Okay, I’ve been passively watching, safe in my relative geography. Then today I read that there are TWO Fukushima nuclear plants.

It’s F1 that’s having all the problems, reportedly F2 is shut down and cooling off.

When I’m confused about geography, my current go-to is Google Earth.

So:

There are two Fukushima nuclear plants, you ask?

Read the rest of this entry »

AUSTIN — Texas medical regulators on Friday placed on probation a West Texas doctor involved in the unsuccessful prosecution of two nurses who complained anonymously that the physician was unethical and risking patients’ health.

The Texas Medical Board technically suspended Dr. Rolando G. Arafiles Jr. but allowed him to continue to practice medicine while on probation for four years if he completes additional training.

via Physician who had nurses prosecuted is placed on probation | State | News from Fort Wort….

Ugh.

Welcome to the Donation Page of

Kate Schickedanz

Join me in my efforts to support Tragedy Assistance Program for Survivors (TAPS)!

On March 27, 2011, I will be participating in the Dallas Rock ‘N Roll Half Marathon in support of the Tragedy Assistance Program for Survivors (TAPS). TAPS provides direct support to families who have been impacted by a death in the military regardless of geography or circumstance.

via FY11 Team Run & Remember Rock ‘N Roll Dallas Half Marathon – General Donation.

I wrote about her late husband, an ED Nurse colleague, after his untimely death here. I’m glad Kate is helping others, and TAPS sounds like a terrific program.

I gave to her goal, and hope you’ll consider doing the same.

I’m in one of those phases where feeding the blog is a) not a priority and b) a potential liability, so it’s one of those things.

It’s not that I don’t like all 9 of you readers, I do.  It’s just that with the repeal of the 24 hour day I have less time to get work/family/TV/CME/all that other stuff in.  2/3 of my kids have been home for a while, it’s been terrific, and tomorrow I go down to 1/3, keeping the lawyer.  Go ahead, tick me off, and find out what having a temporarily unemployed lawyer at the other end of a complaint feels like.  He’d like me to tell you that’s a joke, so it is, because he says it is.  That’s what a decent legal education gets you.

My medical practice is smooth, and I’ve given a couple of talks to groups recently, so that’s fun. I talked for medical CME about whether non-contrast of the abdomen is ready for ED use (short version, no), and it was decently well received; yesterday I spoke to a nursing CME conference, ditto.

If you’re an ED doc and you haven’t at least looked at how to manage patients who come to your ED with a ventricular assist device, catch up.  They are no longer locked up in the CCU, they’re now being sent home with them.  This wouldn’t be a problem except they break a lot of rules… like no CPR if pulseless, etc, and some of these are designed to be pulseless.  You can see the problem.

As for the liability, I’m getting more leadership/responsibility roles, but middle management types can’t blog those.  Paul Levy can, as a CEO, but nobody in the middle can, and it makes sense to me.  Lacking amazing stories of management (and I wonder if there are any), nada to blog about.  Hold your breath for the reports from my addition to the hospital Bylaws Committee.  Yeah, crazy stuff.

On a professional note, I’d like to alert all me ED colleagues that apparently a) jeans are no longer pre-washed before sale b) adolescent females don’t wash them before wear, and c) you’ll see patients in the ED with inexplicably warm yet blue extremities.  Connect the dots, win a prize.  I’ve picked up 3 of these recently (that have seen other docs who haven’t connected the dots), and have added alcohol-preps to my skin exam in select cases.  Awkward diagnosis, and rewarding.  (The key is warm, blue extremities but the skin discoloration skips the ‘between the digits’ areas).

I’ll be here. Thanks for checking in.

Via the Star Telegram:

Just the facts, ma’am.

Ace of Spades HQ has a nice salute to them.

They were murdered (minimally allegedly) by a Physician who should be on trial for Treason as well as murder.

Respect and condolences to the families of those murdered, thank you for their service.

BAKERSFIELD, Calif. (AP) – A doctor involved in an “on-again, off-again” relationship apparently tried to force her way into her boyfriend’s home by sliding down the chimney, police said Tuesday. Her decomposing body was found there three days later.

via Cops: Calif doctor gets stuck in chimney, dies | KOMO News | Seattle News, Weather, Sports, Breaking News – Seattle, Washington | National & World News.

Awful.

Two nurses in Kermit, Winkler County, Texas felt a Physician had done wrong, and did their duty (which is protected), under the law: they reported the doctor to the State Medical Board.

Then, things got bad, but not like any sane person would think. The nurses were eventually charged in Criminal Court for “Misuse of official information“, the flimsiest of pretexts to punish them for their whistleblowing, which the Texas Medical Board said was both good and correct.

This mattered not, and they were forced to go to trial to defend themselves from imprisonment; They were very quickly found not guilty, then came the civil suit, which catches us up for today’s addition to the story…

First, imagine keeping your job as Hospital Administrator after this kind of public derision. No, it doesn’t end as you’d expect:

Via CBS 7:

A week after it was posted at the Winkler County Courthouse that Winkler County Memorial Hospital Administrator, Stan Wiley, would announce his resignation, he changed his mind.

In what board member, John Walton, is calling “the shortest meeting in the board’s history”, Wiley did not resign.

The resignation was put before the board members as a motion.

John Walton seconded the motion to “accept Wiley’s resignation” but none of the other board members did so.

Wiley then acted as if this were a dramatic show of support and decided to not resign.

