Medical School for Everyone: Grand Rounds Cases

Rated 5 out of 5 by from Practicing Medicine Is Like Reading a Crime Scene In this excellent course with Dr. Benaroch, you quickly learn that diagnostic medicine resembles the work of a police detective. You assemble the clues and apply the explanation that fits them best. If there are still multiple explanations, go out and find more clues. In medicine, patients are the most important source of information. Of course, they do not usually arrive with a ready diagnosis, or they wouldn’t need a physician. Instead the patient brings in a “chief complaint,” such as a persistent cough or a rash or bad pain in the gut, which the physician takes as the starting point of his or her inquiry. The patient also provides a history of the present illness, with details about when the problem started, whether it is continuous or intermittent, and which other physicians the patient has already consulted. The physician must complete the story by finding out all the symptoms, some of which the patient may not have connected with his or her chief complaint, and check the vital signs--body temperature, heart rate, respiratory rate, blood pressure and overall appearance. Finally, the physician lists possible diagnoses that match the symptoms and history. After paring down the list as much as possible, he or she orders one or more tests to confirm or refute the suspected diagnosis. Only then can treatment begin. Note the relative importance of patient history and vital signs against tests. Modern testing is technically brilliant, with laboratories for analyzing blood, urine and other bodily substances, and machines for scanning the patient with X-rays (including computer tomography), ultrasound waves, or a magnetic field (the MRI). There are also specialized tests for assessing the presence of HIV/AIDS, diabetes, celiac disease, allergies, and anemia, among other diseases. Yet the old-fashioned patient history and check for vital signs are still the first and essential steps in arriving at a diagnosis. As you already know, patients see the physician not only for the diagnosis, but also the treatment. I say treatment rather than cure because the problem is often incurable and must be managed with changes in diet or lifestyle, vitamin or mineral tablets, or pain relief medication. Measures that can cure certain illnesses include antibiotics, surgery, chemotherapy and radiation. Unfortunately, physicians make mistakes and Dr. Benaroch uses his cases (which are partly fictionalized to protect patient privacy) to warn against them. If you are a doctor, don’t focus only on explanations related to your specialty (if you have one) to the exclusion of others. Don’t fail to tease out missing pieces of the history that the patient may be too embarrassed to reveal. Don’t order unnecessary tests or let test results distract you from addressing the patient’s complaint. Make sure you give your patient clear instructions for treatment or other action by the end of your session. If you are a patient, make sure to tell the physician everything, and that means everything, that might be related to your health problem, and don’t go home without understanding what you should do next. Each of the twenty-four lectures has its own disease as well as other ones for comparison. They include common ones like cancer, migraines, drug and alcohol addiction, the flu, and diabetes as well as more unusual ones that I had never heard of, like Ménière’s disease, celiac disease (the cause of all that gluten free food now on the market), Wernicke’s encephalopathy, and chronic idiopathic urticaria. I won’t spoil the course by telling you which problem is in which lecture. Everything is so well-presented and easy to understand, you might get the idea that medicine isn’t so difficult after all, and that anyone can do it with some hard work and motivation. The cure for THAT idea is Anthony Goodman’s Understanding the Human Body: An Introduction to Anatomy and Physiology (Great Courses # 160). Watch it and you’ll find out just how complicated our bodies are.
Date published: 2020-07-12
Rated 5 out of 5 by from Good Diagnosis This course really delivers!!! Highly entertaining and informative Helps the layperson to better understand how a doctor thinks while at the same time presenting the interested student a diagnostic challenge! I am a retired Middle School teacher, a
Date published: 2020-06-08
Rated 5 out of 5 by from Very interesting I truly enjoy the course. It shows that to be a good physician, you need to be a good detective. It gave me an insight of how most doctors think, and I feel it will help me communicate better next time I see a physician. The one thing I wish we had, (not just with his course), is the ability to have some sort of practice test for every lesson to test if you truly understood the material. Just make it available for whoever wants to take it. Other than that, outstanding job.
Date published: 2020-05-09
Rated 5 out of 5 by from Informative, but the title is misleading Very interesting case histories of various patients and diagnoses. Not medical school, but instead, a window into the practice of medicine
Date published: 2020-01-06
Rated 5 out of 5 by from Excellent course..talented instructor. This is a fascinating course. The doctor is an outstanding lecturer. I have greatly enjoyed working my way through each case. I will gladly take the pediatrics case next
Date published: 2019-11-28
Rated 5 out of 5 by from Practical medicine well explained The grand rounds approach covered important topics very well. The material was intermediate in depth coverage and not much beyond a lay person's understanding. In some topics, there could have been a more detailed discussion and the different drugs that would be applicable. Wish there were another 50 grand round cases.
Date published: 2019-10-19
Rated 5 out of 5 by from Fasinating Course on How Doctors Think Although the various diseases/ailments in each lecture are rather common, what is utterly fascinating is the logical inductive reasoning doctors employ to determine the diagnosis of each disease/ailment. We learn briefly about anatomy and physiology too. We also see how important it is to the diagnostic process for doctors to be empathic to the concerns of their patients. And in the process, it is highly interesting and educational to find out what each disease/ailment is not. So for example, if the lecture turns out to be the diagnosis of the flu, you will also learn about the 5 or 6 possible diseases that will be ruled out. This is all presented in a clear and easy to follow format by the doctor. Professor Benaroch also makes asides about how the psychology of doctors and patients can make medical diagnosis and treatment a fallible human endeavor. This helps personalize and bring the whole scientific process down to earth. All of this makes 'Grand Rounds Cases' one of the best lecture series that I have seen (out of dozens).
Date published: 2019-07-14
Rated 5 out of 5 by from Highly enjoyable Usually a read the relevant chapter in the course guide before each lecture but in this case I left the reading until after the lecture to see if I could identify the condition discussed. Was about 50/50 on that. Well presented & accessible to the layperson as well as those with some medical background.
Date published: 2019-05-24
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Medical School for Everyone: Grand Rounds Cases
Course Trailer
I Never Feel Good
1: I Never Feel Good

