4F rants

I'm not gone

2009-02-11T13:33:00.001-08:00

just resting....

Wither Freedom?

2008-11-12T05:40:00.000-08:00

The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries. W. Churchill...
Except I don't expect those in power will share the misery.

We contend for a nation to tax itself into prosperity is like a man standing in a bucket and trying to lift himself up by the handle.

"Magic" foods

2006-05-25T08:59:00.000-07:00

There seems to me to be a major disorder of thought out there. People think that eating "special" foods will cure all their ills. It's not just the "eat grapefruit" diets, eat protein diets, etc. that I'm thinking of. It's the idea that the quantity doesn't matter. If I eat 90 calories of sugery crap, I'll get fatter than if I eat 100 calories of nutrious fruit. UNTRUE. Calories are calories.

Medical Ethics--NOT

2006-03-24T05:57:00.000-08:00

Why is it the NEJM and MSM covers Gitmo abuses non-stop, wonders about medical interactions with prisoners, executions, etc., but never comments about the other side?
http://news.independent.co.uk/world/middle_east/article353015.ece

Insurgent doctor killed dozens of wounded soldiers
By Patrick Cockburn in Kirkuk
Published: 23 March 2006
When policemen, soldiers and officials in Kirkuk who were injured in insurgent attacks arrived in the emergency room of the hospital, they hoped their chances of surviving had gone up as doctors tended their wounds.
In fact, many of the wounded were almost certain to die because one of the doctors at the Republic Hospital was a member of an insurgent cell. Pretending to treat the injured men, he killed 43 of them by secretly administering lethal injections, a police inquiry has revealed.
"He was called Dr Louay and when the terrorists had failed to kill a policeman or a soldier he would finish them off," Colonel Yadgar Shukir Abdullah Jaff, a senior Kirkuk police chief, told The Independent. "He gave them a high dosage of a medicine which increased their bleeding so they died from loss of blood."
Dr Louay carried out his murder campaign over an eight to nine-month period, say police. He appeared to be a hard working assistant doctor who selflessly made himself available for work in any part of the hospital, which is the largest in Kirkuk.
He was particularly willing to assist in the emergency room. With 272 soldiers, policemen and civilians killed and 1,220 injured in insurgent attacks in Kirkuk in 2005, the doctors were rushed off their feet and glad of any help they could get. Nobody noticed how many patients were dying soon after being tended by their enthusiastic young colleague.
Dr Louay was finally arrested only after the leader of the cell to which he belonged, named Malla Yassin, was captured and confessed. "I was really shocked that a doctor and an educated men should do such a thing," said Col Jaff.
The murderous work of Dr Louay is symbolic of the ferocity of the struggle for the oil province of Kirkuk. The dispute over its fate is the most important reason why the political parties in Baghdad have failed to create a new government three months after the election on 15 December. The Kurds, expelled from Kirkuk and replaced with Arab settlers by Saddam Hussein, captured the city on 10 April 2003. They have no intention of giving it up. "We will never leave Kirkuk," said Rizgar Ali Hamajan, the former Kurdish peshmerga (soldier) who heads the provincial council. "It is part of Kurdistan."
He recalls that when he was 18 months old, his parents fled with him from his village north of Kirkuk moments before the Iraqi army destroyed it.
But Ibrahim al-Jaafari, the Prime Minister, has frustrated Kurdish demands, enshrined in the new constitution, for Kurds to be allowed to return to Kirkuk and Arabs settlers to be removed to their original homes. The Kurds expect a referendum in Kirkuk that would lead to the province joining the highly autonomous Kurdish region ruled by the Kurdistan regional government in northern Iraq.
For the 1.9 million Kurds, Turkomens and Arabs of Kirkuk province, oil has brought few benefits. They live on top of at least 10 billion barrels of oil which was first exploited in 1927. Despite that, people wanting to buy petrol in Kirkuk wait all day in queues of battered vehicles. "It is the most devastated city in all Iraq," said Mohammed Othman, deputy head of the Patriotic Union of Kurdistan, the most powerful Kurdish party in Kirkuk.
All Iraqi provinces were seriously damaged under Saddam Hussein but few on the scale of Kirkuk. Sinister mounds in the fields mark where Kurdish villages once stood before they were destroyed. Often the Iraqi army poured concrete into the village wells to prevent people returning. Saddam Hussein also bulldozed four districts in Kirkuk after the failed Kurdish uprising in 1991. Between then and 2003 at least 120,000 Kurds and Turkomens were expelled, in addition to those forced out in the previous 40 years.
