West Nile 2004

According to an amazingly poorly phrased CNN report, New Mexico and Arizona have both already reported human cases of West Nile disease.

For those interested, the CDC has a very good West Nile information page.

And, as last year, the USGS will have better maps than the CDC, though their maps seem to lag a few days behind the CDC numbers (but they’re still very very informative).

Wear your bug spray!

This is wrong

I have written before about my coffee drinking problem. A couple of days ago, I went to the breakroom, and saw this:

TheHorror!

This is just plain wrong. For those who need it spelled out:
the coffee pot is empty!
the brewing basket is not just not ready to brew, it is actually empty (i.e., someone emptied it out but didn’t refill it)!

I took this photo to help non-coffee drinkers understand, so that perhaps others will not be scarred, as I was.

Where art thou, QFever?

OK, it’s been 5 1/2 months since the last QFever.

Join me in writing them to get back to work. You’ll be glad you did.

Clinical Tip

When examining the pupil, it’s preferable to have the patient look into your own eyes. “Look into my eyes” should be left to horror movies and pickup bars, so a different approach is needed.

Let me explain how I learned what to say, and what not to say.

I used to say “Look at my nose, here”.

One patient said “why would I look at your nose hair?”

Now, I say “look at my glasses”. That works fine.

“Would You Mind

leaving the room”? asked a patient the other evening.

“Uh, why”? asked I.

“Because I need to pass gas” said the patient.

We left the room.

I cannot make this stuff up. And, we didn’t go back for a while.

Happy Birthday Dad!

Happy Birthday Dad!

Happy Birthday, Dad, from all of us.

In case you wondered how a binary nerve gas shell actually works

The Command Post – Iraq – Facts about Sarin, Binary Agents, and 155mm Shells

Answer to Guess the Diagnosis

On the 14th, I published an “unknown”, and challenged you to make the diagnosis. I am gratified that it got so many comments, and that people are interested in getting to the answer.

The correct answer is: left diaphragm rupture with herniation of the stomach and colon into the left hemithorax, with mediastinal shift. There are marked-up copies of the original in the extended entry to illustrate what we’re seeing, and to answer a few questions asked in the comments.

The patient was very short of breath, which was handily relieved by putting his bed into “reverse trendelenberg”, making his feet lower than his head. This caused the abdominal contents to stop compressing so much lung, and probably allowed the heart and great vessels to resume their normal position.

He went to the OR, and had his torn diaphragm repaired, a splenectomy, and his two pericardial tears fixed, leaving a pericardial window.

Interesting case.
[Read more...]

NAS Lemoore SAR search

I got this today, and in the spirit of public affairs, here it is:

Hello

Saw your posting on a website and would like to inquire if you have any info on lemoore sar. I am currently the senior medic at lemoore sar and we are being decommisioned. We are looking for any info of people who knew lemoore sar or worked with them. Any help you can provide would be much appreciated.

HM2 Stephen Taylor
Lemoore SAR
stephen.taylor@navy.mil

There you are. I’m not going to turn this into a “lost my buddy” board, but as this is the first of these I’ve gotten, I felt it was interesting.

My Drug of Choice

Coffee for me
It’s kind of a joke in the ER, but I drink coffee. I mean, from the time I get there until I leave, I like to drink coffee. Black coffee. If I wanted candy, I’d get candy. Coffee is only coffee when it’s black.

Today, I took a picture of my coffee. And now, I share it with you.

What would you do?

You’re a genius. You are so smart you went to college at the advanced age of 13, and graduated with a degree in chem at 18.

What would you do? Of course, you’d join the Marine Corps.

Astonishing as it is, this happened: Marine Corps Moms: Military Intelligence

Read the article to find out why he didn’t pursue a commission, and other interesting facts. This young man is exceptional, in the real definition of an overused word.

Armed Forces Day (Yesterday)

DefenseLINK – Armed Forces Day

Phooey. I know it was Armed Forces Day yesterday (Saturday), and I didn’t post anything. Shame on me.

The above link has a picutre of a very nice poster for Armed Forces Day, 2004, along with an explanation of the history. Since the link is for the front page, and that’ll change soon, I’ll put a screen capture of the page in the “continued” section.
[Read more...]

Marine Corps Moms

Marine Corps Moms is a website that I’m going to be reading frequently, and I’d encourage the three of you to have a look!

Added to the sidebar under miscellaneous excellence.

New Feature: Guess the Diagnosis

Answer above (read it if you haven’t been to this one before).

OK, since I will not play in the outrage of the week fan club, perhaps I can interest all three of you in “guess the diagnosis”. I may never do this again, and may do it every week. The winner gets pride in smugly affirming their intelligence, everyone else gets to know the diagnosis. All diagnoses are made by me, and I’m also the judge, so appeals will be brief.

Adult male, brought by EMS after an MVA. Complains of Left chest pain and severe shortness of breath. A chest xray is obtained:
supine AP portable cxr
Supine, Portable AP CXR

OK, have a good look, then decide (that’s how it works in the real world). A CT is below to confirm or refute your diagnosis.
[Read more...]

the underwear drawer

the underwear drawer

Somehow, I’ve missed this medical resident weblog. She’s a pediatrics intern in NYC, and her blog has been going on for quite a while now.

What you cannot miss is her “scutmonkey comics“, which may be the best short presentation of medical school, ever.

found via Code:theWebSocket;