American Idol top 9 - "and I thought these were good singers" edition

Noop Dogg - just okay, partly due to crappy backup singers. 6
Megan - hot mess. 2
Danny - crap. 4
Allison - utter rubbish. 3
Scott - a little off key at times, but nice. 6
Matt - stupid song, mediocre perfomance. 5
Lil - too nasal then too shouty and overall too boring. 4
Adam - he just can't resist being stupid on stage. 3
Kris - good. Not great. Stupid end note. 7

Predictions: bottom 3: Megan, Allison, Matt.  Megan goes home

On an aside, although I have almost universally hated Adam's performances, I have quite enjoyed - or at least solidly tolerated - his studio versions, with Ring of Fire being one of my favorite studio versions so far this year (though not as good as Anoop's Always On My Mind).

Testing

I just installed this app for my iPhone to be able to post to my blog (yes, that means I got the iPhone and I love it - but more on that later).

So testing testing one two three... Oh and hello from the hospital parking lot.

Just Surviving

Have you ever had one of those days where you feel like you are just surviving?

That pretty much describes the last month or so for me.  My whole family has been sick on and off, and sleep has somehow become an alarmingly precious commodity, and when I go to work, somehow I just manage to survive the day only to get home for a couple hours with the family and crash.

Please don't give up on me, though.  I've continued to collect stories and thoughts that will eventually become posts, but right now, I'm just surviving.

American Idol Top 10 - Mediocre Motown

I like these quick reviews.

1. Matt - He was aiiight, but the song didn't really go anywhere. 6/10
2. Kris - Not terrible, but he's no James Taylor.  5/10
3. Scott - My wife said, "I'm officially sick of his voice."  Me too. 4/10
4. Megan- Trainwreck.  Goodbye. 3/10
5. Fact: Anoop's voice can melt steel, but I could think of several better song choices for him. 7/10
6. Michael - How is he still in this? 4/10
7. Ground Rounds - Shouty. 4/10
8. Elvis Lambert - Good job, but way too high and mousy for me. 6/10
9. Danny - He wasn't finishing his words, and why would you say that Smokey knows best, and then not take his suggestions? 6/10
10. Allison - Good, but not as good as David Hernandez last year. 6/10

All in all, kind of a boring night.

My predictions:  Megan, Scott, and Michael in the bottom three.  Michael goes home.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Dizzy, Vomitting, Diahreah, CHILLS, abdominal ache

I guess he just really wanted to be sure I knew about the chills.  He was also apparently a little bit upset about having to be around his wife Diahreah.  I can't see another reason for putting her name on the list of problems.

My New Band

Okay, so just for fun, I found this little game on a relative's blog, and thought it would kill a few minutes, so off I went.  I don't have photoshop on this computer, so I did what I could with Microsoft Paint (which is not very much).  Also, I didn't use the first Wikipedia article, because it made no sense whatsoever, and the second one just happened to already be a band.  That's fine, though, because I never follow the arbitrary rules in these memes anyway.

CREATE YOUR OWN BAND AND DEBUT ALBUM!

To Do This

1 - Go to “wikipedia.” Hit “random”

or click http://en.wikipedia.org/wiki/Special:Random

The first random wikipedia article you get is the name of your band.

2 - Go to “Random quotations”

or click http://www.quotationspage.com/random.php3

The last four or five words of the very last quote of the page is the title of your first album.

3 - Go to flickr and click on “explore the last seven days”

or click http://www.flickr.com/explore/interesting/7days

Third picture, no matter what it is, will be your album cover.

4 - Use photoshop or similar to put it all together. (I don't have photoshop and didn’t spend a ton of time on mine)

And here is the result:

I Can't Afford It

Happy has a post up about patients telling him that they want to quit smoking because it is too expensive.  I've seen some of that, but more, I've seen stories like this one from a month or two ago:

Patient's Significant Other: "Oh, can we get a prescription for neosporin for this tiny little abrasion to her cheek?  We can't afford the medication."
Me: "um... I think your best bet is to go to the dollar store and buy some.  That's cheaper than any copay and works just as good."
Patient's SO: "I don't even have a dollar."
Me: "so then how are you going to pay the copay on the Vicodin and Flexeril?"
Patient's SO: "My insurance doesn't have copays."

