Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
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The week of pharyngitis
4 Dec2009
Almost 30 years later, I have a renewed passion for adolescent and young adult pharyngitis. I remember how naive I was doing my first sore throat study. I look at my writing and shudder.
During these years I have had incredible opportunities in academic medicine. Periodically I would come back to pharyngitis – the clinical problem that gave me academic credibility.
I always cared about this problem, because I felt that I looked at pharyngitis through the eyes of a "real doctor". My first consideration always focused on how physicians in offices, walk-in clinics or emergency rooms saw pharyngitis.
Over time I changed my focus to the patient. Experience taught me that teenagers and 20 somethings with pharyngitis felt miserable. How could we make them feel better faster?
I never thought that group A strep should be the only consideration. My earliest research helped me understand the importance of non-group A strep. But I never accepted that patients with significant symptoms and exudates had routine viral infections.
Learning of Fusobacterium necrophorum fit my view of sore throats. While the puzzle is not yet complete, adding F. necrophorum to the pharyngitis paradigm makes the picture more clear.
I started studying the most mundane of clinical complaints. Now with renewed enthusiasm, I am studying and writing about a disease that can portend great danger. I find great intellectual satisfaction through understanding the nuances of pharyngitis. I find great emotional energy in trying to help teenagers and 20 somethings.
I have been smiling all week. My paper will likely make a difference, and that really is why we write papers. And this blog and you the loyal readers have made all the difference in how I view this problem.
Thanks
Related posts:
- Natural history, guidelines and performance measures
- Expanding the pharyngitis paradigm – the rest of the story
- A sore throat death
- Antibiotics for strep throat?
- Another podcast about pharyngitis
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- In: Medical Rants
1 Response to The week of pharyngitis
Moises Auron
December 4th, 2009 at 1:03 pm
Actually in Pediatrics, the American Board of Pediatrics have been giving a lot of importance to Arcanobaterium hemolyticum as an important culprit of tonsilopharyngitis in adolescents.
The importance of it is that it is not sensitive to betalactams but to macrolides.
Today in my Pediatrics rounds at the CCF Children's hospital we saw 2 teenagers with acute tonsilopharyngitis; it was an interesting discussion and I pulled your article from Annals to discuss about Fusobacterium necrophorum and Lemierres', as well as the Up To Date(surprisingly didn't mention F. necrophorum).
Interesting discussion as this as said is an entity that cause significant discomfort and poor quality of life. We discussed then the complication of streptococcal infections, including PANDAS and post-streptococcal GMN. It was a nice round!