Interesting plates

Over the last few weeks I’ve seen some interesting vanity plates, and got pics of 3:

so over you...

so over you

beat the heck out of OU

Beat the Heck out of OU

aggies don't like TU

Aggie plate: beat the heck out of Texas

These made me chuckle.

Former Winkler County Hospital Administrator Pleads Guilty, Must Serve Jail Time

From Texas Attorney General Greg Abbott

ODESSA – Former Winkler County Memorial Hospital administrator Stan Wiley pleaded guilty today to abuse of official capacity. The defendant’s guilty plea stems from his decision to fire two nurses after they filed an anonymous complaint with the Texas Medical Board against one of the hospital’s physicians.
Visiting Judge Robert H. Moore III sentenced Wiley to 30 days in the Winkler County Jail for his improper conduct.

Today’s plea deal was reached after the defendant agreed to cooperate with the State’s prosecution of three remaining defendants in this case. The Texas Attorney General’s Office is handling the case as district attorney pro tem, as the Winkler County District Attorney recused himself from these proceedings.

Today’s guilty plea stems from the Office of the Attorney General’s investigation of official oppression, retaliatory conduct, and misuse of official information by four Winkler County officials: Wiley, Sheriff Robert Roberts, County Attorney Scott Tidwell, and former Winkler County Memorial Hospital physician Dr. Rolando Arafiles.

If the guy who made a deal gets 30 days, what is the Attorney General going to be looking for in those that go to trial?

I’ve written about the Winkler County nurses before, and I wonder if this gives them some solace. I doubt it.

I take my job for granted

until a student of medicine shows me it’s unusual…

We have (mostly) non-EM studs rotate through our ED on their sometimes mandatory, sometimes killing a month elective ED tour. There is little reason for EM destined students to rotate in our place, as we don’t have a residency and we’re not part of the club of EM residency directors ( i.e. letter of rec writers). So, usually not EM hard chargers. Nothing wrong with that, but they’re not my cuppa tea.

Today’s lesson: shoulder reduction for the non-EM Stud, and for me in What We Do Isn’t Usual.

As is our norm, after a thorough Hx, PE, Xrays and Time Out, was in on a 2 doc reduction; One does the sedation, one the reduction. I don’t typically have students follow me: I don’t dislike the students, but I don’t have them. Personal preference.

Today, a shoulder reduction. My colleagues’ student. Not destined for a life in the ED (already matched, not in a remotely EM specialty). My colleague is on the sedation, and I’m on the reduction. I, after discussing the technique, in my presence and under my direction, allowed the stud the first attempt at reduction after sedation. No go. Good effort, not enough muscle.

Second attempt was mine, and when we got the happy “clunk” (with the accompanying interesting sound), I was happy but the Stud wasn’t. While not actively vomiting, the Stud wasn’t uber-happy. At all. Wide eyed, in fact. Unpleasantly surprised, in reality.

After a period both the patient and the Stud recovered. One with a shoulder that’ll work, and one with an appreciation for what it takes to reduce a dislocated shoulder.

And I got the indirect lesson, that what I do isn’t common, and is actually a skill.

Students teach, too.

Thank you for the lesson.