Protected: Chr1s R0ck on Politics (HB0 2008)

Canada On Strike!

Today is Canada Day!  And in honor of a blog friend (to whom I won’t link so there’s no inappropriate association, but s/he knows who s/he is) I post this funny (language NSFW) to celebrate along with:

Obviously, this is from South Park, but this time Canada strikes back!  You hear that, buddy?  Oh, I’m not your buddy, friend?  Well, OK buddy.

Believe it or not, YouTube was full of bum links for this, and obviously the copyright bots are out in full force for something like South Park, so this is my own copy and is being hosted locally.  I’ll keep this post up for a day or so then consider taking it down before the lawyers start sending C&D letters.  Happy Canada Day!

The Natural Orifice Consortium

Or more completely, the Natural Orifice Consortium for Assessment and Research, a group dedicated to investigating and exploring ways to perform surgery through natural orifices, such as the vagina, anus/rectum, and about any other opening nature provides:

Using patients’ natural openings (the mouth, vagina or rectum) as entry points to the body is perhaps the intuitive next step to laparoscopic surgery…

The group’s official acronym is NOSCAR–yes, that there is a gratuitous “S” to make the clever “no scar.” When I read the word “Consortium,” I can’t help but think of some underground, covert organization–guys in dark suits, meeting in secret places, speaking in the language of riddles and subterfuge. About orifices, of course, because you can’t talk about that stuff in the open, it’s gotta be in secret. Can you imagine the higher-ups of this “Consortium” going out for a dinner, paying with some black Amex where the business name is embossed on the card? Maybe there’s even a sphincter watermark that needs to be checked for authenticity… OK, I’m blaming my Lortab this late at night, I apologize…back to the real story at hand. (The truth is out there…)

If we were talking a huge fish-gutting midline incision, perhaps going through one of someone’s tender bits and saving days and days in the hospital and weeks of recovery would be a tradeoff. But the article above (which is from Time BTW–there might be something more scholarly out there, but alas, I don’t have those resources anymore) is talking about a simple appendectomy. An appefrickindectomy!!! Why am I shocked? Because even when comparing “open” vs. laparascopic, we’re talking a 2″ or so incision in the RLQ via the external oblique muscle (surgeons, please correct my newbie knowledge here) or a couple of similar/smaller incisions for the lap technique. How on God’s green earth is cutting open some poor women’s hoo-ha a better surgical choice? I mean maybe–MAYBE–said female works as a swimsuit/lingerie model, but even then, if that’s her professional job, she’ll have professional makeup artists to cover the tiny-ass scars.

But wait, there’s more:

Surgeons Santiago Horgan and Mark Talamini made a small incision in the wall of the patient’s vagina, through which they passed surgical tools and a small camera to the appendix, removing the organ through the same incision. Surgeons also made a small cut in the bottom of the patient’s bellybutton and inserted another camera through it to help guide surgery. The procedure took 50 minutes from start to finish, 20 minutes longer than a standard laparoscopic appendectomy.

Wha?! So they made an umbilical incision anyway, just like lap, so this magically wards off the evil spectre of herniation…how? And almost doubling surgical time is ALWAYS a plus…good going guys! (Note that an open appy is probably 15 minutes for someone who wants to book it out of there (maybe less–never been at a clocked speed test case), tripling the time.

But let’s now turn to that first quote and change the patient to a man. Say a young, otherwise healthy male presents to an ER with an acute abdomen, rebound tenderness, McBurney’s sign, the works. Cocksure eager surgeon dude comes and offers the poor guy a “minimally invasive” option–going through his ass. Last I checked, having a trocar sticking out one’s ass as all these scissors, cautery, etc. get shoved in en route to the appendix (is this in a right decubitus or a jackknife position here, anyway?) is about as invasive as you get.

Yes, the total instrument travel distance in this case is pretty short, and if there’s no serious shit going on, it probably is technically a more direct approach than going through layers of muscle, fascia, etc. Again, I appeal the the surgeons to educate me on basic surgical points here, but isn’t an immediate entry into the peritoneum via the GI lumen–and specifically the rectum of all places–just presenting a contamination problem right away? Yes, there will be abx irrigation, but going through the gut lumen for starters just seems wrong from an aseptic technique POV. Dunno. The whole thing is whack, which is my whole point, so there.

