Friday, May 30, 2008
On June 2, PZ Myers of the Pharyngula blog is coming to the Pacific Science Center for a talk titled, "On Science, Blogs, and Intelligent Debates." It's at 7:00 PM and is co-hosted by the Northwest Science Writers' Association.
The very next day, Melanie Roberts, FOSEP founder and two-time AAAS Policy Fellow will speak about "How can YOU influence the federal policy process." She worked in Senator Jeff Bingaman's office and at the NSF. That talk is on the UW campus at 4:00 in the Health Sciences Building's room 747.
If you are in Seattle and are reading this blog, I think you'll find both of them interesting!
Thursday, May 29, 2008
There are four locations. Two collect and two buy the metal.
- Collector: Fairbanks North Star Borough 456-1482
- Collector: Joy Elementary School 456-5469
- Buyer: C & R Pipe & Steel 479-5174
- Buyer: K & K Recycling 488-1408
There aren't many other items that can be recycled. Paper is on hold, glass is not available. Copper, metal scrap and cell phones are accepted at various locations, as is cooking oil. Head over to Green Star for more information.
Wednesday, May 28, 2008
It's time for you to check out another of my articles at The Differential. This one's about how little recycling occurs at hospitals and what could be done to stem the waste-stream. Click it to Read it!
Some rotations I've been on consist of half your time in "rounds," a quarter of your time in "sign-out," and the rest split between conferences and patient care. (I know, rounds and sign-out technically are patient care, but they hardly feel personal to me...)
It's no wonder residency programs have to keep their residents over night every fourth night. When else would work get done?
By the way, "rounds" is when a team of students residents and an attending physician walk around on the ward updating each other on patient status. "Sign-out" is when one team tells the next all of the details from the patients' care that day.
"I didn't think I'd pay $4 a gallon for water," Fitts said. "But I didn't think I'd be paying $4 for gas, either."Um. Wake up Mr. Fitts!!! That case of bottled water in the back of the SUV you were driving your kids to the hardware store in? I bet that water cost more than $4 a gallon...
By the way, gasoline is so expensive in Alaska that they don't even bother putting the price up on the station marquees. This weekend, I paid between $4.15 and $4.75.
Monday, May 26, 2008
But for now, I need to finish writing up two patients for my OB/GYN clerkship requirement. One who had a basketball-sized ovarian cyst (benign) and another who delivered a breach baby boy by Caesarian section.
Sorry for the delay.
Tuesday, May 20, 2008
Sunday, May 18, 2008
Need more reason to head over there? There's a sweet picture of a moose.
Saturday, May 17, 2008
"Your time in the OR can be especially valuable because of the quality of pelvic exams you'll be able to do while patients are sedated."Caution: squeamish topic ahead...
Last week, I wrote in The Differential about the blurred line in the operating room between humor between physicians and laughs shared with patients. With another week comes for me another state, another clerkship, and another uncomfortable situation in the OR.
Learning the pelvic exam is an important part of medicine. As a doc in a busy ER, I bet I'd average one a shift. But who wants a student doing their exam? Any manipulation downstairs is one that needs to be done with respect and professionalism. There are gender issues, privacy issues, and the question of whether the exam is medically indicated. (Many docs subscribe to a policy of giving a rectal exam to every patient with gastrointestinal problems or anal pain - a colorectal surgeon I recently worked with thought otherwise.) In the context of these issues is the fact that students don't have a clue what they're doing when they start doing exams!
Med students learn these important exams first with paid healthy volunteers (NOT each other!), and graduate to willing patients. With rare exception, a student's exam will need to be followed by a resident's or attending's exam. Two for the price of one. Would I volunteer? Many patients do not.
Which brings me back to the quote above. When a woman has a hysterectomy or other gynecological procedure under general anesthesia, it is very important to know where the uterus and cervix are. The patient has agreed to having a student in the OR, so implicitly agrees to an exam. The pain from the procedure far outweighs any discomfort caused by a pelvic exam, and the anesthesia leaves the patient without a trace of memory from the exam.
So why am I still uneasy about performing a pelvic exam on a sleeping patient? Strangely, I'm more comfortable with someone conscious. But I bet I need the practice.
Didn't know the words to this song in the first place? Now you can sing along about the microbes you don't want to get...
Monday, May 12, 2008
Sunday, May 11, 2008
As in, I took this photograph of my rental car at 9:30 PM.
I'm in Fairbanks for my obstetrics and gynecology rotation. My wife will be doing surgery. Today consisted of finding the hospital, the outpatient clinic, and a delicious Korean restaurant in a bowling alley's basement. We also paid visits to the Safeway for groceries. This evening, it's 63 degrees and party sunny. Notice in the photo above the power cord hanging out of the Subaru's grille. This isn't some alternative energy scheme, when temperatures drop, a preheated engine increases the chances of successful start and also reduces emissions. We don't expect to use the plug. After all, we noticed college co-eds from the University of Alaska walking down the street in shorts and bikinis this afternoon!