So I walk over to the provider and ask her if I can get her to add bacitracin to the prescription for the poor packaday smoker who can't afford her meds.  With said prescription in hand, and my wallet hurting from the tax hike I'm about to get for buying meds for someone who refuses to take personal responsibility for their own health, I walk back in the room just as the patient is handing some kind of receipt to her SO.  The only problem is that the receipt is being pulled from on top of a pile of money that she pulled from her pocket.

Yeah, you don't have a dollar... you have 40.

And this is why even good hearted idealists like me get jaded.

Improving the ER - Idea 426432

Install a CT scanner in the ambulance entrance.  The medic stretchers can just roll right through and get the CT scan out of the way on the way in the door, because we all know that these days the docs are all going to order one anyway to avoid the ever-present lawsuit threat.

Bonus: An Ativan spritzer could be included in the CT scan, so that you don't have to do any of that messy IV stuff.

American Idol Top 11

I'll be even quicker tonight:

1. Michael - Really bad song to try to show off vocals with.  4/10
2. Allison - Was that a sheep up there?  5/10
3. Kris - Nice, but it felt just a little like he had to force some of those notes.  7/10
4. Lil - Big song makes Lil's voice seem little.  5/10
5. Adam - Weird.  Just weird.  2/10
6. Scott - Nice, but a little weak.  6/10
7. Alexis - Is it just me or did she just sing the word "Jolene" over and over?  Brooke did this song better.  5/10
8. Danny - I listened a second time and didn't like it as much.  7/10
9. Anoop - I listened to this one five times and I'll listen many more.  Perhaps the first song of the year that I will probably go and buy the studio version.  Did I ever mention that Anoop is my homey?  9/10
10. Megan - I'm officially sick of her voice.  5/10
11. Matt - It wasn't bad, but it wasn't great.  6/10

So there you have it.  Once again, you could kick off all the girls tonight (Alexis, Allison, Adam, Megan, Lil) and the show would be none the worse for it.

My predictions:  Megan, Allison, and Michael in the bottom three, with a chance of Alexis sneaking in there if her fan base isn't loyal.  Megan goes home.

Calling All iPhone Users and Critics

I have been using a pocket PC since 2003 when they were big and klunky.  A few years ago I switched to a phone version to avoid carrying around both my PDA and my cell.  Most recently I have been using the XV6800, which is a competent phone but which has some frustrating features.  As I have been looking at the options for upgrade, I've been drawn to the iPhone, but my loathing for all things Apple have had me very much doubting any decision to support the company of all things rotting fruit.

Nevertheless, my interest has constantly been piqued when I have seen others using it, and a couple times I've had a chance to play with one.  I've also tried to play with the Google phone and a few other, newer Windows Mobile phones as well as the Blackberry Storm.  Then the other day while walking around the new mall in our area, we walked past an Apple Store, and so I decided it would be fun to go tinker with the iPhone.  Thanks to some inexplicable rule that says that nobody in an Apple Store can be comfortable, we were required to tinker while standing next to unnaturally high tables, and after just 15 minutes or so, we left with slightly kinked necks and sore feet.  And yet the joy of simplicity and the power of the phone's capability lingered.  So yesterday when I had a chance to go out on a Daddy-Daddy date (that's personal time and not an obtuse reference to some kind of gay liason), I went back to the mall and sacrificed my body by spending three hours playing with every app I could and toying around with all the features.

