Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Wednesday, April 21, 2004
    Creativity Challenge

    I was inspired by the latest mass email from Tertiary Hospital Medical Network (makers of fine medical timewasting spam). It reaches a new low. Judge for yourself:


    Improving hand hygiene among health care workers supports one of the 2004 National Patient Safety Goals. [The] Infection Control Committee invites all employees and medical staff to participate in a contest to create a new slogan and/or logo regarding the importance of hand hygiene by health care workers.

    The selected slogan or logo will be used in this year's hospital-wide campaign to increase awareness and motivation for improving hand hygiene among our staff, visitors and patients.

    The winning entry will be selected by the Infection Control Committee and awarded $100 worth of Recreation Connection merchandise.

    Here's my entry:

    Do you know where your hands have BEEN??

    Have at it. If you win, I'll pass your prize along. No, really.

    Oh, by the way, I'll be out of town for a few days... see you next week.

    Wacky Products Links

    Everybody needs a Banana Guard ("Protect your banana!"). You'll never ruin your lunch with a damaged banana again, and it's only $4.99 Canadian!

    Then, of course, there's the Subservient Chicken, courtesy of Burger King. This website apparently was created to promote their new chicken sandwich. You may already have seen the website, but have you seen the list of commands you can get the chicken to do?

    But my current personal favorite has to be the article on desalinated seawater selling for $33.50 (American)!

    Japanese consumers are paying top dollar for desalinated Hawaiian deep-sea water being marketed as a dietary supplement that aids weight loss, stress reduction, skin tone and digestion.

    I'm sure it works; my stress is down just reading about it.

    Tuesday, April 20, 2004

    This is why I hate breast cancer:

    I have a 46-year-old patient who was diagnosed and treated 19 months ago. At surgery she had no lymph nodes, and whole body scan showed no sign of metastases. She had radiation and chemo and was expected to do well.

    Three weeks ago, she started having headaches. At first they were mild, but steadily worsened. I checked her over and ran a CA 15-3 level (that's an enzyme used to track the spread of breast cancer); it was normal. She started vomiting. I ordered an MRI.

    Her brain was full of metastases.

    We admitted her to the hospital, started her on steroids and radiation, and she got better quickly - but a CT scan showed widespread mets in her liver, adrenals, and chest (in the lymph nodes).

    She wants to be aggressive, and we can buy her some time - how much, I don't know. But how an initially innocuous-looking tumor can spread like wildfire, less than six months after she completed radiation therapy... these are the cases that remind me that we don't have cancer under control, and we probably never will. You can follow the protocol, do all the right things, and still wind up with Stage IV breast cancer in a matter of months.

    Saturday, April 17, 2004
    Signs of the Apocalypse

    Adult Happy Meals at McDonald's. They consist of salads mostly. I wonder if toys are included?

    UPDATE. McDonald's CEO Dies of Heart Attack

    He was 60.

    Thursday, April 08, 2004
    L'Chaim Part II

    [Disclaimer: sorry for the delay. I drafted this several days ago, but work's been busy, I had to get the bounty hunter to bust me out of the Mexican jail my neighbor and I wound up in, and...]

    OK, I lied, no jail was involved. The story of our night out may not be quite so interesting as you had hoped, but we had a very enjoyable time. After debating what car to take to the Arsenal, we went with the Jag (not mine; my neighbor's). My motto: if you're going to a biker bar, you may as well stand out.

    My first hint that things had changed at the Arsenal was the valet parker that greeted us. Valet parking? Also, the restaurant now had doors opening onto the street instead of being accessible only from the parking lot. When we got inside, I was delighted to see the decor was unreconstructed 1970's with deep red walls and black Naugahyde booths. The bartender had dreadlocks, and the bar's glass shelves were decorated with neon backlighting in lurid orange. We eyed the drinks menu and were amused to find Pink Squirrels on it, as well as Sex on the Beach and all those other oddball drinks so popular in the late 70's. (Major disappointment: no Harvey Wallbanger listed.)

    My friend surveyed the bar denizens, the decor, inhaled the ambiance and announced, "In a place like this there's only one drink to have." She got a shot of tequila. I stuck with white wine - boring, I know, but I like it. No bikers were to be seen but several guys in polo shirts and caps, looking as if they'd just come off the local public golf course, strolled in over the next half hour. We talked about our jobs - a friend of hers who's managed to get in trouble with the IRS over her investments, and the game plan my friend planned to get her out of it; and some of my patients, and my house project. (She's put up with all the noise and mess for months, so she has a vested interest in it.)

    We relaxed to the point that we decided to stay for dinner, which was as good as advertised. A 6 oz. filet mignon with Bearnaise and potatoes was $13, 11 oz. was $20. And it was good. No veg on the plate - that was extra, but we were happy with our meat, potatoes, and booze. No wonder guys like this place! As we prepared to leave, we made plans to spend the summer going on a "retro restaurant cruise" of West Los Angeles. Next stop: Billingsley's, also on Pico but half a mile west of the Arsenal. I hear they're also known for good cheap dinners...

    Tuesday, April 06, 2004
    L'Chaim! Or Something!