Feelin’ the love

Thanks to all who wished me a Happy Birthday on Monday via email, Facebook, telephone and telepathy. I really appreciate it. In the future, though, if any of you want to band together to get me a gift basket–not just limited to my birthday–the picture below is a nice example of a proper “man’s gift basket” that will sure to be received with much cheer and joy. I’m just sayin’…

Screwed up from the beginning

The 1975 JC Penney’s Catalog. I definitely don’t remember this one, but my childhood was full of dreaming of getting things from phonebook-sized catalogs, like the Sears Wishbook, to smaller-sized but no less desirable merchants, such as Radio Shack. Given that I was 3-4 at the time this came out, my entire formative years would have been immersed in imagery such as this in everyday life. I’m going to need more therapy than I thought…
Something worthy of mention: Brooke Shields is actually one of the models in the girl’s clothing picture! And for those of you who think (correctly) that the fashion industry nowadays sends the wrong message to girls to be unreasonably thin, check out that same picture which advertises “also chubby sizes.” (!!!) That’s one step away from me regressing to a 10-year-old being bought Sears Toughskins “husky” sized jeans. AAAH!!! Not the “X” stitched on the back pocket! Nooooo!!!

There’s also another page of PG-13 items, like “water pipes.” (Hash sold separately)

(via BoingBoing)

Gimme a little somethin’ somethin’

A friend sent me this article at CNN about a pictureboard used to help with patients who don’t speak English. Especially in emergency settings, it helps assist healthcare personnel to 1) identify the nationality/language of the person so that an appropriate translator can be found, and 2) obviously, so the patient can easily communicate what’s wrong, what happened, what they need, etc., at least in a basic fashion until #1 can be achieved.

When I saw the blowup of the picture board, however, I felt it was missing some crucial squares that ED personnel would need regularly. Above is an excerpt from the official board and below is my addition, based on what I feel could also assist personnel establish a differential about what actually might be wrong:

Difficult psych patients

A friend of mine completed her psychiatry rotation here not too long ago. We were talking about it the other night, and she told me of an incident which showed her ability to handle a difficult situation. The public psych hospital here is a ward, and patient interviews, etc. aren’t conducted in the enclosed space of their private room, since it doesn’t exist. Think One Flew Over the Cookoo’s Nest, Bellevue, what have you.

In dealing with one patient, another kept bothering her. It was getting annoying. Finally, after having enough, she turned and said these words of serious kung-fu skill:

If you don’t leave me alone, I’m going to steal your thoughts.

The patient promptly left, and she went on about her business. Impressive. Hilarious.

Lymphocyte Social Life

My cousin, who recently fled the field of neurology to begin his basement dwelling pathology residency, sent me this hilarious quote from his fancy-ass new Blackberry (bitch!) as he was reading a histology text:

Lymph nodes are like singles bars for lymphocytes and antigen, providing the perfect location for lymphocytes to be exposed to a wide variety of antigens to undergo stimulation.

I thought this was too priceless not to share. Non-medical readers will just have to trust me, it’s seriously funny, medgeeky humor. I was going to msg him back and ask him why he was reading a histo book for Pete’s sake, as not even I have cracked open one of those in almost 2 years, much less him. Then I figured starting anew with path, he’d have to start somewhere remembering all those intimate cell-type details. So instead, I messaged him back about one of those cells at the bar “being a total lympho.” I know, I know…

Sicko: OB/Gyn Love

I’m in the middle of studying for a huge exam on Monday (more later on that), but I simply could NOT WAIT to post this, probably one of the best Bushisms I’ve ever heard:

I’ve only watched the first 20 minutes or so, but if I’m brave enough I’ll post my useless review/opinion in the next day or so. Of course I’m leaving off how I got the video. It’s confidential research materials, after all.

P.S. For those returning readers wondering where the school posts of late went, I’m going to make a final update on that later today. Don’t worry–it’s not bad news. (for once)

22 Reasons You’re Fat!

Believe it or not, the subject above is the actual subject I got from an eDiets email the other day. I hate eDiets with the burning heat of a thousand suns. They are horribly unprofessional, have no real expertise to speak of, and are even sexist. When I was a member, I’d say a full 1/3 of my emails had principal subjects like “fighting weight gain during menopause,” and other “busy mom” topics, including how to get the kids’ stuff done, your stuff done, and even have the energy left for hubby at the end of the day. Um, last I checked, I had a Y chromosome, so the whiz-bang database administrators over at eDiets are a clause short on their SQL query ("AND WHERE SEX = 'F'").

The biggest problem I had apart from the impossibility of their “We’ll tell you exactly what to buy” diets (while living in Mexico where I can’t get 75% of the stuff) was the fact that to cancel, you had to call a 1-800 number. That 1-800 number had a labyrinthine maze of options, only to be placed on hold indefinitely. I tried canceling online and had no less than 3 emails from eDiets saying “Your email has been received and we’ll get back to you within 48 hours.” Finally, by sheer luck, it happened with yet another phone call, but another month had been charged to my credit card–exactly the result I’m sure they were trying to accomplish.

However, I still get their emails, at least for now. Here’s a screenshot of the first part of the aforementioned email as seen from my GMail account. Notice the confidence-building caricature accompanied by the inspiring “Fat Forever?” This is proof that they simply don’t care. Avoid them at all costs!