By the time I was done with all that biz, I definitely had iPhone lust.  And yet the problem remained: do I really want to pay all the extra money that it would cost to upgrade to the AT&T plan and leave my month-to-month plan with Verizon?  So I went over and talked to the peeps at the kiosk and the (surprisingly) easy-going and non-pushy saleswoman walked me through what it would entail and how I could get a plan to fit my needs.  In the end, it turns out that my wife (who is not into the whole computer-in-your-pocket type of phone) can get a simple phone with mp3 ability but not much more and I can get my iPhone with all the bells and whistles and accompanying data plan, and the net effect on our monthly statement will be... nothing.  It will be the same cost, so the only difference will be the price of the phone itself and, unfortunately, the 2 year commitment.

So after looking around and talking to people I know (including one person who works for Microsoft), nobody has yet said anything to talk me out of taking the plunge and betraying my very being by purchasing and actually using an Apple product.

That is where you come in.

What I need from you, faithful reader, is to talk some sense into me... or further my resolve to go ahead with the iPhone.

And while you are at it, answer me a few questions if you can:

* How well does Outlook sync with the iPhone?
* From what I have read, there is no way to get my mobipocket ebooks that I have purchased to switch over to the iPhone.  Is that true?
* One of my favorite programs on my pocket PC is kidcolor, which is a little drawing program that locks down the operating system so that I can let my daughter scribble to her hearts content, which is great for waiting rooms and church meetings.  Is there anything like that on the iPhone?
* For anyone else who has made the plunge to iPhone, is there anything that you didn't expect you would miss but now you do?
* I use skyscape and epocrates on my pocket pc.  What are the best medical programs on the iPhone, and is it true that skyscape on the iPhone requires you to re-purchase each program annually?
* That sucks.
* Does anybody have any experience using AT&T navigator?  Is it any different than Verizon's Navigator?
* Other questions that aren't coming to mind right now.

So there you have it, faithful readers.  Convince away.  Talk me into it.  Talk me out of it.  Laugh quietly to yourself and move on with your lives, but remember, a young man's very soul hangs in the balance, and you will have to live with your decision for eternities to come.

You may now speak your mind.

How to fix the Backyardigans

Do you have children?  Then you probably know about the backyardigans.  My daughter loves this show.  I want to pull my toenails up through my intestines and out my left ear when it is on.

So it was with great interest that I came across this post by Jay Black about some ideas on how to make the show more current.  I hope that the show's producers are paying attention.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

heR thing is hurting

This one comes courtesy of a mother of a little toddler who was complaining of pain on urination.  In case you were wondering where the pain was, it was in... you know... her thing.  This, of course, is not to be confused with little miss thing*.


* I just put "little miss thing" in google, and it gave me this.  I can only imagine the psychological trauma that girl in the picture will go through when she is 16 and realizes that her mother made her wear that headband.  I'm just saying...

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit: (Today I present to you a double shot)

theeth
Swooling thorat sore

Everybody makes spelling mistakes sometimes, even me, in my state of near-perfection can maike mistaykes, but every once in a while you get one that just makes you wonder if English is a person's first (or second or third) language.  In both cases above, the answer is a sad yes.  Particularly in the second example, where she must have realised that she was spelling swelling wrong and so she crossed it out only to murder her next attempt also.

And theeth just leaves me dumbfounded.  I keep trying to come up with something clever to say about it, and words fail me, so I'll just let you look at it one more time and marvel.

theeth

American Idol Top 13

I'll be quick tonight:

1. Lil - I can see why people like her, but to me, she is a one-trick pony, and I don't like her trick.  5/10
2. Scott - He is just so darn likeable.  7/10
3. Danny - He took a crappy song and blew it out the box.  9/10
4. Michael - He beat my expectations, but then again, my expectations weren't very high.  4/10
5. Speaking of low expectations, Jasmine gets a 7/10 - the best female performance of the night.
6. Kris - My wife thinks he is cute.  I think his wife is cute.  7/10
7. Allison - Another one-trick pony.  She's good in her niche, but you can only pull songs into your niche for so long.  5/10
8. Anoop is my homey, and the judges are stupid.  9/10
9. Jorge - Boring.  4/10
10. Megan - She has a spicy, unique voice, but like any spice, I can only stand so much of it.  5/10
11. Adam - I was enjoying the toned-down beginning and was looking forward to getting behind it.  Then it got bad.  Then it got terrible.  Kara said he was singing notes she didn't even know existed.  That's right, Kara, because they don't exist.  It is called screeching, and it is usually what animals do as they are dying.  3/10
12. Matt - I couldn't really understand him.  Not bad.  Not good.  6/10
13. Alexis - She swallowed so many words, she's going to need some Tums.  Way overdone.  5/10

