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EMNerd (EMCrit)

Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation

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The Nihilistic Ramblings of Rory Spiegel, MD

A Case of Shadows

August 31, 2014 by Rory Spiegel 14 Comments

In medicine we frequently propagate half-truths and unsubstantiated certainties. Thus, truth is a relative experience, dependent primarily on how we choose to define it rather than any concrete state of reality. Increasingly we have favored a technological definition of truth over that of the clinical perspective. As such we are driven to act in disease […]

A Secondary Analysis of the Adventure of the Crooked Man

August 15, 2014 by Rory Spiegel 3 Comments

Removing a cervical collar in the early aftermath of a traumatic injury is becoming an increasingly difficult task. With ever more sensitive imaging modalities we have progressively devalued the traditional methods used to evaluate the integrity of the spinal column in favor of more technologically advanced ones. Despite decades of success in treating this pathology, […]

“The Adventure of the Red-Headed League”

July 24, 2014 by Rory Spiegel 4 Comments

A peasant traveling home at dusk sees a bright light traveling along ahead of him. Looking closer, he sees that the light is a lantern held by a ‘dusky little figure’, which he follows for several miles. All of a sudden he finds himself standing on the edge of a vast chasm with a roaring […]

“The Adventure of the Golden Standard”

July 1, 2014 by Rory Spiegel 7 Comments

We have all been told ghost stories and fairy tales. Campfire fables intended to frighten the gullible populace into behaving in a manner deemed appropriate. Even in Emergency Medicine we have our fair share of ghost stories. Most notably we are taught from an early age to fear and respect the clinically occult pulmonary embolism. […]

“The Adventure of the Dancing Men”

June 9, 2014 by Rory Spiegel 5 Comments

  The illustrious Cardinal Commendoni suffered sixty epileptic paroxysms in the space of 24 hours, under which nature being debilitated and oppress’d he at leangth sank, and died. His skull being immediately taken off, I found his brain affected with a disorder of the hydrocephalous kind.         -Gavassetti, 1586       The […]

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