Archives for March 2004

Went to the Mavs game

and got dinner AND a show! And, it wasn’t the game that was the big show (for me).

OK, dinner was nothing special (except for my first french fries in more than 2 months (Atkins no-no).

And the game was very good, with the final score not showing how close it was until the last 3 minutes. I’m not a basketball fan, so I’m not following the season, but my son is. Which brings me to the show.

With about 3 minutes left in the 1st quarter, a Mavs guy leaned over to my 21 year old son (who was wearing a Mavs jersey), and asked “Would you like to be in the show at the break?” I was just able to get out of the way quickly enough, and off they went, behind the stands.

The break begins, and out he comes in his Boston Market t-shirt and wearing a chicken hat on his head. Really. He and 4 others, it should be noted. Then, when the music started, they danced the ckicken dance to the amusement of everyone in the arena. He didn’t win the popular vote, but he has established himself as the best chicken dancer in the family.

He finally got on the court at a pro game, and it was as the second best chicken dancer. Irony continues.

Advice for Medical Students

In the comments to an entry over at Bloodletting, Dr. Moriarity holds forth with his advice for med students on clinical rotations. I asked him for permission to post them here (and there’s a bonus diagnostic rule set at the end, by a medical student he once knew).

Dr. Moriarity’s Advice to Medical Students:

Know your patients.

Arrive early. Stay late, but not a second longer than you should. (Patients come to those who wait.)

Comport yourself as a member of an ancient and honorable profession.

Ask questions, but do not question the medical judgement of your seniors. (The only thing worse than a dumbass medical student is a smartass medical student.)

Take the initiative.

Go for the money, not the zebras. (See Sutton’s Law.)

Do not brownnose. Do not lie. Do not cheat. Do not dump on your team or your classmates. Do not try to bullshit. Never assume that anyone besides you has cared for your patients. (We are at least as interested in how well you work with others as how much you know.)

Treat nurses and hospital staff with respect, regardless of how they treat you.

Recognize that you are a valuable part of a team, even when it seems like all you’re doing is being abused, pimped and scutted to death.

Work hard, but remember: You are there to learn, not to work.

[Read more…]

Chernobyl Cyclist Posts Again

GHOST TOWN is the photojournal of a nice Russian lady who rides her motorcycle through the Chernobyl dead zone, and takes photos. She did this before, and now she’s added to it.

Her site has some of the previous photos, but many more new ones. It’s supremely powerful.

BTW, some of the photos are labeled “”, which has been registered (in Melbourne) as a domian name, but there’s no site there (yet).

via Slashdot

Family Seeing Codes

Cut To Cure has an interesting after-action on his CME trip to Vegas. The part that caught my attention was:

On the last day, half of the morning was spent on discussions of “ethical issues” the most interesting one was related to the presence of family members in the trauma bay during resuscitation. Objections included the lack of space in the ED, having family members “fall out” during a resuscitation, family member interference and criticism (that’s not how Dr. Carter did it on ER last night!) and of course, fear of litigation if things don’t go well. Those that support the presence of family members during resuscitation cite reports (mainly related to ICU codes) that state the emotional benefits and “closure” that having family members present provides. The speaker polled the audience asking who would want their family member to see them with all of the accessories that go along with a complicated trauma resuscitation, very few said yes. I think that the presence of families in the trauma bay can only be a hindrance.

I do resuscitations for a living, and can say that only in VERY limited circumstances would I NOT allow a family into the room. (One or two, not the extended family).

There is, when present, no doubt in their mind that everyone is doing everything to “save” their loved one. I would say that the family of the chronically ill “do the best”, as they’ve been around medicine and hospitals for a long time, and the environment isn’t overwhelming. Those who aren’t hospital aware are frequently comforted by the fact that all those people are working so, hard, which is the absolute truth.

I support letting the family in. If they’re disruptive, let them go (with the Chaplain, or your equivalent), but most will understand. It’s what I’d want. I wouldn’t insist reluctant observers be forced to attend, but were it me, and my family is on the table, I want to be there.