Quite the vote of confidence…

That was on August 10th, by the way, the same day, again from CBS 7:

After their original concerns about Dr. Rolando Arafiles were substantiated by a state fine levied against Winkler County Memorial Hospital and an official complaint lodged against the Dr., the “Winkler County Nurses” were “compensated” today for their damages.

The nurses will split a nearly $1,000,000 settlement but nurse Anne Mitchell says this case was never about any money.

Vickilyn Galle and Anne Mitchell believed their anonymous report to the state in 2008 would be just that: anonymous (as is prescribed by nurse reporting laws).

There’s no way they could have predicted that standing up for patients’ rights would get them arrested, then prosecuted, then vindicated and now, more than two years later, leave them hard pressed to find a nursing job.

The four Winkler County Commissioners voted unanimously Tuesday afternoon, to settle the civil suit filed against the county and numerous other defendants.

The move means they are agreeing to pay $750,000 dollars to nurses, Anne Mitchell and Vickilyn Galle.

The county only has to pay $150K, the rest is covered by a risk management pool, which appears to be how Texas Counties self-insure.

I’d like to have seen the trial on this. It’s not enough for two nurses who will have to move a long way to even possibly continue their careers, and the behavior of the Sheriff and Prosecutor in all this is bafflingly ugly.

The lesson? 1) Don’t live in Winkler County, their public decision-making seems atrocious on every level and 2) if you’re going to report someone anonymously, don’t do it from a County owned computer, lest it be ‘investigated’. (Feel free to add your lesson in the comments, but I’m not interested in getting sued, so let’s not libel anyone, shall we?).

HT to Glenn, my West Texas news connection.

Remember this?  The Chair of the Arkansas Medical Board being critically injured with a car bomb?

A multi-disciplined physician is on trial for the crime:

LITTLE ROCK – The Arkansas Medical Board chairman, his face scarred and embedded with bits of tire, testified Wednesday that he lost an eye, his sense of smell, teeth and some hearing when a bomb went off in his driveway.

Dr. Trent Pierce testified against Dr. Randeep Mann, who prosecutors say planned the attack as retaliation for the medical board taking away his license to write prescriptions. Pierce took the stand after a jail inmate told jurors Mann had offered him $50,000 to kill Pierce to keep him from testifying.

Wow.  I’m glad he pulled through.  And I wonder at the (alleged) depravity of those who should have insight.

HT: Glenn

Update: I’m informed by the informative Ramona that neither physician is from Little Rock, actually.  (I thought that due to the by line of the original article).  So, Non-Little Rock (Big Rock?) docs…

(AP) A spokesman for a South African emergency service says a man has survived after shooting himself in the head and then being hit by a truck.

via Man Survives Bullet in Head, Being Hit by Truck – CBS News.

If South Africa has a lottery, this guy should buy himself a ticket.

I’ve been able to study Paul Levy’s management of BIDMC during several classes (more on that someday), and he’s a smart guy.  Which makes this dumbfounding, if humanizing:

The Board of Directors of BIDMC today issued the following statement, which has been distributed to the media and to the entire hospital community.

The Board of Directors of Beth Israel Deaconess Medical Center, with the assistance of outside counsel, has completed its review of allegations made involving President and CEO Paul Levy. The review focused on a personal relationship with a former employee of the Medical Center. The Board found that over time the situation created an improper appearance and became a distraction within the hospital.

via Running a hospital: I was wrong. I am sorry..

Good for him, and I doubt this is going to be enough.  There’s a scandal worth and immediate $50K penalty and the threat of more in contract negotiations.

Time to call Oprah, or something, and do it All at Once.  Get it all out (and don’t hold back, a la Tiger), etc.  People will forgive bad judgment, they will pillory you for a cover up.

It’s going to come out, so Just Do It.

This is going to sound awful, but… if you kill yourself you’re obligated not to take others with you.  I know that people who kill themselves aren’t thinking about others, but, here’s a cautionary tale:

Bullet from suicide try ends up in Starbucks

GRAPEVINE — A Starbucks customer stirring his drink Thursday afternoon heard a bullet whiz by his ear after a man shot himself across the street from the coffee shop, police said. The man was on the front porch of his house in the 900 block of East Wall Street, said Lt. Todd Dearing, a Grapevine police spokesman. The bullet went through the man’s head and the drive-through window at Starbucks and past the customer and finally lodged in a restroom wall at the back of the business, Dearing said. The man who shot himself was taken to …a hospital…

Bold by me.

via Briefs: Bullet from suicide attempt ends up in Starbucks | Northeast Tarrant | News from….

Rifle?  Crazy high powered pistol firing a very solid bullet?  I doubt we’ll ever know, but it’s a cautionary tale.  Extremely fortunate that round didn’t collect an innocent soul.

It was the only place I saw Cowboys play home games in my lifetime, and I got to march there in the HS band long, long ago (big stuff when you’re 16).  I have some ‘souvenir’ AstroTurf from the first time they recarpeted the place.

For those who are going to be up that early, the WFAA link to their live streaming web page is here: WFAA.

Here’s the video, via Austin’s KXAN.  Implosion starts about 1:10.

CNN Video:

Jerusalem (CNN) — Dubai’s police chief said Sunday the secretive Israeli foreign intelligence unit Mossad “needs to be ashamed” after the January killing of a Hamas leader in a Dubai hotel.

via Dubai police chief: Mossad should be ‘ashamed’ over Hamas killing – CNN.com.

I concur.  Really, 26 people to smother one guy?

Seriously….