Things I Will Never Write About On This Blog:
The Arab/Israeli conflict. No winners. Bad real estate. Religion.
My neighbor's vagina.
My neighbor's other thing that sounds like a motorcycle. Tiny motorcycle with "Hello Kitty" designs on it.
Food that comes in round paper buckets. Trapezoidal paper buckets and actual metal buckets are OK, though.
This blog. Except this one time. You see the logical conundrum.
Foghat. I just have absolutely nothing to say about Foghat, and so should you.
Canadian francophone television humor. One simply cannot discuss that which does not exist.
Lite beer. Really. Look at me. Does anything about me say "lite beer?!" Heck no.
Small dogs. Except that I despise them. Dogs are supposed to be BIG. Capiche?
People who say "Capiche." If I discuss my relations with them I will surely die a violent death at the hand of close relatives.
My old lovers. I've already smeared them enough in college literary publications. And besides, they're all old and can't get it going anymore. Not me, though. I'm literally a marathoner. But I'm not proud. That's just the way it is. 2:46 best. 33.29 in the 10K on the track. Sheesh.
Celtic step-dancing. The fiddles are way OK though.
Arizona pizza. We have the best pizza shop in the world down at Copper Square. But I will not discuss it here. Instead go to his sandwich shop up Central a little ways.
Actual medical stories. Federal law requires that I fictionalize everything I say about my job, which does not actually exist. Ever. Anywhere. Period. So I will never discuss things that occur at The Great Muffin Factory where I allegedly work if I even had a job, which I probably don't, since these are quite scarce.
Nail care. I have my ideas, you have yours. Mine are better, but these require asymmetry and a lot of various files and papers.
Cedar versus Spruce. I'm leaning towards spruce, but then again there was that old Ramirez I played in college. Loud and dark, but not so easy. OK, spruce has it. Heck, why not both?
I don't count guitars anymore. It's rude. Really.
Episodes. I have a general rule in life just to never discuss Episodes. Ususally it's embarrassing to somebody, and we don't go for that here. Unless you're a Republican. Then, as we like to say, it sounds better in metric.
Tuesday, June 27, 2006
Sunday, June 25, 2006
Gore (Al, That Is.)
One of the most interesting things about "An Inconvenient Truth" is that in it we see Gore as Gore, not as the media wished us to see him in the 2000 campaign.
The media lied back then about Gore. He is not poll-driven. He is not a flip-flopper. He is not a stuffed shirt. He is not robotic. He never claimed to have invented the internet, though it is well-established that he supported political initiatives that led to its widespread use.
He is well-spoken and he presents an easy intelligence that comes off as common-sense, which of course is exactly what he suggests we use in our confrontation with global warming. Common sense, because this issue affects all of us, rich and poor.
Perhaps this was an underlying impulse for the creation of this movie: it shows us Gore, and his primary issue, unfiltered through the media bullshit grinder.
By sidestepping the media and viewing the movie, people can actually see the threat of global warming for what it really is, and see its best spokesman for what he truly is: an expert with a Carl Sagan-like ability to communicate scientific concerns to a wide audience.
Even people who are too thick-skulled, propagandized, or just plain unable to understand spoken words can just look at the pictures and see that Gore has a good point.
We were fools not to have elected this man.
It was also just a fine example of movie-making. To take what was essentially a college lecture and make a great film out of it reminded me of, say, 'Stop Making Sense' or perhaps another wonderful concert film by Jonathan Demme, 'Storefront Hitchcock.' The film-making facilitated the message and the messenger with a breezy competence and clarity.
I knew I'd like it, but it was even better than I expected.
The media lied back then about Gore. He is not poll-driven. He is not a flip-flopper. He is not a stuffed shirt. He is not robotic. He never claimed to have invented the internet, though it is well-established that he supported political initiatives that led to its widespread use.
He is well-spoken and he presents an easy intelligence that comes off as common-sense, which of course is exactly what he suggests we use in our confrontation with global warming. Common sense, because this issue affects all of us, rich and poor.
Perhaps this was an underlying impulse for the creation of this movie: it shows us Gore, and his primary issue, unfiltered through the media bullshit grinder.
By sidestepping the media and viewing the movie, people can actually see the threat of global warming for what it really is, and see its best spokesman for what he truly is: an expert with a Carl Sagan-like ability to communicate scientific concerns to a wide audience.
Even people who are too thick-skulled, propagandized, or just plain unable to understand spoken words can just look at the pictures and see that Gore has a good point.
We were fools not to have elected this man.
It was also just a fine example of movie-making. To take what was essentially a college lecture and make a great film out of it reminded me of, say, 'Stop Making Sense' or perhaps another wonderful concert film by Jonathan Demme, 'Storefront Hitchcock.' The film-making facilitated the message and the messenger with a breezy competence and clarity.
I knew I'd like it, but it was even better than I expected.
Wednesday, June 21, 2006
This is one of the most important poems in American literary history.
Why? Got me swinging. It questions identity, obviously, a universal and yet American cultural concern.
I just love the playful irony of it. "Then there's a pair of us." No doubt even more than that!
"I'm nobody! Who are you?
Are you nobody, too?
Then there's a pair of us--don't tell!
They'd banish us, you know.
How dreary to be somebody!
How public, like a frog
To tell your name the livelong day
To an admiring bog!"
I've visited her house, and for this I feel blessed.
Why? Got me swinging. It questions identity, obviously, a universal and yet American cultural concern.
I just love the playful irony of it. "Then there's a pair of us." No doubt even more than that!
"I'm nobody! Who are you?
Are you nobody, too?
Then there's a pair of us--don't tell!
They'd banish us, you know.
How dreary to be somebody!
How public, like a frog
To tell your name the livelong day
To an admiring bog!"
I've visited her house, and for this I feel blessed.
Saturday, June 17, 2006
Serpent Uncoils
"Do Not Go Gentle Into That Good Night," by fave Dylan Thomas, was rolling around in my mind this morning as I walked the dog around the neighborhood. Like the last poem I put up, "Mad Girl's Love Song," by Sylvia Plath, it is a villanelle. Though these two poems are modern examples of an ancient form, their popularity likely outstrips that of any earlier examples of the format.
"Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on that sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light."
You may have already guessed what I am about to tell you, the secret of a new interpretation of this classic: it's about peak oil.
Hehehe.
So that is how I read the poem over in my pointy little head today, as I strolled the local streets with one of my trusty black lab pooches. How will this corner of civilization survive after the era of cheap petroleum ends? How will we each react to this change, so intense it can be compared to a kind of death?
It's mostly irrigated, this neighborhood, because in the immediate past it was primarily orchard land. Citrus, pomegranites, olives, date palms, pecans, avocados, and peaches. With a little effort every available inch of the open properties here could be harnessed into production of merchandisable local produce.
Your roof is a solar collector. Ours here could be put to use with PV cells to produce electricity during the day, allowing the use of power tools and electronics on a modest scale.
The canal which runs along the northern edge of the neighborhood provides a defensible border as well as reliable a source of water one can expect in a desert city.
There are small schools within walkable distances, local retail spaces, and no big-box stores.
A highway borders the neighborhood on its eastern edge, also providing a defensible boundry and perhaps allowing some remnant of mass transportation in the future.
Enough of the apocalyptic fantasizing and back to the poem: I suppose the stanza that now applies best to my thinking is the fourth one, pertaining to "wild men:"
"Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night."
I am fortunate enough to have lived in times which were amongst the luckiest of any earthly generations, with ample cheap energy and all the luxury that came of it. And now I'm shouting from the rooftops that this era is closing, and the grieving process comes to fore.
But there's hope. Civilization has a good chance of re-creating a post-industrial sort of society somewhat along the lines of the pre-industrial communities that produced Haydn and Mozart, the Pont du Gard, brutally simple and elegantly accurate lunar calendars, and even good-old American lawn-art.
"Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on that sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light."
You may have already guessed what I am about to tell you, the secret of a new interpretation of this classic: it's about peak oil.
Hehehe.
So that is how I read the poem over in my pointy little head today, as I strolled the local streets with one of my trusty black lab pooches. How will this corner of civilization survive after the era of cheap petroleum ends? How will we each react to this change, so intense it can be compared to a kind of death?
It's mostly irrigated, this neighborhood, because in the immediate past it was primarily orchard land. Citrus, pomegranites, olives, date palms, pecans, avocados, and peaches. With a little effort every available inch of the open properties here could be harnessed into production of merchandisable local produce.
Your roof is a solar collector. Ours here could be put to use with PV cells to produce electricity during the day, allowing the use of power tools and electronics on a modest scale.
The canal which runs along the northern edge of the neighborhood provides a defensible border as well as reliable a source of water one can expect in a desert city.
There are small schools within walkable distances, local retail spaces, and no big-box stores.
A highway borders the neighborhood on its eastern edge, also providing a defensible boundry and perhaps allowing some remnant of mass transportation in the future.
Enough of the apocalyptic fantasizing and back to the poem: I suppose the stanza that now applies best to my thinking is the fourth one, pertaining to "wild men:"
"Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night."
I am fortunate enough to have lived in times which were amongst the luckiest of any earthly generations, with ample cheap energy and all the luxury that came of it. And now I'm shouting from the rooftops that this era is closing, and the grieving process comes to fore.
But there's hope. Civilization has a good chance of re-creating a post-industrial sort of society somewhat along the lines of the pre-industrial communities that produced Haydn and Mozart, the Pont du Gard, brutally simple and elegantly accurate lunar calendars, and even good-old American lawn-art.
Friday, June 16, 2006
Apocalipstick
Oh freakin' my. We need to keep things moving here in Arizona.
Like what "things"? Sprawl? Fake urban lakes? Substandard-of-living-wage jobs? What exactly does Arizona produce that must be moved, either within, or out-of-state to create income for us?
A few microchips, maybe. Some turquoise jewelry, I suppose. The occasional college graduate.
Anything else? No, not really.
The only thing we need to move is food, produce, and cheap plastic crap from China into our geographically fantastic state, and in return we move out our mortagages, to the same Chinese that just sold us the $10 computer keyboard, American flag, and genuine Mexican pinata.
We don't make anything much here. Goldwater Republicans, and there's little market for them.
But we consume like crazy, thanks to cheap oil and easy motoring. Isn't that what tourism is all about? How many New York and Japanese tourists hike here to visit the wonders of out state? None. They drive or fly.
"On Wednesday, at a transportation summit sponsored by the Arizona Chamber of Commerce, business and government leaders talked about the need to build freeways faster to keep our economy humming. "
Drive cars and fly planes. In a generation or two nobody will be doing much of either. So why call highway construction "planning?" It's not "planning." It's stupid. It's obsolete. It's a continuation of a great misallocation of resources at the behest of The Great American Nightmare: to own a suburban lawn that requires petrochemical sustenance and mowing regularly.
Lawns, you see, not naturally occuring on this continent, are simply a manifestation of cheap oil, which sponsors their growth with fertilizer and machine maintenance. (So is mid-plains industrial farming.) Even if you hand-mow it with a mechanical person-powered mower, the likes of which I haven't seen in 40 years, and nourish it with organic animal droppings. I bet oil had something to do with production and transport of the foods you need to feed your pets. Even the offal in the litter box is therefore beholden to cheap oil. Funny, that.
It just keeps going on and on.
We could make electric energy, with the abundant sunshine here. But we don't because the center of the earth is full of magically self-replenishing oil reserves, which unfortunately lay under the sands of Araby.
Like what "things"? Sprawl? Fake urban lakes? Substandard-of-living-wage jobs? What exactly does Arizona produce that must be moved, either within, or out-of-state to create income for us?
A few microchips, maybe. Some turquoise jewelry, I suppose. The occasional college graduate.
Anything else? No, not really.
The only thing we need to move is food, produce, and cheap plastic crap from China into our geographically fantastic state, and in return we move out our mortagages, to the same Chinese that just sold us the $10 computer keyboard, American flag, and genuine Mexican pinata.
We don't make anything much here. Goldwater Republicans, and there's little market for them.
But we consume like crazy, thanks to cheap oil and easy motoring. Isn't that what tourism is all about? How many New York and Japanese tourists hike here to visit the wonders of out state? None. They drive or fly.
"On Wednesday, at a transportation summit sponsored by the Arizona Chamber of Commerce, business and government leaders talked about the need to build freeways faster to keep our economy humming. "
Drive cars and fly planes. In a generation or two nobody will be doing much of either. So why call highway construction "planning?" It's not "planning." It's stupid. It's obsolete. It's a continuation of a great misallocation of resources at the behest of The Great American Nightmare: to own a suburban lawn that requires petrochemical sustenance and mowing regularly.
Lawns, you see, not naturally occuring on this continent, are simply a manifestation of cheap oil, which sponsors their growth with fertilizer and machine maintenance. (So is mid-plains industrial farming.) Even if you hand-mow it with a mechanical person-powered mower, the likes of which I haven't seen in 40 years, and nourish it with organic animal droppings. I bet oil had something to do with production and transport of the foods you need to feed your pets. Even the offal in the litter box is therefore beholden to cheap oil. Funny, that.
It just keeps going on and on.
We could make electric energy, with the abundant sunshine here. But we don't because the center of the earth is full of magically self-replenishing oil reserves, which unfortunately lay under the sands of Araby.
Black Equals White So Blue Is the Truest Color (except green)
The night shift nurse was still giving me a one-on-one report when Abe, the certified nursing assistant, bent over the station counter and held the glucometer up to us and said "5-B." It read 55. I've seen people reading a glucose of 30 and up walking around so I got there when I got there.
The patient wouldn't take juice. They just kept saying (for lack of a better word!) Meh, meh. A little blood oozed from their lips, and some brown-green emesis was spread a little down the hill of their upright head-of-bed. Fish in my koi pond were more verbally appropriately responsive.
We checked their temperature and they were hot, about 102F., whatever that is in centigrade. They looked post-ictal to me. They'd been incontinent too, and an embarrassed resident, who was obviously uncomfortable at the sight of a patient who'd messed all over themselves, asked if I "could clean the patient up."
Of course.
But first I wanted to give the patient a dose of D50 and an acetaminophen suppository and maybe Yankauer the crap out of their mouth, while the resident stood there like a pigeon on a wire. Then I checked my other patients, as yet unseen, just to make sure none of them were blue and lying on the floor.
Good.
They weren't.
I do not mean to run down the resident. He's a real sweetie, and one of my favorites. Usually he's all over medical issues like wet paint on a bench, but poop scares him. He's not a parent yet, I think. Diapers to him are like braille maps to NASCAR racers.
In college I particularly studied, after music, Surrealism and Zelda Fitzgerald. Whenever I find myself saying "blah-blah-blah is like so-and-so" I cannot help but recall those heady days. But mostly I studied early music techniques and free jazz. It's all of a piece, really, once you get there.
Imitative modal counterpoint. Free association poetic constructs. Adult diapers. Pharoah Sanders. Anime. There ya' go.
The other patient in the room was not of an acute situation. More chronic. Thrown from a vehicle in a motorvehicle accident, they had four broken limbs and a closed-head injury. Freakin' brain stitches, right?
More of a long-term situation here.
In an hour or so the room-mate was awake and oriented, fever and blood-sugar issues resolved, tegretol levels within normal limits, skies clear with gentle breezes out of the west.
In the meantime roomie had an episode of tube-feeding loose stool rivers of flowing crap down between the legs and over the edge of the bed, cascading out of the room out into the halls like the Slime From the Video.
Cleaned, turned and positioned, tube-feedings checked, IV sites clear, we joked a little with the patient and although they could not speak, due to the closed-head injury, they smiled and with the hand they could move a little, signalled a clear "thumbs-up."
Man, that was the best. What a grin. Cheshire cat-like. Cheesecake to my eyes.
We got there. We did something for them that they recognized and appreciated, even though they couldn't speak. They blinked it.
The other patient was basically out of the woods. Theirs was an acute situation and they'd go home soon, back to their normal life.
But this one would never be themselves again. The accident robbed them of speech, mobility, and control of their bodily functions. We wondered when the docs would finally get a PEG tube placement ordered. Some thought that maybe the patient could get through a swallow study, but I had doubts.
If you can't turn your head much voluntarily, then you probably can't swallow without dropping a bunch of crap into your lungs.
That is not a Surrealistic comparison.
It's more of a Republican comparison. You see, both of these patients are the same. They are both hospitalized. They have the same needs, politically, because neither of them are likely to vote. And they have nobody but family to advocate for them. No political lobbies shovelling millions into campaign coffers. No casinos. No churches. No Scottish golf junkets.
This is nothing.
These people are no-accounts.
And I love them with all my heart and soul and I will devote my working days to them as rainbows are devoted to the sky-waters that foster them, because I am just a normal person just like you and you'd do the same if you were me.
The patient wouldn't take juice. They just kept saying (for lack of a better word!) Meh, meh. A little blood oozed from their lips, and some brown-green emesis was spread a little down the hill of their upright head-of-bed. Fish in my koi pond were more verbally appropriately responsive.