I’m a control freak, and it’s very hard for me to let go, but this is one time when letting go of control, and letting in the family, is the best for all concerned.

Friday Night Lights

My fellow blogger George Jones (an attorney!) in Midland has been keeping a close eye / blog on the filming of Friday Night Lights, the film adaptation of the book by H. G. Bissinger. The blog can be found at Sleepless in Midland: “Friday Night Lights”, and keep scrolling.

I am very anxious about this movie, mostly because I see history repeating itself. Bissinger comes to Odessa, ingratiates himself with the Permian players and the good people of Odessa, which he then makes Odessans out in the book as debased redneck racists. Now, a movie company has come to Odessa for the purpose of bringing the book to the silver screen, the friendly people of the area are welcoming them with open arms. And I have my eyes closed like a crash is about to happen.

I really hope the people quoted in the blog Sleepless in Midland are serious that they’re not going to “…bring in a lot of the stuff that seemed to have made a lot of the populous unhappy when book came out.”

I very cynically said (me? cynical?) earlier in his blog something to the effect that ‘people don’t come to West Texas to make us look good’. I hope I’m wrong, and that this movie presents the people of the entire Permian Basin as the decent , High School Football loving people they are.

I also hope Bissinger doesn’t get a cent.

Medical News Digest

I perused the CNN health headlines today, and as a public service I’ve condensed the two that got my attention:

Smoking may negate pets’ allergy benefit. Don’t let your pets smoke, especially around the kids.

FDA issues suicide caution for antidepressants. News flash: depressed people sometimes commit suicide.

You’re welcome.

Odessa Medical Helo Crash MCH helicopter crash claims four lives

An early morning crash of Medical Center Hospital’s CareStar helicopter in Ward County has left four people dead and a fifth injured.

The helicopter – a Bell 407 – was enroute to University Medical Center Hospital in Lubbock from Big Bend Regional Hospital in Alpine. Communication with the helicopter was lost just after 2:00 a.m.

The crash site was located by a Texas Department of Public Safety helicopter shortly after 6:00 a.m. near the intersection of FM Highway 1927 and County Road 36 in Ward County.

Reported killed in the crash are pilot Micky Price, 46, of Dumas, Texas; paramedic Paul Lujan, 32, of Odessa, Texas; patient Pedro Urias Modesto, 3 months, and his mother Ana Lillia Urias, both of Mexico.

A fifth occupant, registered nurse Ronald Stephens of Midland, was injured in the crash.

Medical helo crashes are both tragic and seemingly unavoidable. They fly at unscheduled times, over irregular routes, and sometimes in bad weather. The majority are single pilot operations, as cost control is important and helos constantly have to fight with weight and payload issues. Single pilot is a balanced risk: there is no guarantee that a second pilot would prevent any crash, but it seems logical that it would help sometimes.

Crashes like these are why most ED residencies stopped requiring residents to fly as part of the program, and why I always cringe a little when Doc Shazam writes about her latest flight.

Best wishes for Nurse Stephens, and condolences to all those who lost loved ones.

CNN Story.


I have been very busy. I was going to call this “household happenings”, but since I’m not in the house while awake these days, I don’t have a lot to say. We’re very very short ER docs at work, and it’s spring break, so a lot of the docs are off on vacation, therefore I’m working lotsa long hours.

The one thing I did do around the house was a big geek disappointment: my robot mower won’t work. I bought a RoboMower, which is really neat technology, and I was looking forward to feeding it rechargable batteries and having a nice yard, but it’s not to be.

The mower has a tilt-angle safety, to keep it from cutting when it shouldn’t, and that shuts it off on the steepest hillock I have in the back yard. I was worried about it, and it won’t do the job. Yeah, I could keep it to do the front yard, and most of the back, and just hand-mow the steep bits, but the object was to rid myself of the hand mowing altogether.

So, no robot for me. Now I need a lawn service.

And a day off.

