Monthly Archive: July 2012

Top Ten Most Disgusting Medical Therapies

If you thought 'gross' and 'disgusting' were adjectives that could only describe medical conditions, think again. Over the years, we in the medical field have developed our fair share of revolting medical therapies. After the great success of The Top Ten Most Disgusting Medical Conditions, I decided I needed to also divulge my Top Ten Most Disgusting Medical Therapies.  The idea for this article was born while working with a gastroenterologist in the hospital.  We were discussing a patient with clostridium difiicile (nicknamed C-diff), a terrible infection of the colon. The medical field has developed some great therapies for C-diff including antibiotics and, when necessary, surgery. Unfortunately, the infection is notoriously difficult to treat and sometimes the medicines do not help.  As we were sitting in the hospital discussing a patient the gastroenterologist asked me a shocking question.

"So, do you think it is time for a fecal transplant?"

"A what !?" I said.

"A fecal transplant. You know, implanting another person's feces into this patient's colon to treat the C-diff?"

I thought I was going to throw up right there in the hospital. I was sure he was kidding, he had to be, right? But there he sat, totally serious and staring at me. He was actually shocked and disappointed that I had not thought of it myself. How had I never heard of this before?  Fecal transplant! Gross.

Well, as it turns out, fecal transplant is a very well researched and well known therapy for C-diff infections. The theory behind its use is also very sound and well documented. As I progressed further in my training I began to mention it as a possible therapy for late stage C-diff infections without even thinking about how gross it actually is.  And that folks, is how really really gross things become so accepted in medicine: desensitization.

And now, the Top Ten Most Disgusting Medical Therapies
Note: All of the procedures are STILL IN USE!



The art of bleeding the body for medicinal purposes is one of the oldest techniques in the world.  The practice began more than 2,000 years ago independently in many parts of Asia, Africa, and Europe. It was initially thought of as a way to balance the humors in the body. Humorism is the idea that the body is made up of four distinct body fluids, blood being one of the four. Illness, then, was the misalignment of these fluids into abnormal proportions. Therefore, relieving the body of too much blood was one way of realigning the humors and ridding the body of illness.  The practice of bloodletting was widely practiced around the world until one hundred years ago when more sophisticated science began to trump humorism. However, bloodletting has not disappeared. Doctors still use the practice in a few specific circumstances, but to distance the current therapy from humorism bloodletting, we have changed the name. We know refer to bleeding the body for medical reasons as "Therapeutic Phlebotomy". There are a few blood disorders that result in too many red blood cells. These illnesses (hemochromocytosis, and polycemia vera as examples) lead to such an over-abundance of red blood cells that the body can start to shut down. The best therapy we have for these disease, naturally, is to bleed the patient until they have a normal amount of blood.  Perhaps modern medicine is not too different from Humorism!



Not only is leech therapy still in use, it is in vogue and becoming quite popular.   Like blood letting, the art of leech therapy has evolved significantly and is quite different from its roots thousands of years ago. However, at the core the principles are the same: leeches suck blood.  Historically, leeches were used  for all sorts of things that have little scientific evidence and are no longer acceptable including treating skin diseases, back pain, and migraine headaches. They were a very important tool in the art of bloodletting, discussed above, for obvious reasons. In fact, in the 1800's the use of medicinal leeches became so popular that the species Hirudo medicinalis (the most commonly used medicinal leech) was nearly wiped out.  We have recently discovered that the persistent blood sucking of leeches is still medically useful.  The field of microsurgery is rapidly evolving and progressing. Today, we can take pieces of skin and tissue from one place on the body and sew the blood vessels into other places on the body.  However, in order for the new reconstructions to survive they need adequate blood flow. Sometimes the blood begins to flow to the new skin on its own. For those instances where we need to help the blood flow to the new skin, we attach on leeches to suck the blood through. Beautiful.
