Some Kurds have returned, but not to a land of plenty. In the old sports stadium in Kirkuk, hundreds of families are squatting amid the garbage and sewage. The guerrilla war continues at a low but persistent level and the Arabs are not going to leave or be marginalised without a fight.
Smoke was rising over Kirkuk this week as children set ablaze tyres to celebrate the Nowruz, the Kurdish spring festival.
Kirkuk is not a place where many people would like to live - but the battle to control it may yet destroy Iraq.
When policemen, soldiers and officials in Kirkuk who were injured in insurgent attacks arrived in the emergency room of the hospital, they hoped their chances of surviving had gone up as doctors tended their wounds.
In fact, many of the wounded were almost certain to die because one of the doctors at the Republic Hospital was a member of an insurgent cell. Pretending to treat the injured men, he killed 43 of them by secretly administering lethal injections, a police inquiry has revealed.
"He was called Dr Louay and when the terrorists had failed to kill a policeman or a soldier he would finish them off," Colonel Yadgar Shukir Abdullah Jaff, a senior Kirkuk police chief, told The Independent. "He gave them a high dosage of a medicine which increased their bleeding so they died from loss of blood."
Dr Louay carried out his murder campaign over an eight to nine-month period, say police. He appeared to be a hard working assistant doctor who selflessly made himself available for work in any part of the hospital, which is the largest in Kirkuk.
He was particularly willing to assist in the emergency room. With 272 soldiers, policemen and civilians killed and 1,220 injured in insurgent attacks in Kirkuk in 2005, the doctors were rushed off their feet and glad of any help they could get. Nobody noticed how many patients were dying soon after being tended by their enthusiastic young colleague.
Dr Louay was finally arrested only after the leader of the cell to which he belonged, named Malla Yassin, was captured and confessed. "I was really shocked that a doctor and an educated men should do such a thing," said Col Jaff.
The murderous work of Dr Louay is symbolic of the ferocity of the struggle for the oil province of Kirkuk. The dispute over its fate is the most important reason why the political parties in Baghdad have failed to create a new government three months after the election on 15 December. The Kurds, expelled from Kirkuk and replaced with Arab settlers by Saddam Hussein, captured the city on 10 April 2003. They have no intention of giving it up. "We will never leave Kirkuk," said Rizgar Ali Hamajan, the former Kurdish peshmerga (soldier) who heads the provincial council. "It is part of Kurdistan."
He recalls that when he was 18 months old, his parents fled with him from his village north of Kirkuk moments before the Iraqi army destroyed it.
But Ibrahim al-Jaafari, the Prime Minister, has frustrated Kurdish demands, enshrined in the new constitution, for Kurds to be allowed to return to Kirkuk and Arabs settlers to be removed to their original homes. The Kurds expect a referendum in Kirkuk that would lead to the province joining the highly autonomous Kurdish region ruled by the Kurdistan regional government in northern Iraq.
For the 1.9 million Kurds, Turkomens and Arabs of Kirkuk province, oil has brought few benefits. They live on top of at least 10 billion barrels of oil which was first exploited in 1927. Despite that, people wanting to buy petrol in Kirkuk wait all day in queues of battered vehicles. "It is the most devastated city in all Iraq," said Mohammed Othman, deputy head of the Patriotic Union of Kurdistan, the most powerful Kurdish party in Kirkuk.
All Iraqi provinces were seriously damaged under Saddam Hussein but few on the scale of Kirkuk. Sinister mounds in the fields mark where Kurdish villages once stood before they were destroyed. Often the Iraqi army poured concrete into the village wells to prevent people returning. Saddam Hussein also bulldozed four districts in Kirkuk after the failed Kurdish uprising in 1991. Between then and 2003 at least 120,000 Kurds and Turkomens were expelled, in addition to those forced out in the previous 40 years.
Some Kurds have returned, but not to a land of plenty. In the old sports stadium in Kirkuk, hundreds of families are squatting amid the garbage and sewage. The guerrilla war continues at a low but persistent level and the Arabs are not going to leave or be marginalised without a fight.
Smoke was rising over Kirkuk this week as children set ablaze tyres to celebrate the Nowruz, the Kurdish spring festival.
Kirkuk is not a place where many people would like to live - but the battle to control it may yet destroy Iraq.

