The Accidental Artist

Clarence was dropped off by the police after waved them down around 4 AM. It was a holiday adn Clarence was alone. I asked him where he lived and he told me that his friends spotted him everywhere as he rattled off the names of local municipalities. “How much beer did you have clarence?”

“Just a little…two 24 ouncers.”

“OK, and how much wine before that???”

He stood next to his bed with his feet wide apart, wrapped all his figners around the collars of his 3 tshirts and struggled to get them off over his head. as soon as his eyes were covered, he would start to stagger, let go of the shirts and grab the bed rail, forcing him to start all over. I finally just asked him to have a seat on the side of the bed.

We talked for awhile. I commented on his seashell necklace.

“I made it,” he said. “I’m an accidental artist,” as his voice trailed off and his eyes drifed shut.

As I was getting ready to leave the room, he asked me what my name was. I told him my real first name. His eyes widened and he said to me, “Shazam!”

And as our unit clerk would say in a thick Picksburgh drawl… “That’s the honesttogods truth!”

Salt of the earth

I am in Santa Barbara right now for a conference on homeless medicine. Tonight was a great night of friendship. Went out to dinner with friends of my cousins who live in town…real “salt of the earth” type of people that you could spend infinate amounts of time with an still enjoy being with them. My cousins are that way too. AFterwards they dropped me off at a club where others from the conference were meeting. Great latin music in a 6 piece band, with one of my closest friends (who helped organize the conference), and two other real neat folks. I was in heaven being surrounded by good music, great friends and a bottle of red wine. I will remember this night for a long, long time.

Travel nightmares.

So I’m flying to Santa Barbara tomorrow, and last night I had a really strange dream. I was in the airport with my flight loading and I decided to go to the bathroom first, but when I got there, I couldn’t go. This is in stark contrast to my actual last plane flight from honduras in which 18-rabbit’s revenge hit me IN the airport while my flight was boarding. So in the dream, I get back to the desk and it’s 8 minutes until the flight leaves. The lady says she can get me on teh plane, but then I go and sit down in the lobby and an hour later I go back and ask why I’m not on the plane. On top of all this, I had my bicycle with me. For some reason, I decided to store my front wheel in a closet & figure it would be easier to travel without it, an djust pick up another front wheel at my destination. So I hand my bike to this guy (only now it’s a comlete bike), and when I get off the plane, he wheels it right up to me. No bike box, no fuss, no scratches or dents or anything. But then later, it’s missing teh front wheel again and I have no idea where I left it.

Hmm. What do you suppose it means?

I don’t think I’m mentally prepared for this trip!

ER Docs Rule

In contrast to my last post makign ER docs look like fools, this article shows how ER docs can be the good guys when it comes to acute myocardial infarction.

Not only that, but EMS has a huge role as well, but only if we listen to what the medics have to say. It is important for paramedics to be able to do pre-hospital EKGs, be able to READ the EKG in terms of whether or not they are actively having a heart attack, and lastly, the ER docs need to listen to them and trust that they know what they are seeng. This quote describes the impact of prehospital EKGs, with time saved on the order of 15 minutes…a lifetime for someone with a dying heart.

Also, steps like having paramedics do EKGs on the way to the hospital turned out to matter less than what hospitals did with the information.

“It’s only when they acted on the pre-hospital electrocardiograms that they really speeded up the time” to treatment, Krumholz said.

It’s about time the laypress recognized that sometimes we are the good guys…

Hospitals now are wasting too much time summoning too many people to consult on a case before starting treatment, Bradley said.

“You can imagine all those calls and all those people involved,” she said. “Our recommendation is to allow the emergency room physician to decide” and assemble a team, “and they should be able to do it with one single call.”