Archives for August 2007

Ankle bracelets and medical nomenclature

Ex-astronaut can take off ankle bracelet –
(CNN) — A former NASA astronaut accused of assaulting a romantic rival at a Florida airport can take off her electronic tracking bracelet while she awaits trial, a judge ruled Thursday.

When I come across these in my ED, I describe them as “judicial bracelet(s)” in the record. What do y’all do? Ignore them?  If you don’t, how do you describe them?

Rickety Contrivances of Doing Good: Grand Rounds: Volume 3, Number 49

Rickety Contrivances of Doing Good: Grand Rounds: Volume 3, Number 49

I like the ones that use the numbering system.  I’m like that.

Gunner, 2

Riding today, I was about 8 miles in, and I was loafing, enjoying the scenery. Then I got passed by a mountain bike. A mountain bike.

So, I did what any modestly competitive skinny-tire cyclist would, I let him get out about 100 yards, then turned it up. As I’d get close he’d look back, see me, and stand up in the pedals to pull out another lead. We were going upwind (slightly), and so I’d just slowly reel him back in, and he’d power away again. (I should mention here that I’m not a terrific cyclist, but the relative advantage of a skinny-tire bike on smooth pavement is big, and I wasn’t having to work nearly as hard as my mountain-bike rabbit).

That lasted for about 3 miles, then reality set in, I drafted for a while, and thanked him for the nice tow as I panted by.

And, it did me a lot of good. I ride solo, and had been stuck at one narrow range of average MPH on this ride; thanks to the challenge, I went more than a full MPH faster for the course, which is a big step (and it tells me I’ve been slacking).

Thanks to you, enthusiastic mountain-biker!

Oh, and Gunner 1 (Link now fixed).

Dr. Wes: The Best Chest Pain Case

Dr. Wes: The Best Chest Pain Case is a very funny tale, and you should read it.

I have the ED equivalent.

As told to me by one of my residency attendings, here’s the setup: playing ball with one of those 4′ basketball goals in the driveway with and about 5 year old son. They’re having a good time, then the child has a gravity attack and skins his knee. Much crying ensues. Consolation is offered.

The child, composing himself, innocently destroys his father with: “I know, dad, it’s just a virus”. Father cringes inside, just a little.
He tells this tale as a warning to all; not everything is ‘just a virus’.

Americans Fatter

Yahoo reports that Americans are getting fatter, and includes an illustrative photo. But, there’s a problem with the photo:

Unfortunately, the photo is from Merry Olde England, in Heathrow Airport to be exact. Maybe in the international terminal, but still an amusing touch.

Doesn’t change the fact we’re getting to be Fat Nation.

Scenes from a Ride

Kayaking the Mighty Trinity

Kayaking on the Mighty Trinity.

Eight Things About Me

Tagged by the Bohemian Road Nurse, and having nothing else to say, I’ll play along with the meme, “Admit eight things about yourself”.

  1. I’m not nearly as nice, or collected, as is portrayed on the blog. I’m able to filter my life through the keyboard. I am occasionally very pleasant, am usually at least sociable, but have my moments I’m not too proud of.
  2. “I have No Physical Talents: That’s why I went to medical school”. Well, the lack of physical talents is correct, but, that’s not why I went to med school, it’s just an amusing thing I say. I do have good reflexes and don’t mind strenous activities, but sportsman or athlete will never be my appellation.
  3. I went to medical school because I didn’t want to get a real job, not because of any single high-minded ideal. Oh, I’ve grown into it, but it wasn’t any desire to ‘help people’ or anything goofy like that. (I think that if your motivation for medical school is “I want to help people” you just haven’t met enough of them. I told interviewers I wanted a profession, something that would keep my mind sharp, and challenge me.)
  4. I know the tunes to about 1,000 songs, and the words to about 30. Band-kid problem; you don’t need lyrics in the band.
  5. I don’t want an iPod. I know this makes me one of about 20 people on earth who have no desire to add a soundtrack to my life, but frankly I don’t see the point. I’ve bought them for relatives, and played with them, but it’s nothing I’m interested in.
  6. TV medicine gives me hives. The only show I can watch is Scrubs, mostly because it’s a sitcom set in a hospital, not due to its medical content. And I laugh out loud. (There’s a cut-out here for the first year or two of ER, when I was a doc for the USMC, wanting nothing more than to be an EM resident. I watched a lot of it, yelled at the TV when they got things wrong, and enjoyed it).
  7. I’m big on personal/family security. Because of that, nothing else will be said. (I think this has to do with SomeDude, and my real job in the ED).
  8. I generally consider these memes dull, contrived reasons to fill a blog. So, I’ll not pass this one on. (I break chain-letters, too).