Geek Code

2006-02-18T06:10:00.000-08:00

My geek code:

Version: 3.1GMD d(++)@ s-:- a+ C++ U? P? L !E? W++ N o? K--? w !O !M V? PS+ PE++ Y !PGP t++ 5+++ X-- R tv++ b+++ DI++ D++ G++ e++++ h---- r+++ y++++ k++ F3+

with weapons modifiers http://kuoi.asui.uidaho.edu/~kamikaze/doc/geekWeapons.html

Liberal or Conservative

2006-02-02T10:08:00.000-08:00

A conservative is a liberal who's been mugged.....
A liberal is a conservative who's been arrested....

Truth or Fiction?

OMFG at work

2006-02-01T12:28:00.000-08:00

There was a program on TV this week, about the moon shots. The launch director was talking about time frames and how 20 seconds during a launch is a long time. We had a patient with asystole (no heart beat) for 90 seconds or more. That's a long time. More to follow.

Required reading....

2006-01-20T11:06:00.000-08:00

Following is a list of books I would consider “required reading” for understanding how the world works (from my point of view). I’d like other suggestions for important books that contributed or changed one’s point of view.

Part of the impetus for some of these readings are the following quotes from Robert Heinlein:

The three-legged stool of understanding is held up by history, languages, and mathematics. Equipped with these three you can learn anything you want to learn. But if you lack any one of them you are just another ignorant peasant with dung on your boots

And

Anyone who cannot cope with mathematics is not fully human. At best he is a tolerable subhuman who has learned to wear shoes, bathe, and not make messes in the house.

So here is the list....Not in any particular order

The Wisdom of Crowds: Why the Many Are Smarter Than the Few and How Collective Wisdom Shapes Business, Economies, Societies and Nations by James Surowiecki

The Tipping Point: How Little Things Can Make a Big Difference by Malcolm Gladwell

Blink : The Power of Thinking Without Thinking by Malcolm Gladwell

Guns, Germs, and Steel: The Fates of Human Societies by Jared Diamond

Brave New World Revisited (Perennial Classics) by Aldous Huxley

The Demon-Haunted World: Science as a Candle in the Dark by Carl Sagan

Freedom Evolves by Daniel C. Dennett

Darwin's Dangerous Idea: Evolution and the Meanings of Life by Daniel C. Dennett

The Sokal Hoax: The Sham That Shook the Academy by The Editors of Lingua Franca

The Flight from Science and Reason by Paul R. Gross

The Power of Myth by Joseph Campbell

The Hero with a Thousand Faces (Mythos Books) by Joseph Campbell

Innumeracy: Mathematical Illiteracy and Its Consequences by John Allen Paulos

A Mathematician Reads the Newspaper by John Allen Paulos

Conflict of Interest.....

2006-01-19T08:59:00.000-08:00

Why is it that an NIH funded investigator supporting view X has no conflict of interest (even though supporting view X will give him more funding) , but an industry funded person supporting view Y is always suspect?
We should evaluate the data independent of the source. That is, read the methods and results section and ignore the extrapolations in the conclusions….

Marine Anesthesia

2006-01-18T11:24:00.000-08:00

No, Not underwater anesthesia, but a comparison. The Marine Rules for gunfighting can be found in a number of spots on the web...Here they are, followed by my Anesthetic Rules of Engagement....