So there you have it.  You could kick all six girls off tonight (Alexis, Allison, Adam, Megan, Jasmine, Lil) and the show would be none the worse for it.

My predictions:  Jorge and Michael go home.  Maybe Allison or Megan instead.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Neck, shoulders, Back

Oh, and by the way, I FELL FROM THE TOP OF A BUNKBED, but why bother putting the actual reason for your visit on the line that says reason for your visit?

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Back pain and Leg

As it turned out, not only did she have a Leg, but, in fact, she had two.  Needless to say, I rushed her right back.

Sick

I don't know which is worse:

• Being sick
• The feeling of letting down your co-workers by not coming in
• The knowledge that Big Brother is in the background somewhere notching another mark against you
• Having to get up so @#$%$ early in the morning to decide if you are sick enough to call in so that they don't send a small detachment of assassins to your house.
• Not being able to get back to sleep

And then there is the trying to stumble through the actual sick call itself:

"Um, hi, this is Braden, and I'm calling... oh, um, it's Braden Nurseykindaguy and I'm calling... oh, um, from the ER... yeah, RN.  Um, what was I saying?  Oh yeah, I'm *mindstartsracingtotrytofigureouthowtosaythiswithoutsoundinglikeatotalhoserwimploser* um, not coming in today.  Oh, why? um, because I'm not feeling well... I mean, I've got a fever and chills and my stomach is hurting and I feel like I may throw up and when I went to the bathroom just a minute ago... what?  Oh, you don't want details?  Okay, just let the ER know please.  Okay.  Don't hate me.  Mmmbye."

Okay, I'm going to go lay back down and pretend like I'll be able to get back to sleep.  We'll see how long that lasts.  Mmmbye.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Remove Stin

She actually meant, "Remove Stitches".  At least I think that's what she meant, because that's what I did.  Hopefully I wont get a lawsuit across my desk in the next few days asking me why this lovely young lady is still walking around with all of her Stin still in place, and where, perchance, I may have placed her precious stitches.

Here's to keeping my fingers crossed.

Anoop

Yay!

American Idol Results - Anoop Anoop Where Have You Been All My Life Edition

My TV came dangerously close to having a remote control flung through its innards as wildcard pick after wildcard pick after... wait a minute... is that Tatifreakinana?  Whatevs, peeps.

Where was I?  Oh yeah, as they got ready to call the last pick, my arm was cocked (can I say that on live television?) and ready to fling away, but luckily, my TV was spared a mild disembowelment when Anoop's beautiful name was squirted off the tongue of my dear friend Simon.

Now the important question:  of these 8 singers, who will the judges pick?  And the choices are:

