Enclothed Cognition

    • Guest Blog: It's a Man's, Man's World

      My pants fell down today. I was listening to the lungs of a patient, and she had a toddler, about waist high, who tugged on the drawstring of my scrub pants to tell me something. They puddled on the floor, leaving me to examine my patient in my pink polka-dot panties. How professional. Nobody wants to be caught with their pants down. Particularly not in an audition rotation where you are trying to prove competence and professionalism to possible future colleagues. Given that I look young to begin with, a look exacerbated by no makeup and a daily ponytail, I try to make sure that I give a professional presentation in both a tailored dress and manner. Pink polka-dots were not the look I was going for. I dropped my stethescope and snatched up my pants, silently cursing the bastard that invented "unisex" scrubs. They are the suggested uniform of the wards, and required to enter any surgical procedure. They are an ugly green two-piece set freely dispensed from the ScrubX machine in the hall. They say "unisex" but are clearly designed by a man for a man. First of all, no woman would pick that atomic booger color. Secondly, they don't fit. I have the option of scanning my badge and pressing "10" for a size small uniform, and "12" for a medium. I can press "10" and get pants that are huge on the waist, yet hug my hips so tight that it brings the rise and hem of the pants four inches above my socks. I can press "10" and recieve a shirt that is so big that when I bend over, you can see my belly button through the v-neck. Or, I can press "12" and get a pair of pants that easily slides over my hips but has twenty extra inches around the drawstring waist and a rise halfway down to my knees. You can see my toes through the v-neck in that shirt. Usually I opt for the "12" since I don't like things tight on my hips nor unintended capri pants, but this choice leaves me vulnerable to rogue toddler pantsings. Men do not have these problems. They walk around confident, broad-shouldered and tall, scrubs draped gently over their physician physiques. They look like doctors, not girls wearing their father's scrubs. I do have some Medelita scrubs that fit me. I spent about $100 a pair, and they were worth it. Designed for a female doctor, they look like clinician scrubs, not nursing scrubs, and fit every curve and height. I look like a well-polished version of myself; the tailored female equivalent to the uniforms my male colleagues wear so easily and for free. But I can't wear them in outside of ambulatory care. Any procedure requires a hospital-issued uniform where its sterility can be verified. With almost half of new doctors being female, this "unisex" policy is dysfunctional for nearly a majority of physicians. In ob/gyn, there were only 7% female physicians in 1970; today females make up 80% of incoming obstetricians. Yet most women look like I do, uncomfortably sandwiched or swimming in an ill-fitting professional uniform. Medicine is still a man's world. Scrubs designed for a man's form are issued to women. I've sat in many doctors lounges filled with only males, making women driver/shopper/insert your stereotype here jokes over lunch, seemingly oblivious to the fact that I was there. Ugly, fat men that I have done hernia assessments on pull down the underwear and tell me to be careful, don't get turned on during your exam down there. Surgical instruments fit in a man's hand, not my small fingers. If a toddler pulled on a man's drawstring, their pants would stay up. Aside from offensive jokes and patients with too much self-esteem, I genuinely think that our male counterparts are oblivious to the day-to-day difficulties that face a female physician. I'm sure they don't think how uncomfortable it is for pants to pull around your widest part all day, or for a male patient to leer down a gaping top. The tide of medicine is still changing; since older physicians are still in practice, females make up only 30% of doctors despite nearly equivalent numbers of males to females in medical school. And perhaps some of these challenges will change when the gender of the work force evens out. In the meantime, I think of James Brown's 1966 song... This is a man's world This is a man's world But it wouldn't be nothing, nothing Without a woman or a girl Dr. Anne KennardMedelita Guest Blogger: Dr. Anne Kennard. Anne is an OB/GYN resident in Phoenix. She has kept a collection of writings about medicine/becoming a doctor since her second year of medical school, and we're honored to welcome her as a guest blogger for Medelita.
    • From the Battlefield to Bellevue: The Origin of the Ambulance

      Imagine being a wounded soldier on a battlefield. Through the pain you watch as the war continues around you - comrades fall, gunfire plays an incessant and deafening melody, and the ground seeps a chill through your skin. Prior to the 19th century, you would have had a long wait before help arrived. The wounded were not collected until the battle was over, and millions of casualties occurred simply because the wounded were left too long without medical care. Luckily in the modern world, our brave soldiers are moved quickly to medical stations, but it was not until 1792 that emergency ambulances were developed to transport the wounded during battle. As Napolean Bonaparte's chief physician, Dominique-Jean Larrey noticed the speed with which soldiers moved the wheeled artillery and applied the concept to the development of the "flying ambulance." Larrey's ambulance was a lightweight horse-drawn wagon that collected the wounded during battle and delivered them to tents or field hospitals. The new ambulance system not only increased soldier survival, but also boosted morale. Continuing a trend of military to civilian development in the medical industry, the ambulance was introduced to American civilians in 1869 by a US army surgeon, Edward Dalton. Dalton founded an ambulance service in Bellevue, Washington, and medicine throughout the public sector was forever changed.
    • Are Your Titles Listed Correctly?

      Every day we proudly add exquisite finishing touches to our lab coats and scrubs in the form of name & title embroidery. We've noticed over the years that the order in which degrees are listed often changes from one person to the next, and in my ever-curious quest for knowledge I recently wondered, "Is there an official system for determining the order of degrees in a title?" The answer isn't simple. I can neither say yes nor no, because it seems to be based largely upon opinion. In an effort to shed some light on the subject, let's go over some of the unofficial rules regarding post-nominal titles. Opinion #1: Chronological Order According to the Gregg Reference Manual, 10th edition, post-nominal titles should be listed in the order in which they were awarded. Honorary degrees should follow earned degrees, and when both academic degrees and professional designations follow a person's name, the academic degrees should be listed first. Opinion #2: Order of Importance - Highest to Lowest More than one source stated that degrees should be listed in order of general importance, i.e. Sam Brown, Ph.D., MS, RN, FAAN. However, this way seems very contextual - the importance of a degree being based upon the current work of the professional. For instance, if a medical doctor is writing a book about history, a subject for which he also has a Ph.D, he ought to list the relevant Ph.D. first. Similarly, if a medical doctor is working as a pharmacist, then the MPH should be listed before M.D. Opinion #3: Order of Credentials - Lowest to Highest On the opposite end of the scale, the University of Oxford states that degrees should be listed in ascending order from the degree with the lowest credentials to the degree with the highest. I should note as well that academic degrees outrank professional degrees. In the end, the rules on this subject are a matter of opinion and personal preference. What's your opinion? How do you list your post-nominal titles and why?
    • Under Age Tanning: California Takes a Stand

      I went to a tanning salon once . . . only once. I was about 16, and my mother had convinced me to go with her. I have the sort of English skin that burns within seconds - as though the sun and I are simply sworn enemies. My mother (who somehow doesn't burn even when she covers herself in oil) thought I was too pale, and so we headed to the tanning salon. At the salon, I declined the option of donning a heart-shaped sticker (for a heart-shaped tan line), and I stepped into the impossibly small circular box and closed the door. Naked and surrounded by lights, I read the instructions - hold the strap above my head . . . don't touch the lights less than an inch away on all sides . . . stand in the most uncomfortable position possible. Regretting the decision already, I pushed the button and an industrial fan assaulted me with a hurricane of air while I essentially microwaved myself with lights capable of both blinding and burning me. I never went back, but millions of teenagers today are practically addicted to tanning. California teenagers, however, are now going to have to spend more time outside, on our beautiful beaches, if they want to maintain their tan. As of January 1st of this year, minors cannot legally use tanning beds in the State of California. While 31 other states have tanning restrictions for minors, California is the first state to completely ban the use of tanning beds for anyone under the age of 18. According to the American Academy of Pediatrics, “the incidence of melanoma is on the rise”, increasing by 3% a year. Caucasian women aged 15 - 39 are the most affected demographic, and melanoma is the second most common cancer of women in their 20s. The American Academy of Pediatrics, the World Health Organization, the American Medical Association, and the American Academy of Dermatology all condemn the use of artificial tanning devices for minors. Could California be the first of many states to follow? What are your thoughts?
    • Medelita® Announced as Winner of 2012 Univator Award for Product Innovation

      I'm proud to announce that we were recently honored by Uniform Market with the 2012 Univator Awards for Product Innovation. As Uniform Market News states, the Univator Awards recognize innovation within the uniform industry and serve as a reminder that, even in times of economic upheaval, companies both large and small can still improve. We were awarded this honor in recognition of our line of dental-specific lab coats. The newly developed line of gender-specific dental lab coats - featuring the Elsie G. and Lucy H.T. lab coats for women and the Fauchard lab coat for men - offer snap closure to the neck and knit cuff sleeves, consistent with OSHA recommendations. In addition, our dental coats are ergonomically designed to accommodate motion from a seated, arms extended position, a requirement of dental professionals. As with all Medelita lab coats, the lightweight, 100% pre-shrunk cotton fabric of the dental coats resists wrinkling and is distinctly more breathable and comfortable than polyester blend fabrics. Certified performance fabric by DuPont repels fluid, soil and stains - including blood and the impression material used extensively within the dental industry - maintaining a bright white lab coat that signifies prestige and professionalism. Our dental coats are the direct result of feedback from colleagues like you. We're so grateful for your support, and as a company, we're actively committed to involving our customers as we grow, maintaining a consumer-centric approach to both customer service and product development.
    • Children and iPads: An Apple a Day?