Marine Corps Rules for Gun Fighting
1.Bring a gun. Preferably, bring at least two guns. Bring all of your friends who have guns.
2. Anything worth shooting is worth shooting twice. Ammo is cheap. Life is expensive
3. Only hits count. The only thing worse than a miss is a slow miss.
4. If your shooting stance is good, you're probably not moving fast enough nor using cover correctly.
5. Move away from your attacker. Distance is your friend. (Lateral and diagonal movement are preferred.)
6. If you can choose what to bring to a gunfight, bring a long gun and a friend with a long gun.
7. In ten years nobody will remember the details of caliber, stance, or tactics. They will only remember who lived.
8. If you are not shooting, you should be communicating, reloading, and running.
9. Accuracy is relative: most combat shooting standards will be more dependent on "pucker factor" than the inherent accuracy of the gun.
10. Someday someone may kill you with your own gun, but they should have to beat you to death with it because it is empty.
11. Always cheat; always win. The only unfair fight is the one you lose.
12. Have a plan.
13. Have a back-up plan, because the first one won't work.
14. Use cover or concealment as much as possible.
15. Flank your adversary when possible. Protect yours.
16. Don't drop your guard.
17. Always tactical load and threat scan 360 degrees.
18. Watch their hands. Hands kill. In God we trust. Everyone else, keep your hands where I can see them.
19. Decide to be aggressive ENOUGH, quickly ENOUGH.
20. The faster you finish the fight, the less shot you will get.
21. Be polite. Be professional. But, have a plan to kill everyone you meet.
22. Be courteous to everyone, friendly to no one.
23. Your number one option for personal security is a lifelong commitment to avoidance, deterrence, and de-escalation.
24. Do not attend a gunfight with a handgun, the caliber of which does not start with a "4."

Anes Rules for Engagement
1. Bring an IV. Preferably, bring at least two IVs. Bring all of your friends who have IVs.
2. Anything worth a liter of fluid is worth two. Crystalloid is cheap. Life is expensive
3. Only working IV’s count. The only thing worse than a miss is a slow miss.
4. If your sterile technique is good, you're probably not moving fast enough.
5. Move away from bodily fluids. Latex is your friend. Follow Universal substance precautions
6. If you can choose what to bring to a trauma call, bring a big IV and a friend with an ETT.
7. In ten years nobody will remember the details of IV gauge, location, or tactics. They will only remember who lived.
8. If you are not managing fluids or airway, you should be communicating, restocking, and running.
9. Accuracy is relative: most drug dosing standards will be more dependent on "pucker factor" than the inherent factors of the drug.
10. Someday someone may kill your patient with an IV, but they should have to beat him to death with it, not cause an air embolism because the IV is empty.
11. Always cheat; always win. The only unfair fight is the one you lose.
12. Have a plan.
13. Have a back-up plan, because the first one won't work.
14. Use cover or concealment as much as possible. Always wear gloves, mask, & glasses.
15. If one approach to an IV or drug doesn’t work, try another.
16. Don't drop your guard.
17. Always check IVs, drugs and scan monitors 360 degrees.
18. Watch the surgeon’s hands. Hands kill. In God we trust. Everyone else, keep your hands where I can see them.
19. Decide to be aggressive ENOUGH, quickly ENOUGH.
20. The faster you finish the code, the more sleep you will get.
21. Be polite. Be professional. But, have a plan to resuscitate everyone you meet.
22. Be courteous to everyone, friendly to no one.
23. Your number one option for personal security is a lifelong commitment to avoidance, deterrence, and de-escalation.
24. Do not attend a trauma code with a IV, the caliber of which does not start with a "14."

4F rants

2006-01-18T09:56:00.000-08:00

This is 18 Jan 2006. I am at the Computers in Anesthesia meeting in San Diego, blogging this on a dell xps M170. The future of this blog is yet to be determined, but may serve as a place to rant on various/varied topics from medicine to politics.