Tatifreakin - No prayer of making it.  She is back to bring in the same types of people who slow down to see how much blood there is at the rollover accident.  Fodder.
Megan Corkrey - The judges sure seem to love her, and man does she have a cute smile.  I think she has a very good chance to make it through.  In fact, dare I say it, one spot is hers to lose.
Jasmine Murray - The weirdly cute teenager who the judges brought back even though she was horridly horrible in her top 36 performance would need to knock it out of the park while the other singers all puked on Simon's shoes during their performances in order to get a ticket to ride the top 12 express.
Jesse Langseth - I think that the judges are more wild on her than her voice supports, but that said, I really like that she seems to be an intelligent contestant who does more than just blindly do whatever anyone wants.  Because she breaks the typical mold, I think she has an outside chance.
Von Smith - No way.  They picked him because they needed an easy person to eliminate.  Fodder.
Matt Giraud - I really like his potential, but when he sang that trainwreck of a song last week and then said that it represented the style of music he wants to sing, he lost a lot of my support, and I think the judges felt similarly.  He has a chance if he can really get out there and bring it, but I see the judges picking Ricky or Megan over him.
Ricky Brady - We didn't get to know him at all before the top 36, and I think that the reason is perhaps that they want to grant him the title of dark horse, because a "suprise" success brings in ratings.  He has a good chance to make it through.  If you've never heard anything from him, check him out in this youtube clip of some song called "Love Me Like LA."  Not brilliant, and the song is missing something, but he certainly can sing, and even more than that, can emote with his voice, which I appreciate.
Anoop Dog - Dear American Idol, I know where you live.  Sincerely, Me.  Seriously, though, I think he is the most likely to get through, if for no other reason than that Simon said he was the easiest pick to bring back.  I want him to sing My Prerogative.  We only got to hear 5 seconds of it in Hollywood Week and it sounded like he really nailed it.

My prediction: Anoop, Ricky and Megan make it through, although if the producers want to avoid an 8-4 guys/girls split, they may sneak Jesse in over Ricky.  Matt would be the other one that might just sneak through.

Oh yeah, and Scott Macintyre, Flank Steak, and Jorge Nunez made it through from this week.  I think Scott may be able to win me over, I hate Lil Tritips style of music, and I could maybe enjoy Jorge as a Latin artist if he would lighten up a bit.  Nobody I'm really excited about, though.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Bad tooth ache on Right side Bottem

I'm not sure how I was lucky enough to triage one of those rare cases of Dentobuttia, but the book royalties should be enormous.

American Idol Top 36 Week 3

So the last 12 of the top 36 are up this week and ho-diddly-hum who cares.  I look down this list of singers and I couldn't care less if they all got in a plane crash tonight.  As long as it wasn't next to my hospital.

1. Von Smith - You're All I Need To Get By (Marvin Gaye)

Dear Von,

You are not Marvin Gaye.

Sincerely,

Me

5/10.  Okay, in retrospect, it got better as he went on.  I'll make that a 6/10. (But he is still not Marvin Gaye)

2. Taylor Vaifanua - If I Ain't Got You (Alicia Keys)

I wish she would enunciate, because I like her voice, but I can't understand a lot of what she is singing.  Once she hit the chorus, she nailed it, but I think the shaky beginning hurt her a lot. 6/10

3. Alex Wagner-Schmagner - I Guess That's Why They Call It The Blues (Elton John)

Yes, he's dorky, but he's funny.  Before he even starts singing, I like this kid.  Then he starts singing.  When he's not trying too hard, he sounds okay, but unfortunately for him, he's trying too hard for most of the song.  Simon nailed it:  "You are like a little hamster trying to be a tiger."  He shouldn't go through, but I could see him getting the "lovable guy" vote.  5/10

4. Arianna Afsar - The Winner Takes It All (Abba)

Very shaky performance coupled with boring song = too much for her big voice to overcome.  4/10

5. Junot Joyner - Hey There Delila (Plain White T's)

Didn't he sing this in Hollywood week?  I wonder if it is possible to sing this song any slower?  He has a nice roughness to his voice, but so does Danny, and he's no Danny. 6/10

6. Kristin McNamara - Give Me One Reason (Tracy Chapman)

I can't put words to why I didn't like that performance, because if I have to rate her vocal performance, it would be at least an 8 or a 9, but in the end, I was left feeling cold.  6/10

7. Little Girl Marshall - I Will Do Anything For Love (Turkeyloaf)

That was the most boring exciting performance I've seen.  The music got big and the words got fast, but the boring stayed steady.  4/10

8. Felicia Barton - No One (Alicia Keys)

Kind of opposite of Kristin, I don't know why I liked this performance given the pitch problems, the timing being off from the backup singers, and the horrendous haircut.  That said, I liked it.  7/10

9. Scott MacIntyre - Mandolin Rain (Bruce Hornsby)

A few weak points, but overall a good job.  He's got a lot of potential.  7/10

10. Kendall Beard - This One's For the Girls (Martina McBride)

She's cute.  This song is dumb.  She sounds just like every other wannabe female country singer who has tried this song.  Paula says she gets the prize for the best outfit.  I say she gets the prize for the best burlap bag.  5/10

11. Jorge Nunez - Don't Let the Sun Go Down On Me (Elton John)

What's up with the eyebrows, homey?  This is a credible performance, but he's got David Archuleta's shoes to fill, and Jorge, you are no David Archuleta.  6/10

12. Lil Rounds - Be Without You (Mary J. Blige)

She loves her name.  I think it sounds like a cut of beef.  She's a good singer but like Kendall, she seems kind of generic for her genre.  Also, she was really eating her words at the beginning.  6/10

My predictions: Scott, Lil and Jorge make it to the top 12.

Who should make it: I don't really care, because I can't get excited about any of these singers.  I just hope Drama Queen doesn't make it.

Live With the Consequences of Your Actions

Scalpel or Sword is one of my favorite ER blogs, and I usually find myself agreeing whole-heartedly with what he has to say, but today, I found a post I couldn't support.  His premise was that it is okay to not be completely accurate on the medical record so that a patient doesn't risk losing their insurance plan.  Go read the post.  Here is the comment that I left for him:

I'm also scared of socialized medicine, and wouldn't vote for Obama even if he offered me a 13 dollar per week tax cut, but the principle of accepting the consequences of your actions are solid conservative principles.

If you don't want to find yourself down on the list of kidney transplant patients, then here's some advice: STOP DOING DRUGS!

The idea that people can do whatever they want and get away with it is a solidly liberal principle, and quite frankly, I'm a little shocked that you would go along with it.  You don't have to go tell the cops, but if a patient comes in with a very real health problem (even if it isn't the reason they gave for their visit) and you ignore it, are you really doing them a service?

When they come in with a near-fatal overdose in a month and the attending doc has no history to go by, will you have done her a favor?  When she is living on the street thanks to a habit that could have been broken early on with some help will you have done her a favor?  When she needs a liver transplant due to the alcoholism that so often accompanies drug use, will you have done her a favor?

I'm not trying to say that you will be responsible for any possible downfall that she may take, but when you seek to cover the sins of another, you are certainly not doing them any favors.

What do you think?

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

MVA IN Room 24 w/wife

I suppose if you are going to have a car accident, having it while already in the ER is pretty good because you are assured prompt care.  I'm just not sure how you got your car into room 24 to begin with... and we may have a hard time getting the ambulance in there.

American Idol Results - I Heart Brooke White Version

The good: Brooke White

The surprising: Kris Allen made it.  I kind of like him so far.

The meh: Allison made it.  I think she did okay singing, but I don't think that she will prove to be versatile and it is a shame that she is through over Mishavonna who I think is a much better singer than her.

The expected: Adam made it.  He's good, but I just don't like his style.

Hopefully we will see Matt Giraud and Mishavonna in the Wild Card round.  But I still want my Anoop Dog.

To File Away Under Crazy Lab Values

We get a surprising amount of DKA in our ER.  As far as I know, we are not located near any candy manufacturing plants or orange groves, so I'm not sure why we get so many patients with sugars out of control.  I know in a previous ER that I worked at, we had one patient who came by once or twice a week with a sugar of 500, bringing new meaning to the term "uncontrolled hyperglycemia."  I never did find out what happened to him.

But now that I'm in this new ER, I have found that my blood glucose monitor is very friendly.  It seems like a day doesn't go by that the machine doesn't tell me "HI", to which I always respond, "HOW ARE YOU" but rarely ever get any kind of a meaningful answer.  Usually when I get a result like that, I can count on a call from the lab about 30 minutes later to report a critical high sugar of 650 or even 700.