Trepanation is simple the practice of drilling a hole into the brain.  Incredibly, this is the oldest surgical procedure for which we have archeological evidence. Scientists have found hundreds of skeletons from 6,000 BC with trepanation holes in the the skull.  For thousands of years drilling a hole into another individual's head was the best available therapy for anything related to the brain: seizures, migraines, psychiatric illness, confusion, etc. etc. The most incredible part of the trepanation story is that it was widespread all over the world, from Ice Age wanderers, to the Incas in America, to the ancient Chinese: we have found trepanation skulls for all these groups.  Don't forget, anesthesia was invented about 150 years ago!  Thankfully, drilling random holes in skulls is mostly a thing of the past. However, "trepanation" is still used to relieve pressure inside the skull during emergencies, although now we call it a "craniotomy". This is the procedure of choice if someone is bleeding inside their skull (usually the result of a traumatic accident). If the blood is not released it can cause permanent brain damage, so a hole is drilled to relieve the pressure inside the skull. It may also surprise you that the art of skull-hole drilling for random medical illnesses still occurs today (dubbed: voluntary trepanation)


7. Tooth-in-Eye Surgery

Actually, this is a very new therapy, performed in the US for the first time just a couple of years ago. The procedure, also known as Osteo-odonto-keratoprosthesis, is a last resort surgery for individuals with diseased corneas.  When a cornea becomes damaged and cloudy, the eye can no longer see through it and people go blind. There are other surgeries to treat cornea disease, but when these do not work and the eye becomes scarred, the Tooth-in-Eye surgery is a great new tool.  Procedure: The scarred area of an eye and eyelid are removed and are replaced with the lining of your mouth (yes, your cheek mucosa are implanted into your eye). A tooth is then removed. A hole is drilled into the tooth and a small lens is placed inside.  The tooth and eyepiece are then implanted into the patient's cheek for a period of time so that they can develop a blood supply. Once the tooth and lens have a blood supply they are removed from the cheek. A hole is made in the cheek mucosa which is now covering the eye and the bone and lens are placed inside.  In the end, the patients eye is made up of inner cheek skin. This mucosal layer has a hole in the from where the pupil used to be and the bone/lens allow light to be reflected to the back of the eye, allowing the patient to see again. Awesome.





One of the most rewarding experiences during medical training is learning how to do an I&D (Incision and Drainage). It is nothing more than surgical zit popping.  Abscesses form when an infection walls itself off from the rest of the body. When this happens, copious amounts of dead tissue, pus, and blood build up in this cavity and have nowhere to go. The result is a red and painful pus ball under the skin. The therapy is simple, open up the cavity and let the pus drain out. The procedure is painful to the patient for a few moments but provides immediate relief afterward. If you are wondering what could be gross about this…you have never seen one. The puss smells awful. Abscesses form in the nether-regions of the body (arm pit, groin, anus, gums, etc). And, often the abscess are enormous, high pressure pockets that explode as soon as a blade pierces them. Check out the video if you are interested….but beware, it is truly gross.



In the article "The Top Ten Most Disgusting Medical Diagnoses" I mentioned Myiasis (maggot infestation) as the absolute most disgusting diagnosis. The overwhelmingly revolting thing about myiasis is that the infestation is unknown until you move some tissue around only to see hundreds of maggots eating a patient's flesh. Maggot therapy is a little different, but works by the same principle: maggots feed on dead skin. So, if a patient has a chronic wound that is not healing there is bound to be dead skin in the wound. Dead skin quickly leads to infection if not cut out, or "debrided". These patients are in need of constant debridement in order to keep their wounds from becoming infected.  Behold, the grand entrance of the medical maggot! When used medically, maggots are always sterile and home grown. We only use specific species and keep a close eye on the wound from start to finish. But it still grosses me out.



OK, I lied. Lobotomy is the only therapy on this list which is no longer in use. However, it did not fall out of favor entirely until 30 years ago and its inventor, Dr. Egas Moniz, won the Nobel prize for developing the surgery just 60 years ago (1949). Lobotomy was a simple procedure used to cure patients of psychiatric disease. The surgeon would take a long, thin nail (called an orbitoclast) and placed it next to the eye in the eye socket.  The surgeon would then take a mallet and pound on the nail until it broke the skull (think of an ice pick and a sledge hammer). The impact would break the eye socket and ram the nail into the front portion of the patient's brain. This process was repeated several times to "interrupt the connections between the front of the brain and the main processing centers of the brain."  The procedure was actually highly successful, nearly every patient was cured of their psychosis. Unfortunately for the patient's, nearly all of them were also left in vegetative state. Nevertheless, the procedure was popular for many years until anti-psychotic medications were discovered.  So, the next time you hear Tom Cruise tell everyone that anti-psychotic meds are evil, ask him if he would rather have a lobotomy.