      I remember a world before the internet and mobile tablets. I remember the age of pagers and typewriters. I remember the AOL dialup tones and the extraordinary phone bills . . . and, no, I'm not that old - though anyone too young to remember life before the digital revolution of the 90s might disagree.

      There's currently an E-Trade ad on TV featuring a talking baby with a Smartphone. It makes me laugh every time I see it, but today, it does almost seem as though children are born with an innate understanding of technology. An annual survey from Parenting Group, the publisher of Parenting, Babytalk and Parenting.com and the BlogHer network, found that 25% of toddlers have used a Smartphone by age 2. I read an article recently about an 11-year-old boy who developed a successful iPhone/iPad app called iSketch. The boy, Cameron Cohen, donated $20,000 of the proceeds to the Chase Child Life program at Mattel Children’s Hospital UCLA.

      There is a plethora of mobile apps for children, from teaching apps to apps that assist Autism. When there are such examples of children doing and learning amazing things with Smartphone and tablets, it's easy to overlook an important question: Is it safe for young children to use iPhones and iPads?

      The American Academy of Pediatrics (AAP) has advised parents to limit screen time for toddlers and babies, most recently suggesting that kids younger than 2 avoid televisions altogether. The AAP notes that children do best when interacting with other humans. However, the AAP’s new policy doesn’t address iPhones or iPads.

      According to a NPR interview with Dr. Ari Brown, the lead author of the AAP’s revised guidelines on toddlers and TV, “There might be a real educational use for those items on these screens,” she says. “We just don’t have any data to say one way or the other.”

      What's your opinion? Are we helping or hindering the development of our next generation?

    • Theodor Billroth: A Surgeon by Profession, A Musician by Passion

      Theodor Billroth, the Father of Modern Abdominal Surgery, never planned to be a doctor. As a matter of fact, his passion was music, and he was deemed to be a poor student who lacked the ability to focus on anything else. However, at the wishes of his mother and the prodding of his friends, Theodor Billroth entered medical school . . . and went on to prove that one need not abandon their dreams to be successful. Life in the Medical Field Theodor Billroth was born on April 26, 1829 in Prussia. His father died when he was five, leaving his family no other choice but to move to his grandparents’ house in Greifswald, Germany. He began his medical education here and later enrolled in the University of Gottingen and University of Berlin. After receiving his doctorate degree in medicine in 1852, Theodor Billroth went to work briefly in the clinic of the famous ophthalmologist, Albrecht von Graefe. Then, following a failed attempt to start his own practice in Vienna, Theodor returned to the University of Berlin, where he studied pathological anatomy, lectured, and demonstrated surgical techniques for several years. It was here in Berlin that he met and fell in love with his wife, Christine. Their marriage brought them five children, four daughters and a son. In 1860, Billroth transferred to Zurich, where he introduced the concept of audits - reporting both good and bad results in order to foster frank discussion of surgical techniques. Seven years later, he was appointed professor of surgery at the University of Vienna. During his tenure in Vienna, Theodore Billroth performed several landmark surgeries, including the first esophagectomy in 1871 and the first laryngectomy in 1873. He is most famous, however, for performing the first successful gastrectomy for gastric cancer in 1881. His success came after many failed attempts, and in what I consider a rather serious job hazard, Billroth was allegedly nearly stoned to death in the streets of Vienna when his first gastrectomy patient died. Life with Music Though Billroth became a renowned surgeon, his love for music never waned. During his prime, Theodor Billroth became the good friend and confidante of the famous composer Johannes Brahms. The well-known composer even asked Billroth to review a few of his works and dedicated two of his string quartets to him. Though he had played the piano as a child, Billroth had a passion for string instruments and took up the viola in his adult years. He played in a popular string quartet for a long while, spent late nights in the city while enjoying the company of Brahms and other musicians, became a guest conductor at the Zurich symphony orchestra twice , and wrote a book entitled, “Wer ist musikalisch?” (What does it mean to be musical?), which was an organized approach on how music can relate to man’s physiological and psychological nature. Indeed, Billroth was a man with many talents. In our sleep-deprived world filled with rushed coffee breaks and overdue paperwork, balancing work and play can often seem like an impossible task. Yet Theodor Billroth found the time to become a legendary surgeon AND a respected musician - an inspiring example of living life to the fullest.
    • Guest Blog: Porcupines on a Plane