We checked their temperature and they were hot, about 102F., whatever that is in centigrade. They looked post-ictal to me. They'd been incontinent too, and an embarrassed resident, who was obviously uncomfortable at the sight of a patient who'd messed all over themselves, asked if I "could clean the patient up."
Of course.
But first I wanted to give the patient a dose of D50 and an acetaminophen suppository and maybe Yankauer the crap out of their mouth, while the resident stood there like a pigeon on a wire. Then I checked my other patients, as yet unseen, just to make sure none of them were blue and lying on the floor.
Good.
They weren't.
I do not mean to run down the resident. He's a real sweetie, and one of my favorites. Usually he's all over medical issues like wet paint on a bench, but poop scares him. He's not a parent yet, I think. Diapers to him are like braille maps to NASCAR racers.
In college I particularly studied, after music, Surrealism and Zelda Fitzgerald. Whenever I find myself saying "blah-blah-blah is like so-and-so" I cannot help but recall those heady days. But mostly I studied early music techniques and free jazz. It's all of a piece, really, once you get there.
Imitative modal counterpoint. Free association poetic constructs. Adult diapers. Pharoah Sanders. Anime. There ya' go.
The other patient in the room was not of an acute situation. More chronic. Thrown from a vehicle in a motorvehicle accident, they had four broken limbs and a closed-head injury. Freakin' brain stitches, right?
More of a long-term situation here.
In an hour or so the room-mate was awake and oriented, fever and blood-sugar issues resolved, tegretol levels within normal limits, skies clear with gentle breezes out of the west.
In the meantime roomie had an episode of tube-feeding loose stool rivers of flowing crap down between the legs and over the edge of the bed, cascading out of the room out into the halls like the Slime From the Video.
Cleaned, turned and positioned, tube-feedings checked, IV sites clear, we joked a little with the patient and although they could not speak, due to the closed-head injury, they smiled and with the hand they could move a little, signalled a clear "thumbs-up."
Man, that was the best. What a grin. Cheshire cat-like. Cheesecake to my eyes.
We got there. We did something for them that they recognized and appreciated, even though they couldn't speak. They blinked it.
The other patient was basically out of the woods. Theirs was an acute situation and they'd go home soon, back to their normal life.
But this one would never be themselves again. The accident robbed them of speech, mobility, and control of their bodily functions. We wondered when the docs would finally get a PEG tube placement ordered. Some thought that maybe the patient could get through a swallow study, but I had doubts.
If you can't turn your head much voluntarily, then you probably can't swallow without dropping a bunch of crap into your lungs.
That is not a Surrealistic comparison.
It's more of a Republican comparison. You see, both of these patients are the same. They are both hospitalized. They have the same needs, politically, because neither of them are likely to vote. And they have nobody but family to advocate for them. No political lobbies shovelling millions into campaign coffers. No casinos. No churches. No Scottish golf junkets.
This is nothing.
These people are no-accounts.
And I love them with all my heart and soul and I will devote my working days to them as rainbows are devoted to the sky-waters that foster them, because I am just a normal person just like you and you'd do the same if you were me.
I Wedge Allegiance
Trolling through today's reliably insane ramblings in the Arizona Republic's editorial page, I had to set down my coffee and think for a moment after reading this:
"However, let's be clear about something:
The schools and the classrooms belong to the taxpayers of this country. It is not the letter writer's classroom."
Hmmm... Well, I am certainly a taxpayer. So I guess I'm a shareholder in this classroom business. But supposing that the original letter writer also is a taxpayer. That seems likely. So though all taxpayers have an interest in public classrooms, it seems not all taxpayers agree on the appropriate expression of mandatory flag-worship in the school setting.
But he wanted to be clear about something. I wonder what?
Rhut-rho, Rheorge.
Conflict. Perfectly expressed in the ironically fumbling rant of praise for the flag-idol.
But wait, there's even more on the same page:
"If the letter writer disagrees with a requirement that a flag be displayed in the classroom, then he should exercise his right to dissent by resigning his position as a teacher."
That's right, dude. Bow to the flag, or move your sorry butt to Iran.
Those clever Republican political geniuses just can't ever pass up an opportunity to find a stupid and irrevelevant but intensely divisive wedge issue to motivate the mouth-breathing red-staters and their fabulous regimentarians of the 101st Fighting Keyboarders.
This has nothing to do with the flag. Bush and Cheney, having never served, really don't give a damn about some stupid piece of cloth, just as they have little use for that "it's just a piece of paper" old Constitution of ours.
This is about dividing America.
If the kids are kept busy spitting at one another then they won't notice that daddy has robbed their piggy banks and he's out on another drunken spree. Again.
"However, let's be clear about something:
The schools and the classrooms belong to the taxpayers of this country. It is not the letter writer's classroom."
Hmmm... Well, I am certainly a taxpayer. So I guess I'm a shareholder in this classroom business. But supposing that the original letter writer also is a taxpayer. That seems likely. So though all taxpayers have an interest in public classrooms, it seems not all taxpayers agree on the appropriate expression of mandatory flag-worship in the school setting.
But he wanted to be clear about something. I wonder what?
Rhut-rho, Rheorge.
Conflict. Perfectly expressed in the ironically fumbling rant of praise for the flag-idol.
But wait, there's even more on the same page:
"If the letter writer disagrees with a requirement that a flag be displayed in the classroom, then he should exercise his right to dissent by resigning his position as a teacher."
That's right, dude. Bow to the flag, or move your sorry butt to Iran.
Those clever Republican political geniuses just can't ever pass up an opportunity to find a stupid and irrevelevant but intensely divisive wedge issue to motivate the mouth-breathing red-staters and their fabulous regimentarians of the 101st Fighting Keyboarders.
This has nothing to do with the flag. Bush and Cheney, having never served, really don't give a damn about some stupid piece of cloth, just as they have little use for that "it's just a piece of paper" old Constitution of ours.
This is about dividing America.
If the kids are kept busy spitting at one another then they won't notice that daddy has robbed their piggy banks and he's out on another drunken spree. Again.
Monday, June 12, 2006
Such a Kidder
From the ever-reliable pages of the local fishwrap kool-aid dispenser comes this delusional gem:
"Eleven years ago my father died at the age of 92 after a lifetime of hard work as a house painter. But through savings and investments he accumulated an estate just a little under the amount we would have had to pay death taxes on, thank God."
Allow me to translate: "Daddy and mommy worked their asses off for almost a freakin' century and they still didn't develop enough upward mobility for estate taxes to affect them."
The estate tax doesn't hurt anybody. It causes no pain. Trauma causes pain. Disease causes pain. Hunger and poverty cause pain. Having $600K left over after Uncle Bush takes his slice does not cause anyone any pain.
So please stop calling the taxation of the very rich "hurtful." It's an abuse of language.
Some economic demographic information for Arizona can be found by clicking on the portion of text I have so consid(a href)erately highlighted.
Hey, if I can do it, you can too.
The estate tax might affect about 2% of the households in the entire state, and chances are it's far fewer than that. Probably more like 0.3%.
"About 99.7 percent of Americans are not rich enough to be affected by the estate tax. The existing exemptions allow their heirs to get whatever is left to them without paying any taxes. But that other 0.3 percent increasingly find themselves in the role of "the deciders."
The repeal of the estate tax is not about the middle class, for whom shrinkage is a much greater problem. The estate tax is not hurtul to anyone. The estate tax affects a tiny fraction of a minority of the children of the very richest people.
The repeal of the estate tax is class warfare.
Say it again, Molly:
"If Mr. Bush has his way, we are going to fight an unprovoked war with Iraq without the financial aid of any allies. The health care system is falling apart in front of our eyes, schoolteachers should be paid at least twice what they make now, lack of low-income housing is making life hell for the working class and now the right wing wants to cut taxes for the rich yet again?
That's class warfare."
Whose side are you on? Your own?
"Eleven years ago my father died at the age of 92 after a lifetime of hard work as a house painter. But through savings and investments he accumulated an estate just a little under the amount we would have had to pay death taxes on, thank God."
Allow me to translate: "Daddy and mommy worked their asses off for almost a freakin' century and they still didn't develop enough upward mobility for estate taxes to affect them."
The estate tax doesn't hurt anybody. It causes no pain. Trauma causes pain. Disease causes pain. Hunger and poverty cause pain. Having $600K left over after Uncle Bush takes his slice does not cause anyone any pain.
So please stop calling the taxation of the very rich "hurtful." It's an abuse of language.
Some economic demographic information for Arizona can be found by clicking on the portion of text I have so consid(a href)erately highlighted.
Hey, if I can do it, you can too.
The estate tax might affect about 2% of the households in the entire state, and chances are it's far fewer than that. Probably more like 0.3%.
"About 99.7 percent of Americans are not rich enough to be affected by the estate tax. The existing exemptions allow their heirs to get whatever is left to them without paying any taxes. But that other 0.3 percent increasingly find themselves in the role of "the deciders."
The repeal of the estate tax is not about the middle class, for whom shrinkage is a much greater problem. The estate tax is not hurtul to anyone. The estate tax affects a tiny fraction of a minority of the children of the very richest people.
The repeal of the estate tax is class warfare.
Say it again, Molly:
"If Mr. Bush has his way, we are going to fight an unprovoked war with Iraq without the financial aid of any allies. The health care system is falling apart in front of our eyes, schoolteachers should be paid at least twice what they make now, lack of low-income housing is making life hell for the working class and now the right wing wants to cut taxes for the rich yet again?
That's class warfare."
Whose side are you on? Your own?
Wednesday, June 07, 2006
Rocky and Bullwinkle Predicted the Future of America
It happened on every show, when Rocky and Bullwinkle did their little patter-dialogue:
"Bullwinkle: Hey Rocky, watch me pull a rabbit out of my hat.
Rocky: Again?
Bullwinkle: Presto!
Lion: ROAR!!!
Bullwinkle: Oops, wrong hat.
Instead of a docile rabbit, a viscious lion, tiger, rhinocerous, or something-such would scream out of the top-hat and Bullwinkle would quickly stuff it back down.
Wrong hat. Well, that depends now, doesn't it?
The hat is what's the matter with Kansas, so to speak.
This is how the game goes down. The "rabbit" intended to spring from the hat is protection of the fabric of society. Sure. That's the ticket.
"The attack on marriage by rogue judges and renegade public officials has congealed a coalition of evangelicals, Catholics, Muslims and Jews to defend marriage by seeking passage of a federal marriage amendment."
Hmmm. Well, not to pick the Catholics, let's just start there by noting that they have a divorce rate of 21%.
"A recent study by the Barna Research Group throws extreme doubt on these estimates. Barna released the results of their poll about divorce on 1999-DEC-21. 1 They had interviewed 3,854 adults from the 48 contiguous states. The margin of error is within 2 percentage points. The survey found:
11% of the adult population is currently divorced.
25% of adults have had at least one divorce during their lifetime.
Divorce rates among conservative Christians were significently higher than for other faith groups, and for Atheists and Agnostics."
Interesting. Since they cannot even legally marry in most places, I am sure that the "divorce rate," so-to-speak, among gays and lesbians is probably statistically zero.
I will let a bit of this second letter speak for me, but first I must call attention to the fact that both the above LTTE and this one occured on the same editorial page on the same day, as counterpoint. Remarkable, compared to the many days, as noted by becca, when they just spray-pepper readers with multiple slime-blankets of similar rotting viewpoint.
"The Constitution is supposed to grant rights to all Americans. It should not now be used as a vehicle to restrict and diminish the rights of Americans. A constitutional amendment that bans gay marriage changes the fundamental role that our Constitution is designed to play."
So Bush intends to dazzle his audience by pulling a rabbit out of a hat, thereby producing a constituional amendment to discriminate against gays. Of course this is doomed to fail.
Any assertion that "marriage is between a man and a woman" is ultimately derived from religion. There's no civil reason to assert this. That's reason number one why such an amendment will not succeed. It's establishment.
Of course there are churches that will marry gays and lesbians. But the civil benefits unfortunately do not proceed from these ceremonies. If religious freedom is really at the core if this, then the marriage-protection antagonists must dispense with their hypocrisy and allow civil recognition of all church marriages, even gay ones.
But they won't.
The second reason such an amendment must fail is the Constitution itself, which makes amending it very difficult, especially for issues that do not have super-majority support.
But, the whole idea is for the issue to fail anyways. Then it's win-win for Bush. He gets to pull yet another bait-and-switch on his base of religious strangers. Instead of a rabbit, a lion pops out of the hat: another tax cut for Paris Hilton! That's his intention all along.
And when the amendment fails, the base gets to go (again) into its oh-aren't-we-so-persecuted-by-popular-culture mode. They eat that shit up. It rallies them. And it works almost every time.
Bush is our Fearless Leader, and we're Pottsylvania now.
"Fearless Leader: What does Pottsylvania have more than any other country? Mean! We have more mean than any other country in Europe! We must export mean."
No doubt.
"Bullwinkle: Hey Rocky, watch me pull a rabbit out of my hat.
Rocky: Again?
Bullwinkle: Presto!
Lion: ROAR!!!
Bullwinkle: Oops, wrong hat.
Instead of a docile rabbit, a viscious lion, tiger, rhinocerous, or something-such would scream out of the top-hat and Bullwinkle would quickly stuff it back down.
Wrong hat. Well, that depends now, doesn't it?
The hat is what's the matter with Kansas, so to speak.
This is how the game goes down. The "rabbit" intended to spring from the hat is protection of the fabric of society. Sure. That's the ticket.
"The attack on marriage by rogue judges and renegade public officials has congealed a coalition of evangelicals, Catholics, Muslims and Jews to defend marriage by seeking passage of a federal marriage amendment."
Hmmm. Well, not to pick the Catholics, let's just start there by noting that they have a divorce rate of 21%.
"A recent study by the Barna Research Group throws extreme doubt on these estimates. Barna released the results of their poll about divorce on 1999-DEC-21. 1 They had interviewed 3,854 adults from the 48 contiguous states. The margin of error is within 2 percentage points. The survey found:
11% of the adult population is currently divorced.
25% of adults have had at least one divorce during their lifetime.
Divorce rates among conservative Christians were significently higher than for other faith groups, and for Atheists and Agnostics."
Interesting. Since they cannot even legally marry in most places, I am sure that the "divorce rate," so-to-speak, among gays and lesbians is probably statistically zero.
I will let a bit of this second letter speak for me, but first I must call attention to the fact that both the above LTTE and this one occured on the same editorial page on the same day, as counterpoint. Remarkable, compared to the many days, as noted by becca, when they just spray-pepper readers with multiple slime-blankets of similar rotting viewpoint.
"The Constitution is supposed to grant rights to all Americans. It should not now be used as a vehicle to restrict and diminish the rights of Americans. A constitutional amendment that bans gay marriage changes the fundamental role that our Constitution is designed to play."
So Bush intends to dazzle his audience by pulling a rabbit out of a hat, thereby producing a constituional amendment to discriminate against gays. Of course this is doomed to fail.
Any assertion that "marriage is between a man and a woman" is ultimately derived from religion. There's no civil reason to assert this. That's reason number one why such an amendment will not succeed. It's establishment.
Of course there are churches that will marry gays and lesbians. But the civil benefits unfortunately do not proceed from these ceremonies. If religious freedom is really at the core if this, then the marriage-protection antagonists must dispense with their hypocrisy and allow civil recognition of all church marriages, even gay ones.
But they won't.
The second reason such an amendment must fail is the Constitution itself, which makes amending it very difficult, especially for issues that do not have super-majority support.
But, the whole idea is for the issue to fail anyways. Then it's win-win for Bush. He gets to pull yet another bait-and-switch on his base of religious strangers. Instead of a rabbit, a lion pops out of the hat: another tax cut for Paris Hilton! That's his intention all along.
And when the amendment fails, the base gets to go (again) into its oh-aren't-we-so-persecuted-by-popular-culture mode. They eat that shit up. It rallies them. And it works almost every time.
Bush is our Fearless Leader, and we're Pottsylvania now.
"Fearless Leader: What does Pottsylvania have more than any other country? Mean! We have more mean than any other country in Europe! We must export mean."
No doubt.
Friday, June 02, 2006
Thank you Monica_A: Freedom Fried
Maybe someday when I grow up daddy will get me some of my own trolls to play with. But in the meantime, here's some fun and games from the Comments section over at Eschaton:
"The sagebrush folk, the swamp people, the cowboys (and girls), the hash slingers, the grit dealers, the station attendents, the truckers, the diner Dons, the floating waitresses, the roadside drifters, the hardworkin’ flag flyers, the mountain diggers, the Western desert grifters, the hay sellers, the coal miners, the preachers and teachers of the Word, the ranchers and farmers, the river men (and women), the dam builders, the interstate sojourners, the shotshell reloaders, the cartridge collecters, the shooting club cabals, the cornfield clans, the barroom brawlers, the BBQ queens, the picinc kings, the tom cat trappers, the trailer park Romeos, the hunting lodge Juliets, the poker jacks, the bric-a-bracs, the Caterpillar prophets, the clay pigeon muppets, the little Miss Muffits, the railroad men, the pickup truck ramblers, the midnight gamblers, the mountain pass pilgrims, the hard-armed lawmen, the good-hearted con-men, the welders, the melders, the managers in the smelters, the sheetmetalers, the drywall stackers, the over-time riverters, the pipe fitters, the country club dissers, the back-alley pissers, the melon-head mashers, the grain-grippin’ gashers, the gospel graspin' speculators, the parking lot Platos, the desieled-up Davids, the eighteen-wheeled Marys, the Sugarland Samsons – the peoples, the folks, the dirty dozens, the masses, the eternal cuzzins, the heartland: all of us are poised, get ready libs - we won’t let you win, EVER.
granmda's own cooking | 06.02.06 - 2:41 pm | # "
The dam builders? Does grandma not realize that we don't really build dams anymore? All the good spots have already been taken.
