A stream originating from hot springs in Suðurland (South Iceland)

First and foremost, leadership does not depend on being the first, the biggest, or the richest.  For most of its history, Iceland has been a rather scraggly country on the westernmost fringe of Europe.  Even in this day and age, for most people, it’s an afterthought: a place of interest that only rarely comes to the forefront barring a geologic or financial catastrophe.

Iceland has not sent a man to the moon, nor has a military of significant size, nor even a soft power that it can project upon others.  But it nevertheless exerts leadership, because Iceland has made the best out of its limited resources.

Through democracy (Iceland’s althing being the world’s oldest existent Parliament), work ethic, and generous financial assistance through the Marshall program, Iceland has been able to capitalize on the intelligence and diligence of its people, and ensures that even though it may not necessarily be at the front of the pack, people look at Iceland with a degree of regard and respect and, to a great extent, wish to emulate.

It seems like a generic observation, but our lives are defined by competition to be the most, the first, or the biggest.  And that’s important but that’s not necessarily what leadership is about.  Leadership, as far as I see it, is about being at one’s own personal best so that one can affect a change in the world.  And that self-confidence to translate personal potential into action, in turn, can prompt us to be leaders at the forefront as the biggest, the best, the first, etc.

I can’t help but apologize for the lengthy delay in getting back to the blog. Fellowship and all the other things that make life so hectic certainly do squeeze out time for blogging. Besides that, a lot of things have occurred in the past two months. One of the more eventful things has been my very recent vacation to Iceland.

It was absolutely breathtaking, and I hope to share some photos and experiences with you soon. While I was there, I had a chance to just ruminate (or,rheuminate, if you will) about leadership, a topic that I’ve been thinking a lot about over the past few weeks. Perhaps it was just because I was away from my desk, but over that week, I saw many different examples of leadership principles that I have been casually reading about.

In fact, I noticed seven overarching themes about leadership during my time there, which will be forthcoming in seven short individual posts, with a few pictures interspersed.

My last case report from Kentucky has finally come out.  You can find it in the Journal of General Internal Medicine (currently e-published nbut will be in print soon). It’s bitter-sweet: it marks the end of an unbelievably academic productive era.

There aren’t any spoilers in this case report – the title says it all.   While deep vein thromboses (clots in the legs) and cellulitis are common causes of leg pain in diabetic patients, physicians should consider diabetic muscle infarction, also called diabetic myonecrosis.  Making the diagnosis makes a huge difference in treatment, especially in directing physical therapy.

Thigh pain in a poorly controlled diabetic? Don't overlook muscle infarction-it looks like cellulitis/DVT.https://t.co/4rMOYpy1lN #medicine

— Bharat Kumar (@BharatKumarMD) February 1, 2016

My second column in The Rheumatologist has just come out.  Don’t let the incredibly boring title fool you; it’s been generating some buzz, at least on social media (I think).  If you want to take a read, here’s the link: Rheumatology Fellow Questions Diagnostic Utility of the Patient Physical Exam.  And if you don’t have time, here’s the short version below.

TL;DR – “Ultimately, the relevance of the physical examination depends on whether we apply the right test at the right time for the right patient. If we treat it perfunctorily as a ritual or gesture, then we take away its significance, and might as well save time and skip it entirely.”

TL;DR – “Fellowship is more than just a continuation of residency. It’s as drastic a change as the transition from medical school to internship.”

I apologize for neglecting the blog.  I kind of expected that as things ramp up this year with more calls and conferences, that posts would get fewer and far between.  But I didn’t expect it to fall off so quickly.

The biggest news in the past week is that I’ve published my first column in The Rheumatologist.  Head on over to read a practical piece for new Rheumatology fellows, entitled “Seven Tips for New Rheumatology Fellows.”

Yes, it has been a while since I updated the website but that’s because I’ve been on call.

When I haven’t been cloistered in the hospital or clinic seeing interesting cases, I’ve been outdoors because the weather in Iowa has been absolutely wonderful.

I ran into this piece of uplifting graffiti the other day, which had a pretty straightforward message.  But I guess that’s Iowa for you.

There’ll be more posts soon once I get off call.  In the meantime, I’ll gladly take the advice of this unknown midwestern graffiti artist.