But the other day took the cake for me when I got word that a patient had a sugar level of 1479.

I later learned that what had happened was that he was supposed to get a liter of blood, but instead was transfused a liter of Hershey's Chocolate Syrup.

Sad.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

I think I have amona It's hard to Breath and Coughing STuff up.

I will admit that when I called this patient up to triage, I had no idea what amona was.  That's okay, though, because I'm pretty good at winging it, if I do say so myself (which, obviously, I do).

Fortunately, thanks to the wonder that is Wikipedia, I found out what amona is.  Apparently, it is a settlement in Gaza where Israeli police are accused of using excessive force in evacuating some homes that were ordered to be demolished.

So armed with this knowledge as I now am, I would certainly have changed how I triaged the patient.  The next time someone says that they have Amona, I'll just beat them over the head with a police club until they give in.

American Idol Top 36 Week 2

To all my rabid fans who have been bombarding me with e-mails asking me where I've been for the past week, please let your fears be alleviated.  There, that helped nobody, because nobody e-mailed me asking me if I'm still alive.  It's okay, though, because my Mom says I'm special, and that's really all that matters, right?

Anyway, I've been working like a busy little bee and now I have 7 days off to enjoy laying around and watching TV and blogging and sundry activities of laziness.

1. Jasmine Murray - Love Song ()
Jasmine comes into this show with a good chance of advancing - she's had a lot of screen time, is very attractive and confident and has a great voice.  The she sings.  Starts out bad but gets better, but not better enough.  If the producers want her, they'll have to wild card her.  5/10

2. Matt Giraud - Viva La Vida (Coldplay)
Here we have the only contestant from this round that I really wanted to see advance to the top 12, but what the @#$%#$% kind of song is this for him?  Who is that sheep up on the stage and what did they do with Matt?  4/10

3. Jeanine Vailes - This Love (Maroon 5)
This week's sacraficial lamb is Jeanine.  She's in the top 36 and we've never heard anythign about her.  Just another example of the stupidity of American Idol's producers.  So now she has to knock it out of the park.  She sounds like she is singing backup for the backup singers.  Ouch.  The judges keep mentioning her legs.  Probably because they have nothing else good to say about her performance.  Yeah, she has great legs, but what's up with the pointy face?  2/10

4. Nick Mitchell - And I'm Telling You (Somebody)
I'm not convinced that Nick is really a great singer, but I have to admit that from the beginning to the end of the song, I was smiling and laughing.  Thanks for the entertainment, and thanks for splashing a little water on Idol's face.  The quote of the night comes from Kara: "You wear the same shirt every night, just like Simon."  7/10 (mostly just for the entertainment factor)

5. Allison Irehata - Alone (Heart)
I try hard to judge these performances based on performance, but when you get a personality so devoid of intelligence (I believe airhead is the appropriate term), it takes a wallop of a performance to overcome it.  Add this to the fact that she just looks bad singing, and despite a pretty good vocal, I have to keep it real.  6/10

6. Kris Allen - Man in the Mirror (Michael Jackson)
The song starts off a little weak, but as he gets going he gets really good.  It takes some real skill to pull of a Michael Jackson song, and I think in the end he did it.  I don't know if it will be good enough to overcome the pre-show hype of Matt G and Adam, but I hope they bring him back for the wildcard round (unless they pick him over Anoop, then I hope he trips and falls in a deep hole).  I just wish he would stop doing the stupid fingerstappingonthemicrophone thing.  8/10

7. Megan Corkrey - Put Your Records On (Every American Idol Contestant Ever)
I really like the edgy quality to Megan's voice, but she is doing something funky with it tonight.  It feels like she is trying to push each word out individually and there is no cohesion to the song.

Dear Megan,

My daughter's doll called.  She wants her dress back.