Maybe she meant "damn" builders. But I have a feeling that's not the case and she perhaps just forgot to include rich white suburban tract housing developers on her partial list, as a sort of incidental oversight.
Then again, she can't spell her own name.
Good-hearted con-men? Well, heck yes, if they're any good at what they do, they're likely to be Republican, but good-hearted? Not bloody likely.
Back-alley pissers. Yes, we all know how essential that demographic is to the continued success of the NeoCon agenda.
As well they should, almost all of the regular Atriots ignored this... whatever this is.
However, grilled troll was still on the menu, thanks to this:
"I have a graduation to attend so this will be my last post on this subject. Let me make it as clear as I possibly can for Grandma and her ilk:
1. Abortion will never be outlawed. It works against the Rethuglicans to outlaw the biggest rallying point. You may think the Roberts' court will give you what you want, but you'd be sadly mistaken.
2. Everytime you vote Rethuglican, you vote against your best interest. You think you're going to be rich someday so you want tax cuts. Let me bring you back crashing into reality: YOU'RE NOT RICH YET AND AT THE RATE YOU'RE BEING RAPED BY THE GOVERNMENT, YOU WON'T BE ANYTIME SOON! Look up Maslow's "Hierarchy of Needs". Until one need is satisfied, you will never progress. Unless you have an education, you will never make a decent salary. Grow up!
3. The rich, white men who run the Rethuglican party will never accept you as one of their own. You are no more than hicks who can be tricked into voting against your best interest because of a pipe dream. I don't remember reading anything about Lil Boots inviting the good citizens of Crawford to his ranch to show his appreciation for their support. I wonder why? Oh, now I remember: because he is a Connecticut Brahmin playing a role.
That is all!
Monica_A: Freedom Fried | 06.02.06 - 3:20 pm | # "
"What's the Matter With Kansas?" by Thomas Frank should be on the required reading lists in all red-state highschool social studies classes.
"The sagebrush folk, the swamp people, the cowboys (and girls), the hash slingers, the grit dealers, the station attendents, the truckers, the diner Dons, the floating waitresses, the roadside drifters, the hardworkin’ flag flyers, the mountain diggers, the Western desert grifters, the hay sellers, the coal miners, the preachers and teachers of the Word, the ranchers and farmers, the river men (and women), the dam builders, the interstate sojourners, the shotshell reloaders, the cartridge collecters, the shooting club cabals, the cornfield clans, the barroom brawlers, the BBQ queens, the picinc kings, the tom cat trappers, the trailer park Romeos, the hunting lodge Juliets, the poker jacks, the bric-a-bracs, the Caterpillar prophets, the clay pigeon muppets, the little Miss Muffits, the railroad men, the pickup truck ramblers, the midnight gamblers, the mountain pass pilgrims, the hard-armed lawmen, the good-hearted con-men, the welders, the melders, the managers in the smelters, the sheetmetalers, the drywall stackers, the over-time riverters, the pipe fitters, the country club dissers, the back-alley pissers, the melon-head mashers, the grain-grippin’ gashers, the gospel graspin' speculators, the parking lot Platos, the desieled-up Davids, the eighteen-wheeled Marys, the Sugarland Samsons – the peoples, the folks, the dirty dozens, the masses, the eternal cuzzins, the heartland: all of us are poised, get ready libs - we won’t let you win, EVER.
granmda's own cooking | 06.02.06 - 2:41 pm | # "
The dam builders? Does grandma not realize that we don't really build dams anymore? All the good spots have already been taken.
Maybe she meant "damn" builders. But I have a feeling that's not the case and she perhaps just forgot to include rich white suburban tract housing developers on her partial list, as a sort of incidental oversight.
Then again, she can't spell her own name.
Good-hearted con-men? Well, heck yes, if they're any good at what they do, they're likely to be Republican, but good-hearted? Not bloody likely.
Back-alley pissers. Yes, we all know how essential that demographic is to the continued success of the NeoCon agenda.
As well they should, almost all of the regular Atriots ignored this... whatever this is.
However, grilled troll was still on the menu, thanks to this:
"I have a graduation to attend so this will be my last post on this subject. Let me make it as clear as I possibly can for Grandma and her ilk:
1. Abortion will never be outlawed. It works against the Rethuglicans to outlaw the biggest rallying point. You may think the Roberts' court will give you what you want, but you'd be sadly mistaken.
2. Everytime you vote Rethuglican, you vote against your best interest. You think you're going to be rich someday so you want tax cuts. Let me bring you back crashing into reality: YOU'RE NOT RICH YET AND AT THE RATE YOU'RE BEING RAPED BY THE GOVERNMENT, YOU WON'T BE ANYTIME SOON! Look up Maslow's "Hierarchy of Needs". Until one need is satisfied, you will never progress. Unless you have an education, you will never make a decent salary. Grow up!
3. The rich, white men who run the Rethuglican party will never accept you as one of their own. You are no more than hicks who can be tricked into voting against your best interest because of a pipe dream. I don't remember reading anything about Lil Boots inviting the good citizens of Crawford to his ranch to show his appreciation for their support. I wonder why? Oh, now I remember: because he is a Connecticut Brahmin playing a role.
That is all!
Monica_A: Freedom Fried | 06.02.06 - 3:20 pm | # "
"What's the Matter With Kansas?" by Thomas Frank should be on the required reading lists in all red-state highschool social studies classes.
Friday, May 26, 2006
Tristan und Isolde
My goodness, how the months go by. The days are long and stressful, but the seasons fly away like sparrows chased by the housecats.
In an instant gone.
So again it happens that school is out for summer, and you, a parent, a grandparent, a friend picking up the child of a friend, whatever... there they are, chatting away in a frenzy of young concerns about summer plans, or no plans at all, same thing, really, in the rear of your vehicle, and maybe you have a little bit of a headache. It's probably the sun. You take a long cool draw on your frosty Starbucks but nothing gets better.
You hate "talking to the box" but the young ones insist and at the drive-thru they order, via your adult voice and filter of knowing better, enough fully hydrogenated fatty acids to sink a Wagner opera, already saturated with full-blown high voices and drama like the ER on a holiday weekend night, like the controlled chaos of the telemetry unit.
Dramatic sopranos scream as you order them fries.
Kids. Sheesh.
You skirt the highway and go back through the neighborhoods, admiring the fruit trees and old architecture of the homes there. Citrus oils perfume the air.
While you drive a hand slips around your throat from behind, a large menacing hand, not the grip of one of the little children in the seats behind you. Then a blade is neatly drawn across the front of your neck, throat slit, circulation to the brain severed, and all goes dim as at the end of a long but satisfying narrative.
Mad Girl's Love Song
By Sylvia Plath
------------------------------------------------------------------------
"I shut my eyes and all the world drops dead;
I lift my lids and all is born again.
(I think I made you up inside my head.)
The stars go waltzing out in blue and red,
And arbitrary blackness gallops in:
I shut my eyes and all the world drops dead.
I dreamed that you bewitched me into bed
And sung me moon-struck, kissed me quite insane.
(I think I made you up inside my head.)
God topples from the sky, hell's fires fade:
Exit seraphim and Satan's men:
I shut my eyes and all the world drops dead.
I fancied you'd return the way you said,
But I grow old and I forget your name.
(I think I made you up inside my head.)
I should have loved a thunderbird instead;
At least when spring comes they roar back again.
I shut my eyes and all the world drops dead.
(I think I made you up inside my head.)"
Strangely this poem does not appear in Ted Hughes' collection of Sylvia Plath's "complete" poems, but to many people it is quite familiar as it shows up in the end-notes to "The Bell Jar" in American editions.
What have we to fear the most? Is it love? Not death?
I fear neither.
I think about both daily.
It's the structure, man, a villanelle, the way it all hangs together. It's like, dude, totally old, like before a freakin sonnet or something. Hey, here's a note... Dude, *duck!*
Note to self: Duck!
In an instant gone.
So again it happens that school is out for summer, and you, a parent, a grandparent, a friend picking up the child of a friend, whatever... there they are, chatting away in a frenzy of young concerns about summer plans, or no plans at all, same thing, really, in the rear of your vehicle, and maybe you have a little bit of a headache. It's probably the sun. You take a long cool draw on your frosty Starbucks but nothing gets better.
You hate "talking to the box" but the young ones insist and at the drive-thru they order, via your adult voice and filter of knowing better, enough fully hydrogenated fatty acids to sink a Wagner opera, already saturated with full-blown high voices and drama like the ER on a holiday weekend night, like the controlled chaos of the telemetry unit.
Dramatic sopranos scream as you order them fries.
Kids. Sheesh.
You skirt the highway and go back through the neighborhoods, admiring the fruit trees and old architecture of the homes there. Citrus oils perfume the air.
While you drive a hand slips around your throat from behind, a large menacing hand, not the grip of one of the little children in the seats behind you. Then a blade is neatly drawn across the front of your neck, throat slit, circulation to the brain severed, and all goes dim as at the end of a long but satisfying narrative.
Mad Girl's Love Song
By Sylvia Plath
------------------------------------------------------------------------
"I shut my eyes and all the world drops dead;
I lift my lids and all is born again.
(I think I made you up inside my head.)
The stars go waltzing out in blue and red,
And arbitrary blackness gallops in:
I shut my eyes and all the world drops dead.
I dreamed that you bewitched me into bed
And sung me moon-struck, kissed me quite insane.
(I think I made you up inside my head.)
God topples from the sky, hell's fires fade:
Exit seraphim and Satan's men:
I shut my eyes and all the world drops dead.
I fancied you'd return the way you said,
But I grow old and I forget your name.
(I think I made you up inside my head.)
I should have loved a thunderbird instead;
At least when spring comes they roar back again.
I shut my eyes and all the world drops dead.
(I think I made you up inside my head.)"
Strangely this poem does not appear in Ted Hughes' collection of Sylvia Plath's "complete" poems, but to many people it is quite familiar as it shows up in the end-notes to "The Bell Jar" in American editions.
What have we to fear the most? Is it love? Not death?
I fear neither.
I think about both daily.
It's the structure, man, a villanelle, the way it all hangs together. It's like, dude, totally old, like before a freakin sonnet or something. Hey, here's a note... Dude, *duck!*
Note to self: Duck!
Shrimpflation
The first time I ever saw a Honda Civic was probably back in the mid-nineteen-seventies, after the Yom Kippur war and the Saudi highjacking of the world oil markets. My friends and I expressed puzzled ridicule of the tiny little car, so different from the behemoth Chrysler station wagons that crowded the driveways in our "development."
Ironically, as young teens we were still heavily dependent on our Raleigh and Schwinn ten-speeds, but we saw the lines at the gas stations and the odd/even license-plate number assignment of gas-purchasing privileges.
Our lives were rocked by inflation. Many of us continued to bicycle long after we attained driving age as car affordability was out of reach for many of us in working-class families, some with parents that lost jobs during this time.
The Prudhoe and North Sea oil fields relieved this situation for awhile, but then along came the toppling of the despicable old Shah of Iran and another oil "shock" diverted our economy into the stagflation that was pretty much responsible, along with the hostage crisis, for ending Carter's attempts to bring America around to energy sanity.
What followed was decades of energy insanity, as manifested in distant "asteroid-belt" (as James Kunstler call these) suburban housing developments and the pre-eminent resurgence of the gas-guzzler, the triumphant SUV.
Now we will see a new economic phenomenom which I have modestly dubbed "shrimpflation." Like "stagflation," this is a combination of a stagnating economy suffering also from inflation. But shrimpflation will be much worse, and have effects that may be permanent.
The shrimpflation theory is based on the rather simple fact that all consumers, such as American citizens, compete for limited resources, specifically the world's declining reserves of oil. Our government itself also competes for oil, and we have recently gone to war over this issue, despite protestations that the invasion of Iraq was somehow not a "war for oil."
It is.
Our government and its military are highly dependent on oil. Think of all the oil we have burned up just getting to the "it's not a war for oil" and then waging it.
As we citizen consumers compete with our own government at the gas pumps for the privilege of buying gas, the price of it goes up. But our government has the ability to tax us, so they can take our money and use it for itself, to buy more oil, thus again driving up its price. With tax money taken from us. And slowing all other economic sectors of consumer spending and investment. Hence "shrimpflation."
Who benefits? People who control the flow of oil. Like the companies associated with the jerks we stupidly allowed to gain the White House.
This can only exacerbate the degree of shrimpflation, as greed, politics, oil depletion, and war have all merged into one leviathan phenomenon.
So what we have is a cabal of psychopathological maniacs who use war and other projects financed by your tax dollars to drive up the price of oil, enriching themselves in the process, and hurrying the depletion of oil at the same time, ultimately slowing economic "growth," which will actually reverse into worldwide economic depression the likes of which the industrial age has never seen.
Oh, did I really call them psychopathological maniacs? Tsk. I meant to call them stupid and greedy psychopathological maniacs.
Sometimes, in between all the advertisements for the various military services, MTV and VH-1 actually play music videos.
Ironically, as young teens we were still heavily dependent on our Raleigh and Schwinn ten-speeds, but we saw the lines at the gas stations and the odd/even license-plate number assignment of gas-purchasing privileges.
Our lives were rocked by inflation. Many of us continued to bicycle long after we attained driving age as car affordability was out of reach for many of us in working-class families, some with parents that lost jobs during this time.
The Prudhoe and North Sea oil fields relieved this situation for awhile, but then along came the toppling of the despicable old Shah of Iran and another oil "shock" diverted our economy into the stagflation that was pretty much responsible, along with the hostage crisis, for ending Carter's attempts to bring America around to energy sanity.
What followed was decades of energy insanity, as manifested in distant "asteroid-belt" (as James Kunstler call these) suburban housing developments and the pre-eminent resurgence of the gas-guzzler, the triumphant SUV.
Now we will see a new economic phenomenom which I have modestly dubbed "shrimpflation." Like "stagflation," this is a combination of a stagnating economy suffering also from inflation. But shrimpflation will be much worse, and have effects that may be permanent.
The shrimpflation theory is based on the rather simple fact that all consumers, such as American citizens, compete for limited resources, specifically the world's declining reserves of oil. Our government itself also competes for oil, and we have recently gone to war over this issue, despite protestations that the invasion of Iraq was somehow not a "war for oil."
It is.
Our government and its military are highly dependent on oil. Think of all the oil we have burned up just getting to the "it's not a war for oil" and then waging it.
As we citizen consumers compete with our own government at the gas pumps for the privilege of buying gas, the price of it goes up. But our government has the ability to tax us, so they can take our money and use it for itself, to buy more oil, thus again driving up its price. With tax money taken from us. And slowing all other economic sectors of consumer spending and investment. Hence "shrimpflation."
Who benefits? People who control the flow of oil. Like the companies associated with the jerks we stupidly allowed to gain the White House.
This can only exacerbate the degree of shrimpflation, as greed, politics, oil depletion, and war have all merged into one leviathan phenomenon.
So what we have is a cabal of psychopathological maniacs who use war and other projects financed by your tax dollars to drive up the price of oil, enriching themselves in the process, and hurrying the depletion of oil at the same time, ultimately slowing economic "growth," which will actually reverse into worldwide economic depression the likes of which the industrial age has never seen.
Oh, did I really call them psychopathological maniacs? Tsk. I meant to call them stupid and greedy psychopathological maniacs.
Sometimes, in between all the advertisements for the various military services, MTV and VH-1 actually play music videos.
Tuesday, May 23, 2006
Read Ducks
Sprawl is unsustainable. There's nothing there, except "mcmansions" and cars and useless yards that produce nothing yet consume resources anyways, and television, with its Faux Lies and Beavis 'n Butthead values and mentality.
You know. The values upon which modern civilization are founded. Stupidity and selfishness. Bush Republicanism. Bullshit.
We need single-payer healthcare coverage. Anything else is a waste of money that basically pays middle-men, and I do mean *men*, to with-hold treatments to the sickest among us in order to maintain a transfer of wealth from the weakest of our citizens to the richest and most secure of our fellow Americans. Reverse communism. Socialism for the rich.
Methamphetamine kills the body's ability to feel pleasure, it's highly addictive, and it's a personality killer. Cheaper than cocaine, which has similar effects, it's the perfect drug for destroying Middle America. "Red" states will continue to lead in crystal production and abuse. It's stupid. Hence the Republican support for its use.
Republican lawmakers have been known to oppose simple measures to assure that meth-lab operators have their precursor-chemical purchases recorded. God bless my own representatives.
Awareness of peak oil issues. Cheap fossil fuel use is soon to be a thing of the past. Modern humans, especially SUV-driving oblivious soccer-moms from Florida, are completely unaware of the FACT that oil is a finite resource and we have already extracted the best and most-easily obtained deposits available.
Everything that depends upon cheap fossil fuel resources for survival will soon be put at risk. Many conventions, such as cheap personal transportation and cheap food production on mega-farms and cheap plastic crap like disposable intravenous medication tubing, syringes, sterile packaging and other hospital items that people like me personally dispose of by the metric ton annually, will be gone.
I'm twisting my little brain into a Gordian knot trying to think of an adequate and cheap substitute for petroleum-byproduct plastic IV tubing.
About four percent of the humans that walk among us have no sense of empathy. Some people have such a lack that they end up as violent criminals, but some have other mental resources and they are able to put on a face of sanity.
We have elected way too many of these monsters. America and its corporations, themselves insane, have leaders that have no ability to feel compassion and a profound inability to conceive of the future. Some have even fashioned an apocalypse-worshipping christian cult religion out of this bare psychopathology.
It would be nice if we could put an end to that.
Good slow food, good music, good guitars, good bloggers, good books, good nookie, good shade, good dogs and cats and koi fish, good gardening, and a good home.
These seem to have become my main and secondary themes.
What else should I blog about?
You know. The values upon which modern civilization are founded. Stupidity and selfishness. Bush Republicanism. Bullshit.
We need single-payer healthcare coverage. Anything else is a waste of money that basically pays middle-men, and I do mean *men*, to with-hold treatments to the sickest among us in order to maintain a transfer of wealth from the weakest of our citizens to the richest and most secure of our fellow Americans. Reverse communism. Socialism for the rich.
Methamphetamine kills the body's ability to feel pleasure, it's highly addictive, and it's a personality killer. Cheaper than cocaine, which has similar effects, it's the perfect drug for destroying Middle America. "Red" states will continue to lead in crystal production and abuse. It's stupid. Hence the Republican support for its use.
Republican lawmakers have been known to oppose simple measures to assure that meth-lab operators have their precursor-chemical purchases recorded. God bless my own representatives.
Awareness of peak oil issues. Cheap fossil fuel use is soon to be a thing of the past. Modern humans, especially SUV-driving oblivious soccer-moms from Florida, are completely unaware of the FACT that oil is a finite resource and we have already extracted the best and most-easily obtained deposits available.
Everything that depends upon cheap fossil fuel resources for survival will soon be put at risk. Many conventions, such as cheap personal transportation and cheap food production on mega-farms and cheap plastic crap like disposable intravenous medication tubing, syringes, sterile packaging and other hospital items that people like me personally dispose of by the metric ton annually, will be gone.
I'm twisting my little brain into a Gordian knot trying to think of an adequate and cheap substitute for petroleum-byproduct plastic IV tubing.
About four percent of the humans that walk among us have no sense of empathy. Some people have such a lack that they end up as violent criminals, but some have other mental resources and they are able to put on a face of sanity.
We have elected way too many of these monsters. America and its corporations, themselves insane, have leaders that have no ability to feel compassion and a profound inability to conceive of the future. Some have even fashioned an apocalypse-worshipping christian cult religion out of this bare psychopathology.
It would be nice if we could put an end to that.
Good slow food, good music, good guitars, good bloggers, good books, good nookie, good shade, good dogs and cats and koi fish, good gardening, and a good home.
These seem to have become my main and secondary themes.
What else should I blog about?
Saturday, May 20, 2006
Hare Today, Rabbit Tomorrow
For the sake of preserving anonymity, let's change things just a little and say that she had a chronic ankle problem surgically repaired a week or so ago. They also had some gastric reflux problems accompanied by recent weight loss, also treated by her local doctors well outside the immediate environs of the Desert Metropolis of Tile-Roofed Sprawl.
A few days after the surgery she went bat-crap, a-few-miles-down-the-road-past-Jack-Nicholson's-House, I-am-the-walrus crazy. Iggy-diggy-blooey-gooey nutso. So they loaded her onto a plane and sent her to...
Me.
Yeah, not personally, but as luck would have it, I became her nurse.
Four-point leather restraints. A few minutes after I got report I went in to see why the patient was screaming that they had to get to their truck so she could go to her sister's house in California to put out the fire in the shop, which was started by Rosecrucians or something. Maybe it was the Illuminati. They're big right now.
The ankle in the restraint seemed wrong to me, so I let that one off. She was disoriented in a way that is comparable to White House counselors; that is to say, she knew her name but nothing else she said had any accuracy as pertains to reality. Still, I do not think she was a Republican.
Over the passing of the day, her sitter (who was well-versed in psychiatric issues as he usually worked on a psych unit,) her fiance, and myself had pretty good luck getting her to come around.
Her labwork had improved, her lithium toxicity was resolving, her kidney function was clearing up with IV fluids and bicarb, and by mid-afternoon she was sitting up in a chair chatting with us.
Then all hell broke loose. She was confused, disoriented, and extremely combative, swearing at us and swinging for the Big Green Wall.
We called Security, who were familiar with her and called her by her first name, from the previous night's experience. We jostled her back to bed and secured three limbs in leathers, and for the next three hours me and the sitter were at the bedside holding her down so she wouldn't yank her recently repaired ankle out again.
We gave IV Ativan and enough Geodon to put a horse in orbit, and an hour after my shift was *supposed* to end, she had tired herself out and was dozing off, instead of constantly fighting to get out of bed to go to San Diego to get her keys and go to her sister's house to get her jeans.
The next day she was completely back to normal. Relaxed, smiling, well-oriented and without any complaints. A true joy to be with.
It was over. The storm had come and gone, leaving behind only the aroma of fresh rain, clean air, and rejuvinated blossoms.
Someday this will happen to America.
We will wake up and Bush will be gone, our mortgages to China will be paid down, alternative energy sources will be relieving our dependence on the largesse of Middle Eastern despots, and Mariah Carey will be too old to make more recordings.
Free at last, free at last, thank God almighty, we are free at last..
A few days after the surgery she went bat-crap, a-few-miles-down-the-road-past-Jack-Nicholson's-House, I-am-the-walrus crazy. Iggy-diggy-blooey-gooey nutso. So they loaded her onto a plane and sent her to...
Me.
Yeah, not personally, but as luck would have it, I became her nurse.
Four-point leather restraints. A few minutes after I got report I went in to see why the patient was screaming that they had to get to their truck so she could go to her sister's house in California to put out the fire in the shop, which was started by Rosecrucians or something. Maybe it was the Illuminati. They're big right now.
The ankle in the restraint seemed wrong to me, so I let that one off. She was disoriented in a way that is comparable to White House counselors; that is to say, she knew her name but nothing else she said had any accuracy as pertains to reality. Still, I do not think she was a Republican.
Over the passing of the day, her sitter (who was well-versed in psychiatric issues as he usually worked on a psych unit,) her fiance, and myself had pretty good luck getting her to come around.
Her labwork had improved, her lithium toxicity was resolving, her kidney function was clearing up with IV fluids and bicarb, and by mid-afternoon she was sitting up in a chair chatting with us.
Then all hell broke loose. She was confused, disoriented, and extremely combative, swearing at us and swinging for the Big Green Wall.
We called Security, who were familiar with her and called her by her first name, from the previous night's experience. We jostled her back to bed and secured three limbs in leathers, and for the next three hours me and the sitter were at the bedside holding her down so she wouldn't yank her recently repaired ankle out again.
We gave IV Ativan and enough Geodon to put a horse in orbit, and an hour after my shift was *supposed* to end, she had tired herself out and was dozing off, instead of constantly fighting to get out of bed to go to San Diego to get her keys and go to her sister's house to get her jeans.
The next day she was completely back to normal. Relaxed, smiling, well-oriented and without any complaints. A true joy to be with.
It was over. The storm had come and gone, leaving behind only the aroma of fresh rain, clean air, and rejuvinated blossoms.
Someday this will happen to America.
We will wake up and Bush will be gone, our mortgages to China will be paid down, alternative energy sources will be relieving our dependence on the largesse of Middle Eastern despots, and Mariah Carey will be too old to make more recordings.
Free at last, free at last, thank God almighty, we are free at last..
Tuesday, May 16, 2006
Cumin
When you start out in the morning, it becomes much easier later in the day.
Usually I just buy whatever large chunk of meat is going for the least amount per pound. Beef or pork, boney or boneless, doesn't matter. Three or so pounds is enough for a good batch of about ten burritos or chimichangas.
Sear all sides in a dutch-oven-style pot with a lid. After it's seared I like to add a couple diced jalapenos and some broth or a small can, maybe four ounces, of cheap spicy Mexican tomato-chili sauce.
Put the lid on and stick it in a low-heat, maybe 275-300-degree oven for a good long while. Until it easily pulls apart with a fork. Three to six hours. While it cooks it releases juices and I thicken these by adding a chopped or finely-torn flour tortilla. Same size as the big ones I use for making the burritos.
When it's cooked I shred it up and add Mexican oregano, cumin, maybe some onion and garlic if not added during the slow-cooking, cilantro, a touch more of black pepper and good salt, and re-add the pot stuff, which is the tortilla all soaked up with the drippings.
Usually I let this all cool off a bit, then I warm up the tortillas a few at a time in the microwave oven for maybe twenty seconds, then I wrap them up. These last a couple days in the fridge; long enough for those days when I'm working back-to-back 12-hour shifts and I have no time for cooking or anything else around the house.
Mexican oregano is funkier than the Italian variety. But the ground cumin is the key. Not too much. But it's the essential flavor, the one that makes this Mexican and not just a great big meat egg roll.
If you deep-fry these you get chimichangas, naturally. The same filling in a little corn tortilla makes a kind of taco, but it's better if you make a rolled taco and then deep-fry that, making a crunchy flauta side-dish item. I like these with a salad that features greens, fresh little tomatos and sliced avocado.
Cumin is the key. A tortilla is just a crepe or an eggroll without a decent amount of cumin. And hot chilies, of course.
I have rather mistakenly referred to this stuff as "Mexican," when a better word for it would simply be "American," since this style of cooking preceded both the establishmant of the Spanish "Mexican" state and any-and-all "American" cooking styles, which generally were imported from Europe.
Barbecue is probably also a native cooking style.
Usually I just buy whatever large chunk of meat is going for the least amount per pound. Beef or pork, boney or boneless, doesn't matter. Three or so pounds is enough for a good batch of about ten burritos or chimichangas.
Sear all sides in a dutch-oven-style pot with a lid. After it's seared I like to add a couple diced jalapenos and some broth or a small can, maybe four ounces, of cheap spicy Mexican tomato-chili sauce.
Put the lid on and stick it in a low-heat, maybe 275-300-degree oven for a good long while. Until it easily pulls apart with a fork. Three to six hours. While it cooks it releases juices and I thicken these by adding a chopped or finely-torn flour tortilla. Same size as the big ones I use for making the burritos.
When it's cooked I shred it up and add Mexican oregano, cumin, maybe some onion and garlic if not added during the slow-cooking, cilantro, a touch more of black pepper and good salt, and re-add the pot stuff, which is the tortilla all soaked up with the drippings.
Usually I let this all cool off a bit, then I warm up the tortillas a few at a time in the microwave oven for maybe twenty seconds, then I wrap them up. These last a couple days in the fridge; long enough for those days when I'm working back-to-back 12-hour shifts and I have no time for cooking or anything else around the house.
Mexican oregano is funkier than the Italian variety. But the ground cumin is the key. Not too much. But it's the essential flavor, the one that makes this Mexican and not just a great big meat egg roll.
If you deep-fry these you get chimichangas, naturally. The same filling in a little corn tortilla makes a kind of taco, but it's better if you make a rolled taco and then deep-fry that, making a crunchy flauta side-dish item. I like these with a salad that features greens, fresh little tomatos and sliced avocado.
Cumin is the key. A tortilla is just a crepe or an eggroll without a decent amount of cumin. And hot chilies, of course.
I have rather mistakenly referred to this stuff as "Mexican," when a better word for it would simply be "American," since this style of cooking preceded both the establishmant of the Spanish "Mexican" state and any-and-all "American" cooking styles, which generally were imported from Europe.
Barbecue is probably also a native cooking style.
Friday, May 12, 2006
Hip-Hop Marx
Of course, the rich of this country nominally pay most of the income tax collected by Halliburton, Blackwater, Enron, and other arms of the Republican-led federal government. The rich make inordinately much more income than do those people in lower tax and income brackets. Unlucky duckies!
Paris Hilton probably has more money than that contained in the ten-year budgets of many hospitals in many communities. This is shameful and ludicrous to anyone with a proper sense of balance, but not to modern White House conservatives.
So hospitals get cuts in the amount of money given to them by the government. And Paris Hilton gets tax cuts that save her a few hundred thousand dollars a year. It's the same thing in BushSpeak. Both your local community hospital, where you go when you break your leg trying to make the pie higher, and Paris Hilton, a very high pie indeed, both get cuts.
It's the same thing, see? That's how fair Bush is to all of America. That's how his policies help America.
Sometimes sarcasm can cloud an argument. Basically what I want to say here is this: Bush is perpetrating class warfare against everyone but his rich and mostly corrupt pals that occupy the ether of the highest income categories in the entire world.
Before the last drop of blood is squeezed from the small pale hard stone that is your paycheck, we must fight back. This will involve real, honest class warfare of the Robin Hood variety, not the reverse, taking from the poor and giving to the very very rich, as currently imprinted in Bush tax policy.
If this country is to survive, as it has through centuries of war and internal strife, the rich will have to suffer their own version of Kent State.
No, I do not advocate violence, but the metaphor is apt. There must someday soon be a watershed moment when the tide of tax relief flows against the very rich and back into realm of community services, or we will have no place to live anymore.
See New Orleans.
Bush has done nothing to improve things for the United States of America, because he has been too busy advancing the interests of his class.
Yes, I did study that guy back in college. America is a Marxist state, and now we have our very own Stalin. The Constitution no longer applies, as Bush makes "signing statements" designed to allow him to circumvent and disobey any and all laws.
Only the laws of class warfare apply now.
Paris Hilton probably has more money than that contained in the ten-year budgets of many hospitals in many communities. This is shameful and ludicrous to anyone with a proper sense of balance, but not to modern White House conservatives.
So hospitals get cuts in the amount of money given to them by the government. And Paris Hilton gets tax cuts that save her a few hundred thousand dollars a year. It's the same thing in BushSpeak. Both your local community hospital, where you go when you break your leg trying to make the pie higher, and Paris Hilton, a very high pie indeed, both get cuts.
It's the same thing, see? That's how fair Bush is to all of America. That's how his policies help America.
Sometimes sarcasm can cloud an argument. Basically what I want to say here is this: Bush is perpetrating class warfare against everyone but his rich and mostly corrupt pals that occupy the ether of the highest income categories in the entire world.
Before the last drop of blood is squeezed from the small pale hard stone that is your paycheck, we must fight back. This will involve real, honest class warfare of the Robin Hood variety, not the reverse, taking from the poor and giving to the very very rich, as currently imprinted in Bush tax policy.
If this country is to survive, as it has through centuries of war and internal strife, the rich will have to suffer their own version of Kent State.
No, I do not advocate violence, but the metaphor is apt. There must someday soon be a watershed moment when the tide of tax relief flows against the very rich and back into realm of community services, or we will have no place to live anymore.
See New Orleans.
Bush has done nothing to improve things for the United States of America, because he has been too busy advancing the interests of his class.
Yes, I did study that guy back in college. America is a Marxist state, and now we have our very own Stalin. The Constitution no longer applies, as Bush makes "signing statements" designed to allow him to circumvent and disobey any and all laws.
Only the laws of class warfare apply now.
Thursday, May 04, 2006
As in Dead
Let us start with this little bit, from a local rag that offered plenty of words of support for the incompetent psychopath in two "elections":
"Enter President Bush's 2007 budget, which inexplicably proposes $36 billion in cuts to Medicare and Medicaid over the next five years, including more than $8 billion in reimbursements to hospitals. And this comes on the heels of the deficit reduction act, signed by the president in early February, which will already cut more than $13 billion from Medicare and Medicaid."
The article is basically about Bush's plan to help local communities hit by an outbreak of avian flu. It's a simple plan, really, elegant in its brevity and, indeed, wit.
"Sorry, there's nothing I can do for you."
I know what I will be doing if avian flu makes the jump and spreads to my little berg. I'll be sick myself, most likely, and as a health-care worker in a hospital already short of nurses, I'll be showing up to work anyway so I can spread the noxious germs around to patients who are already weak and vulnerable.
Patient "D" was in a skilled nursing facility getting months' worth of intravenous antibiotics, through a PICC line, to treat resistant strains of bugs that had grown fond of them. "D" had a long history of alcohol and drug abuse, hepatitis, HIV-AIDS, seizure disorder, and was oriented only to self. At one point they'd eloped from the skilled nursing facility and they were found out on the streets having a seizure. Then they came to us.
