One can’t but help feel powerless. When patients are dying from imminently treatable conditions such as cholera, it’s enough to make anyone shake their heads in despair.  It may be small, but we here at NCL feel compelled to help and would like to engage your help in doing so.  $5 buys a weeks worth of antibiotics or 2 sachets of oral rehydration solution. We’ll donate $5 for each comment posted on our voting panel listed here , and wanted to thank those that have already commented.  Seem like a cynical ploy to obtain votes for our SXSW panel?  Nah, we’re more interested in the discussion, hence our tying our pledge to comments only.  After all, we do label ourselves a social enterprise – so this just made sense.

For those of you that have already posted – thank you! We will honor your posts with our $5 donations, and keep you appraised of the giving process here on our blog. On August 28th, we’ll run our final tally, and write a check to Doctors Without Borders.

So far there are 11 comments = $55 worth of antibiotics and ORS packets. Can we hit $1k? Nerdcore army, that’s up to you.

In the spirit of keeping things interesting, I wanted to share with you why we chose to run a wiki for our knowledgebase. We’re huge fans of keeping things open and sharing our work with the community. A wiki felt like the best way of doing this as, in addition to it being a forum for our sharing concepts with you, it should likewise allow you to share your ideas with us.

Once the wiki re-launches, you’ll see two new additions. Under the descriptions of each Apothecary healer and Lord of Pestilence, there are going to be two new sections: Lore and Hearsay.

Lore is a direct print of what appears on the Healing Blade combatant card – and is generally considered truth.

Hearsay is just that. Rumors, myths, legends or perhaps just things overheard that add to the richness of the world of Soma. After the game re-launches in September, we plan to run a contest aimed at the budding writers looking for the most interesting and well thought out back-stories.

In the meanwhile, if you feel like helping us out by helping to correct the attacks of the nefarious spam bots, we’d greatly appreciate it. If you’ve never edited a wiki before – here’s a crash course in rolling back edits:

a) Just above the ‘Main page’ title heading, are the links Page, Discussion, Edit and History.
b) Click on ‘History’
c) This brings up the edit history and you can see that we’re constantly being revised by spam-bots.
d)Underneath the ‘Browse History’ box, click on the link ‘Earliest’ and you should be able to scan down to where it went from legit edits (either Amathews, or Light Image Studio) to spam bots.
e) Click on the date of the last legit edit (in the case of the main page, August 10th)
f) Viola! the page is restored! NCL 1 – Spambots 0! Now you just need to save the reverted page.
g)At the top of the page, next to the History link, click on the Edit link and then hit Save at the very bottom – and yer done! You have the option to document your change if you like.
h) The people of SOMA thank you!

As physicians, we are bombarded by narrative, and in many ways, rounding is like working through a book of short stories each day, only that we contribute to the narrative, page by page, in the form of progress notes.  Documentation, or the ‘D’ word as some would have it – is a reality of medical practice.  And given how much we take down, one would imagine that we as physicians would be excellent tellers of stories, sharing captivating yarns of woe and intrigue, with works ranging from tragedy to hope and victory through the tales of our patients.  Sadly, this seems more the exception that the rule.  Physician documentation is often workman-like, placing emphasis on objectivity, assessment and planning, which I suppose is not a bad thing.  Scientific documentation should be heavy on details and analysis.  Still, one can’t help but wonder if narrative exposition helps add important nuance that may provide clues to the physician upon re-reading.

Consider these two statements:

• Ms. Jones is awake, alert and pleasant, not complaining of any fever, nausea or chest pain.
• I met Ms. Jones while she was sitting up eating breakfast. She had no complaints, but seemed sad.  When asked, she told me that she missed having breakfast with her husband two years ago and didn’t have much of an appetite.

Far be it from me to criticize one description over the other – however, upon re-reading those, which one creates a clearer picture in you mind?  It is these recollections that we go on to develop as we hand off our patients, whether it be to oncoming colleagues, consultants or the patients PCP’s.  The more vibrant a picture that we create both for ourselves and our colleagues, the stronger the engagement and activation of their deductive processes.   This is by no means a unique notion – kudos to @KateEllington, whom I follow on Twitter, for linking to and discussing the power of narrative medicine.  Furthermore, Rita Charon founded and runs the program in Narrative Medicine at Columbia, which runs three-day workshops to help providers hone their powers of observation, analysis and description of the things that they see, day-to-day.   Here’s to taking back our calling!

Stay thirsty, my friends.

Here are a few suggestions for  individuals that we included in our current list:

a)Yesteyear: Hippocrates, Galen, Al-Kindi, Rogerius Salernitanus, Andreas Vesalius, Louis Pasteur, Ignaz Semmelwies, Joseph Lister, Robert Koch, Charles Darwin, Florence Nightingale, William Osler, Henry Dakin, Ernst Roentgeon

b) The Now: Watson/Crick, Craig Venter, Peter Pronovost, Atul Gawande, Francoise Barre-Sinoussi, Mansfield/Laterbur, Albert Schweitzer, Paul Farmer, Francis Collins, etc.

The physicians that I have looked up to have consistently been the ones to demonstrate intellectual adaptation, flexibility and improvisation when tackling problems, while adhering to sound clinical evidence and maintaining a good knowledgebase. There’s the rub. Creativity and smarts are traits that can sometimes be seen as mutually exclusive – but combining the two is something that Col. Quaritch from the film Avatar would describe as ‘A Potent Mix’. And yet, in the same way clinical decision-making, and keeping one’s self up to date with current standards of care requires dedication and commitment, I would like to contend that being creative, or being creative in an *effective* way, requires similar commitment. From plastic surgeons that happen to be amazing at playing donkey kong, to scientists that happen to be creative writers – examples abound of individuals that regularly access both hemispheres of their brain and enjoy success as a result. The Healing Blade begun as a began as a napkin idea and rapidly evolved into an exciting little project, but little did I realize that it would also turn into my Unofficial Research Fellowship in Infectious Disease and Game Design. A fellowship that I’m pretty sure didn’t exist before the Blade.

You folks are businessfolks, right? You’re interested in selling as much stuff as possible, right? I read about Healingblade in The Scientist, immediately thought of how much fun it would be to play this game with my kids, but one look at the artwork snuffed that ambition right out. Any chance of making an edition without the T and A, or maybe just cranking it down a degree? Seriously, why flip the bird to an entire market? I’m sure there are many others out there who’d buy it for kids except that all the breasts and buttucks make them uncomfortable.

All valid points, sir.  Let’s start off with the obvious.  We are businessfolks, but, really, just barely.  I mean, seriously, who waits until their stock is about depleted and then drops a story onto the intertubes only to have hundreds of potential customers bump up against a ‘sold out’ sign? Uuhhh, that would be us.  We’re more a bunch of guy and gal docs that happen to have a little too much free time on their hands, that happen to be excited about learning in new ways.  As for the T&A?  There’s no way you could have known this, but on the box we clearly state that the lower limit of ages that we feel comfortable handling this stuff is 13.  Yes there’s T&A, but no less than your average Lady Gaga or Rihanna video.  Perhaps most importantly though, two of the most sexed up characters happen to be abstract representations of sexually transmitted diseases – T. pallidum and N. gonorrhea.  At what age should kids start learning about these particular conditions?  Well, I’ll defer to my public health colleagues on that one.

But we’re not completely absolved here, as Carlso Hernandez magnificently iterates:

N.B. I do worry, slightly, about the male-subtext here: what, only male and lesbian warriors get the pox? A small detail, but the semiotics of the game seem to me important beyond just political correctness; they might create misleading subtexts for the diseases and treatments they characterize. So be careful with your text and art, fellas!

This was something that we completely overlooked and are supremely glad that it was brought to our attention.  You’re absolutely right, Carlos – our art would suggest that only sultry women act as honeytraps pertaining to the transmission of STD’s.  This of course is ludicrous.  There is gender equality with regards to STD’s and our art, by a glaring oversight, does not accurately reflect this.  We will be working to balance this in future editions of THB, and appreciate your bringing this to our attention, sirs.  If you feel strongly about this either way, consider heading over to the Healing Blade FB group and commenting on this issue.

Dan Barrett, or @dangerawesome on twitter, brought it to our attention. A new gaming product ‘Healing Blade’ has a piece of art that has some interesting similarities to a well known Magic card. While the art is obviously heavily inspired by Radha, Heir of Keld, it cannot be called plagiarism as it is clearly a different drawing.

Yup. There she was.  Ceftriaxone.  Our beautiful Ceftriaxone.  And Radha, Heir of Keld, of the awesome Magic: The Gathering.  Our thanks to the folks at ManaNation being as civil as possible, but let’s call a spade a spade.  From the posing, to the background to the subtle detail, there can be no doubt that there was malfeasance on the part of one of our subcontracted artists.  Phonecalls were made, voices were raised and apologies were given.  This post is our somewhat poor attempt to apologize to the community of the card-battle players and artists that set forth the high bar of excellent work that is Magic.  Without you guys, NCL wouldn’t exist, and we take any and all issues regarding intellectual property very seriously, as we’re well aware that for small companies such as ourselves, IP is our livelihood.   Our solution?  A ground up re-design of the third generation warrior from the cephalosporin family that we’ve come to know and love as the mighty Ceftriaxone.   Without further ado:

Please let us know what you think.  Perhaps more importantly, (and I’m looking at you, you MTG, card battling, fellow fanboys and fangirls) if you find any more *ahem* similarities between our art assets and those that already exist – we would be eternally grateful for notification so that we could address the issue.  But! Wait! Theres! More!  If you do find something that ultimately needs to be updated, we will work with you to design the appropriate replacement Apothecary / Pestlience, giving you credit on our site and in the game.  (and perhaps a little schwab bag for yer troubles too:-)

We’re all in this together.