Deposition Article

I've written another article, this time for WebMD's Medscape: Eight Things to Never Do at Your Deposition

It is the first in a series. I hope you don't need the advice, but if you do, I hope it helps!

Help With The Heat

I've been seeing a lot of patients lately who have tried to be out in the heat, and tried to do the right thing, but have come up short. Sometimes you have jobs that make you go outside. Or you play sports. Or garden. Whatever keeps you outside in 90+ degree heat, you need to take a few precautions. Sunblock, of course, see my blog on the dangers of certain types of sunscreens for more information on which ones to buy.

Most importantly, you need to be hydrated. And water doesn't cut it.

Are you shocked that I'm telling you that drinking water is bad for you for the heat? Here's why:

Your body tries to regulate your temperature to prevent overheating by sweating and evaporation. Have you noticed your sweat is salty? That means you don't have pure water coming out--you have electrolytes too. If you sweat electrolytes, but replace with water, you will dilute your electrolytes and lead to imblances that can cause cramping, or worse, heart abnormalities and altered mental status.

The outside temperature for which your body can maintain a normal body temperature is 84 degrees. Higher temps and/or humidity can increase your body temp.

You are at higher risk if:
  1. Physical activity in hot/humid weather
  2. Extremes of age
  3. Excessive clothing
  4. Dehydration
  5. Cardiovascular disease
  6. Skin disorders (i.e. schleroderma or severe burns)
  7. Obesity
  8. Medicines
What are heat cramps?
Cramps tend to occur later in the day when relaxing or taking a cool shower after having been in the heat. Normal body temperature. Involve calves, thighs and shoulders most commonly.
-Prevent by injesting salt and water (electrolyte solutions like gatorade work well)
-Treatment: Rest in cool environment, Salt replacement (electrolyte solutions or IV saline)

Heat exhaustion:
Extreme fatigue, profuse sweating, dizzy, nausea/vomiting, even diarhea. Dull headache. Body temperature normal or slightly elevated. Most common heat illness that usually occurs during heat waves. Lots of sweating.

Heat stroke:
Least common, most serious. Suspect if altered mental status and elevated body temp after having been in hot/humid environment. Alcoholics and elderly particularly vulnerable. Hot DRY skin.
-Treat with COOLING not fluids. Too many fluids can lead to congestive heart failure. (of course call 911 and get the patient to an ER ASAP)
---Remove clothes. Spray water onto skin, don't apply ice directly to skin. Fan patient. Ice packs to underarms and groin. Some oral electrolyte solutions if able, but don't overdo.

You need to drink electrolyte solutions such as gatorade, propel, powerade, etc... or drink water, eat crackers (salt) and bananas (potassium).

How much should you be drinking to prevent illness?

As much as you can, as often as you can, as long as you are exposed to heat. As long as you are making large amounts of dilute urine, you are drinking enough. If you aren't urinating or are urinating dark urine, you need to drink more.

New Experience

While I have written many things: books and scores of articles, I have never acted as a journalist before. I usually write based on my own knowledge. But recently I had an opportunity to step out of my comfort zone and interviewed some architects to produce my latest effort: "Building a Better ED: An Architects Perspective."

You can view it here:

It was a wonderful challenge. Hope you like it.

Thanks to everyone who came to support me at my launch party for "How to Survive a Medical Malpractice Lawsuit."

I signed lots of books. Drank lots of Sangria. And had lots of great conversation. Thank you again for all of your support!

Mobilize the troops!

Hello all, just a quick note to announce that my book has officially launched! Spread the word. If you are a doctor or know one, buy a book. Or three. It makes great July 4th presents. Father's day. Yom Kippur. Whatever.

I do need a favor. Though I have a better deal than amazon on my site, and I'd like you to buy through me, I need reviewers for

In order to be a reviewer, you must buy the book through amazon. See link:

I ask a few of you to buy through amazon, read the book, and write a review. Please. Thank you. I will answer any and all questions you have through my blog and my email

Dr B

How to get published (Part 1)

First, there are different ways to go about it depending on what type of book you are writing. There's fiction vs nonfiction, and in nonfiction there's trade vs. academic.

For fiction, your book needs to be finished and edited before you can solicit publication.

Nonfiction is different. While having a finished book can help, it isn't necessary. All you need is a proposal which has at most three sample chapters in it; though usually has one or two. A great resource is, "How to Sell, Then Write Your Nonfiction Book." Though that seems counterintuitive, for nonfiction, publishers often like to influence the final product.

I know a lot of people who say, "I'd really like to write a book." The only way to be a writer is to write. The only way to get good at it is to keep writing. But if you have a nonfiction book, write a few chapters, then focus all your efforts on the proposal. You still need to have a detailed outline of your book, but you waste a lot of time if you write the book before trying to sell it. The publishing process is slow. Very very very painfully slow (if you are an ER doc like me). So write a few chapters, write the proposal, try to sell the book, then continue writing the book.

