Tokyo, Japan (CNN) — A body was found in the landing gear bay of an airplane that arrived at Tokyo's Narita Airport Sunday, the airport announced.

The dead man was not carrying a passport or personal belongings, airport police said.

via Body found in plane’s landing gear bay in Japan – CNN.com.

JFK to Narita.  Someone was able not just to approach this aricraft without appropriate ID, but was able to climb into the landing gear bay (under the wing structure, next to the fuel tanks) and hide there.

FWIW, stowing away in a wheel well is a bad way to die.  If you’re not crushed to death by the landing gear coming up (it’s hydraulic, powered to lift a couple of tons against high airspeeds, there’s not any ‘extra’ room in the wheel well*), there’s not enough oxygen to survive at cruising altitude, even if it were heated, which it’s not.  So, don’t try it.

Now, substitute the word bomb for body.  Someones’ security isn’t good enough.  By far.

*Dad was an airline mechanic; back in the Good Old Days, kids could go to work with their dads and watch their dads work on them (and occasionally I got to empty out ash trays and arrange seat belts).  I learned a lot from that.

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If you downed one too many while watching the Super Bowl, here's at least one reason to hold your head high: Drinking beer can be good for your health.

But seriously, a new analysis of 100 commercial beers shows the hoppy beverage is a significant source of dietary silicon, a key ingredient for bone health.

via Beer May Be Good For Your Bones | LiveScience.

Beer.  Wonder and medicine, in a convenient serving size.  (Also, silicon).

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Report a bad doctor to the authorities, go to jail? It might really happen for Anne Mitchell, RN in Winkler County, Texas : Respectful Insolence.

He’s been on this from the beginning.  Good news: one of the nurses was dismissed; bad news, the other is on trial.

Atrocious.

My grandparents lived in Winkler County (Kermit), and are gone now.  I think they’re spinning in their graves over this.

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As an engineering piece ( and without having used it ) it looks terrific.

But, I usually buy a new can shortly after I lose the straw. How will their sales do with this unlosable straw gadget?

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Washington (CNN) — All U.S. military health facilities around the world will now carry the emergency contraception pill known as Plan B One-Step, according to a new Department of Defense policy.

The decision to carry the pill, often referred to as the morning-after pill, was based on a recommendation by the Pentagon's Pharmacy and Therapeutics Committee, an advisory panel made up of medical professionals from the military services, Pentagon officials said Friday.

Many military hospitals already carry the pill, but the new action means it will become a standard part of every medical facility's stock of drugs, including those on bases in Iraq and Afghanistan, the officials said.

via Military increases availability of morning-after pill – CNN.com.

Mostly right, I’d say.  I do wish it was OTC (for installations large enough to have a store of some sort) and not force women into Medical for it (it’s OTC in the US), but it’s better than not having it.

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Trying to avoid a painfully long wait in the ER?

One local hospital system is publicly sharing the current average wait time to see a doctor at all its emergency departments.

Akron General Health System recently began advertising up-to-the-minute wait times for its emergency rooms on billboards throughout town.

Six digital billboards in Akron are automatically updated every 20 minutes to show current average wait times to see a doctor …

The average times are computer generated, based on current patient information from the health systems’ electronic medical records…

via Ohio.com – Akron General puts ER wait times on billboards, Internet.

I think this isn’t terrible, as long as there’s some education that a) these are average times and that b) if you have a real emergency you go to the head of the line.

Oddly, I think this is different than the (currently boutique) practice of scheduling an appointment at an ED over the internet.  I think if you have the time to schedule your emergency, you don’t have one.  So, get a doctor and go there.

Bring on the ‘average wait times’, but make sure the same display is visible in the waiting room!

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And, I don’t care.  Yes, he mispronounced a word I think he should have known, or asked about.  He didn’t, and that’s just one of many things I wish he’d done differently.  Who cares.

He did recognize the service of this corpsman (pronounced cor-man), and to me that’s what matters.

Thank you Navy Corpsmen: what you do matters, and you’re appreciated.

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Grand Rounds from Doctor Rob.  Fun!

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Residents training in large urban centers typically see more than 200 patients a day. They have access to all subspecialty care, typically available 24 hours a day. Residents have around-the-clock access to angioplasty, interventional radiology, hand surgeons, neurosurgeons, and plastic surgeons. Most practice emergency medicine with cardiologists and neurologists in the building or a short phone call away. Decision-making is shared, and occurs with a relative surplus of information and opinions and in a milieu of shared risk.

In reality, though, these very large and highly-specialized EDs with Level I trauma comprise less than five percent of U.S. EDs, according to the American College of Surgeons. The average ED is in a community hospital, and sees fewer than 100 patients a day. This community hospital ED will likely not be designated a Level I trauma center, and the practicing physician will have to make decisions on complicated patients without all of the resources and consultants available at a tertiary care medical center. He will have to make these decisions alone. Given that most graduating emergency medicine residents will practice in such a setting, we should ask ourselves is this the best we can do? Does the current training model best prepare the emergency medicine resident for the kind of practice he will enter

via We’re Failing Our Residents: Training ED Docs for the Real W… : Emergency Medicine News.

Nicely done.

I noticed this myself, first job out of residency.  I could do trauma in my sleep, but had a very steep learning curve at a place with high-end (and high-expectation) cardiology groups.

The reality that in ‘the real world’ there were no surgical consultations, they just wanted to know one thing: do I need to operate or not?  Also in the real world, going from a strong-hand department where the ED was regarded as the best residency with the best residents to being the new guy and the ED is the Repository of All Hospital Guilt, so no matter how thorough you were, the inpatient disaster was phrased so as to be something missed by the ER doc, and not the admitting team.

I did rotate (for one month, at the end of my residency) at a somewhat lower volume community ED, but there’s only so much to be learned while being a visitor for 18 shifts.

This doesn’t mean my trainers were lazy, or bad; it’s the reality that the hospital paying our salaries had expectations we’d be able to see the patients in that joint.

(This is, by the way, one of the better things about moonlighting as an EM resident; stretch yourself, find out what you don’t know while you still have time to learn.  We moonlit at a place about 45 minutes from our Big Center, so there was a safety net to catch us…)  Moonlighting is now Verboten, so there’s another door closed.

I’d like to see the residencies in EM move to decentralize from one place, and give a more rounded experience.  Not going to happen, but it would be nice.

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In what is being billed as “rationalism's Kool-Aid moment”, a mass “overdose” is being planned next week in protest at the marketing of homoeopathic medicines.

More than 300 people who style themselves as “homoeopathy sceptics” will each swallow an entire bottle of homoeopathic pills in protest at the continued marketing of homoeopathic medicines by Boots, the high street chemist chain.

via Homoeopathy sceptics plan mass ‘overdose’ – Health News, Health & Families – The Independent.

Second, I’m with them in spirit!

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