After recently getting involved with “Grand Rounds” (The weekly round up of the best medical blogs on the web) I wanted to take the opportunity to get to know Dr. Nicholas Genes, the founder and maintainer of Grand rounds and Blogborygmi a bit more.

Nicholas Genes, MD, PhD, is a resident in the Emergency Medicine program at Mount Sinai Hospital in New York City. He received a bachelor’s degree in science from Brown University, where he first developed his interests in medicine, research, and writing. After college, he enrolled in the MD/PhD program at the University of Massachusetts, pursuing a medical degree while studying chondrocyte mechanotransduction in Dr. Charles Vacanti’s laboratory for tissue engineering. In the course of writing a freelance article, he discovered the world of medical Weblogs, and he has been active in this nascent community ever since.
Thanks to Nick for answering some of our questions!

Q) What is “Ground Rounds”? When and why did you start it?
In the summer of 2004, several med-bloggers, including Kevin MD, Galen and me, bandied about the idea for a weekly collection of the best in online medical writing. “Carnivals” already existed for political blogs, and other fields, and we thought it was time for medicine, too. So I solicited a bunch of my fellow medbloggers to submit some of their writing, and highlighted it on my website with a link. Every week, the task of soliciting and organizing the links falls on another blogger.
The system works well because it’s driven by traffic. Even though hosting is a fair amount of work, a lot of people check out these carnival host sites each week, and some people stick around, explore the archives of the host blogger, and become regular readers. And of course, bloggers submit their writing to each week’s host, because they want to be featured and drive some of their traffic their way. We weren’t the first to think up this clever concept, we just brought it to medical blogs. Now there’s easily a dozen carnivals of different aspects of medicine.
A year later, the good people of Medscape.com came in to help sponsor Grand Rounds. Medscape direct their readers to each week’s host, in exchange for featuring a “Pre-Rounds” interview that’s published on their registration-required site. So Grand Rounds gets more readers from beyond the blogosphere, and Medscape stays on top of web medicine and gets new subscribers — that arrangement has worked well, too.
Q) How do you go about finding your hosts for each week?
Well, fundamentally, I try to pick hosts whose blogs are ones I’d like to check out — bloggers who write well, and have something interesting or novel to say. A few ground rules I’ve settled on: the writing has to be mostly medical, and the the host should have built up an archive of noteworthy writing (ie, they can’t be complete newbies — it’s amazing how many people set up their blog, write for a few weeks, and then want to host)
Q) What was one of your favorite “Ground Round” weeks or themes and why?
There have been over a hundred and fifty editions now, and each reflects a lot of effort and creativity. But some were particularly impressive —
Those that recast some familiar icons:
http://distractible.org/2007/10/02/grand-rounds/
http://nurse-ratcheds.blogspot.com/2006/12/its-christmas-grand-rounds-charlie.html
http://rumorsweretrue.wordpress.com/2006/11/14/grand-rounds-0308/#more-230
And some of the poetry-themed editions
http://sixuntilme.com/blog1/2007/01/grand_rounds.html
http://trick-cyclingforbeginners.blogspot.com/2007/12/grand-rounds.html
http://drhebert.squarespace.com/dr-hberts-medical-gumbo/2006/10/30/halloween-grand-rounds.html
But a few editions that mix art and medicine really stand out, in my mind:
http://www.mexicomedstudent.com/2006/08/545
http://medhum.blogspot.com/2006/07/grand-rounds.html#comments
there’s more, much more, but I just spent too much time browsing the list!
Q). So many people (especially those with disabilities) have found the internet to be a place not only for information, but for socialization as well. The health and medical blogging world can be overwhelming at times. What advice would you give to a novice health blogger?
I think the best approach to these social web networks is … to be sociable. When you enjoy someone’s post or blog, link to it on yours. Leave positive comments on their site. Contribute to “carnivals” like Grand Rounds — and offer to host carnivals, too. You’ll find your efforts rewarded in terms of good feedback, interesting new links, and more traffic.
Q) Your own personal blog and the “Ground Rounds” blog are primarily health based. Do you write for any other websites or publications? Do you ever write about different topics?
Besides blogging for Medgadget.com, and my own site, I interview bloggers for Medscape.com, and participate in some of Medscape’s Roundtable forums on topics like VIP patients, alternative medicine, and whether doctors should talk about themselves with patients. (links to my articles below). Also I am a reviewer for Emergency Medicine Practice (www.empractice.net). I used to write the occasional freelance op-ed piece for some of the newspapers where I lived — the Boston Globe, Boston Herald, and Providence Journal. I wrote about advertising, the media and technology. It’s something I enjoyed a lot, but since I started residency I’ve found it’s easier to dash off blog posts articles about stuff I know something about, rather than research topics outside my field.
Q) Tell us about yourself. I know you are a doctor.. but what type of medicine? Do you still practice?
I’m a third-year resident in Emergency Medicine, in a four-year program at Mount Sinai in New York City. This means I’m done with medical school but still in specialty training — it’ll be another year before I see patients without oversight, as an attending. Residency is a pretty demanding time commitment, though it’s much better now than it was a decade or two ago. I look forward to the extra time I’ll have someday as an attending… but the extra responsibility is daunting.
Q). Most of the readers of butyoudontlooksick.com are patients, as a doctor what advice can you give to patients when speaking with their doctors? Any tips or advice for the chronically ill to be better prepared for an emergency room visit?
Emergency physicians are trained to think of worst-case scenarios. When a patient arrives in our department, we’ve (usually) never seen them before — and we’ve got to make sure we’re not missing any life-threatening or serious pathology. We have considerable resources at our disposal — but all our tests and imaging are designed to minimize the patient’s risk of, say, going home and getting sicker. Sometimes a disconnect arises, when the patient is expecting an answer to why they’re suffering, but the ER doc is only able to rule out the surgical or medical emergency. For more answers, we can only recommend close follow-up with primary care providers and specialists.
Some patients view the ER encounter as an opportunity for a second opinion — is this dose right for me? What about this tingling in my feet? Since I can’t follow up and see how patients respond to new prescriptions, and since managing chronic disease is outside my expertise, it would be irresponsible of me to give advice. Again, I’m only really able to determine if the chief reason you came to the ER is an emergency — answering questions about other, chronic or unrelated symptoms might be tempting, but is probably bad medicine. Having said that, I know what a time crunch most clinicians are facing, and I know patients are often unable to get all their questions answered in a brief office visit. This is a complicated problem! Hopefully, chronically ill patients can strike a balance between using support groups (online or otherwise) for the quality-of-life issues, and their office visits for medical issues, though of course there is substantial overlap. It takes time.
Q). Do you have any hobbies? What do you like to do for fun?
I love New York. I live near Central Park and Museum Mile, but also like to survey the restaurants, lounges and architecture elsewhere in the city. Over the past couple of years I’ve taken up photography — because there’s so much to see, and I worry that I won’t be able to afford Manhattan after residency. Some of my pictures are on the picasa slowshow, below the sidebar on blogborygmi.com.
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For more information about Grand Rounds click here.
Article written by Christine Miserandino, © 2008 butyoudontlooksick.com