The PICC line was infected so they had to remove that for a while at least. Getting a peripheral line in wasn't so easy. They had the specialty nurse come up with their little IV ECHO machine to scope out a vein in the patients' shoulder, a delicate little 22-guage.
The patient would try to wander about aimlessly, or they would be in their room removing their clothing, telemetry wires, and urinating on the floor. Someone had given them a phone book, and the patient tore out pages, spread these on the floor, urinated on them, and then wadded these up into a wet ball and placed it by the door. It somehow belonged there.
On my day off, "D" was sent to get another PICC, and while in that department they got up off the stretcher and fell causing a laceration on their head.
A patient has to be restraint-free for twenty-four hours before most skilled nursing facilities will accept them, so we basically couldn't tie them down, or we'd never get them out of here.
The next day the patient was in my dutiful hands. I checked on them four or five times an hour but still couldn't keep up. Mid-afternoon I saw that they had pulled out their PICC line but there wasn't much blood on the floor so it couldn't have been out for long.
We got an order to place another PICC, and in the meantime I got a peripheral line into their wrist.
Before doing that I asked the charge nurse to help me by praying to The Great Buddha of Difficult IV Sticks, and I asked if she, presumably Catholic because of her country of origin, knew if there were any Catholic saints earmarked for prayer concerning IV insertions, and she laughed and told me she didn't really know, but to go with the Buddha.
So I did. It worked. Believe me. First time lucky.
The guy from the special department where they did the patient's PICC yesterday called. When I asked him how things were going, he said, and I quote, "I feel like I've been shot at and missed and shit at and hit," with a laugh.
"But seriously," he asked, "What are we doing? Putting another one in, just for them to pull out again?"
I let a semi-dramatic moment go by and then replied, "Well, yes. Duh." He said it wasn't the first time and wouldn't be the last.
Then I promised that we'd try to chemically restrain the patient, but I had been giving them a couple milligrams of Ativan every two hours or so all day long, which probably saved them from seizing on me but it didn't always ease up their general restlessness and bleary-eyed curiousity.
So Bush is proposing a budget that includes cuts to hospitals.
Guess what will soon start happening to people like "D"?
They will be triaged out.
They will be left on the streets or sent home to anyone and anything that will take them in. Or not.
It won't matter. And it probably won't really matter to a lot of our fellow red-state Americans. If they are forced to choose between serving uninsured "D" with their HIV, seizures, impaired mentation, alcoholism, and crystal addiction as opposed to say Their Own Sweet Dying Mother, then "D" gets the boot.
City services will come to include bring out your dead wagons.
"Enter President Bush's 2007 budget, which inexplicably proposes $36 billion in cuts to Medicare and Medicaid over the next five years, including more than $8 billion in reimbursements to hospitals. And this comes on the heels of the deficit reduction act, signed by the president in early February, which will already cut more than $13 billion from Medicare and Medicaid."
The article is basically about Bush's plan to help local communities hit by an outbreak of avian flu. It's a simple plan, really, elegant in its brevity and, indeed, wit.
"Sorry, there's nothing I can do for you."
I know what I will be doing if avian flu makes the jump and spreads to my little berg. I'll be sick myself, most likely, and as a health-care worker in a hospital already short of nurses, I'll be showing up to work anyway so I can spread the noxious germs around to patients who are already weak and vulnerable.
Patient "D" was in a skilled nursing facility getting months' worth of intravenous antibiotics, through a PICC line, to treat resistant strains of bugs that had grown fond of them. "D" had a long history of alcohol and drug abuse, hepatitis, HIV-AIDS, seizure disorder, and was oriented only to self. At one point they'd eloped from the skilled nursing facility and they were found out on the streets having a seizure. Then they came to us.
The PICC line was infected so they had to remove that for a while at least. Getting a peripheral line in wasn't so easy. They had the specialty nurse come up with their little IV ECHO machine to scope out a vein in the patients' shoulder, a delicate little 22-guage.
The patient would try to wander about aimlessly, or they would be in their room removing their clothing, telemetry wires, and urinating on the floor. Someone had given them a phone book, and the patient tore out pages, spread these on the floor, urinated on them, and then wadded these up into a wet ball and placed it by the door. It somehow belonged there.
On my day off, "D" was sent to get another PICC, and while in that department they got up off the stretcher and fell causing a laceration on their head.
A patient has to be restraint-free for twenty-four hours before most skilled nursing facilities will accept them, so we basically couldn't tie them down, or we'd never get them out of here.
The next day the patient was in my dutiful hands. I checked on them four or five times an hour but still couldn't keep up. Mid-afternoon I saw that they had pulled out their PICC line but there wasn't much blood on the floor so it couldn't have been out for long.
We got an order to place another PICC, and in the meantime I got a peripheral line into their wrist.
Before doing that I asked the charge nurse to help me by praying to The Great Buddha of Difficult IV Sticks, and I asked if she, presumably Catholic because of her country of origin, knew if there were any Catholic saints earmarked for prayer concerning IV insertions, and she laughed and told me she didn't really know, but to go with the Buddha.
So I did. It worked. Believe me. First time lucky.
The guy from the special department where they did the patient's PICC yesterday called. When I asked him how things were going, he said, and I quote, "I feel like I've been shot at and missed and shit at and hit," with a laugh.
"But seriously," he asked, "What are we doing? Putting another one in, just for them to pull out again?"
I let a semi-dramatic moment go by and then replied, "Well, yes. Duh." He said it wasn't the first time and wouldn't be the last.
Then I promised that we'd try to chemically restrain the patient, but I had been giving them a couple milligrams of Ativan every two hours or so all day long, which probably saved them from seizing on me but it didn't always ease up their general restlessness and bleary-eyed curiousity.
So Bush is proposing a budget that includes cuts to hospitals.
Guess what will soon start happening to people like "D"?
They will be triaged out.
They will be left on the streets or sent home to anyone and anything that will take them in. Or not.
It won't matter. And it probably won't really matter to a lot of our fellow red-state Americans. If they are forced to choose between serving uninsured "D" with their HIV, seizures, impaired mentation, alcoholism, and crystal addiction as opposed to say Their Own Sweet Dying Mother, then "D" gets the boot.
City services will come to include bring out your dead wagons.
Saturday, April 29, 2006
Finity
This is snipped from a comment made to one of my previous posts:
"A hospital emergency room sent my mother [she was not fat, quite thin and petit] home with a broken arm (in two sharp pieces) with no more than bandages and a sling. It took over a week to get an appointment with a real doctor in his office. As soon as he saw the xrays he had her in surgery as quickly as possible."
This is not the last time you will hear of such a thing. I decry it. Yes, hospital emergency rooms are overcrowded and the nurses, technicians, and doctors who work these probably often feel that they are merely pushing a boulder up a hill only to have it roll back down again after all that vain effort made to get it to the summit.
But there is no excuse sometimes.
They first arrived at the emergency room with a complaint of shoulder pain and a feeling of "whooshing" in the chest. Labwork, chest X-ray, and EKG showed nothing unusual, so they were sent home.
A week later the pain had worsened and radiated into the abdomen. A CAT scan showed an enormous aortic aneurysm that extended from the aortic root all the way down below the kidneys. The original aortic lumen was actually smaller than the secondary along some stretches, and the secondary had calcified somewhat. One of the kidneys was fed blood supply not solely by the original aortic lumen but by the aneurysm lumen also.
A vascular surgeon of national reputation was called immediately to Gore-Tex the aorta from the root over the arch and down. Coronary and carotid arteries were re-attached through the new Gore-Tex. The operation, which must have been spectacular, took eight hours. After being on a pump all that time the patient went into Torsades and had to be shocked once or twice; irritable cardiac muscle and all that. A second-degree heart block later came and went.
After that things went as well as could be expected. The patient was relatively young and had no prior health issues or history to cause worry. The chest tube came out, the pleural rub dissipated spontaneously. The new aortic valve sounded wonderful, and the patient was walking laps in the hallways. A supportive family was very gracious and helpful to both the patient and the staff.
Prior to the operation the patient was your typical walking time bomb and they could have dropped dead any moment if the aneurysm had ruptured.
I would not want to have been the ER doctor that sent the patient home the first time they presented, but I suppose they had nothing really to go on.
"A hospital emergency room sent my mother [she was not fat, quite thin and petit] home with a broken arm (in two sharp pieces) with no more than bandages and a sling. It took over a week to get an appointment with a real doctor in his office. As soon as he saw the xrays he had her in surgery as quickly as possible."
This is not the last time you will hear of such a thing. I decry it. Yes, hospital emergency rooms are overcrowded and the nurses, technicians, and doctors who work these probably often feel that they are merely pushing a boulder up a hill only to have it roll back down again after all that vain effort made to get it to the summit.
But there is no excuse sometimes.
They first arrived at the emergency room with a complaint of shoulder pain and a feeling of "whooshing" in the chest. Labwork, chest X-ray, and EKG showed nothing unusual, so they were sent home.
A week later the pain had worsened and radiated into the abdomen. A CAT scan showed an enormous aortic aneurysm that extended from the aortic root all the way down below the kidneys. The original aortic lumen was actually smaller than the secondary along some stretches, and the secondary had calcified somewhat. One of the kidneys was fed blood supply not solely by the original aortic lumen but by the aneurysm lumen also.
A vascular surgeon of national reputation was called immediately to Gore-Tex the aorta from the root over the arch and down. Coronary and carotid arteries were re-attached through the new Gore-Tex. The operation, which must have been spectacular, took eight hours. After being on a pump all that time the patient went into Torsades and had to be shocked once or twice; irritable cardiac muscle and all that. A second-degree heart block later came and went.
After that things went as well as could be expected. The patient was relatively young and had no prior health issues or history to cause worry. The chest tube came out, the pleural rub dissipated spontaneously. The new aortic valve sounded wonderful, and the patient was walking laps in the hallways. A supportive family was very gracious and helpful to both the patient and the staff.
Prior to the operation the patient was your typical walking time bomb and they could have dropped dead any moment if the aneurysm had ruptured.
I would not want to have been the ER doctor that sent the patient home the first time they presented, but I suppose they had nothing really to go on.
Tuesday, April 25, 2006
Return to Sender
During my college years my best friend was a brilliant and artistic person, outspoken and strong-willed, but who constantly struggled with weight concerns. One summer they lost over 100 pounds, only to gain a fair portion of it back over ensuing months.
Later I came to understand just how typical this is, and I worked for a time in a hospital setting with bariatric surgeons and their patients. Now I am convinced that at this time the best treatment for many morbidly obese people is surgery; indeed, when I see a very large person, what I say to myself is not "that person needs to eat more sensibly," but instead I think that person needs surgery.
Many people do not understand this, and continue to think that diet will work for the morbidly obese. To such people I recommend this: go on a 1200-kilocalorie-per-day diet for the rest of your life, then get back to me. Good luck, and have fun.
Having said all that, some people are just fat obnoxious hate-filled pigs.
Like the patient in the corner room, whose call light was always on, whose family had continual little hissy fits over the most mundane things, whose nurse (thankfully not me) made every effort to please them and meet their needs only to get no appreciation for any of their efforts.
This patient was an unhappy sloth who saw it as their remaining life's goal to make as many other people also as miserable as possible, and after many decades of practice they had become quite proficient at this. And their younger family members, whose upbringing had convinced them that such ugliness was normal, played right along with it.
A sucking vortex of meanness and abject misery, plain and simple.
The day before yesterday was the patient's day to be discharged to whatever bright shining hell-hole they lived at, and the nurse was so happy in thinking that the patient would not be there in that corner room the following day. They rejoiced openly.
But on the way out to the stretcher van that was to transport the patient to their residence, the patient fell off the gurney and fractured a shoulder. They also probably broke a thumb, but the fear of a broken hip was ruled out on X-ray. The patient was re-admitted to the hospital and ended up in the very same room, much to the dismay of the nurse so assigned.
Paydirt. The mother load. Ka-ching.
Now the ugliness of their family misery was compounded by revengeful greed, and of course they've got a case.
Later that day I saw a couple strange-looking creatures, like the space lizards in Zathura only a little smaller, poking around until they finally found the patient and entered the room.
While they were visiting the patient did not put on their call light.; not even once, for about a half-hour. Then they wordlessly walked out and down the hall, eyes straight ahead.
Lawyers.
The surgeons decided that the patient was not a candidate for repair, so the plan was to discharge them the next day with a sling for their arm and shoulder. Naturally "I'm so glad I have tomorrow off" was the nurse's constant refrain.
Later I came to understand just how typical this is, and I worked for a time in a hospital setting with bariatric surgeons and their patients. Now I am convinced that at this time the best treatment for many morbidly obese people is surgery; indeed, when I see a very large person, what I say to myself is not "that person needs to eat more sensibly," but instead I think that person needs surgery.
Many people do not understand this, and continue to think that diet will work for the morbidly obese. To such people I recommend this: go on a 1200-kilocalorie-per-day diet for the rest of your life, then get back to me. Good luck, and have fun.
Having said all that, some people are just fat obnoxious hate-filled pigs.
Like the patient in the corner room, whose call light was always on, whose family had continual little hissy fits over the most mundane things, whose nurse (thankfully not me) made every effort to please them and meet their needs only to get no appreciation for any of their efforts.
This patient was an unhappy sloth who saw it as their remaining life's goal to make as many other people also as miserable as possible, and after many decades of practice they had become quite proficient at this. And their younger family members, whose upbringing had convinced them that such ugliness was normal, played right along with it.
A sucking vortex of meanness and abject misery, plain and simple.
The day before yesterday was the patient's day to be discharged to whatever bright shining hell-hole they lived at, and the nurse was so happy in thinking that the patient would not be there in that corner room the following day. They rejoiced openly.
But on the way out to the stretcher van that was to transport the patient to their residence, the patient fell off the gurney and fractured a shoulder. They also probably broke a thumb, but the fear of a broken hip was ruled out on X-ray. The patient was re-admitted to the hospital and ended up in the very same room, much to the dismay of the nurse so assigned.
Paydirt. The mother load. Ka-ching.
Now the ugliness of their family misery was compounded by revengeful greed, and of course they've got a case.
Later that day I saw a couple strange-looking creatures, like the space lizards in Zathura only a little smaller, poking around until they finally found the patient and entered the room.
While they were visiting the patient did not put on their call light.; not even once, for about a half-hour. Then they wordlessly walked out and down the hall, eyes straight ahead.
Lawyers.
The surgeons decided that the patient was not a candidate for repair, so the plan was to discharge them the next day with a sling for their arm and shoulder. Naturally "I'm so glad I have tomorrow off" was the nurse's constant refrain.
Friday, April 21, 2006
Appearances
Sometimes you hear somebody resort to the old cliche "you can't tell a book by its cover," which in these faith-based anti-liberal hate-filled days of Republican screed is so not true... consider the epic tomes of Michael (fake name Savage) Wiener and Ann (Adam's Apple) Coulter, for example, whose titles alone eloquently save you the bother of actually reading the contents inside.
The Young One Who Pays No Heed to Parental Authority has lately ironically discovered, thanks to me, the songs of the Beatles. So the "White Album" has been in the CD player and as you know the cover of that doesn't tell you anything at all except the name of The Beatles when that was who they were.
Plain white wrapper, music of glorious beauty and variety inside. Who'd 'a thunk it?
He had been bleeding from the moment he returned from the operating room. The doctors had surgically incised a few cysts from each armpit. I didn't see any external sutures. Looked like they slit each open, espressed whatever ooze was in these, (there were a few) and then sent him back to us.
He wasn't my patient, but the looks on the faces of the nurses involved told me to take a stroll down that way. My little team was under control, which I rarely have the pleasure of saying. I'm a magnet for the most unpleasant things usually. Feces, degrading cardiac rhythms, sagging blood pressures. That's my ilk.
The patient's nurse, a nearby nurse, and the admission/discharge/transfer nurse were all taking turns holding pressure on the guy's armpit, but it was still oozing a steady trickle of blood. I brought a few boxes of 4X4 gauze. Then I took a turn myself, holding pressure with a wad of gauze while his nurse injected morphine.
He was talking on the phone while holding his left arm straight out above shoulder level to his side, so we could try to soak up the blood trickling from his armpit. Blood was on the sheet under his arm.
"Careful, he's HIV," said his nurse to me. She looked like she was about to cry, but it wasn't an emotional thing. She was fronting down a case of double pink-eye. I was properly gloved.
Once every few minutes I'd peek under the gauze to note the trickle. The A/D/T nurse spelled me, but I came back later to hold pressure again and see how things were going.
The surgeon who excised the cysts was off, so he told the nurse to try the on-call trauma surgeon, and he just said that he was 45 minutes out and to "hold pressure." The nurse explained that we had been doing that for like over an hour but he had no more to add.
