Rubor, Dolor, Calor, Tumor
Blog Address:
August 1, 2012

Regrets and Records

I have few regrets, despite an advanced age where I should have ample opportunity to look back over a life of woulda, shoulda, coulda.  Maybe I have been lucky, or maybe I am an amoral sociopath, although the two are not mutually exclusive.

There are a few minor things I wish I had done differently.  One is a simple database of every patient I had ever seen.  Name, med rec number, bug and diagnosis.  After 25 years it would be cool.  Of course I started medicine before such a plan was practical, but any youngsters out there, I would recommend it.  Not that anyone is OCD enough to follow through.

The other is I wish I had kept better track of some the extremes of labs I have seen.  A sodium over 200, a leukemoid of 85,000,...

Posted By: Mark Crislip  

July 30, 2012

Back from Vacation

Back from vacation.  It was terrible: hiking, biking, golfing, eating and reading in Eastern Oregon.  Oregon really is the best place in the US to live, or at least vacation. But after 10 days it is good to get back in the pus.

When I had left last week the last consult was a middle aged male with a known bicuspid aortic valve who had been ill for 5 months, yes 5 months, ...

Posted By: Mark Crislip  

July 18, 2012

Do I believe it?

Patient is bit by a cat on the hand.  Within 24 hours there is spreading erythema, fevers and pus is draining out the bite.  So the patient is off to the ER then the OR.  Despite antibiotics (Unisin) the erythema spreads and I am called.

Now cellulitis immediately after a cat bite is often Pasteurella, and there is some resistance to ampicillin and I have a qu...

Posted By: Mark Crislip  

July 16, 2012


Everyone gets satisfaction from different aspects of medicine. At least I hope so.  Some parts of medicine seem so relentlessly dull I don't see how anyone could enjoy their job, but to each their own.  For me, the reason I get out bed in the morning is the pleasure of (maybe) finding things out. &n...

Posted By: Mark Crislip  

July 12, 2012


I don’t mind curbsides.  I work with a very good of hospitalists, many of which I have known since their med student days, and I feel comfortable giving advice about patients I haven’t actually seen.  They usually know not to mention it in the chart, that my advice is to be considered generic to the issue at hand.  I am at that point in my life, with far fewer qu...

Posted By: Mark Crislip  

July 10, 2012

Podagra Plus

You might have noticed that the frequency of entries has fallen off here at RDCT.  Work is slow, and I have not had much to write about.  As I enter my 23rd year of practice, I note in passing that as a specialty ID has been at the forefront declining work volumes.

Compared to 20 years ago there are fewer HIV OI’s thanks to HAART, fewer neutropenic fever thanks to G...

Posted By: Mark Crislip  

July 2, 2012

Didn't Even Consider It

The patient comes in with 24 hours of progressive encephalopathy and hemiparesis.  A spinal tap has 200 WBC, 1200 RBC a 50:50 mix of lymphs and PMN’s, a protein on 120 and a glucose of 34.  After 48 hours they call me when there is no diagnosis.

The patient by this point is on a ventilator and the nurse tells me he not moving his right side.  No one from the fami...

Posted By: Mark Crislip  

June 27, 2012

Ursine Questions

The scariest thing about Splash Mountain is not the sudden precipitous drop to end the ride.  It is the anamatronic animals leading up to the drop.  Especially the bears.  I think they are the only animals on the ride not to wear pants.  I always wonder why, some Disney pun on bear/bare?   

The patient today had been in Alaska a month ago, hunting and ...

Posted By: Mark Crislip  

June 25, 2012

Never Tried the Stuff

I have a friend who has never had an apple. Ever. Not even as pie.  It has become an odd point of pride, and he will probably go to his grave never eating an apple.  I have yet to try raw oysters, but that is more cowardice than obstinacy.  I have had raw horse when I was in Japan, and keep telling myself I will try a raw oyster next time, but they look like snot on a shell,...

Posted By: Mark Crislip  

June 22, 2012

Crislip's Sign

As I have far fewer years to practice ID in front of me than I do behind me, I realize I have yet to have anything named after me. I want to be a verb, like 'to swan' was when I was an intern.  Or at least a noun, like Groshong.  It is my own fault, I suppose, since I have neither the time nor inclination for formal publication in the peer reviewed literature and I have never invented...

Posted By: Mark Crislip  

« previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 next »
About This Blog

For the Benefit of Mr Kite, there will be ID tonight. Infectious Diseases! Antibiotics! Viruses and Bacteria and Fungi! Oh my! Exclamation marks!!!!!! No trampolines, nor will any band be playing at 10 to 6. And Henry the Horse died of the Strangles. Sorry. That's the problem with infections.

The endless excitement that is the daily practice of Infectious Diseases in a Portland teaching hospital! The need for meta data!

Every day I make infectious disease rounds in the hospital and see at least one cool case or learn something new. 25 years and I still do not know everything. Why be selfish and keep all of that wonder and knowledge to myself? This blog will be a mostly qod account of days events, a cool ID case, a referenced pearl, and a minimum of 1 horrible, yet ultimately feeble, attempt at humor.

While usually written in the present tense, the cases are not necessarily current and all identifying information is altered or obscured as long as it is not absolutely pertinent to the case. Can't have a female with prostate infection for example.

I write these at night or in spare moments. There is always someone who will quibble about spelling, punctuation or grammar. My response is live with it. It's a blog, not Mandel.

Read and listen to more of me at my multimedia empire linked below.

The first 2 years blog posts have been collected and edited and are available as The Puswhisperer, Volumes 1 and 2. Really. Perfect for the pus lover in your life.
Because The World Needs More Mark Crislip (tm).
Flies in the Ointment: Essays on Supplements, Complementary and Alternative Medicine (SCAM).
A carefully selected and edited compendium of my best blog posts from The sections have been edited for redundancy, updated for 2017, and classified into themes including my influenza rants.

All on Amazon.

Disclosure: Mark A. Crislip, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Pusware LLC
Have a 5% or greater equity interest in: Pusware LLC (owner)

  • Mark Crislip

    Mark Crislip, MD, has been practicing in infectious diseases in Portland, Oregon, since 1990. He is nobody from nowhere, but he has an enormous ego that leads him to think someone might care about what he has to say about infectious diseases. And so he blogs and podcasts and writes on the most endlessly fascinating specialty in all of medicine. Links to his multimedia empire of blogs, podcasts, books, apps and tweets can be found at

    Mark A. Crislip, MD, has disclosed the following relevant financial relationships: Owner, Pusware LLC. He as not talked to a drug rep in over 25 years and does not even eat the pizza provided at conferences. But he is for sale for the right price. Please. Someone. Buy me.

The content of this blog does not necessarily reflect the viewpoints of Medscape.
Share This
Add this blog page to your favorite Social Media site.

All material on this website is protected by copyright, Copyright © 1994-2018 by WebMD LLC. This website also contains material copyrighted by 3rd parties.