Grand Rounds and Workouts

Grand Rounds is up today at Cut-to-Cure. I nice succinct roundup with watercolors, too!

Also, I’ve finished out the month of February with all time highs in swimming distance and running duration. The numbers aren’t big, but for me, it’s a big step forward, and another step towards the Escape from Alcatraz this June. The Escape is a 1.5 mile swim from alcatraz island, an 18 mile bike through golden gate park, and a killer 8 mile beach run with booby traps along the way (sand ladder? Stairs?)

Hello from Colorado Springs

I’m at the international coaching conference for triathlon, and there are a number of outstanding speakers here, including coaches & athletes of world class caliber. Mark Allen, 6 time Iron Man Championship winner, with the last at age 37, gave a lecture at dinner tonight, then hung out with us in the bar afterward. It was pretty cool to just lok over and see him sitting there at the next table over drinking a beer. I’ll never be the endurance athlete that he is, but it’s inspiring to see that he’s a normal human being with filled with emotion, feeling and self-doubt just like the rest of us.

I have an extra day here in COlorado springs after the conference, but am without a rental car and stuck at the conference center. It wouldnt be the worst thing to just sit on my porch and look at the rocky mountains until my plane leaves, but it would be nice if I could get a car, or hop on a tour bus, to check out the olympic training center, the US air force academy, or to stop by the local emergency department and check it out.

Schizophrenic Cat Artist

Schizophrenic Cat Artist

I am fascinated by schizophrenia. My medical school application essay featured a schizophrenic man I used to enjoy speaking with while volunteering with a homeless healthcare group in Pittsburgh called Operation Safety Net. I got a lot of exposure to a variety of psychoses this way, and then again as an ER doc. There was a guy downtown who used to draw these incredible current event flowchart diagrams linking things like mideast oil supply with the outcome of the local high school basketball games, but with a tangled web of a score or more intermediates.

I wonder what sorts of things were going through Louis Wain’s mind in his later years? Look at the fascinating detail of the cats in later sketches, less resembling cats than kaleidascopes.

Louis Wain was born in London’s Clerkenwell district in 1860 and eventually became an artist, selling his sketches of dog shows to the Illustrated Sporting News. He married his youngest sister’s governess, Emily Richardson, which was considered quite scandalous at the time. His wife contracted breast cancer and died three years later. To entertain her on her sickbed, Wain started drawing their cat, Peter. Emily encouraged him to send these drawings to newspapers and magazines, and soon the Louis Wain cat was a household name, not only in Britain but also in America, where his comics and drawings of cats appeared in several newspapers.

I am fascinated by schizophrenia. My medical school application essay featured a schizophrenic man I used to enjoy speaking with while volunteering with a homeless healthcare group in Pittsburgh called Operation Safety Net. I got a lot of exposure to a variety of psychoses this way, and then again as an ER doc. There was a guy downtown who used to draw these incredible current event flowchart diagrams linking things like mideast oil supply with the outcome of the local high school basketball games, but with a tangled web of a score or more intermediates.

I wonder what sorts of things were going through Louis Wain’s mind in his later years? Look at the fascinating detail of the cats in later sketches, less resembling cats than kaleidascopes.

Link via Boing Boing, via Neatorama

Too Young to Die

Another story, part truth, part fiction. Loosly based in reality.

He left his home that weekend morning to earn a little extra money. His construction job allowed him flexible work hours during the week, but also on the weekends. His wife took the kids shopping and had a valentines dinner planned. It wasn’t anything special, but it was, after all, valentine’s day.

He was standing on the ground floor when it happenned, but all he had been doing was hammering nails. His supervisor heard a thud, looked over, and there he was on the ground. The ambulance arrived within minutes of him falling. He had no pulse and wasn’t breathing. The crew started their usual routine, hooked up the monitor, got out the bag mask, started pushing air into his lungs and started CPR. They got out all their routine cardiac arrest meds. Push some Epi. Push some atropine. Shock. Intubate. You know, the usual stuff.

They were on scene for over 20 minutes, with little improvement in his condition. His eyes were getting glazed, surely brain damage had already begun due to a lack of circulating blood and oxygen. Finally, the man was loaded up into the back of the ambulance, where CPR continued all the way into the emergency department. Quick report was given to the nurses and the physician who were waiting in the room prior to his arrival.

How long? the doctor asked. How many shocks? She queried. How many rounds of epinephrine?

The team quickly hooked him up to the hospital monitors, which told the same story as the medics’. No pulse. No rhythm. A few last effort meds were given…calcium, bicarb, the position of the endotracheal tube was confirmed.

“Time of death…” called out a soft, matter of fact voice…

All activity stopped. The medics quickly gathered their items. The nurses conferred with one another to be certain everything was adequately documented. The charge nurse called the family who lived over an hour away. “You need to come to the hospital right away…you’re husband is very sick…”

The physician finshed up her shift long before the deceased patient’s wife arrived.

“I have a really bad signout for you,” she said to the oncoming doc…

The new doc reviewed the medic and nurses notes so that she too had a good grasp of all the effort that had gone into trying to revive a heart that had given up. The wife finally arrived, the new doc took 10 minutes out of her busy day to give the harsh news to her. She was less than 40 years old.