3. HELMINTHIC THERAPY (a.k.a. "Hook Worm Therapy")

Up until 20 years ago, when someone traveled to another country and came back with 'worms' it was a terrible thing. That may not be the case any longer. Recently, researchers have found that parasitic worms have great medicinal qualities. Specifically, they are the world's best treatment for allergies and can successfully treat many autoimmune disorders including Crohn's Disease, ulcerative colitis, and inflammatory bowel disease. Undergoing helminthic therapy is as easy as taking a pill; you simply drink a glass full of live, parasitic worms. Once they have colonized in your body, they begin to work against the autoimmune diseases. The success rates in recent studies is actually very impressive. While there are a number of theoretical explanations for why the therapy works, the best evidence of their effectiveness is the the fact that in countries where most humans are colonized with parasitic worms, there is virtually no autoimmune disease.


2. ELECTRO-CONVULSIVE THERAPY (aka ECT or "Shock Therapy")

When I started medical school I was shocked to learn that "Shock Therapy" was still in widespread use around the entire world. ECT is used for a wide variety of psychiatric conditions including schizophrenia, depression, and severe bipolar disorders. To complete the procedure, electrodes are placed on the scalp, the patient is sedated, and the a series of high voltage shocks are applied to the brain.  Essentially, we induce a seizure in a willing person.  It is not like the old movies where the shock sends the patient's body into a convulsion, these days most patient's are temporarily paralyzed during the procedure.  However, though I know that it is effective, there is still something inside of me that feels uneasy about sending large amounts of electricity through the brain of an unconscious person.



As my leading story alluded, fecal transplant is the real deal. It is an effective therapy for late-stage clostridium difficile (C-diff) infections. C-diff is an infection of the large intestine that usually occurs after using antibiotics.  It is a normal bacterium that lives in your gut and is usually kept in check by the other bugs that normally live there.  When a person takes antibiotics, the normal bacteria in the gut are often killed but C-diff is usually note affected by ordinary antibiotics. This gives C-diff free reign to take over your whole guy all for itself.  We have good medications against C-diff, but they do not always work. In theory, replacing the ordinary bacteria back into the gut should bring C-diff back into check. How can we do this? Easy. By taking the feces from a healthy patient with normal intestinal bacteria and transplanting it into the patient with C-diff.  So, don't get mad the next time you walk into a doctor's office and you really want an antibiotic and the doctor says "It looks like a viral infection, I don't think you need antibiotics." In reality you should thank your doctor, he/she is only trying to save you from having another person's feces transplanted into your backside.


HONORABLE MENTION (Just outside the Top Ten)

Tapeworms are known to colonize the gastrointestinal tract of human beings. They are notoriously difficult to get rid of because they use strong teeth to latch onto the intestinal wall once they are inside the gut.  The "Milk Bath" remedy is often cited as a great solution. Most clinicians and scientist will tell you that this therapy does not, or at least should not work. But that advice does not stop thousands of people around the world to continue practicing it, and openly reporting on its success.  Supposedly, when you are infected with tapeworms, there is a simple way to get the out of your body–a lure. If patients submerge their backsides into a bucket of milk, or sleep with their mouths open next to a bucket of milk, the tapeworms will crawl out, preferring fresh milk to human gut. If true, the migration would be very slow and the patient would have to endure the feeling of worms crawling out of their orifices for many hours.  Looking at that picture, I think I would rather stay colonized.



Skin cancer is one of the most common cancers, and one of the most preventable.  Wearing good sunscreen greatly decreases your risk of skin cancer. So, what is the best sunscreen?  Recently, studies show that hippopotamus sweat might be the next big sunscreen breakthrough. The natural product does no damage to human skin, does not harm animals in its processing, and blocks nearly 100% of all UV rays.  Sound perfect?  That's because you haven't seen hippos sweat! This is not a clear, salty sweat like we have. Hippo sweat is referred to as a 'blood sweat' and is actually neither blood nor sweat, but a natural sunscreen. I really don't want skin cancer…but I don't know if I can put that stuff on my body.