The medical doctors she tried to call deferred it to surgery, but eventually a medical resident showed up and wrote orders for blood pressure meds (170/105 last, 205/110 before going to the OR.) He also ordered some STAT labs so we could check the anticoags and hemoglobin.
A little blood goes a long way. I was holding pressure again when the ADT nurse spelled me and I took a look at the blood.
It looked like blood.
Sure, it was HIV positive and Sam knows I wouldn't want to take that home with me. But it looked like plain old blood and nothing else.
After a couple hours of various nurses holding pressure on a one-centimeter-length armpit incision, it finally eased off bleeding. They'd wrapped a wad of gauze with kling to hold it over the wounds, and no blood was visible. He had his arm down.
I wondered. The next time I have a patient with uncontrollable bleeding from the armpit, I will have him hold his arm down. I do not know why; it's an instinct thing. I mentioned it to the guy's nurse, but it didn't really seem important. It's probably nothing.
"At night all cats are gray."
To which I might add: "At night all black Labrador Retrievers are... gray?!"
The Young One Who Pays No Heed to Parental Authority has lately ironically discovered, thanks to me, the songs of the Beatles. So the "White Album" has been in the CD player and as you know the cover of that doesn't tell you anything at all except the name of The Beatles when that was who they were.
Plain white wrapper, music of glorious beauty and variety inside. Who'd 'a thunk it?
He had been bleeding from the moment he returned from the operating room. The doctors had surgically incised a few cysts from each armpit. I didn't see any external sutures. Looked like they slit each open, espressed whatever ooze was in these, (there were a few) and then sent him back to us.
He wasn't my patient, but the looks on the faces of the nurses involved told me to take a stroll down that way. My little team was under control, which I rarely have the pleasure of saying. I'm a magnet for the most unpleasant things usually. Feces, degrading cardiac rhythms, sagging blood pressures. That's my ilk.
The patient's nurse, a nearby nurse, and the admission/discharge/transfer nurse were all taking turns holding pressure on the guy's armpit, but it was still oozing a steady trickle of blood. I brought a few boxes of 4X4 gauze. Then I took a turn myself, holding pressure with a wad of gauze while his nurse injected morphine.
He was talking on the phone while holding his left arm straight out above shoulder level to his side, so we could try to soak up the blood trickling from his armpit. Blood was on the sheet under his arm.
"Careful, he's HIV," said his nurse to me. She looked like she was about to cry, but it wasn't an emotional thing. She was fronting down a case of double pink-eye. I was properly gloved.
Once every few minutes I'd peek under the gauze to note the trickle. The A/D/T nurse spelled me, but I came back later to hold pressure again and see how things were going.
The surgeon who excised the cysts was off, so he told the nurse to try the on-call trauma surgeon, and he just said that he was 45 minutes out and to "hold pressure." The nurse explained that we had been doing that for like over an hour but he had no more to add.
The medical doctors she tried to call deferred it to surgery, but eventually a medical resident showed up and wrote orders for blood pressure meds (170/105 last, 205/110 before going to the OR.) He also ordered some STAT labs so we could check the anticoags and hemoglobin.
A little blood goes a long way. I was holding pressure again when the ADT nurse spelled me and I took a look at the blood.
It looked like blood.
Sure, it was HIV positive and Sam knows I wouldn't want to take that home with me. But it looked like plain old blood and nothing else.
After a couple hours of various nurses holding pressure on a one-centimeter-length armpit incision, it finally eased off bleeding. They'd wrapped a wad of gauze with kling to hold it over the wounds, and no blood was visible. He had his arm down.
I wondered. The next time I have a patient with uncontrollable bleeding from the armpit, I will have him hold his arm down. I do not know why; it's an instinct thing. I mentioned it to the guy's nurse, but it didn't really seem important. It's probably nothing.
"At night all cats are gray."
To which I might add: "At night all black Labrador Retrievers are... gray?!"
Sunday, April 16, 2006
It's About Time For One About Nursing
You want a chocolate cake, fine, I know a dozen recipes just off the top of my head because when I was about 10 years old my mother got sick of me asking for cake and told me to bake my own, We pulled the old Betty Crocker batter-stained cookbook down and from then on I was the family cake wholesaler.
But I'm no pastry chef, and we wanted to make apple turnovers so we went to the local gourmet market to get pre-made pastry and a snack.
Nice scene at lunchtime. A musician outside. An outside sandwich grill going, too. As well as the usual mid-Phoenix scenesters and characters: the tall newsguy dude we feel sorry for, the guy with the Bouvier de Flandres dog, and other regulars.
I think I recognize a woman at a table with others as we settle into an outdoor table ourselves. I sat at the opera next to her last year, and she cried out loud when Magda stuck her head in an oven.
I listened in as they talked about job turnover wherever it is that they slave away their weekdays, and I noted that she had a baked apple smell about her. Perhaps it was the perfume she wore to the opera also? Maybe not. Who wears apple perfume?
In the twelve years I have been a registered nurse I've held seven different positions, most of which have sooner or later involved bending over and grabbing my ankles with my hands while keeping my knees locked straight.
Old joke. But what isn't really funny is this:
"America’s nursing shortage has worsened and is eroding the quality of patient care. A recent study found that 60% of registered nurses are now over 40 years of age and projects that if present trends continue, the nationwide shortage of nurses will exceed 400,000 by 2020. According to the Acute Care Hospital Survey of RN Vacancies and Turnover Rates report by American Organization of Nurse Executives, the average RN turnover rate in acute care hospitals is 21.3% with an average nurse vacancy rate of 10.2%."
When I first came back to the city of Sonoran Tile-Roofed Endless Sprawl, I had been recruited by a large metropolitan medical center. Even though they gave me an appreciable relocation bonus of well into 4 figures, I quit before my orientation ended and I returned the bonus.
Is there a statistic for that? Is it called "nurse turnover" if you quit while still an orientee?
On one of my training shifts I witnessed a perfectly decent nurse, my preceptor in fact, drop a pill on the floor only to pick it up and administer it to a willing patient. So what? you may ask. Five-second-rule and all that.
Not me. Not my style. Okay, so sometimes I bark at the moon and scratch my ear with my foot. But, I don't eat off the floor.
Later that same shift one of the other nurses was talking about shooting cans with his new gun. He went on to say "You know, Mexicans, Africans, Puerto Ricans... Creeped me out totally. And besides that, he kept looking at me funny.
So I quit. That was a Thursday. By Friday afternoon I had completed a couple few interviews, caught up on my sleep, and landed a job that matched the sign-on bonus and even paid a little more in salary.
Of course you may think that the magic invisible hand of the free market, guided by the infallible laws of supply and demand, is responding to these issues of nursing turnover and shortages. Then again, maybe not.
"According to the National Council of State Boards of Nursing, the number of first-time, US educated nursing school graduates who sat for the NCLEX-RN®, the national licensure examination for registered nurses, decreased by 10% from 1995-2004. A total of 9,353 fewer students in this category of test takers sat for the exam in 2004 as compared with 1995."
On my next job, the entire staff of my little 28-bed telemetry unit turned over during my first year there. There were days when I was the only worker on the unit who was not an agency nurse who had just come in for a shift. We went through travellers like Mike Tyson went through ears.
The second year, during a meeting the director of nursing informed me that the turnover rate was only 87%. Much better.
Then she got canned, and my unit supervisor left. He was the guy that had hired me, and I always liked him. His replacement lasted a few months, then the "new" director of nursing was also let go. Sometime during all this we purchased Shrimplate Manor in the central corridor, and I wanted to work at a place closer to home.
I called the guy-who-had-hired-me ex-supervisor, and he insisted I join a specific organization. Before I could even finish my online application, they were calling me, and soon I was working at The Great Muffin Factory.
The turnover rate here is probably about normal, which is to say a lot less than 87%, but I see people come and go.
Things are much worse in nursing homes and long-term-care facilities:
"In May 2005, the National Commission on Nursing Workforce for Long-Term Care released Act Now for Your Tomorrow report which found that there are nearly 100,000 vacant nursing positions in long-term care facilities on any given day, and the nurse turnover rate exceeds 50%. The shortage is costing long-term care facilities an estimated $4 billion a year in recruitment and training expenses."
There was a time when I did about a nine-month part-time stint in a nursing home back in The Dismal Wilderness. I went to work never knowing if it would be an 8 or a 16-hour shift, because if your replacement didn't show up, you had to stay all night. I didn't know much what I was doing anyways, having just come out of school and off an intensive care aide job where I had become familiar with cardiac medications but knew relatively little about stool softeners.
As trends continue, there will be more patients and fewer nurses, which will only increase nursing turnover rates and shortages, as well as good old-fashioned burnout.
It might be different if the magic invisible hand of the free market would respond to increased demand for nurses and retention of nursing staff by actually, you know, paying them more. But where oh where would we ever, as a society, find the money to do this?
Oh, I dunno, maybe here:
"Iraq was awash in cash - in dollar bills. Piles and piles of money," says Frank Willis, a former senior official with the governing Coalition Provisional Authority. "We played football with some of the bricks of $100 bills before delivery. It was a wild-west crazy atmosphere, the likes of which none of us had ever experienced."
We could abandon our notions of pre-emptive wars for oil fought against third-world countries, and in so doing usher in a new period of responsibility and commitment to the healthcare of our fellow Americans, or, as Theodoric of York, Medieval Barber would say, "Naaaah."
But I'm no pastry chef, and we wanted to make apple turnovers so we went to the local gourmet market to get pre-made pastry and a snack.
Nice scene at lunchtime. A musician outside. An outside sandwich grill going, too. As well as the usual mid-Phoenix scenesters and characters: the tall newsguy dude we feel sorry for, the guy with the Bouvier de Flandres dog, and other regulars.
I think I recognize a woman at a table with others as we settle into an outdoor table ourselves. I sat at the opera next to her last year, and she cried out loud when Magda stuck her head in an oven.
I listened in as they talked about job turnover wherever it is that they slave away their weekdays, and I noted that she had a baked apple smell about her. Perhaps it was the perfume she wore to the opera also? Maybe not. Who wears apple perfume?
In the twelve years I have been a registered nurse I've held seven different positions, most of which have sooner or later involved bending over and grabbing my ankles with my hands while keeping my knees locked straight.
Old joke. But what isn't really funny is this:
"America’s nursing shortage has worsened and is eroding the quality of patient care. A recent study found that 60% of registered nurses are now over 40 years of age and projects that if present trends continue, the nationwide shortage of nurses will exceed 400,000 by 2020. According to the Acute Care Hospital Survey of RN Vacancies and Turnover Rates report by American Organization of Nurse Executives, the average RN turnover rate in acute care hospitals is 21.3% with an average nurse vacancy rate of 10.2%."
When I first came back to the city of Sonoran Tile-Roofed Endless Sprawl, I had been recruited by a large metropolitan medical center. Even though they gave me an appreciable relocation bonus of well into 4 figures, I quit before my orientation ended and I returned the bonus.
Is there a statistic for that? Is it called "nurse turnover" if you quit while still an orientee?
On one of my training shifts I witnessed a perfectly decent nurse, my preceptor in fact, drop a pill on the floor only to pick it up and administer it to a willing patient. So what? you may ask. Five-second-rule and all that.
Not me. Not my style. Okay, so sometimes I bark at the moon and scratch my ear with my foot. But, I don't eat off the floor.
Later that same shift one of the other nurses was talking about shooting cans with his new gun. He went on to say "You know, Mexicans, Africans, Puerto Ricans... Creeped me out totally. And besides that, he kept looking at me funny.
So I quit. That was a Thursday. By Friday afternoon I had completed a couple few interviews, caught up on my sleep, and landed a job that matched the sign-on bonus and even paid a little more in salary.
Of course you may think that the magic invisible hand of the free market, guided by the infallible laws of supply and demand, is responding to these issues of nursing turnover and shortages. Then again, maybe not.
"According to the National Council of State Boards of Nursing, the number of first-time, US educated nursing school graduates who sat for the NCLEX-RN®, the national licensure examination for registered nurses, decreased by 10% from 1995-2004. A total of 9,353 fewer students in this category of test takers sat for the exam in 2004 as compared with 1995."
On my next job, the entire staff of my little 28-bed telemetry unit turned over during my first year there. There were days when I was the only worker on the unit who was not an agency nurse who had just come in for a shift. We went through travellers like Mike Tyson went through ears.
The second year, during a meeting the director of nursing informed me that the turnover rate was only 87%. Much better.
Then she got canned, and my unit supervisor left. He was the guy that had hired me, and I always liked him. His replacement lasted a few months, then the "new" director of nursing was also let go. Sometime during all this we purchased Shrimplate Manor in the central corridor, and I wanted to work at a place closer to home.
I called the guy-who-had-hired-me ex-supervisor, and he insisted I join a specific organization. Before I could even finish my online application, they were calling me, and soon I was working at The Great Muffin Factory.
The turnover rate here is probably about normal, which is to say a lot less than 87%, but I see people come and go.
Things are much worse in nursing homes and long-term-care facilities:
"In May 2005, the National Commission on Nursing Workforce for Long-Term Care released Act Now for Your Tomorrow report which found that there are nearly 100,000 vacant nursing positions in long-term care facilities on any given day, and the nurse turnover rate exceeds 50%. The shortage is costing long-term care facilities an estimated $4 billion a year in recruitment and training expenses."
There was a time when I did about a nine-month part-time stint in a nursing home back in The Dismal Wilderness. I went to work never knowing if it would be an 8 or a 16-hour shift, because if your replacement didn't show up, you had to stay all night. I didn't know much what I was doing anyways, having just come out of school and off an intensive care aide job where I had become familiar with cardiac medications but knew relatively little about stool softeners.
As trends continue, there will be more patients and fewer nurses, which will only increase nursing turnover rates and shortages, as well as good old-fashioned burnout.
It might be different if the magic invisible hand of the free market would respond to increased demand for nurses and retention of nursing staff by actually, you know, paying them more. But where oh where would we ever, as a society, find the money to do this?
Oh, I dunno, maybe here:
"Iraq was awash in cash - in dollar bills. Piles and piles of money," says Frank Willis, a former senior official with the governing Coalition Provisional Authority. "We played football with some of the bricks of $100 bills before delivery. It was a wild-west crazy atmosphere, the likes of which none of us had ever experienced."
We could abandon our notions of pre-emptive wars for oil fought against third-world countries, and in so doing usher in a new period of responsibility and commitment to the healthcare of our fellow Americans, or, as Theodoric of York, Medieval Barber would say, "Naaaah."
Wednesday, April 12, 2006
What Can VooDoo
Sure, many of us live within walking distance of local grocery stores and such. Or within a bike ride to get to work.
"Ervin Goodall, 56, a professional driver pumping supreme grade into his large sedan, was paying $3.29 a gallon.
"It's lot higher than last year, a bigger hit," said Goodall, who added that when it comes to personal driving he's scaling back: no more Saturday day trips."
The modern era of cheap fuel will not be saved from eventual certain oblivion even if a few of us make the ultimate sacrifice of cutting back on Saturday fun drives.
From this article on today's front page. The price of gas is creeping upwards, but drivers are not really cutting back. After all, how can they? Especially in the sea of tract-home suburbia we have lately created for ourselves? We have spent half a century developing a lifestyle that requires we must first drive in order to do anything.
It's like what Tracey Walter says as "Miller" in Repo Man: The more you drive, the less intelligent you are.
As applied to entire societies; well, yes.
Will the suburbs be abandoned and lapse back into fields of roses and local produce? Will the central core of city buildings grow tall and shady, filled with people who pedal to their jobs? How much will that really accomplish anyways?
Yes, I can walk to Basha's, but the avocados cannot. Nor can the coffee beans and the half & half.
"Ervin Goodall, 56, a professional driver pumping supreme grade into his large sedan, was paying $3.29 a gallon.
"It's lot higher than last year, a bigger hit," said Goodall, who added that when it comes to personal driving he's scaling back: no more Saturday day trips."
The modern era of cheap fuel will not be saved from eventual certain oblivion even if a few of us make the ultimate sacrifice of cutting back on Saturday fun drives.
From this article on today's front page. The price of gas is creeping upwards, but drivers are not really cutting back. After all, how can they? Especially in the sea of tract-home suburbia we have lately created for ourselves? We have spent half a century developing a lifestyle that requires we must first drive in order to do anything.
It's like what Tracey Walter says as "Miller" in Repo Man: The more you drive, the less intelligent you are.
As applied to entire societies; well, yes.
Will the suburbs be abandoned and lapse back into fields of roses and local produce? Will the central core of city buildings grow tall and shady, filled with people who pedal to their jobs? How much will that really accomplish anyways?
Yes, I can walk to Basha's, but the avocados cannot. Nor can the coffee beans and the half & half.
Sunday, April 02, 2006
Four and More (Infomercial)
In my humble small kitchen, this Chroma 301 santoku is the knife I most often find myself using. It's blade maintains sharpness enough to get one through both episodes of Kill Bill, but I still have a Chantry sharpener at hand for regular blade maintenence. It's easy and it works on everything. I've never much liked the traditional knife steel. It's too easy to get the wrong angle.