Start your rounds with a trip to a general clinic, where you meet a patient whose chief complaint is, "I never feel good." Along the way, you'll learn how doctors solve mysteries like this with the aid of several tools-the most important being the patient's medical history.

35 min
A Persistent Fever
2: A Persistent Fever

Go back to an outpatient clinic in 1981, where a young man's fever, cough, and ulcers led to a surprising diagnosis. This powerful lecture is an opportunity to learn more of the basic tools of medical diagnoses and to discover how doctors began to fight back against this modern epidemic.

32 min
Puzzling Pain
3: Puzzling Pain

Learn how critical a complete medical history, a thorough physical exam, and collaboration between doctors can be to make a tricky diagnosis. Your patient: "Louisa," a woman who has suffered from abdominal pain for years. Does she have irritable bowel syndrome? Is it all just psychological? Or is it something else entirely?

33 min
Just Look at Me
4: Just Look at Me

This lecture's case involves an illness that's been around for millennia but which many of today's physicians have never seen. It involves a 10-year-old boy suffering from a rash that doesn't bother him, red-appearing eyes, and a cough. And the true culprit is one that could easily have been prevented.

32 min
Headaches in Wonderland
5: Headaches in Wonderland

Your patient is back in the emergency room with another "sinus headache," but the nurses think he's just after drugs. What's the real story? In finding out, you'll learn how physicians diagnose headaches; the differences between primary and secondary headaches; red flags doctors look for when determining their severity; and more.

30 min
The Tennis Player
6: The Tennis Player

Discover how doctors diagnose a common disease that can kill a healthy 36-year-old woman in months but, in a 90-year-old, may not need to be treated at all. Through the case of a woman with increasing hip pain, you'll learn more about the genetics of this disease, ways to test for it, and more.

32 min
Sudden Collapse
7: Sudden Collapse

You're at the grocery and the person next to you suddenly collapses. What do you do? Here, learn how doctors (and laypeople) can use basic lifesaving steps to deal with a sudden catastrophe. Also, explore the methods physicians use to prevent health emergencies before they happen.

31 min
School Failure
8: School Failure

Meet a surly young man who could just be your typical teenager-or who could be suffering from an illness that's a severe threat to young adults. His story is a fascinating window into how doctors sort through myriad symptoms to diagnose and alleviate a highly prevalent-and all too serious-medical problem.

30 min
Dizzy Attacks
9: Dizzy Attacks

Tina suffers from attacks of dizziness and is certain she has hypoglycemia, but doctors should never fall into the mental trap of starting a diagnosis with a false assumption. In this intriguing lecture, Dr. Benaroch shows you how physicians make expert diagnoses when one specific test isn't available.

31 min
Weight Loss
10: Weight Loss

Charlene has come into your office for a checkup and it is clear that she's lost a significant amount of weight. Follow along as Dr. Benaroch uses his medical savvy to make a diagnosis, reveal insights into what the real problem is, and establish a course of treatment that goes far beyond just taking pills.

33 min
I Can't Walk
11: I Can't Walk

Discover how a young man's painful calves lead to a surprising diagnosis. As you'll learn, sometimes even the most uncommon of complaints can signify the presence of a fairly common illness. You'll also discover why you should never underestimate the seriousness of this particular diagnosis.

31 min
Learning from Failure
12: Learning from Failure

Sometimes doctors make mistakes. As Dr. Benaroch guides you through the diagnosis of a patient with a case of recurrent hives, he reveals several powerful lessons for both doctors and patients. These include insisting on clear instructions and remembering that treating the disease is not the same as treating the patient.

30 min
The Children Who Come and Go
13: The Children Who Come and Go

Discover how a young man's painful calves lead to a surprising diagnosis. As you'll learn, sometimes even the most uncommon complaints can signify the presence of a fairly common illness. You'll also discover why you should never underestimate the seriousness of this particular diagnosis.