This is probably the most common therapy on this entire list. Eye injections are used for everything from eye infections, to macular degeneration, to diabetic disease in the eyes. The procedure is done routinely in the offices of ophthalmologists around the world.  Unfortunately, if you are diagnosed with a disease that requires medical injections into your eye, you will likely need a series of at least 3 injections. The needles used for eye injections are small, and the area is numbed up very well: most patient's report not even feeling the stick. However, something about sticking a needle in an eye just seems wrong.



The data are very limited, and I have never met a physician who endorses urine therapy. However, I can't find any information debunking the theory either. Urine has been used since Roman times for medical therapy for everything from infections to psychiatric illness. Many not in the medical field suggest that it has strong anti-cancer effects and many of us have heard that if you pee on your foot, you can cure athletes foot. None of these suggestions have much medical support, as urine is mostly made of water and electrolytes.  However, urine therapy is still used in modern medicine, just not human urine. Horse mares are known to pee out a large amount of estrogen. Pharmaceutical companies have realized this and now collect female horse urine, extract the estrogen, and sell it as an estrogen tablet.  Yummy.


  • ICHTHYOTHERAPY (a.k.a. "Fish Therapy)


The garra rufa species (a small fish, nicknamed the "Doctor Fish") lives in rivers in Turkey and Iran.  For hundreds of years humans have known of their strange affection for abnormal skin. Individuals with skin rashes, skin infections, and skin growths often come to the region to let their feet soak in the water and let the Doctor Fish pick away their diseases. Recently, garra rufa fame has become more well known and the fish have been the subject of numerous medical experiments. Indeed, research is showing that they have some ability to pick away skin disorders of the feet including dermatitis and psoriasis. Those who have felt the healing power of the garra rufa say there is no pain involved, and that the experience is more relaxing than painful.


Spotlight Interview: Why Did You Choose Anesthesia? (Pittsburgh Resident)


An Anesthesia Resident's Perspective: From an interview with an anesthesia resident from the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.


  • What attracted you to Anesthesia?

I was attracted to the intimate patient care, to a specialty that is procedurally oriented, and to a specialty that requires a working knowledge of physiology and pharmacology.  I saw a lot of energy in the fact that anesthesiologists need to have the ability to control all aspects of a patient's response to surgery in real time.


  • Describe an Anesthesiologist's typical work day?

This depends on the type of practice you will ultimately choose. Generally, anesthesiologists arrive early-ish (like 6:30-7am) and are usually done when all surgeries are finished for the day (this can range from 3pm- 6pm depending on working environment).  Weekends and nights are infrequent, but some call is generally taken at least early in your career.


  • What type of lifestyle can a Anesthesiologist expect?

The lifestyle is very good. Like I said, weekends and nights are usually free unless you need to take hospital call, which is infrequent at worst.  If you end up at a private practice at an outpatient surgery center you can expect to work from 7am until 5pm Monday thru Friday!


  • What is the average salary of a Anesthesiologist?

250k-450k per year.  Some jobs will start you as high as 400k if you will move to a 'less desirable' location.  Salaries are lower for big cities, just like all other specialties. More details at


  • What is the job market like for Anesthesiology?



  • What can you tell us about Anesthesiology Sub-specialties?

Most fellowships are another 1-2 years after residency. The most common fellowships are pain management, pediatrics, critical care medicine, and cardiovascular anesthesia.


  • What are the potential downsides of Anesthesiology that students should be aware of?

There is some concern over liability, but this is no different than Ortho, neurosurgery, ob/gyn, and many other specialties involved in surgery..  The concern that CRNA's will take all the work away is commonly overstated.


  • What else would you tell medical students who are considering Anesthesiology?

Work hard in all rotations, and especially on your anesthesia rotation.  Commonly an anesthesia rotation is one where you can go home at lunch and no one notices, but it pays huge dividends if you get noticed working "late" (like til 4pm).  Actively seek out procedural opportunities on all rotations.  Try to do related rotations like pulmonary consults and pain management. You definitely should complete an ICU rotation and you should do you best to excel at it.


Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.


Spotlight Interview: How to Match in Anesthesiology (Pittsburgh Resident)


An Anesthesia Resident’s Perspective:  From an interview with an anesthesia resident from the University of Pittsburgh School of Medicine in Pennsylvania.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.


  • How competitive is the Anesthesiology match?

The anesthesia match is moderately difficult.  However, the answer to this question really depends on how you look on paper and in person. Our match is not as difficult as plastic surgery, but there are always a few people in the country who do not match. You should speak with one of the deans of your medical school if you have concerns.


  • What are residencies looking for in an Anesthesiology applicant?

The most important factors initially are a student's performance in anesthesia rotations and letters of recommendation.  Board scores do matter, but need not be sky high.  Mostly, anesthesiologists are laid back and are looking for someone they can work easily with.  You also need to show initiative and be able to make decisions quickly and respond to crises effectively. I am not sure exactly how one portrays these qualities, but the interview certainly can help.  Have answers in your mind to questions that you will almost certainly get asked (examples: Why have you chosen anesthesia?,Can you tell me an example in your life of problem solving?, Where do you think the specialty is going in next 10-25 years?, etc.).


  • What do you wish you knew before application/interview season?  

I did not have much exposure to FREIDA. I would recommend researching program statistics on FREIDA prior to applying, you will learn some interesting things about programs and may even choose not to apply to one and to apply to a different program.  Also, the ASA (American Society of Anesthesiologists) annual meeting is in October (right before interview season) and there are a number of medical student specific programs that include an opportunity to meet and talk with many program directors (this event occurs on the weekend portion of the meeting).  I would try to attend if it is at all financially possible to do so.


  • What should students be looking for in an Anesthesia residency program?

Use FREIDA and your other tools to determine what size program you want to be part of. Large and small programs each have their positives and negatives. Look for residencies that fit into the program size and 'level of prestige' that fits what you're looking for in the work/life balance and where you want to go with your future career.  You will also find that more prestigious schools at big research universities also have positives and negatives.


  • What other advice do you have for students applying to Anesthesiology residency?

Start early and get everything submitted ASAP, most programs filter through the applicant pool once and then fill all interview spots. Furthermore, spots fill quickly, so have your email forwarded to your phone/pager and don't be afraid to excuse yourself from your rotation to set up an interview; 4 hours later may be too late.  It is not uncommon for programs to send out more invites than they have interview spots.


Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


Reflections of a Graduating Intern

Today is the first day of my PGY2 year. I am writing this at midnight, just as the final hours of my life as an intern have evaporated. My main emotion, which I am sure is not unique to me alone, is a feeling of relief. However, as I reflect on the actual experiences that I have had over the past 12 months, I am mesmerized by how freaking cool my job is. The internship, no matter your specialty, is one of the most demanding professional experiences in the entire world. Yet, it is also one of the most rewarding experiences that can be found in any profession.  I would like to reflect on a few of the overriding feelings I have had over the past week.

Dear medical students and new interns:

Your job rocks

You change lives every day Every Single Day. You will know the basic treatment of nearly every single patient that could walk through a hospital door. You are a DOCTOR!  You are not an orthopod, an ophthalmologist, a dermatologist, or an internist [yet]…you are simple a well-rounded DOCTOR! You get to be part of some of the most important situations and conversations that your patients will ever experience. You will provide live saving service to hundreds of the coolest people you will ever meet. It is hard to grasp the reality of your job as a student or a resident. But take a small step back and think about it.

Do not allow yourself to be jaded

You are an intern, these things are a given: awful work hours, negativity from your colleagues, difficult patients, even more difficult families, intolerable work load, mistakes. These issues are inevitable and to allow them to bring you down is a sign of weakness. Recognize that no matter what you do, where you do it, or who you do it with, you will encounter each of these things. Rise Above! Don’t forget #1 above: you actually have a great job.  [Note: I am not a rockstar. I was frequently jaded, I was occasionally the negative colleague, and I did not always have the best bedside manner. But I can tell you, when I decided to get over that stuff, my job was great and patient care improved]

Work hard in medical school

Work hard, not for yourself, not for the grade, not for the board score or to check off another box on your CV. Work your tail off for your future patients. Remember, you came to medical school for them, not for yourself. If you were doing this for yourself you would be getting an MBA and working on Wall Street. As you sit there studying biochem, embryology, PreTest for the Pediatric Shelf Exam, and First Aid for the USMLE Step 2 you will not realize what is actually happening. You are acquiring information that at some point in the near future will be lifesaving to another person. DO NOT take your studying lightly. As I learned in my first days as an intern, your knowledge WILL be relied on very soon to save someone’s life. Let me provide you with just a few examples over the past 12 months to drive this point home. I recount these stories not to boast, as I am sure every intern in my class would have done exactly the same; I share them only to reiterate that you can NOT take your studying lightly.

NOTE: Stories have been altered to mask any identifiers but are otherwise true.

Exhibit A:  Early in my internship I was called to the emergency department to admit an older woman who was complaining of right hand weakness. She was unable to open and close one hand at all and the other was not much stronger. She said she had a vaccination about 4 weeks earlier.  Walking had become more difficult and she felt like her shoulders were now weak.  My ears began to perk up, the words and phrases from my countless hours of studying flashed in my head, as they will in yours. She then said, “you know, I am having some trouble swallowing right now.” BINGO! At this point a light must go off in your head. [GBS! GBS!]. Her weakness is above the neck and she has minutes to hours before her respiratory muscles will fail.  I immediately called my senior resident (something you should always feel comfortable doing, especially early on). We intubated her within minutes and she made a slow but great recovery.  I was the only one there. I was one month out of med school. DON’T TAKE STUDYING LIGHTLY.

Exhibit B: Towards the end of internship I was in the basement of a friend’s house when a three year old boy who I know very well was playing with a marble and inhaled it. He made the universal sign with his hands up to his neck. He coughed twice, and then stopped coughing and breathing all together. I immediately grabbed the boy, flipped him upside down and gave him a whack on his back (ACLS/BLS Protocol). After the first whack there was no change, only the same choking boy. I then gave him a second and viscous whack. A large marble erupted out of his trachea and onto the basement floor.  I am sure the toy was completely blocking off his airway because he had stopped making any noise at all.  DON’T TAKE YOUR TRAINING LIGHTLY (BLS/ACLS ESPECIALLY)

Exhibit C: Early in the year I was speaking with a patient when the nurse next door screamed for help. I walked in the room and the nurse pointed to the patient (not my patient) who was staring blankly into space. She said that the patient was conversing normally minutes ago and had been recovering well from a small GI bleed.  All of the sudden the patient turned towards me, opened her eyes wide, and then spewed out nearly a liter of blood from her mouth.  Any clot overlying her bleed was now obviously gone and she was acutely loosing incredible amounts of blood via hematemesis.  If you are not yet aware, such an episode is can lead to death within minutes. I was the only doctor on the floor. My reading, rounding, and studying of GI bleed was the only thing available.  DON’T TAKE STUDYING LIGHTLY.

Call your resident

It is not weakness. If you have a question, call. If you ever think about calling your resident, call.  In the grand scheme of things, is it better to be irritating or to harm a patient for fear of being irritating?


You knew this was going to be hard. You knew you would work more than everyone in your family and all of your friends. You knew you would have little free time. You knew there would be crummy nurses and egomaniac residents and attendings. Don’t act surprised. Don't be weak and let these things change you. These things exist in every profession. The difference is, you get to have a profound and positive impact on your patients that could change their lives forever.  And you get to do this EVERY SINGLE DAY!

You will make mistakes.

Get over it. Don't flatter yourself: you, just like every other intern that has ever lived, will make mistakes. Learn from them and teach students and other residents about them so that they never happen again.

Choose to be happy

Yes, it is a choice. Find a time to stop and reflect on what you are actually doing. You will certainly be overburdened by progress notes, H&Ps, nursing calls, terrible call nights, and trying to keep the rest of your life from disappearing.  Set aside a time where you can think about the great experiences you are having and the hundreds of lives that you are improving. If you find a way to smile and be happy, you will not only love your job, you will also become a world class physician and your patients will love you.  Attitude is everything.

You Job Rocks!

No, really, I am serious. It rocks.