    Yesterday while walking with my next-door neighbor we got to talking about her upcoming birthday (tomorrow). My neighbor is widowed, about ten years older than I am, and a stockbroker. She's coming off a recent breakup with some guy she met playing golf (I met him once and wasn't too impressed). She'd needled him into giving her an engagement ring, but the relationship stalled out after that and no wedding plans were made; eventually he gave her the "I think it's time we called it a day" speech and that was the end of that. This is her first birthday she'll celebrate without him, and after the recent loss of a close relative on top of that, she wasn't looking forward to her birthday too much - atypically for her, she hadn't made any plans.

    "Then you and I should go out!" was my response. "Let's do something different, like pick some really wacky place you'd never normally go to. I've got a great idea." I then told her the story of my visit to The Arsenal, and its abrupt termination.

    This is what happened. A local food critic had written a review of the Arsenal, which is some sort of low-rent steakhouse in West Los Angeles, and made it sound pretty good (despite his comment that the waitresses had been there "since Century City was a bean field"). One night a friend and I were looking for a place to eat, and I persuaded him to try it. Our first challenge was locating the restaurant. I knew roughly where it was, but still it took some cruising up and down Pico Boulevard before we finally found the place. The side that faced the street was one of those flat, windowless storefronts that instantly make me think "sleazy nightclub"; nevertheless, we persevered, pulled into the alley leading to the parking area - and were confronted by a string of Harleys in the parking lot.

    My friend is a wonderful guy, but "macho" is not his middle name. His startled response to the choppers massed in front of us was "Oh my God, maybe we'd better try someplace else." Part of me agreed with him, but part still was eager to test what could be an underrated but tasty dining experience. Therefore, in we went. All I remember of the interior was the dozen or so pairs of eyes belonging to the Harleys' owners boring into us as a greeting.

    In tandem, we halted, spun on our heels and headed for the door. The noise that rose behind us brought back memories of taunts on the playground in childhood: "YEAAAAA!"

    Laughing our heads off, we scrambled back into the car; I threw it into reverse and hit the accelerator, miraculously avoiding the motorcycles standing around like dominoes waiting to be knocked over. We found somewhere else to eat that night. So you can see, of course, why I was so eager to go back and try again, right?

    Well, neither could my neighbor. "You want to eat DINNER there??" was her amazed response.

    "Look, it'll be an adventure. We both need one. It'll take your mind off things!" I responded. "Let's live a little!"

    "Well, I guess we could go there for a drink," she responded.

    So that's where things stand; we're headed to the Arsenal for a drink tomorrow night, and then who knows what after that? I'll keep you posted.

    A Trivial Pursuit

    I'm spending WAY too much time on IMDb.com, having discovered their quotes and trivia pages. Here is some of what I've found:

    - Did you know that Love, American Style spawned more spinoffs than any other American TV series? (Most were related to Happy Days.)

    - Did you know that J. Lo got her start as a Fly Girl dancer on In Living Color?

    - Did you know that the characters of Barney Fife and Andy Taylor on The Andy Griffith Show were cousins?

    - And that the flute in the Inspector Morse theme music spells out Morse's name in Morse code? (And sometimes they throw in the murderer's name too!)

    Not to mention the quotes. Try any James Bond movie. Or Doctor Who. Or Are You Being Served?

    Don't click unless you're prepared to spend hours surfing the site...

    Thursday, April 01, 2004
    What Would We Do Without Experts?

    (Note: this headline is a direct steal from The Wall Street Journal's Best of the Web Today.)

    From the California Medical Association's CMA Alert newsletter:

    Experts Predict High Demand for Flu Vaccine This Season

    Gee, that's going out on a limb.

    It's Hell in Hollywood - If You've Got Brains

    I was tipped off to this story about the new movie Hellboy via Bookslut. I've never read the Hellboy comic and have no feelings about the movie one way or the other, but I think the interview with the director brilliantly illustrates the current mindset in Hollywood regarding ideas for films:

    "An executive said to me, `What about a regular actor who gets angry and turns into Hellboy?'" said del Toro, wrinkling his face in disgust. "I go, `That's ... not ... very good."

    "Then they would say, `What if you call him Hellboy and he comes from Hell and all that, but he looks like a guy?' Then they would suggest things like, `Can he have a Hellmobile?' `Can he have a dog? A pet dog that comes from hell and is red?'

    "It's funny when you say it," del Toro said in his Encino, Calif., office while the film was being edited. "But it's not funny when it happens."

    Hellboy has no problem surviving a battle with a gargantuan monster tentacle, but he nearly didn't make it through the pummeling of bad ideas del Toro faced as he shopped his vision of the story from studio to studio.

    "I always was thinking, `The movie's never going to be made. Don't get your hopes up,'" said Mike Mignola, the comic book artist who created the character in 1993.

    I may have to go and see the movie after all, just to register support for any director that was smart enough to hold out for five years to hire Ron Perlman to play Hellboy instead of coming up with a computer-generated animation of the character instead. (Anybody else remember Beauty and the Beast? Man, he was good in that.)

    The line that really cracks me up here, for some reason, is: "Can he have a dog? A pet dog that comes from Hell and is red?" Hollywood can pick good directors but can't trust them to do a good job after they're hired for some reason. Actually, the reason is easily identifiable: too much money, not enough brain cells.