A common question is, "Can I go straight to the publisher to sell my book or do I need an agent?"

Fiction: While there are certainly exceptions, most authors must get an agent to solicit a publisher to buy your book. Harlequin is an example of a publisher that will take direct submissions. Not sure? Go to their website. It will tell you if they read unsolicited manuscripts.

Nonfiction Trade (books that sell to the general public): If this book can be sold to a large number of people, you'll need an agent. If it is for a niche market, you often can do a direct submission. Again, use the websites for information. Sending manuscripts to places that don't want them will be a waste of time, and a poor use for the trees that valiantly gave their lives in vain.

Nonfiction Academic: Usually is direct to publisher-no agent required. Look on your bookshelf for textbooks. There has been a lot of corporate consolidation, so there are not that many independent players. You'll find that different labels are often supplied by the same editors. Make sure you pay attention to this-it would be a mistake to send your query to the same editor more than once.

Another major question aspiring authors ask, "Why should I get an agent when they take 10% of what I earn? Won't I do better going straight to the publisher?"

Answer: Agents earn their money. Publishers will negotiate with an agent items that you'll never even know to ask for, and how to ask for it. It is likely that you will get a better contract working with an agent, even accounting for the lost 10%. Now if you do a direct submission to a publisher and get a contract, I recommend spending the $300-$400 an hour for a literary attorney to negotiate your contract. It sounds like a lot of money, and it is, but you'll get that back and more because of a more favorable contract. I recommend Paul S. Levine because he is an attorney and agent, so you kinda get a two for one special.

To be continued...

In my shameful act of self promotion: if you are a health care provider or know one, please buy my book, "How to Survive a Medical Malpractice Lawsuit." Link to buy is on the upper right of my blog

How to Survive a Medical Malprace Lawsuit Part 2

It feels really good to hold the books in my hands. It will feel even better handing them off to people who want and need the advice within.

It has come to my attention that a lot of people subscribe by email to my blog, and therefore the links to buy don't function.

If you want to buy my book, go to my website and all the information to buy will be there: Reviews, Book Excerpt, Pretty Cover, etc...In the upper right corner of the main page, you will see a "Buy Now" button. In the space above that enter in any information you want in your autograph. Then buy through paypal.

If for some reason you hate the idea of buying through paypal, click on one of my tabs and there will be a link to amazon on those pages where you can buy through them.

Thank you all for your support.

I'm thinking of having a series of articles on the blog, "How to get your book published." Anybody interested? Let me know.

-Dr. Brenner

How to Survive a Medical Malpractice Lawsuit

Today is a special day. I held my newly published book for the first time. Since the book doesn't officially come out until May 24th, 2010, you can't get one yourself for several weeks. However, you can order an autographed copy from me for $31 plus $4 shipping (see website link below or to the right). Or you can do the pre-order now (see below).

I've added a new page that tells you why you should buy my book. And another page that has a book excerpt, not found on's site, that will show you why you should buy this.

Or I can tell you now - If you are a healthcare provider that hasn't been sued yet there are things you don't know about your medical malpractice policy that could become a problem later on if not resolved now. There are preventative tips that could decrease the likelihood of your getting sued. And if you are unlucky enough to be involved in a lawsuit now or in the future, this book will tell you things that most physicians never realize. And what you don't know can hurt you.

In a few weeks I will have a free iphone app that you can download that will summarize some very important parts of the book. It is a quick fire guide to surviving a suit. I will update the blog when this is ready for launch. And if you don't need this app, but have an iphone, ipad, or ipod touch, please download it anyway. It will help my rankings.

How to Survive a Medical Malpractice Lawsuit

Every Doctor seeks to avoid getting sued, but few doctors know what to do once it happens. Risk management courses abound, but they are not mandatory and relatively few physicians attend. Despite the information in these courses, there is a surprising dearth of instructions to help you AFTER you get sued.

And this is why, when first served with papers declaring a complaint against them, Doctors are completely unprepared for the crucial moments that follow.

My book will prepare physicians for the battle ahead. Physicians can not sit back and assume their attorney will save them. They have to save themselves. Read this book once before you get sued for critical advice that can help prevent a lawsuit, and set you up better if one occurs.

Then read it again after you get sued for step-by-step advice to walk you through the process, including detailed question and answer sections to help succeed at the deposition and cross-examination.

You may purchase this book through me, using the below paypal links. The book will come autographed if you wish, and please include any text you want to show up in the autograph. It officially is available May 24, 2010, but you can secure a copy by clicking on the paypal link. The price is $31 with $4 for shipping. I can do better than that for bulk orders of more than 9 copies. Contact me directly for special bulk orders at

If for some reason you wish to purchase via, you can use the link at the bottom of the page.

Autograph Text: