Archives for July 10, 2003

Fort Worth Fastest Growing City in US

Census: Fort Worth Grows Fastest In Texas, Austin Sees Population Decline

Fort Worth’s 2.6 percent population growth rate between 2001 and 2002 was the highest among Texas’ 10 largest cities, according to estimates made public Thursday by the Census Bureau. Cowtown expanded to nearly 568,000 people, about 10,000 shy of El Paso, which grew by 1.1 percent. If those paces continue, Fort Worth will supplant El Paso at No. 5 by next summer.

And, as one who has lived in both cities, Fort Worth is better in every single respect.

Other surprises:

More than 11,000 people moved out of Dallas between 2001 and 2002 despite its net increase of about 5,600. Texas state demographer Steve Murdock noted that San Antonio, which gained about 23,000 to reach 1.17 million last summer, by now should be on the verge of passing Dallas (1.21 million) as the state’s second-largest city.

Best quote? It’s about Austin:

Austin, which grew at a brisk 4.1 percent annually during its tech-driven heyday, was the only major Texas city to lose population as it shrank by about 1,100 between 2001 and 2002.

Austin is still a place where people want to live, says downtown-area real estate broker Kevin Burns. It seems to help, though, if they don’t need a job.


Anger Management – Plant shooter took anger management classes – Jul. 10, 2003

Which tells us all we need to know about Anger Management classes.

Anger management classes are a “time out” penalty for adults. When I was on active duty, I knew several people who elected to go to anger management rather than some other punishment. My evaluation then, as now, it that it’s a valuable tool to tell someone you’re paying attention to them, but that it’s otherwise a big time waste (like ‘ethics’ classes, but that’s a different rant).

Rapid West Nile Test: my work just tripled – FDA approves rapid West Nile virus test – Jul. 9, 2003 and my life just got harder.

West Nile virus is transmitted by mosquitoes, and in most people causes no symptoms or a very very mild viral illness; a very few go on to develop the most dangerous of these infections, meningitis. The biggest risk factor, past mosquito bite, is age greater than 50.

Roughly everyone on the planet is going to be bitten by mosquitoes this summer, and there are a terrific number of people who are going to worry incessantly about their bug bites. They’re going to come, or be sent, to the ED.

Last year, we were able to tell people (truthfully) that there wasn’t a decent, reliable test, and that the only people we were testing for this usually always self-limited viral illness were saved for those being admitted to the hospital for meningitis.

Now, we’re going to be innundated with people who are worried they ‘may have the virus’ and ‘want the test’.

Talk all you want about education, when people come to the ED they want The Test, and it doesn’t matter if it’s a blood test or an MRI in the middle of the night. This is going to cause a lot of extra ED visits, at least in the short run, until the public gets used to the endemic nature of West Nile. (Then, look for a test on the store shelves).

Oh, and bring back DDT, and this will be a non-issue.

West Nile from the CDC.

The LP

Today, I had a Physician Assistant Student (PAS) in the ED. I like to teach, and I do it infrequently enough that it’s fun. Today’s topic: the Lumbar Puncture.

The PAS hadn’t seen an LP before, so we talked about it before the procedure, after a nice long talk with the patient about risks, benefits and alternatives.

This was the best, easiest, smoothest LP I have done in about 2 years, of course. The only other option, given the audience, was abject failure and humilitation, which was thankfully avoided. The patient had very little discomfort (see below), and tolerated it exceptionally well.

Afterward, everyone who had been in the room (the ED tech, the scribe, the PAS and I) were actually laughing (very very professionally) at how easily it went, and how completely unrepresentative of a usual experience the whole thing was. It was a completely unrepresentative introduction to the procedure, and everyone involved pointed that out.

If I were to make a movie about ‘how to perform an LP’ this is the one I wish I had on tape.
(Discomfort is a doctor term for pain that other people feel).