InstaPundit causes Asthma?

Another first for the blogosphere! – Which cities are worst for asthma sufferers? – Mar 16, 2004

Asthma hits all areas of the United States, but Knoxville, Tennessee, is the worst, according to an organization’s ranking of the nation’s cities released Tuesday.

Tennessee is also home to two other cities in the top 10: Memphis and Nashville.

To bring awareness to the potentially fatal disease, the Allergy and Asthma Foundation of America developed a list of 100 metropolitan areas across the country that they term “asthma capitals.”

The group looked at the prevalence and mortality from the disease, outdoor air quality, smoking laws and the number of asthma medication prescriptions and specialists.

Note they didn’t look into blog rankings . Although not a traditional risk factor, blogs really have changed everything.

Update: then he skips town. Something is up!

Bias in Medical Journalism

Oh, That Liberal Media: Bias in Medical Journalism
An interesting article about a medmal trial going on in Seattle, which has big implications for all medical researchers, not just the ones on trial there.

The really interesting thing is that the Washington Post actually called the Seattle newspaper out about their flawed / biased journalism, apparently to no avail.

ACEP gets new Executive Director

From ACEP:

Washington, DC – The American College of Emergency Physicians (ACEP) today announced it has hired Dean Wilkerson as its new executive director. For more than a decade, Wilkerson has served as the national executive director of Mothers Against Drunk Driving (MADD), the nation’s premiere organization supporting victims and working to stop impaired driving and prevent underage drinking.

J. Brian Hancock, MD, president of ACEP, said “We are excited to have a seasoned advocate like Dean joining ACEP. He will help bring attention to and seek effective solutions to the problems facing many hospital emergency departments and their patients.”

The the irony kicks in:

Dr. Hancock explained the announcement comes at a pivotal time for the organization, as it strategically examines the urgent medical liability crisis, overcrowding occurring in emergency departments throughout the country, and the failure of government to adequately fund emergency medical care, especially for the poor and uninsured. (Emphasis added)

So, ACEP gets the Executive Director of MADD, the same group that came out against Texas’ Proposition 12, lawsuit reform.

I have no idea if he had any hand in that decision, but it’s certainly made me look at MADD in a new light, and they’re off my donation list. It’d be interesting to hear what he has to say about MADD’s stands to ACEP.

How Bad is it in America?

How Bad Is It In America?
A conservatve with writing skills goes to the ED and sees what we in the ED see every day. Highly recommended.

via Code:theWebSocket , who’s been on a link roll lately.

Spain Reads Blogs

Within about 3 hours of my linking to the below BBC article, I got two comments, both from Spanish bloggers, one of whom is a Physician, both proud of the Spanish EMS system. These are my first (known) truly international comments! (if Americans in Kuwait are placed in a different category).

I have replied to the one who left an email, and have run both linked websites through AltaVista’s Babelfish service (thanks, AltaVista), and they are, of course, very interested in the identity of the attackers, be they ETA or Islamofascists.

Wow. Small world. (And I’m suitably embarrased that the Spanish bloggers can read my US blog, and I have to get a rough translation to read theirs).

Madrid ER during crisis

BBC NEWS | World | Europe | Eyewitness: ‘Hospitals struggle to cope’
I have been wondering when these stories would come out: how a metropolitan city of about 2 million took on 1,200+ casualties from multiple bomb sites. Looks like they did well, and that their disaster plans worked. I really look forward to many more reports of the “this worked and this we could do better” variety.

What most folks don’t realize is that the every day emergencies keep occuring, and those neary completely saturate every ED I’ve ever been in. Staffing for everything, bed availability, etc., is all predicated on the number of ‘routine’ emergencies; the surge capacity isn’t all that big.

Kudos to the Spanish ED’s and their staffs. I hope they recover quickly.

via Code:theWebSocket

Comanche Program Explanation

The cancellation of the Comanche program was a big surprise, at least to me. Via The Onion, here’s a nice “Infographic”: why the comanche died
via the AG