      As a veterinarian, I like to share my crazy animal stories. This one does not involve me directly, but my husband Max, and our friends, Drs. J and V, fellow veterinarians. J. owns a single engine 6 seater Cessna, and we enjoyed many fun flights together a few years ago, when we lived in Nevada. J and his wife V are not your average veterinarians. They spend their free time running a non-profit educational zoo, where they emphasize hands-on experience for the visitors. They started by getting a few kangaroos years ago, and now take care of about 160 animals! One may wonder how they managed to get all these exotic animals to Nevada. Well, this story is an example of how far one has to go to get a new pet... J offers us to join him on his next flight to go get new "residents" for the zoo. Two porcupines are waiting in South Dakota, about 1000 miles away. How exciting! After a week of bad weather, take off is finally scheduled for Saturday morning. Unfortunately, I cannot go since I have to work that day. On the big day, my husband wakes me up at 1am to kiss me good-bye. Thanks. I have to be at work very early and I cannot fall back asleep, I am too excited for them! All morning I keep checking the weather for their route, between a dog vaccination and a cat spay. Finally, I get a voicemail “We just landed. We have the Joey, we are waiting for the porcupines”. In a different context this could be a code for a secret trade, but in the veterinarian world it just means that they are ready to exchange animals. J's friends who have the porcupines also raise “Roos”. During the flight there, J had warned Max that they might have to go and catch the porcupines themselves. I can only imagine my husband’s face, thinking, “I didn’t sign up for that”. But a good cross-country flight is worth a porcupine hunt. Thankfully, when J's friends arrive with the precious cargo, the pets are in cages, and there is no need to chase them! Everything is going to be fine after all. They will be back in the air soon, and back in Nevada in about 5 hours. Perfect. Until they look at the metal cages a little closer. The porcupines are in two large carriers. More importantly, there are several layers of zip-ties and wires securing the carriers… “Oh, yeah, they are kind of aggressive right now, and I don’t want you guys to crash because of these little fellows", says J's friend. “Great, I didn’t sign up for that either", thinks Max. Pilots and pets all made it back safely to Nevada, but it was a trip worth remembering! Medelita Guest Blogger: Julie Pearson, DVM. Julie is currently working on the East Coast as a small animal veterinarian. She was born and raised in France, where she got her degree before getting licensed in the USA. She enjoys being a general practitioner, and feels privileged to be there for her patients, whether it is for a wellness visit or a serious medical issue. Julie has been wearing Medelita since August 2010, and is seen here wearing her scrubs.
    • Mercury Rising: The Origin of the Thermometer

      Do you know how long this thin, fragile rod has been around? And why there are so many different temperature scales? Whether used to determine a fever or to help decide whether to wear a coat or a tank top, nearly everyone is familiar with thermometers . . . but are you familiar with its origins? Early History The word thermometer comes from the Greek words thermos ("warm") and meter ("to measure"). The Greeks, brilliant and curious as they were, invented the earliest temperature-measuring gizmos around the first century B.C. The first thermometer was a simple device consisting of a tube filled with air and water. As the air grew heated, it would expand and cause the water to rise. There was no system of measurement applied to these crude devices, and they were used primarily to observe changes in temperature. Thermoscopes In 1592, Galileo Galilei improved upon the Greek creation and invented the 'Thermoscope' - a bulb with a long thin neck, upturned over a container of water. When the bottle was heated, the air expanded to push the water level in the neck down. When the bottle was cool, the water rose. Galileo also later invented the 'Galileo Thermometer' - a large glass cylinder containing several bulbs of varying density. As the temperature of the water inside the cylinder increased, the density decreased, changing the buoyancy of the inner bulbs. The lowest bulb would then indicate the temperature. In the early 17th century, an Italian physician, Santorio Santorio was the first to add a scale to a thermoscope, in order to quantify changes in temperature. Designed to be placed in a patient's mouth, Santorio's invention is considered the first clinical thermometer. The Fahrenheit Scale Though many people created versions of the thermometer, each with unique scales, only a few were able to survive the test of time. German physicist, Daniel Gabriel Fahrenheit, was the first to use mercury in a thermometer. Daniel Fahrenheit became well-known during the early 18th century for the accuracy and quality of his scale, which used 96 F, "blood heat" (In 1835, it was discovered that blood heat was actually 98.6°F) and 32 F, the melting point of ice, as its two fixed calibration points. The Celsius Scale Scientists and inventors, aware that the Celsius thermometer was influenced by atmospheric pressure, looked for ways to trounce its effects. In 1742, Andres Celsius, a Swedish astronomer, created the centigrade scale which used the temperatures measured when the thermometer bulb was dipped in melting snow (100 C) and when it was immersed in boiling water (0 C) as its fixed calibration points. By the end of the 20th century, the Celsius scale had replaced the Fahrenheit scale throughout most of the world.
    • 3 Brazened Quacks

