Rails replacement, with an invitation for tech-savvy Radio users frustrated with that platform to ask about the alternative.

A brief tribute to grandmother Ruth Fragen, who passed away at age 102 after years of unconsciousness following a stroke, remembered as a lawyer who never practiced and an accomplished violinist.

A short birthday note celebrating daughter Sophie turning five years old, with a reminder to eventually add a photo to the post.

VoodooPad, a desktop wiki application, is highlighted as a surprisingly capable CMS for static sites through its template-driven Web Export feature, while also mentioning involvement with Squib, an open-source Ruby on Rails replacement for Radio UserLand.

A candid pre-operative reflection on the uncertainty of relying on a nuclear medicine GI bleeding scan to guide surgery for an AVM, with fingers crossed that the bleeding stops before the operation is finished.

A brief heartfelt note celebrating 14 wonderful years of marriage and expressing that he would do it all over again without hesitation.

A first visit to the Apple Store at Fashion Island results in spending more than ten times the planned budget, prompting the rueful observation that it is probably a good thing there is not one nearby.

A recap of a breast cancer talk given to the American Society of Cosmetic Breast Surgery, covering three core points: refer cancer cases to specialists, investigate suspicious exam findings before any cosmetic procedure, and always obtain a screening mamm…

A short belated birthday message to Dave Winer on his 50th birthday, with thanks for the opportunity to beta test Pike years earlier.

Responding to Aggravated DocSurg, the author argues that the FDA advisory panel overstepped its mandate by restricting silicone implant sales to board-certified plastic surgeons only, since credentialing is a hospital responsibility, and predicts the FDA…

An FDA advisory panel voted 7-2 to recommend lifting the ban on Mentor silicone breast implants with strict conditions, including a board-certification requirement the author argues constitutes an unlawful restraint of trade given the varied specialties of

Responding to a surgeon colleague facing an unacceptable HMO contract, the post argues that relentlessly declining physician reimbursement will turn most doctors into salaried employees, threatening professional drive and innovation, and predicts a major…

A loving birthday message to son Jonathan on his 10th birthday, reflecting on how profoundly fatherhood has changed life for the better.

A JAMA study finding that a widely used CPOE system facilitated 22 types of medication error risks is highlighted, challenging the assumption that such systems reliably prevent errors, while the author notes he has been tapped as physician liaison for a C…

A thank-you recap of a snowy Park City ski trip hosted by brother Alan for his 40th birthday, highlighted by the kids thriving in ski school and a private chef who cooked nightly dinners for the group of seventeen.

Building on a GruntDoc post about consultant rudeness, the author argues that calling surgical consults purely to spread liability -- rather than for genuine clinical need -- is neither efficient nor conscientious medicine.

A brief enthusiastic endorsement of the newly released MarsEdit 1.0 blog editor from Ranchero Software, praising it for simply working like all of Brent Simmons software.

A Medscape article is highlighted that documents alarming surgeon shortage figures and argues that declining reimbursement, malpractice costs, and subspecialty migration threaten to strip general surgery of its professional identity.

A frustrating on-call experience illustrates why attending physicians must communicate their clinical concerns directly to surgical consultants before the consult visit.

A rhetorical challenge to the common assumption that bipartisanship means the majority must yield to the minority.

A note about neighbor John Kimberling and his book making the case that both major parties have failed Americans and that a new third party is needed, with a promise to share thoughts on the argument after reading it.

California voters approved a $3 billion bond measure for stem cell research despite the state deficit, prompting the argument that nationally beneficial medical research should be funded federally or through private money rather than state bonds.

A brief note on Barack Obama handily winning his Illinois Senate seat after his breakout keynote at the 2004 Democratic convention, with a prediction that this sharp politician is worth keeping an eye on.

Relief that the 2004 election is over, with a call to set aside anger and partisanship and a suggestion that those shocked by the results need to better understand and listen to rural America.

A reflection on a civil email debate with a friend about 2004 election issues, along with frustration at bloggers who parrot political talking points without independent thought.

A family visit to Mission San Juan Capistrano, prompted by a fourth-grade school project, proves well worth the trip, with a tip to arrive at opening time to beat the crowds and get better photos.

An experiment using an OS X Folder Action to automate blog upstreaming reveals it only fires on direct file additions or deletions in the watched folder, not in subfolders, making its practical value questionable.

Vacation is finally here, and the greatest anticipation is reuniting with a wife and kids who have been away for nearly five weeks.