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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    Tuesday, March 22, 2011
    Cheap and Cheerful

    Via Instapundit, 30 Ramen Hacks. I especially liked the "ramenepherd's pie" idea. (Shepherd's pie with ramen on top instead of mashed potatoes.)


    Sunday, March 20, 2011
    You're Wrong, Albert Hammond. Oh, and Zombies.

    They say it never rains in Southern California...

    Well, I'm here to tell you it does. Even on the first day of spring. Even on Marathon Sunday. It has been pouring nonstop for at least the past nine hours. We didn't see the Supermoon, as it was clouded over; the lights have been flickering and I have heard the occasional banging outside which may be coming from a local transformer. Still, I'm rather enjoying it as this could be the last rain of the season and certainly it's likely to be the last storm of any significance.

    This apocalyptic weather has led me on to other thoughts. Recently I have been trying to blog more, but at the best of times I tend not to blog much about major world events. There are several reasons for this (see above, dilatory blogger). There are better sites on the web by far to pick up analysis of world news; I don't really think that reading "OMG, how horrible" on yet another website offers any insight. That said, after seeing everything that has happened in Japan my main resolution for the rest of this year is to be better prepared for disasters. Instapundit has been very good about offering links to disaster preparedness sites, and another favorite site of mine - Home Ec 101 - offered a recent update with some good, basic hints. One important one: try not ever to let your gas tank go below half full. Me, I think it wouldn't hurt to also keep a couple of extra gallons of gas in the garage; of course I haven't bothered to do anything about this yet.

    Another simple hint. Save your two-liter plastic soda bottles, rinse them out and fill with water. It's a simple and cheap way to keep an emergency supply of H2O on hand. Refill bottles with fresh water every six months. Also, keep a manual can opener and reasonable supply of canned food on hand. I would like to get a propane fired grill later this year, too. With that and a few tanks of propane you can boil water and cook food. I personally am not into the dehydrated food storage thing, but if you are, that wouldn't be a bad idea either.

    My former neighbor (who has since moved) was on the Emergency Preparedness committee of her alma mater, Redlands College. Redlands, in case you are unaware, basically lies atop the San Andreas Fault. A few years ago we went out to breakfast with another neighbor who lives across the street - it was our habit to do this every few months. Neighbor # 1 had just been to her annual committee meeting, which lasted an entire weekend, and she had brought a notebook stuffed with information for us to peruse. It even had suggestions on what to do with dead bodies (wrap in plastic sheeting and leave in a cool place).

    Redlands has to plan like this, not only because they have to protect the student body but because they have to assume that the locals will be coming to campus seeking food, water and shelter. They are also working on the assumption that the government will not be able to help for two to three weeks in the event of a major disaster. I was impressed with their thoroughness.

    I recently came across a mention of a novel about the aftermath of an EMP called One Second After. I haven't read it yet but it sounds ghoulishly intriguing. The protagonist's daughter, for instance, is a 12 year old with Type 1 diabetes, dependent on insulin. I think I can guess what happens to her. The book is structured around the effect on the population of a sudden return to 19th century technology. There are waves of "die offs" - the first being hospitalized and nursing home patients; then those with chronic illnesses who can't get their medication; then those with mental illnesses who can't get their antipsychotics. The review I read said that only about 20% of the population was left alive after a year. Scary stuff.

    The wind has picked up and I'm going to sign off before the power goes out - not such an unusual thing around here. Tree branches take out power lines nearly every time the wind kicks up. Los Angeles doesn't plan well for its winter storms; I hate to think what might befall us in the event of a true disaster. The state is close to bankrupt as it is.

    On that note, enjoy the rest of your weekend.

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    Thursday, March 17, 2011
    Day of Reckoning

    Nothing blitzes a good mood faster than seeing a new lung mass on the chest X-ray of a smoker. Damn it.

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    Wednesday, March 09, 2011
    How to Tell if your Doctor is Having a Bad Day

    Is your doctor huddled over the computer keyboard muttering "F...! F...! F...!"?
    Does your doctor scream when you hand over your jury excuse form?
    Have you overheard your doctor mutter "If I have to write one more Letter of Medical Necessity, I'm gonna puke"?
    Is your doctor hooked up to an IV bag of coffee?
    Is your doctor swigging from a suspicious looking bottle of clear liquid, explaining that "it's my nerve medicine"?

    Your doctor may be having a bad day.


    Tuesday, March 08, 2011
    Butt, Kicked

    Happy freakin' Mardi Gras, everybody.

    A few weeks ago I made the decision to start seeing patients earlier in the morning, with the goal of getting out earler in the evening. Let me tell you just how well that's working out: I had dinner at 8:30 pm tonight.

    Still, it could be worse; last week at our monthly staff meeting our CEO put up a PowerPoint slide of the number of patients seen by each doctor in the group one day earlier in the month. For me it was all entertainment, as the day chosen was a Thursday and I don't see patients on Thursdays. The names of the doctors weren't given; too bad, I thought. That would have made it more entertaining. Number of patients seen ranged from 1 to 73. In case you are wondering the doc who saw 73 patients in one day was an orthopedist (that's par for the course). A lot of docs saw fewer than 18 patients. I always see more than that.

    I have noticed that I am getting a steady flow of new patients, which is a great blessing. The economic problems of Southern California continue to hit us hard and our total number of patients seen is down. With the improved employment numbers from this week, maybe things are getting better; I certainly hope so.

    And now off to bed. I have to get up and do it again tomorrow.