      Without a doubt, the history of medicine is a dignified one, with a fundamental goal to alleviate human suffering and prolong human life. But it is not without a share of con artists, charlatans and incompetents, whose greatest malevolence was to cast doubts on the real advantages of proven medicine in the minds of unknowing people. Quackery is a derogative term used to express the promotion of fraudulent or unproven medical practices, and a “quack” is a fraud who publicly or professionally pretends that he has the medical skills, knowledge or qualifications that he does not actually possess. Here are three unabashed quacks in the history of pretend medicine who used the most erroneous methods and achieved the nastiest of results. William J.A Bailey (1884 - 1949) This man might have tried to turn a nuclear power plant into a resort hospital. William John Aloysius Bailey was a Harvard drop out who fallaciously proclaimed himself to be a doctor of medicine. He was the president of Radium Company and was known to prescribe radioactive radium to his patients as a cure for fatigue, flu, cough and other common illnesses. He produced many products including Radithor, a solution of radium in water which Bailey claimed would help revitalize tired people, Arium, an “aphrodisiac” for married people whose desire for each other had waned, a radioactive belt-clip for “portable energy” and a radioactive paperweight that would presumably “awaken” tired and weary businessmen. His most noteworthy patient was Eben Byers, an affluent industrialist who took in 1400 bottles of Radithor, before having his entire jaw fall off, and subsequently dying from poisoning. Upon Eben Byer’s death, it was revealed that the radium had devoured gigantic holes in his skull and brain. Walter Freeman (1895 - 1972) There are a lot of things that come in vans, like ice cream, tacos, and even mobile dog groomers . . . but lobotomies is going a bit too far. Walter Freeman was a well-known psychiatrist and neurologist who popularized the lobotomy by making it simple and “handy”. He “perfected” the transorbital lobotomy by inserting a sharp instrument (such as an icepick from his very own kitchen), into the inside corner of the eyes and hammering it until it broke through the skull and penetrated the frontal lobe of the brain. Once it is inside, the instrument was then wiggled to cut neuronal connections. These so-called surgeries were done outside the operating room, without an anesthetic, and only after the patient was put out of action by electroshock therapy. Freeman ultimately created his own lobotomy instrument and called it a “leucotome”. He had to refine it though after one went kaput inside a client’s orbital socket. Even after his license was taken away for killing a patient with his methods, he still travelled around the country in his “Lobotomobile” to render service to the needy - only $25 per lobotomy. He performed 3,439 lobotomies in his entire career, but the physical and psychological damaged he caused was no doubt immeasurable. Albert Abrams (1863 - 1924) Introducing the delightfully devious, devilishly deceptive, diagnosing Dynamizer! I really can't picture Albert Abrams without imagining him on a soapbox trying to swindle the good folks of a small town. Abrams claimed that his invention, the Dynamizer, could diagnose any ailment simply by reading a sample of a patient's blood . . . or handwriting. The absurdity of handwriting proving the same information as blood aside, if given the choice between bleeding or writing, I would always choose writing - wouldn't everyone? Albert Abrams operated the Dynamizer by attaching an electrode to the forehead of a bare-chested assistant. The assistant faced West under dim light, and his abdomen was then struck repeatedly with a mallet. Abrams was, by his own account, able to decipher the vibrations from his assistant's abdomen to determine the disease. If your response was ". . . what?", then you're not alone. The skeptical medical community sent a drop of rooster blood to be analyzed with the Dynamizer - the "patient" was diagnosed with malaria, syphilis, diabetes, and cancer. That's one sick chicken. What's the most ridiculous "cure" you've ever heard of?
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