I also like a traditional chef's knife, but I prefer a somewhat smaller blade, that being a simple six-inch chef knife. The bolster on the Wustof is thick and safe. Compared to other German cutlery, this style of bolster is much less threatening, even if Messermeister blades are themselves a little harder. If you compare bolsters you see what I mean.
The Chroma" knives I like have a nasty little sharp edge where the bolster would be if these featured ones. Instead these have a little "pearl" that juts from the handle to guard against getting the hand too forward to the blade.
I'm OK with this, but I have my young one use a German knife. They have their own little four-inch chef's knife which they are very proud of, and though I'd prefer a thicker bolster, they wouldn't trade their blade for any other at this time. Radish trimming. Kinda fun, really.
They picked it out at the kitchen store all by themselves, with good advice from the store cooking coaches. My little one sees no need for the Santoku style blade; instead, moving right up to the traditional cleaver, good for big jobs like quartering a chicken or working out the final episodes of the opera Salome.
We decided that knife blocks took up too much precious countertop space, so we have a magnetic knife rack. Looks way cool, and the blades are easier to inspect for cleanliness. I like the way these look stuck up against the wall above the counter, and it's way better than dulling them in a cutlery drawer.
And now back to our regular programming:
How much money has the Iraq war taken from your pockets so far?
I also like a traditional chef's knife, but I prefer a somewhat smaller blade, that being a simple six-inch chef knife. The bolster on the Wustof is thick and safe. Compared to other German cutlery, this style of bolster is much less threatening, even if Messermeister blades are themselves a little harder. If you compare bolsters you see what I mean.
The Chroma" knives I like have a nasty little sharp edge where the bolster would be if these featured ones. Instead these have a little "pearl" that juts from the handle to guard against getting the hand too forward to the blade.
I'm OK with this, but I have my young one use a German knife. They have their own little four-inch chef's knife which they are very proud of, and though I'd prefer a thicker bolster, they wouldn't trade their blade for any other at this time. Radish trimming. Kinda fun, really.
They picked it out at the kitchen store all by themselves, with good advice from the store cooking coaches. My little one sees no need for the Santoku style blade; instead, moving right up to the traditional cleaver, good for big jobs like quartering a chicken or working out the final episodes of the opera Salome.
We decided that knife blocks took up too much precious countertop space, so we have a magnetic knife rack. Looks way cool, and the blades are easier to inspect for cleanliness. I like the way these look stuck up against the wall above the counter, and it's way better than dulling them in a cutlery drawer.
And now back to our regular programming:
How much money has the Iraq war taken from your pockets so far?
Tuesday, March 28, 2006
Learners vs. Non-Learners
It has lately come to pass that the word incompetent is the single term most likely to be associated with President Bush. It's about time. Those of us who were aware of this all along are quite happy to find others catching on. Yay, team.
"Brownie, you're doing a heck of a job."
— Praising Michael Brown, director of the Federal Emergency Management Agency, the morning after he revealed (in a network television interview) that he did not know about the thousands of people stranded at New Orleans' convention center until a day after extensive media reports on the situation. (Washington Post, "FEMA Director Singled Out by Response Critics", Spencer S. Hsu and Susan B. Glasser, Sept. 6, 2005.)
Incompetent, and also unaware of it. Yes, this has been rather thoroughly discussed among the Atriots and other real bloggers, but I will chime this bell repeatedly until I hear the mainstream media taking it up as an acceptable narrative. Or until hell freezes over, likely first.
We argue that when people are incompetent in the strategies they adopt to achieve success and satisfaction, they suffer a dual burden: Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it.
Snipped from a nifty study put out by the Journal of Personality and Social Psychology a few years back, which you can see here if you like.
It so applies to our current assinine dunce of a president.
And again, thoroughly discussed by the Atriots, god bless 'em all. I just love those people.
The essence of it all is that some people just do not learn from their mistakes. Most of us do. Bush does not. He's one of those "doomed to repeat it" kind of guys. Plus, he's a psychopath, so even if he could learn from mistakes, he wouldn't care if he did, and he wouldn't bother unless it accrued him greater power or ability to command misery upon others.
**********************
The Epic of Gilgamesh is probably the oldest written story to have come down to us over lo so many centuries. Interestingly, part of it involves a pre-emptive attack on a "monster" which turns out very badly for the hero, as his best friend Enkidu (who apparently has the sexual stamina of an ultra-marathoner) is subsequently taken from Gilgamesh and killed.
Let's recap, shall we:
The mighty hero Gilgamesh who somehow fashions himself part-divine pre-emptively attacks a Middle-Eastern "monster" and this turns out badly for him and his nation.
I read Gilgamesh when I was a highschool student. Bush, not much of a reader himself, has probably not been exposed to this. The oldest story known to mankind. And if not exposed to it, how could he then learn from it?
Well, not at all. Which just happens to be the same way he learns from things he has been exposed to. That is to say, not at all.
He just doesn't learn.
Because everything is going OK, and no mistakes have been made, and even though New Orleans was drowning and its population devastated and dispersed, everything was just swell. In Iraq every day more of our young soldiers die senselesly, but this is progress in the minds of many in this Administration.
He screws up, but he thinks everything is just fine, because he is unable to see otherwise. He's blind.
And naked. And, to tell you all the sad truth, quite small, if you know what I mean.
Tiny, in fact.
Miniscule.
There remains a schism between two types of people in the world: those who learn from mistakes, and those who don't.
We apparently now are ruled by those for whom a thousands-years-old story holds no lessons at all. They don't get it, and they never will, because they do not learn, and besides that they are incompetent psychopaths.
Get into the groove, patriots. It's still your country, and mine.
"Brownie, you're doing a heck of a job."
— Praising Michael Brown, director of the Federal Emergency Management Agency, the morning after he revealed (in a network television interview) that he did not know about the thousands of people stranded at New Orleans' convention center until a day after extensive media reports on the situation. (Washington Post, "FEMA Director Singled Out by Response Critics", Spencer S. Hsu and Susan B. Glasser, Sept. 6, 2005.)
Incompetent, and also unaware of it. Yes, this has been rather thoroughly discussed among the Atriots and other real bloggers, but I will chime this bell repeatedly until I hear the mainstream media taking it up as an acceptable narrative. Or until hell freezes over, likely first.
We argue that when people are incompetent in the strategies they adopt to achieve success and satisfaction, they suffer a dual burden: Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it.
Snipped from a nifty study put out by the Journal of Personality and Social Psychology a few years back, which you can see here if you like.
It so applies to our current assinine dunce of a president.
And again, thoroughly discussed by the Atriots, god bless 'em all. I just love those people.
The essence of it all is that some people just do not learn from their mistakes. Most of us do. Bush does not. He's one of those "doomed to repeat it" kind of guys. Plus, he's a psychopath, so even if he could learn from mistakes, he wouldn't care if he did, and he wouldn't bother unless it accrued him greater power or ability to command misery upon others.
**********************
The Epic of Gilgamesh is probably the oldest written story to have come down to us over lo so many centuries. Interestingly, part of it involves a pre-emptive attack on a "monster" which turns out very badly for the hero, as his best friend Enkidu (who apparently has the sexual stamina of an ultra-marathoner) is subsequently taken from Gilgamesh and killed.
Let's recap, shall we:
The mighty hero Gilgamesh who somehow fashions himself part-divine pre-emptively attacks a Middle-Eastern "monster" and this turns out badly for him and his nation.
I read Gilgamesh when I was a highschool student. Bush, not much of a reader himself, has probably not been exposed to this. The oldest story known to mankind. And if not exposed to it, how could he then learn from it?
Well, not at all. Which just happens to be the same way he learns from things he has been exposed to. That is to say, not at all.
He just doesn't learn.
Because everything is going OK, and no mistakes have been made, and even though New Orleans was drowning and its population devastated and dispersed, everything was just swell. In Iraq every day more of our young soldiers die senselesly, but this is progress in the minds of many in this Administration.
He screws up, but he thinks everything is just fine, because he is unable to see otherwise. He's blind.
And naked. And, to tell you all the sad truth, quite small, if you know what I mean.
Tiny, in fact.
Miniscule.
There remains a schism between two types of people in the world: those who learn from mistakes, and those who don't.
We apparently now are ruled by those for whom a thousands-years-old story holds no lessons at all. They don't get it, and they never will, because they do not learn, and besides that they are incompetent psychopaths.
Get into the groove, patriots. It's still your country, and mine.
The Sign Says Not to Feed Them
They look just like you and me, but they have no emotional center, no way to put the brakes on their wants and desires. They are not burdened by care for others, and they are quite willing to exploit the empathy of other individuals if this will further their own selfish aims.
"It has often been noted that psychopaths have a distinct advantage over human beings with conscience and feelings because the psychopath does not have conscience and feelings. What seems to be so is that conscience and feelings are related to the abstract concepts of "future" and "others." It is "spatio-temporal." We can feel fear, sympathy, empathy, sadness, and so on because we can IMAGINE in an abstract way, the future based on our own experiences in the past, or even just "concepts of experiences" in myriad variations. We can "predict" how others will react because we are able to "see ourselves" in them even though they are "out there" and the situation is somewhat different externally, though similar in dynamic. In other words, we can not only identify with others spatially - so to say - but also temporally - in time. "
They realize that they are different, yet also generally play-act as if they sincerely do have the same feelings the rest of us have. They wear the "Mask of Sanity." This can be stressful for them, though, and tell-tale slips often occur.
"Our enemies are innovative and resourceful, and so are we. They never stop thinking about new ways to harm our country and our people, and neither do we."
—Bush addressing a group of witnesses at the signing of the Defense Appropriations Act for Fiscal Year 2005 in Washington, DC on Aug. 4.
The article linked above even contains a suggestion that the psychopath is a new kind of hominid, with the survival advantage of lack of a constraining conscience. That scares the heck out of me, and I'd hate to see what the planet would end up like after Homo psychopathosis became the dominant species on our once-fair Earth. I don't think it's yet too late for us to take our country, all countries, back from these monsterous people.
The points bearing repetiton here are that psychopaths are all around us, and they are making a miserable mess of things, and we should do our best to recognize and contain them. We should stop electing them. We should see to it that their political party ceases to have power over us.
This next quote comes from one of the comment moderators for the political blog called "Red State," which was at the center of the fleeting Ben Domenech fiasco at the Washington Post.
"For the record By: Thomas
I repeat: Should the entire American Left fall over dead tomorrow, I would rejoice, and order pizza to celebrate. They are not my countrymen; they are animals who happen to walk upright and make noises that approximate speech. They are below human. I look forward to seeing each and every one in Hell.
To those conservatives who couldn't wait to find wrongdoing where none existed: Gee, funny you didn't get all hyped up about this with Bob Bork. Or Sam Alito. I guess maybe your common sense detector -- or decency reserve -- only kicks in when it gets you something you want?
You're all dead to me, as well. Too bad: One lady in particular was a favorite writer of mine. Ah, well.
If this is mastery, then I'm a donut. - Mike Krempasky
Personally, I think it might very well be that "Thomas" is himself a bit of a psychopath. In that quote he certainly espouses the tone of one. If you hold your nose and peruse that thread you will see that other posters there call him to task, but with the expected futility.
A psychopath of the more severe variety could slaughter a whole dormitory full of schoolgirls and similarly order a pizza, no? And the projection is also a common sign amongst these unholy bretheren; to repeat Thomas:
I guess maybe your common sense detector -- or decency reserve -- only kicks in when it gets you something you want?
I believe he might be trying to tell us that he feigns common decency only on occasions when it would appear to be advantageous for himself. And of course, he tries to weasel out of things later by posting this:
Properly, by the way, I was not "expressing approval of harassment, arrest, immprisonment, torture, or death of liberals and Democrats." I was stating preemptive joy at the sudden, accidental death of the American Left. I'm frequently told by liberals that liberal does not equal Left; I took that as a given.
Yes of course, that's much better. Whatever.
Anyways, the next time you get flamed by some illogical rightwing freeper-type keep in mind that they are most certainly a psychopath. Treat them as such, protect yourself, and above all, discourage their reproduction, both figuratively and biologically.
They have also their disadvantages. They are predictable, they are unclear in their desires, except perhaps to repeatedly harm others, they can be sloppy, and they can be beaten, as they must be.
"It has often been noted that psychopaths have a distinct advantage over human beings with conscience and feelings because the psychopath does not have conscience and feelings. What seems to be so is that conscience and feelings are related to the abstract concepts of "future" and "others." It is "spatio-temporal." We can feel fear, sympathy, empathy, sadness, and so on because we can IMAGINE in an abstract way, the future based on our own experiences in the past, or even just "concepts of experiences" in myriad variations. We can "predict" how others will react because we are able to "see ourselves" in them even though they are "out there" and the situation is somewhat different externally, though similar in dynamic. In other words, we can not only identify with others spatially - so to say - but also temporally - in time. "
They realize that they are different, yet also generally play-act as if they sincerely do have the same feelings the rest of us have. They wear the "Mask of Sanity." This can be stressful for them, though, and tell-tale slips often occur.
"Our enemies are innovative and resourceful, and so are we. They never stop thinking about new ways to harm our country and our people, and neither do we."
—Bush addressing a group of witnesses at the signing of the Defense Appropriations Act for Fiscal Year 2005 in Washington, DC on Aug. 4.
The article linked above even contains a suggestion that the psychopath is a new kind of hominid, with the survival advantage of lack of a constraining conscience. That scares the heck out of me, and I'd hate to see what the planet would end up like after Homo psychopathosis became the dominant species on our once-fair Earth. I don't think it's yet too late for us to take our country, all countries, back from these monsterous people.
The points bearing repetiton here are that psychopaths are all around us, and they are making a miserable mess of things, and we should do our best to recognize and contain them. We should stop electing them. We should see to it that their political party ceases to have power over us.
This next quote comes from one of the comment moderators for the political blog called "Red State," which was at the center of the fleeting Ben Domenech fiasco at the Washington Post.
"For the record By: Thomas
I repeat: Should the entire American Left fall over dead tomorrow, I would rejoice, and order pizza to celebrate. They are not my countrymen; they are animals who happen to walk upright and make noises that approximate speech. They are below human. I look forward to seeing each and every one in Hell.
To those conservatives who couldn't wait to find wrongdoing where none existed: Gee, funny you didn't get all hyped up about this with Bob Bork. Or Sam Alito. I guess maybe your common sense detector -- or decency reserve -- only kicks in when it gets you something you want?
You're all dead to me, as well. Too bad: One lady in particular was a favorite writer of mine. Ah, well.
If this is mastery, then I'm a donut. - Mike Krempasky
Personally, I think it might very well be that "Thomas" is himself a bit of a psychopath. In that quote he certainly espouses the tone of one. If you hold your nose and peruse that thread you will see that other posters there call him to task, but with the expected futility.
A psychopath of the more severe variety could slaughter a whole dormitory full of schoolgirls and similarly order a pizza, no? And the projection is also a common sign amongst these unholy bretheren; to repeat Thomas:
I guess maybe your common sense detector -- or decency reserve -- only kicks in when it gets you something you want?
I believe he might be trying to tell us that he feigns common decency only on occasions when it would appear to be advantageous for himself. And of course, he tries to weasel out of things later by posting this:
Properly, by the way, I was not "expressing approval of harassment, arrest, immprisonment, torture, or death of liberals and Democrats." I was stating preemptive joy at the sudden, accidental death of the American Left. I'm frequently told by liberals that liberal does not equal Left; I took that as a given.
Yes of course, that's much better. Whatever.
Anyways, the next time you get flamed by some illogical rightwing freeper-type keep in mind that they are most certainly a psychopath. Treat them as such, protect yourself, and above all, discourage their reproduction, both figuratively and biologically.
They have also their disadvantages. They are predictable, they are unclear in their desires, except perhaps to repeatedly harm others, they can be sloppy, and they can be beaten, as they must be.
Satire Over a Cliff
Craig Cantoni (see link below) recently wrote:
"You might think this is a leap of logic, but the installation of new digital cameras and recorders costing $1,400 apiece on 85 Scottsdale Unified School District buses is a symbol of social decay and a harbinger of the nation's eventual demise ("Schools upgrade cameras on buses," Scottsdale Republic, March 2). "
Leap of logic?!
No.
Well, lemming logic, maybe.
So you see, it's not the deficits, which have saddled every man, woman, and child in the U.S with $30K of debt each.
It's not the way the Bush administration has chiselled out whole sections of the Bill of Rights and tossed the rubble into the cold and dirty Potomac.
It's not the failure of our government to yet fully investigate the 9/11 attacks and explain the odd implosion of WTC 7.
It's not the rampant corruption of campaign financing, not the outing of CIA agents, not the immigration issue, not our failure to fund healthcare for the neediest among our fellow countrymen, not the dismal failure of a war in Iraq, nor is it global warming.
It's our misguided devotion to school bus safety that is tearing at the fabric of society.
If Dave Barry were to take over writing columns for Craig Cantoni, yet maintaining his byline, I suspect many people would not see any difference.