So, now you know a little more about me. Sorry ’bout that.

Aggravated DocSurg: Closing Time

Aggravated DocSurg: Closing Time

A moving account of when the cut cannot cure, and a family who understands.  Highly recommended.

Sumer’s Radiology Site: Radiology Grand Rounds-XV

Sumer’s Radiology Site: Radiology Grand Rounds-XV

The first case is very interesting.

Day Off: 1 of 3

Since I have nothing terribly interesting medical to say, here’s a tiny slice of my incredibly dull life:

Replaced the Reverse Osmosis filters. Thrills of home ownership.

Started troubleshooting my yard sprinklers, which weren’t working (again). This is usually a ‘stuck valve’, trying to water two zones at once. The diagnosis is usually to find the mushy area, that’s where the valve is stuck open. While investigating, noted a river of water coming out of a drainage tube that’s new. Oh, oh. Not a broken valve, it’s the main supply tube to the entire system that’s broken. Under about 5 feet of new dirt and retaining wall.


So, my wife had the obvious solution (which wasn’t obvious to me until she said it), “Why not run a new supply line that avoids that area”?, and the digging was on.

I’m terribly glad I work with a pen, indoors. This shovel work is hard.

Enough from me. More digging tomorrow.

Nurse Ratched’s Place: It’s Roundup Time at Change of Shift

Nurse Ratched’s Place: It’s Roundup Time at Change of Shift

“…We’ve got both kinds, Country and Western!” 

Strange things

A completely random assortment of weird/amusing things I noticed today:

  • Patient’s Chief Complaint: “I want to know if I’m a virgin”.
  • Record ED volume Monday, nearly vacant on Wednesday.
  • Ford F-350 “King Ranch Edition” as a Domino’s pizza delivery vehicle.
  • My Prius’ paint on one door has horrible overspray (found while waxing).
  • The MythBusters have the best job on earth.
  • Patient CC: “Bald spot on back of head”; redundantly foreheaded nurse muses “I’d be a major case, then”.

My seven in a row ends after tomorrow. Perhaps my muse will return during the break.

“The FBI is here to see you..”

…is, frankly, a nice way to get me to make last night’s dinner into diamonds.  It happened today.

Oh, and it wasn’t just the FBI, there was also someone from a major health insurance company, and a rep from the Office of the Inspector General.  They weren’t interested in me, but a patient I’d seen.  I won’t give any details as apparently it’s an ongoing investigation (I wasn’t sworn to secrecy, or anything dramatic), but suffice to say serial narcotic-seeking will eventually get the wrong kind of attention.

I was just glad they weren’t interested in me.

Grand Rounds


Welcome to Grand Rounds at Med-Source. In an effort to bring everyone back up to speed and welcome new students as summer comes to a close, the theme for this edition is “Back to School.” I have received numerous excellent submissions and I hope you find the following both educational and entertaining.

Focused exam

Recently, on one of those zooish evenings in the ED, our on-call plastic surgeon walked through the ED.  On seeing a major trauma patient in one of the major rooms, a very brief and purposefully focused exam was undertaken, from the hallway:

“Face and fingers unaffected” was the synopsis.   Correct, as it turned out.