Archives for April 26, 2008

Dr. Val interviews the Surgeon General

Revolution Health LogoDr. Val is showing the power of blogs (well, the power of professionally done blogs) by getting a one on one interview with the Surgeon General.  Read her post for the interview, but here’s the part that I enjoyed the most:

(Dr. Carmona):….The American public wants the best of everything, they want it yesterday, and they don’t want to pay for it. That pretty much characterizes the problem that we have. We see health as a right, we want somebody to give us a card, and if we want to smoke, that’s our right too. There’s this attitude that if we want to drink excessively, that’s our right, and if we want to ride a motorcycle without a helmet, that’s our right (“you can’t tell us what to do”). However, when I crash my motorcycle and I have a head injury and I’m disabled for life, I also expect society to pay for that.

Heh.  I believe I’ve said something like that myself.

Pallimed: A Hospice & Palliative Medicine Blog: "I Wanna Be A DNR" and other Goodness from the Web

A little humor for your day, via Pallimed (via Dr. Wes. it’s a tangled WWW):

The description, per Pallimed:

A ICU Nurse and some colleagues rewrote the lyrics to the popular Nickelback song “Rockstar” to emphasize how some patients may feel in the ICU. The video itself is just the lyrics. Here is hoping she puts together more song parodies and maybe a video or two.

Gallows humor, but it’s well done and humorous.

Farming community moving on after arsenic poisoning –

I blogged about this when it happened in 2003 (and the suicide of a man who posthumously took the blame), and wondered idly if anything more came of it. Here’s the answer (complete with a what happened in a small ED that night description).

Farming community moving on after arsenic poisoning

By David Sharp, Associated Press Writer | April 26, 2008

NEW SWEDEN, Maine –It has been five years since this tiny farming community was turned upside down by a crime that still baffles: Someone used arsenic to spike the coffee at Gustaf Adolph Lutheran Church, killing one parishioner and making 15 others violently ill.

Soon those who drank the coffee were throwing up, suffering diarrhea, or both.

The first patient arrived in the Cary Medical Center emergency room in nearby Caribou at 3:30 p.m., and sick parishioners kept pouring in over the next six hours. Dr. Dan Harrigan, an emergency room physician, arrived at work at 6:30 p.m. to find one of the parishioners outside on his knees.

Not knowing what they were dealing with, doctors and nurses at the 65-bed hospital struggled to keep patients’ blood pressure from dropping too low.

It wasn’t a pretty sight. Nurses described countertops and the floors covered with vomit-filled basins, buckets and garbage cans. "Out of 26 years in emergency medicine, I doubt I’ll have another night like that," Harrigan said.

By dawn, one of the parishioners had died, several had been transferred to Eastern Maine Medical Center in Bangor, and doctors had figured out they were dealing with a heavy metal poisoning. Laboratory tests later confirmed it was arsenic.

Read the article: several were left with lifelong disabilities, but their community moves on.

Best Procedure of the Day

The patient’s CC: bug in ear.

Physical exam: Pt in mild distress, holding one ear.  Otoscope exam shows the back end of a bug.

I started by filling the ear with 1% lidocaine, to drown the bug so they quit moving (which is apparently painful and freaky in an attached-to-your-brainstem weirdness kind of way).

Then it happened, something that hasn’t happened in years of doing this: the bug came out to keep from drowning!  There’s a little bug running on the bed, which met its maker quickly.  Re-exam showed the inside of the ear none the worse for wear, and the relief of everyone was terrific.

First time I’ve been charged by a bug, though.