"You might think this is a leap of logic, but the installation of new digital cameras and recorders costing $1,400 apiece on 85 Scottsdale Unified School District buses is a symbol of social decay and a harbinger of the nation's eventual demise ("Schools upgrade cameras on buses," Scottsdale Republic, March 2). "
Leap of logic?!
No.
Well, lemming logic, maybe.
So you see, it's not the deficits, which have saddled every man, woman, and child in the U.S with $30K of debt each.
It's not the way the Bush administration has chiselled out whole sections of the Bill of Rights and tossed the rubble into the cold and dirty Potomac.
It's not the failure of our government to yet fully investigate the 9/11 attacks and explain the odd implosion of WTC 7.
It's not the rampant corruption of campaign financing, not the outing of CIA agents, not the immigration issue, not our failure to fund healthcare for the neediest among our fellow countrymen, not the dismal failure of a war in Iraq, nor is it global warming.
It's our misguided devotion to school bus safety that is tearing at the fabric of society.
If Dave Barry were to take over writing columns for Craig Cantoni, yet maintaining his byline, I suspect many people would not see any difference.
Wednesday, March 22, 2006
All Alkaloids End With "ine"
What is pain? How does it work? Downy duck if I know. And I even suppose that I don't care much.
Having said that...
I am rather generous with pain medications. I've worked with enough really hurting people to realize that an amount of pain medication that would probably kill you or me or your average Bengal tiger in a trap does not always relieve the pain of someone like that little old lady in the halo. You know, the one who went through eight 30-milligram Dilaudid PCA cartridges in one twelve-hour shift when I worked with her a few weeks ago?
Chest pain. Tell me about it. I basically don't even bother with sublingual nitroglycerin anymore. Bad habit, you think? Maybe me too.
But if your mother had chest pain rated at an 8-out-of-10 and I gave her a sublingual 0.4mg dose of nitro and took her blood pressure and it was 180 systolic, and then I went and fixed another patient a cup of tea and changed out the bed of a bowel-prepping 95-year-old demented nursing home resident who just luckily came to stay with us, and then came back to your mommy and her chest pain was now a 9 and her pressure was still 180 and I gave her another nitro, you would be very happy, no?
Because I was following protocol.
So I then go answer a call light and take a 50-year-old retired NBA star to the bathroom because he's "afraid to go by himself" and eventually get around to your mommy again, after fielding a few phone calls from out-of-state distant relatives who don't even bother to identify themselves but want to know everything about their dear uncle's condition because they're from Connecticut and they can't get there but federal healthcare information privacy act legislation prevents me from acknowledging that dearest uncle is even a client of ours and they insist that I tell them anyways and I politely apologize and they further insist that I get my manager and then I "accidentally" lose their call so I can see how your mother's doing with her chest pain.
Yes, I do that.
No, I'm not proud.
But there's only so much time in the day.
She looks OK on the monitor, sinus rhythm in the 90's and her pressure's down into the 140's and you're holding her hand but her pain's still a "5" so I go get a couple milligrams of intravenous morphine for her, administer it over a little bit, like a couple television commercials (one of those daytime "judge" shows is on the room TV) and it makes the pain almost entirely go away and your mother says she'd like to take a little nap, but she has a headache (from the nitroglycerin,) so could I get her something for that?
So I get some tea and tylenol and and fifteen minutes later she's sinus rhythm in the 80's and her pressure's 136/80 and the stupid judge just gave the ex-boyfriend his car back when he was plainly being a jerk about the barbecue sauce on his girlfriend's new white shag carpet and her other boyfriend stole the car to pay for the carpet cleaner and was going to give it back anyways, after he got back from Austin because he had to visit his other girlfriend who was sick there. You know, that story.
Sometimes I just go get the morphine first and skip the nitroglycerin completely, and the patient says "thank you" and they get a few moments of precious relief before they go off to the cardiac catheterization lab to get a few stents placed.
There's enough pain in the world. We do not need more. Morphine's cheap and I've got a ton of it in the Pyxis down the hall.
Oh wait... we don't have a Pyxis anymore. Some other thing. Whatever. Some pricey medicine dispensing machine.
Having said that...
I am rather generous with pain medications. I've worked with enough really hurting people to realize that an amount of pain medication that would probably kill you or me or your average Bengal tiger in a trap does not always relieve the pain of someone like that little old lady in the halo. You know, the one who went through eight 30-milligram Dilaudid PCA cartridges in one twelve-hour shift when I worked with her a few weeks ago?
Chest pain. Tell me about it. I basically don't even bother with sublingual nitroglycerin anymore. Bad habit, you think? Maybe me too.
But if your mother had chest pain rated at an 8-out-of-10 and I gave her a sublingual 0.4mg dose of nitro and took her blood pressure and it was 180 systolic, and then I went and fixed another patient a cup of tea and changed out the bed of a bowel-prepping 95-year-old demented nursing home resident who just luckily came to stay with us, and then came back to your mommy and her chest pain was now a 9 and her pressure was still 180 and I gave her another nitro, you would be very happy, no?
Because I was following protocol.
So I then go answer a call light and take a 50-year-old retired NBA star to the bathroom because he's "afraid to go by himself" and eventually get around to your mommy again, after fielding a few phone calls from out-of-state distant relatives who don't even bother to identify themselves but want to know everything about their dear uncle's condition because they're from Connecticut and they can't get there but federal healthcare information privacy act legislation prevents me from acknowledging that dearest uncle is even a client of ours and they insist that I tell them anyways and I politely apologize and they further insist that I get my manager and then I "accidentally" lose their call so I can see how your mother's doing with her chest pain.
Yes, I do that.
No, I'm not proud.
But there's only so much time in the day.
She looks OK on the monitor, sinus rhythm in the 90's and her pressure's down into the 140's and you're holding her hand but her pain's still a "5" so I go get a couple milligrams of intravenous morphine for her, administer it over a little bit, like a couple television commercials (one of those daytime "judge" shows is on the room TV) and it makes the pain almost entirely go away and your mother says she'd like to take a little nap, but she has a headache (from the nitroglycerin,) so could I get her something for that?
So I get some tea and tylenol and and fifteen minutes later she's sinus rhythm in the 80's and her pressure's 136/80 and the stupid judge just gave the ex-boyfriend his car back when he was plainly being a jerk about the barbecue sauce on his girlfriend's new white shag carpet and her other boyfriend stole the car to pay for the carpet cleaner and was going to give it back anyways, after he got back from Austin because he had to visit his other girlfriend who was sick there. You know, that story.
Sometimes I just go get the morphine first and skip the nitroglycerin completely, and the patient says "thank you" and they get a few moments of precious relief before they go off to the cardiac catheterization lab to get a few stents placed.
There's enough pain in the world. We do not need more. Morphine's cheap and I've got a ton of it in the Pyxis down the hall.
Oh wait... we don't have a Pyxis anymore. Some other thing. Whatever. Some pricey medicine dispensing machine.
Friday, March 10, 2006
Why I Use Brass Knuckles At Work
This comes from a recent LTTE in our locally renowned and ever-useful ink-smeared forest by-product:
"Three years ago, I worked a whopping nine days at two Valley hospitals before I quit for greener pastures. What I saw was two ERs filled with people with the sniffles, sunburn, minor headaches, paper cuts, watery eyes, etc."
No doubt.
I am certain of this not because I myself work in an emergency room flooded by uninsured people who have no other outlet to which they can go with their minor and often non-existent medical issues. My certaintly comes from my experience with such people who manage to actually get fully admitted to my particular work area.
People may be uninsured and deranged, manipulative, a bit stupid, and desparate. But after a couple-few emergency room visits, some will learn that if they exaggerate or outright fake some symptoms, they are in and a heavenload of nitroglycerin, morphine injections, lab draws, X-rays, stress tests and if they really hit pay dirt, a trip to the cardiac catheterization lab await them, luminous in full glory like Saint Peter's gates. And there is our three-star cuisine, of course.
The sugar-free apple pie is very popular.
Finally a day or two later some sympathetic but discerning cardiologist will rub a knuckle on the patient's sternum, note the outcry, write in their sign-off note that the chest pain is "atypical and reproducible," and the hospitalist sends the patient home, if they should happen to have one.
But the next time the patient shows up at the emergency room complaining of severe chest pain that goes down their arm, the knuckle-on-the-sternum trick earns nothing. Because now they know.
"Three years ago, I worked a whopping nine days at two Valley hospitals before I quit for greener pastures. What I saw was two ERs filled with people with the sniffles, sunburn, minor headaches, paper cuts, watery eyes, etc."
No doubt.
I am certain of this not because I myself work in an emergency room flooded by uninsured people who have no other outlet to which they can go with their minor and often non-existent medical issues. My certaintly comes from my experience with such people who manage to actually get fully admitted to my particular work area.
People may be uninsured and deranged, manipulative, a bit stupid, and desparate. But after a couple-few emergency room visits, some will learn that if they exaggerate or outright fake some symptoms, they are in and a heavenload of nitroglycerin, morphine injections, lab draws, X-rays, stress tests and if they really hit pay dirt, a trip to the cardiac catheterization lab await them, luminous in full glory like Saint Peter's gates. And there is our three-star cuisine, of course.
The sugar-free apple pie is very popular.
Finally a day or two later some sympathetic but discerning cardiologist will rub a knuckle on the patient's sternum, note the outcry, write in their sign-off note that the chest pain is "atypical and reproducible," and the hospitalist sends the patient home, if they should happen to have one.
But the next time the patient shows up at the emergency room complaining of severe chest pain that goes down their arm, the knuckle-on-the-sternum trick earns nothing. Because now they know.
Sunday, March 05, 2006
Waters of Babylon
The good news is that huge new areas of coastal playland will become available upon which the slimy rich will put up new vacation-get-away dachas. But the bad news is that other areas will be adversly affected by rising sea levels and climatic instability.
This nice new real estate will be on the lovely continent of Antarctica, already noted for its fine five-star amenities and friendly and colorful locals.
"Those same areas have lost an estimated 5,500 square miles of ice in the last 30 years, calving icebergs the size of Belgium and Rhode Island. In 2002, an entire ice shelf collapsed into the sea.
But the newest work signals a broader loss across the entire continent — an amount equal to more than 13% of the annual sea level rise measured in recent years, the researchers said. The shrinkage is concentrated in the West Antarctic Ice Sheet, which has enough fresh water to raise sea levels more than 20 feet."
That's a lotta feet. Way too many for other coastal places. So say good-bye to Venice.
And Boston.
"Their research shows that over the next century, damage to residential, commercial and industrial buildings and their contents in metropolitan Boston (an area stretching from Ipswich to Duxbury) could exceed $20 billion, depending on how the city responds to rising sea levels. Costs could run as high as $94 billion, if climate weather conditions are more severe than expected."
Say good-bye to Florida and Louisiana. What's left of Louisiana, that is.
"Moreover, a rise in sea level would increase the exposure of many communities to storm waves. This poses a significant threat to low-lying urban areas. At particular risk would be many areas of southern Louisiana and Florida -- the highest point in Florida is only 53 feet above sea level, and the Florida Keys are all less than 10 feet above sea level. In addition, the low-lying barrier islands off the North Carolina coast already are highly vulnerable to the damages associated with storm waves, a phenomenon that will experience increasing stress as sea level rises."
Say good-bye to Manhatten.
"At our Global Initiative, which the Mayor mentioned, in New York around the opening of the UN, we were told that insurance losses from severe weather events in the last 10 years were triple those of any previous decade in history. And I know that if the climate warms for the next 50 years at the rate of the last 10, rising sea levels in the North Atlantic will claim at least 50 feet of Manhatten Island. It might good for the value of the real estate that is left there, but it will be a very bad thing indeed. It will be a harbinger of changing of agricultural production patterns, millions of food refugees created throughout the world, intense disruptions."
It just gets worse. Say good-bye to Beacon's Beach, too. Right sad, the loss of that.
This nice new real estate will be on the lovely continent of Antarctica, already noted for its fine five-star amenities and friendly and colorful locals.
"Those same areas have lost an estimated 5,500 square miles of ice in the last 30 years, calving icebergs the size of Belgium and Rhode Island. In 2002, an entire ice shelf collapsed into the sea.
But the newest work signals a broader loss across the entire continent — an amount equal to more than 13% of the annual sea level rise measured in recent years, the researchers said. The shrinkage is concentrated in the West Antarctic Ice Sheet, which has enough fresh water to raise sea levels more than 20 feet."
That's a lotta feet. Way too many for other coastal places. So say good-bye to Venice.
And Boston.
"Their research shows that over the next century, damage to residential, commercial and industrial buildings and their contents in metropolitan Boston (an area stretching from Ipswich to Duxbury) could exceed $20 billion, depending on how the city responds to rising sea levels. Costs could run as high as $94 billion, if climate weather conditions are more severe than expected."
Say good-bye to Florida and Louisiana. What's left of Louisiana, that is.
"Moreover, a rise in sea level would increase the exposure of many communities to storm waves. This poses a significant threat to low-lying urban areas. At particular risk would be many areas of southern Louisiana and Florida -- the highest point in Florida is only 53 feet above sea level, and the Florida Keys are all less than 10 feet above sea level. In addition, the low-lying barrier islands off the North Carolina coast already are highly vulnerable to the damages associated with storm waves, a phenomenon that will experience increasing stress as sea level rises."
Say good-bye to Manhatten.
"At our Global Initiative, which the Mayor mentioned, in New York around the opening of the UN, we were told that insurance losses from severe weather events in the last 10 years were triple those of any previous decade in history. And I know that if the climate warms for the next 50 years at the rate of the last 10, rising sea levels in the North Atlantic will claim at least 50 feet of Manhatten Island. It might good for the value of the real estate that is left there, but it will be a very bad thing indeed. It will be a harbinger of changing of agricultural production patterns, millions of food refugees created throughout the world, intense disruptions."
It just gets worse. Say good-bye to Beacon's Beach, too. Right sad, the loss of that.
Wednesday, March 01, 2006
Drought
The play was to open that very night, and I was to act as one of the leads. The character was a good fit for me. I was costumed in a black shirt, black pants, black boots, and a black beret. I was also to wear black-framed horn-rim eyeglasses, and I would play a philosophical type.
But I had not yet read the play nor learned my lines.
I flipped through a copy of the script, but I couldn't even find my entry points. And none of my speaking lines. So I just decided to wing it.
As this was a play with occasional musical numbers, I had a song. Of course I didn't know what it was, so when the pit band began and the conductor cued me I improvised a plaintive lament in a minor key, singing with the shattered passion and pianissimo yearning of Blake's wild tiger confined to a depressing zoo, my voice moving in a range narrow as the opening measures of the Rachmaninoff Third Piano Concerto:
This is my philosophy,
its time has come.
It is no philosophy
just for me,
It is no philosophy
for two or three.
It is a philosophy of one.
It is love.
The other players on stage and in the pit were aghast. The audience, however, was relatively clueless as to the improvisatory nature of my dirge, and they came around to the mournful tune and clapped. Routinely enough, like they wanted things to move along to whatever was supposed to happen next.
I woke up with the tune in my head still.
It was a work anxiety dream. I've had these ever since I can remember. But this one had a happier ending than most.
Often I wake up perplexed and exhausted by dreams of impossible workloads, shifting responsibilities and priorities, and interpersonal conflicts gone unresolved. Then I go off to work where it's just the same but real and wakeful.
We sat on the couch and drank our coffee, sharing dreams, before the young one was up and about. My spouse has been going through a series of death-avoidance dreams. I listened to their dream, then recounted mine and sang my sad little cavatina.
It was a cloudy morning with the smell of rain in the air, but none came.
But I had not yet read the play nor learned my lines.
I flipped through a copy of the script, but I couldn't even find my entry points. And none of my speaking lines. So I just decided to wing it.
As this was a play with occasional musical numbers, I had a song. Of course I didn't know what it was, so when the pit band began and the conductor cued me I improvised a plaintive lament in a minor key, singing with the shattered passion and pianissimo yearning of Blake's wild tiger confined to a depressing zoo, my voice moving in a range narrow as the opening measures of the Rachmaninoff Third Piano Concerto:
This is my philosophy,
its time has come.
It is no philosophy
just for me,
It is no philosophy
for two or three.
It is a philosophy of one.
It is love.
The other players on stage and in the pit were aghast. The audience, however, was relatively clueless as to the improvisatory nature of my dirge, and they came around to the mournful tune and clapped. Routinely enough, like they wanted things to move along to whatever was supposed to happen next.
I woke up with the tune in my head still.
It was a work anxiety dream. I've had these ever since I can remember. But this one had a happier ending than most.
Often I wake up perplexed and exhausted by dreams of impossible workloads, shifting responsibilities and priorities, and interpersonal conflicts gone unresolved. Then I go off to work where it's just the same but real and wakeful.
We sat on the couch and drank our coffee, sharing dreams, before the young one was up and about. My spouse has been going through a series of death-avoidance dreams. I listened to their dream, then recounted mine and sang my sad little cavatina.
It was a cloudy morning with the smell of rain in the air, but none came.
Subscribe to:
Posts (Atom)