32 min
Guardian's Day
14: Guardian's Day

How does a doctor get from the common complaint of constipation to a diagnosis of something much more dangerous? In solving this medical riddle, you'll learn about a particular medical epidemic so powerful and prevalent that, in one county in Kentucky, it's deprived many children of their parents.

29 min
Dickens's Diagnosis
15: Dickens's Diagnosis

At 55 years of age and quite overweight, Joe falls asleep all the time. Is it narcolepsy? Is it kidney disease? The real culprit, you'll discover, is a condition originally described by author Charles Dickens; one whose effects are more wide-ranging (and life-threatening) on the human body than you can imagine.

31 min
Shaking Sammi
16: Shaking Sammi

Meet Sammi, an infant girl who's brought to the emergency room and suddenly starts shaking right on the examining table. How do doctors act to both help her and diagnose her as the attack happens? And what are the mysterious connections between the underlying diagnosis and a critical deficiency?

29 min
Hickam's Dictum
17: Hickam's Dictum

Sometimes, a single patient can have more than one disease (a medical "philosophy" called Hickam's Dictum). This idea is illustrated by a middle-aged woman who can't stop vomiting. The road to determining her interconnected diagnoses is a harrowing story that illustrates why doctors always need to stay on their toes.

29 min
Forgetting Jerusalem
18: Forgetting Jerusalem

Explore from two perspectives the case of a patient with a mysterious illness. First, see how doctors diagnose his condition and work with the patient to prevent a medical emergency so old it's mentioned in the Bible. Then, find out what happens in the worst-case scenario, where time is of the essence in saving a life.

29 min
Sherlock's Investigation
19: Sherlock's Investigation

Step inside a university's student health center, where your patient, Elena, makes repeated visits complaining of nausea, then vision troubles, then a urinary tract infection. What's going on here? Investigate how seasoned doctors act like Sherlock Holmes to arrive at a diagnosis of a disease that predominantly affects young adults.

32 min
The Boy Who Doesn't Speak
20: The Boy Who Doesn't Speak

This lecture's diagnosis is surrounded by controversy about what causes this specific illness, how it should be treated, and even how common it is. In exploring how doctors approach it, you'll learn insights into childhood development; specifically, how to know when something may be wrong and what tests can help narrow down a cause.

31 min
Antarctic Adventure
21: Antarctic Adventure

You're on an expedition in Antarctica. You're diagnosed with a problem that requires immediate emergency surgery, and there's only one person who can perform it: you. Use this real-life scenario from the Soviet Union's Sixth Antarctic Expedition in 1961 as an intriguing window into how doctors diagnose and treat this problem in less extreme, 21st-century circumstances.

30 min
A Sunday Drive
22: A Sunday Drive

This Grand Rounds starts with you as an eyewitness to a serious motorbike accident, where the diagnosis is obvious and the story lies in what happens to the body when it's pushed to the edge of survival. Follow this patient from treatment at the site to lifesaving strategies in the emergency room.

31 min
Cough, Cough, Cough
23: Cough, Cough, Cough

Margo, a 49-year-old woman, goes to the doctor with a persistent cough. What are the common (and not-so-common) causes of persistent coughing? How do trained doctors analyze cough for clues about an underlying diagnosis? And when this particular diagnosis is reached-how is it treated in an outpatient clinic?

29 min
A Confused Father
24: A Confused Father

Dr. Benaroch concludes this lecture series with an elderly patient who has frequent confusion and forgetfulness. Is the most obvious diagnosis the correct one? Then, he sums up the many lessons you've learned throughout the course, both about being a good doctor and a good patient.

34 min
Roy Benaroch

Doctoring is about listening and paying attention. There's a lot to know, too-- but if you're not paying attention, you'll be misguided by what you think you already know. An open mind is a better diagnostic tool than one stuffed with facts

ALMA MATER

Emory University

INSTITUTION

Emory University

About Roy Benaroch

Dr. Roy Benaroch is Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine. He earned his B.S. in Engineering at Tulane University, followed by his M.D. at Emory University. He completed his residency through Emory University's affiliated hospitals in 1997, serving as chief resident and instructor of pediatrics in 1998. Board certified in general pediatrics in 1997, Dr. Benaroch practices full time at Pediatric Physicians, PC, located near Atlanta, Georgia. In his dual roles, he teaches medical students and residents at his practice and gives regular lectures to physician's assistants at Emory University.

Dr. Benaroch has published two books on parenting and pediatric health topics: Solving Health and Behavioral Problems from Birth through Preschool: A Parent's Guide and A Guide to Getting the Best Health Care for Your Child. He also has a blog for parents and health professionals at pediatricinsider.com, and he has served as a featured expert on WebMD.com. Dr. Benaroch also serves on the board of directors of the Cobb Health Futures Foundation, Inc., a nonprofit group dedicated to public health for people of all backgrounds.

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