In Spokane, our apartment was adjacent to Lincoln Park, which offered a nice place for evening strolls. Here in Fairbanks, we're just next to a bird sanctuary called Creamer's Field. On our exploratory walk this evening, we saw sandhill cranes! Some were engaged in their silly mating dance.
My recent entry over at The Differential explores this idea in the context of some of my recent patient experiences.
Check it out. If you have a chance, let me know what you think about humor as therapy.
Thursday, May 08, 2008
Just northeast of Seattle is an area of amazing beauty and spectacular scenery that until today was just a patch of government land. Today, after many years of politcal wrangling, it has been Federally designated as wilderness, thereby protecting it for generations to come. This wouldn't be possible if Richard Pombo (R-Ca) had not been defeated in 2006 and if George W. Bush wasn't trying to salvage his 2000 campaign promises of expanding national parks and preservation areas.
The photo above shows an area just up the ridge from the Skykomish River, nearly at the point where I wrapped my canoe around a boulder two summers ago. I'd like to blame the scenery on my faulty steering, but really, I just read the river wrong... What's nice is that the 'Sky' river is just on the border of this soon-to-be pristene area. It will now be difficult to develop the river, thereby preserving the land, the sport and the fishery in that basin.
Put the Wild Sky Wilderness on your list of must-hike outdoors destinations. But not too many of you...
Photo credit to Joshua Trujillo and the Seattle P-I.
Wednesday, May 07, 2008
How does all the information get into the computer?
Doctors from my generation (and especially my 5 year younger classmates) grew up typing. They'll be able to type their notes and orders real time. In the outpatient setting, many resident physicians carry a laptop into the office to enter patients' data. But what about the folks who can't type very fast?
Doctors have notoriously bad handwriting. As patient encounters became more important for the legal record and later were stored digitally, there needed a way for scribbles to be translated into typeface. Docs started using services that would transcribe speech into text. Sometimes 'in house' stenographers collect tapes at the end of the day and type them up the next day. In more urgent situations, docs can call an 800 number and connect with a service that contracts out the conversion from spoken to written word.
These days, voice recognition software is phasing out the transcriptionist. Voice recognition is good enough that docs can list the illness history, physical exam findings and treatment plans realtime between patients.
But whether it's human transcription or computer, there will be typos. Take for example my recent discovery of a patient who presented with a significant history of bacertial rasmosis. 'Bacertial' looks enough like 'bacterial' that my mind barely noticed it. But rasmosis? A new class of infection? I immediately consulted Dr. Google. About the closest I could find was the species name for the herbal called black cohosh. Cimicifuga racemosa. Black cohosh is bad enough for you - especially in women of child-bearing age. I hadn't heard of infection exacerbation. That's the funny thing about medicine - there's always something new to learn.
The other funny thing about medicine is that some of what you learn is wrong.
Enter the punchline. This woman had recurrent bacterial vaginosis. The record was an error of transcription. Welcome to the EMR.
Shown above is a schematic of a self-retracting IV catheter needle like we use to place peripheral lines.
I'm in the hospital's library studying right now and just heard the helicopter land. You might be an aspiring ER doc if the sound of chopper blades makes you think "Airway Breathing Circulation" and inspires you to flip in your trauma surgery notes to the section on the four main types of shock...
Must... Keep... Focus... On... Studying...
Tuesday, May 06, 2008
A Long Term Study Of The Forces Of Nature On Assorted Fruits From The Western United States"
Wood, Glass, Found Berries
January 8, 2008 - May 6, 2008
Let's get it over with, already. We need to start from scratch! It's beginning to be berry season in the Northwest and I'm anxious to move on with this piece of art...
Monday, May 05, 2008
One of the reasons I like reading his blog is that his insight reveals a connection with science, teaching and mentorship that I resepect. Exhibit A:
[One] thing to keep in mind ... is that by the time you reach the end-game of grad school, are finishing up the last few experiments, and are beginning to write the thesis, it is highly likely that you will be pretty much completely disgusted with the science underlying your project, life in the laboratory, and science as a career. This state of mind is a natural consequence of the grueling process of earning your PhD, and does not reveal anything particularly salient about how you really feel about a life in science.
It is similar to how Army recruits feel at the end of basic training: drained, exhausted, miserable, and wanting to quit. But this is no time to make life-altering decisions, such as leaving science for some other profession. As soon as the thesis is accepted, a huge weight lifts, and over the course of a few months, you begin to remember the joys of a life in science.
He sure hit the nail squarely, here. Except for one thing.I'll let you know when the weight lifts.
Saturday, May 03, 2008
If I were 5 years younger...
If I wasn't married...
If I could be content doing one thing at a time...
If I could put up with the hierarchy just a little longer...
I would totally pursue a career in cardiac or vascular surgery. In its favor is:
The 'get in there and fix it' mentality,
The meticulous microsurgery,
The dependence on bioengineered technologies,
The adrenaline of cutting open the aorta (on purpose), and
Working on a team.
I suppose I can find those things and a lot more elsewhere. Well except for the cutting open the aorta part...