Wednesday, February 28, 2007

Rapid Interpretation of EKGs

Edit: I have heavily edited this post after learning that the author of this book is a convicted pedophile. I no longer think Dale Dubin is the greatest man on earth. But, it's still a good book so I've kept my post about it. My advice - get a used copy.

For anyone who ever tried to learn how to read EKG's the name Dale Dubin probably rings a bell. He is the author of the wildly popular "Rapid Interpretation of EKG's". This summer when I was working with an internist for a few days and he was doing stress tests I said I didn't know how to read an EKG so he gave me the book he learned EKGs from - a very tattered copy of Dr. Dubin's masterpiece (blanks not filled in so I'm not sure if he really got the maximum out of it). This book has stood the test of time and is now in a very glossy and colourful 6th edition.

Basically, this book is fill in the blanks and by being fill in the blanks prevents one from skimming the pages and tuning out and not learning anything. If only every book I've ever had to read was fill in the blanks I'd probably be a lot smarter. The only way I can fall asleep while studying EKGs is to put this book down, that's how much it captivates my attention. Not that I don't still fall asleep, I just have to put the book down first.

My only issue with Dr. Dubin's book is that he doesn't discuss the cardiac axis until chapter 7 on page 203, and it isn't until this chapter that he discusses the 12 lead ECG and the orientation of the QRS complex in each lead. Furthermore, I'm a little confused still about the correct orientation of the p-wave in all of the leads. Nevertheless, I'm not finished the book, so maybe these things will become clear with time.

This is the only book I've bought this semester so far, and I gotta say, it was totally worth it.


Liana said...

Dubin's book is great, isn't it. I don't have my copy at hand right now, but I seem to remember that there is a weird sentence near the front about identifying the car on page x and then winning some kind of prize (I'm post-call so this might not make a lot of sense).

There is a Dr. Dale Dubin who is a convicted pedophile, but I am not 100% sure that it's the same guy.

Nathan said...

It's the same guy. Which is why I would get a used copy if I bought the book. But I've been exquisitely fortunate in my teachers, and haven't needed it.

Liana said...

Okay, I'm not entirely crazy.

The weird sentence is on page ii and it talks about winning a car. Look for it!

medstudentitis said...

I just found out about the pedophile thing today. I'm not sure if I believe it though, I'll have to investigate it myself.

Nathan said...

Liana, check out Snopes about that car. Medstudentitis, see the same for the word on Dubin.

Nathan said...

And here is the official state of Florida notice that his license is revoked. And here is the article in the Yale Daily News (for some reason no longer online except in this cached form, that I can find) detailing his conviction.

It is most unfortunate that someone whose work has helped so many can be so repellent himself.

Liana said...

Nathan, thanks for the snopes link. I'd always wondered if the car was just a scam.

The Dr. Dale Dubin I read about online who was convicted of pedophilia was a plastic surgeon, hence I'd always wondered... why does a plastic surgeon know so much about EKGs?

Your web search was obviously more complete than mine. Thanks.

Calavera said...

Hmm, I would put the cardiac axis somewhere in chapter two, to be honest! When we present an ECG to our seniors, it's one of the first things we talk about!

First we go through the demographics, of course, ("This is a 12 lead ECG of Joe Bloggs, who is 52 years old, taken on the 2nd of this month at 10:20am") then we go through the rate, rhythm and then state the axis!!

Keep at it though, I'm getting better at this cos I try and look at one every day and interpret it!

Brian McMichael, M.D. said...

Liana, consider the complexity of the matter - Dubin has served his time, his "pedophilia" amounts to pleading guilty "to 22 counts of child pornography and cocaine charges.
Eleven of the drug counts involved a 16-year-old girl who was seduced by Dubin with the help of pills and vodka and eventually agreed to participate in sexual encounters with Dubin, another 17-year-old girl and a 23-year-old woman.
Dubin videotaped some of the encounters for his pleasure." - Dale Dubin Sentenced To Five Years
Proprietary to the United Press International, March 7, 1987

A scumbag for sure, but someone who forcibly raped a 5-year-old, or seduced an 8-year-old as the epithet implies, no. Not having sat on the jury, I'm still sure that it's slightly more complex than just what's on the face of the charges.

What I will tell you is that you will have to take care of felons and other bad/unsavory people. You will not give them lesser care nor even treat them differently without risking being unethical.

The question ya gotta ask yourself is, "will your future patients benefit from you having studied Dubin's book?" If the answer is, "Yes," then get over yourself and get back to the business of learning how to save lives and lessen suffering.

If you're really committed on principle, then all the better, write a better book to put Dubin out of business, but don't just cut yourself off from a learning resource out of some kind of tinny sanctimoniousness.

The more you hang out in medical circles the more you will see questionable and even odious conduct from some technically brilliant and even some not-so technically brilliant colleagues. I doubt you will turn in everybody who's not a saint, or stop doing business with everyone who's a little shady. After a while that will turn out to be at least the majority of docs. You'll probably wind up overlooking everything but the most alarming of problems.

In the end all that you can really be responsible for is tending your own garden and minding your own ethics.

Anonymous said...

I was personally a patient of Dr Dubin just prior to his arrest. He was completely professional and a gifted surgeon and the evidence against him was exagerated in the media as the US Attorney was trying to make political headway by forcing Dubin to implicate celebrities and high ranking social aquaintences as part of a sting operation. Dubin refused and Merkle retaliated with bad press and unnecessary and questionable charges. This was definitely not pedophilia in the sense that most people understand and the mother of one of his 'victims' was bartering services for surgery.

Anonymous said...

The man's ability to write a good book says nothing about his moral codes. There are plenty of authors who are nasty individuals. In this case it was 16 & 17 year old girls - at a nudist camp. He was on drugs. We have programs to help impaired physicians.

Anonymous said...

You didn't quite get the concept. It is not a fill in the blank book as such. The originals went out with something like a book mark which you covered the answers with on the right. As you read, you filled in the blank with your head then moved the marker down to see if you were right.

Anonymous said...

Great book used during my residency. Sorry to hear about his misdirection. Many an aspiring cardiologist used his book. Amazing he was a surgical resident. Bright for sure. I have personally known impaired licensed professionals. Addiction can and does catch everyone regardless of education or social status, truly democratic it is.