Question time!

It’s been a while since the last time I asked people if they had anything they’d like me to try discussing.

So, um… is there anything you’d like me to try discussing?  I assume what interest readers may have in my opinions (if any) will tend toward the medical, and that’s the kind of question I’m going to feel the most comfortable trying to answer.  But I’m willing to take a shot at other topics, too.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. I sprained my ankle 4 weeks ago. It’s still swollen and hurts. Should I go to a doctor? Please answer in no fewer than 5000 words. Bar graphs would help.

    Perhaps even MORE selfishly, I’d be curious to hear about your experiences navigating the parenting world as a father in a same-sex relationship. You haven’t seemed to discuss this aspect of your life much (and if you prefer to keep it private, I totally respect that), so I don’t even know how old your son is, if he’s in school, whether he is/will be in private or public, etc. As I’m sure you know, I’m a teacher of young children. As you probably know, I do a lot of “diversity work”*. As you may or may not known, my ubermensch of privilege reality sometimes makes it hard for me to get parents to give me honest feedback on our successes or failures in these endeavors. And as could probably be assumed, I’ve taught children of same-sex parents. All-in-all, I’d be curious to know about your personal experiences (with the promise that I won’t generalize them to all same-sex parents), specifically those that come in relation to schools.

    * I hate this term but it seems to be the one most used nowadays so I’m just going with it.

    • Sorry to hear about your ankle, Kazzy. However, I think a visit to the doctor is unnecessary, and I feel comfortable diagnosing you remotely. (It’s a technique I learned from Bill Frist.)

      You’re clearly suffering from Wisenheimer Syndrome, a condition in which the patient is actually too healthy for his own good. Thankfully, treatments are available. Using the IP information supplied when you commented, a pair of burly “medical professionals” have been dispatched to your location with a surgical-grade nine iron to do a little “procedure” on your kneecaps.

      Struggling is discouraged.

      Also, thanks for the great question! I’ll answer in a follow-up post.

  2. Di you know of a rare and untraceable Oriental itching powder I can use to convince Erik to change the formatting back?

  3. I heard a mention on the radio the other day about the FDA approving a home HIV test kit. What’s your take on this development? I ask this in your capacity as a physician, although the fact you’re a gay man is kind of a bonus.

    Do you think it will be effective at reducing the infection rate? How is this going to affect gay dating behavior? What are the rates for false negatives and positives? How might that inadvertently affect rates of other STD infections? That sort of thing.

  4. I looked at a chart you pointed to from NEJM a while back and was absolutely terrified by a spike in the death rate caused by Spanish Influenza at the tail end of the Great War. Gets me thinking:

    What’s the next big public health risk? Not public health scare, since that’s as likely as not to be something like “psoraisis” given the panicked ignorance that characterizes medical “journalism.” And we have to exclude the “unknown unknowns,” of course, since if something completely new mutates that’s an “out of the blue” sort of thing.

    But what do we know is lurking out there that has the potential to recall 1918?

    • Russell will know more about this, obviously, but I suspect contributing factors was endemic food and fuel shortages caused by the First World War. I suspect these shortages made people more vulnerable to what by all accounts was an already virulent disease.

      I’d also say that the wider interactions among people migrating to and from different countries and regions–soldiers going overseas and returning, large numbers of people coming from the American South to the North–were factors, too. There were more people with different exposure profiles interacting with each other.

      At least those are my guesses.

    • the last big public health risk was the BP disaster. As in” wipe out all life on earth” public health risk.

      sweet dreams!

    • As fas as an acute “kill a lot of people very quickly”, I think zoonotic illness from Africa/Asia will be the leader in the clubhouse. As far as chronic concern, I’d have to say the baby boomers hitting prime Alzheimer’s ages soon is high on this list. You could also say the staggering rises in Type II diabetes in younger people that have been obese since they were about 9.

  5. I know you’ve discussed this somewhat in a recent post, but I’d like to hear more (if you’re willing) about how you balance your adolescent patients’ need for privacy and confidentiality with their parents’ “right” to know what’s going on with their child(ren).

    For example, if you know that the children use drugs, when, if ever, do you tell the parents? Or if you know the children are sexually active and are being reckless or dangerous, do you ever break confidentiality. Or if those are too specific to what *you* do, what are the protocols as you understand them.

    Again, I realize you recently discussed something like this, but I’m curious to hear more if you have any more to offer on the subject.

  6. What’s that smell coming out of my air conditioning unit and what can I do about it that won’t cost an arm and a leg?

    • Most likely stale water in the drip tray, and a dirty condenser coil. Shut the power off and get in there and clean it up. Also check the drip tray for blockages in outlet pipe.

      • Thanks, you are the man!

        Also, “stale water in the drip tray and a dirty condenser coil” sounds kinda like a line from an old sea shanty.

  7. I don’t know if you say JB’s comment over on the main page, about wishing someone would do a post on what things *shouldn’t* be covered in whatever reformed HC we end up with. (e.g.: chiro, vitamins, massage, etc.)

    I would love to see you do a post on that, and throw it up on the FP.

  8. Are children overmedicated (Particularly with regards to ADHD)?

  9. Tell us that vaccinations don’t cause autism. You haven’t had enough exploding heads in here lately.

  10. Are infant and toddler size-weight percentiles useful things for parents to be looking at, as opposed to just aggregations of data for physicians to use? At one point our daughter was 75%ile weight, 67%ile height, and 5%ile (yes fifth) head size…and she looked perfectly normal. This caused me (a small amount of) needless worry, and those numbers had nothing to do with where she is now.

  11. why do toddlers continually vacillate between being the sweetest tiny folk on earth and the biggest tiny assholes you ever met? and how do they do it four times in thirty seconds?

    • … and what’s up with the booger eating?
      That just weirds me out….

  12. Wow! Head off to a couple of meetings and conferences, and look at the bounty!

    Thanks for the questions, everyone. I will start lining up the posts!

  13. What about these Three Blind Mice.
    Is this some kind of vitamin deficiency?

    Are hula skirts more healthy?

    What’s the safest manner to siphon gas from my neighbor’s car?

    Please explain vermouth in terms of ratio.

    Are you serious?

    But aren’t cufflinks only for the circumcised? (That one’s for when you want over 300 comments on a thread)

    Can we do all the rejects of the stupidest stupid questions as one post?

    That’s all for now.

    • As a follow-up to the circumcision question, how did that start? I don’t mean the religious tradition with thousands of years’ custom informing our current society, I mean the very first man to pull that stunt.

      What dude thought, ‘I have this sharpened flint I got from Og. I could strap it to a stick, and get me some rabbit for dinner…or else…hmmm…’ (looks down thoughtfully)

      I just don’t understand *that* man.

  14. What’s your opinion on the theory that circumcision causes autism?

  15. Last night, while watching my stories, there was a commercial for the “#1 Doctor-Recommended” something-or-other.

    To what extent do you tend to recommend stuff in your day to day interactions (and I don’t mean “you’ve got to go to the new Thai place on 3rd” but “it’s my recommendation that you use Kleenex Facial Tissues when you evacuate your nose” kinda recommendations)?

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