Sincerely,

Me

5/10

8. Matt Breitzke - If You Could Only See (Tonic)
Surgeon General's Warning:  Do not attempt to pass stool while singing boring songs. 4/10


9. Jesse Langseth - Betty Davis Eyes (Kim Karnes)
I actually kind of like her personality, but whoa baby is she not attractive.  Anyway, the combination of her swallowing the end of every word and her pulling the mic away from her mouth after every word didn't do her any favors at all.  4/10

10. Kai Kalama - What Becomes of the Broken Hearted (Some Old Guy)
The judges roasted him, but I just loved this performance.  I thought he was strong and in tune and really owned the phrasing.  Weird facial expressions.  Great voice.  8/10

11. Mishavonna Henson - Drops of Jupitor (Who Cares)
I hate this song, but it is hard to find any faults with her performance.  Another inexplicable roasting from the judges will result in her not getting through, which is too bad, because she was far and away the best female performer of the night. 8/10

12. Adam "I'm a Girl" Lambert - Satisfaction (Rolling Stones)
Adam manages to keep his high-pitched girliness to a somewhat reasonable level, but he is just not my style at all.  That said, I have to admit that he has amazing control of his voice and uber-confidence.  He will get through.  7/10


If I had my way, Kris Allen, Kai Kalama, and Mishavonna Henson would make it through this round.

Prediction: Adam, Allison, and Matt will make it.  We will see Kris, Megan, and Jesse in the wildcard round.

American Idol Results - America Sucks Version

The good: Danny made it; Tatifreakinana didn't.

The bad: Ann Marie didn't make it.

The ugly makemewanttothrowmyremoteattheTV: Anoop didn't make it.

Really.  Anoop didn't make it.  After Michael serves up a hot steaming pile of crap, America still voted for him over my homeboy.

America sucks.

American Idol Top 36 Week 1

Last year, I made a blog called A Million Percent Yes, in which I opined on all things American Idol.  It was fun, but a lot of work, and I never really got any kind of readership.  When the season ended, my readership dwindled even more, and over the past few months I've averaged less than one visit per day, so I've decided to leave that blog in the dust pan of history and just post my ruminations here.

I know that this is an ER blog, and many people who read my blog couldn't care less about Idol, so I'll try to limit myself to a weekly recap and then my thoughts on the results, with maybe an additional post here and there.  To those (Nurse K, I'm looking at you) who want pure ER blogging experiences:  please just skip these posts.  It's not hard to do.  To everyone else (Dad, I'm looking at you) who wants to know more about my particular take on Idol:  enjoy.

So this week we had our first live performance.  They have broken the top 36 into 3 groups of 12 and each week the top male and top female vote-getter and the second place overall vote-getter will move on to the top 12 while the rest hope that the judges have pity on them and put them in the "wild-card" round in three weeks.  I hate this format, just like I hate pretty much every other decision that the producers of this show have ever made, but it is what it is, and until someone makes a better singing competition, I'm stuck with this.

Going into the show, I have pegged Anoop, Danny, and Ann Marie as the three I would like to see advance, but I also really like Stevie and what little I've heard of Ricky.

Off we go, then:

1. Jackie Tohn - A Little Less Conversation (Elvis)
Jackie says, "my goal is to get Paula up and dancing,"  My wife: "that's not hard."  Her performance?  Yuck.  Just yuck.  And what's up with that outfit?  Wait a minute, the judges liked it?  At least Simon keeps it real.  4/10

2. Ricky Braddy - A Song For You (Leon Russell)
I found a youtube of a song of his a few days ago, and the dude can sing.  When he is live, he seems to have a breathingintothemic problem, but I kinda like his voice.  That said, I don't think this song is showcasing the best of Ricky, and that's too bad because given that he's had no screen time up to this point, so he has an uphill climb.  Based on the judges' over-reaction to his performance, I think he will be picked in the wildcard round.  7/10

3. Alexis Grace - I Never Loved A Man (Aretha Franklin)
I don't like the "dirtied up" Alexis as much as the one who auditioned.  paraphrasing another blogger (I don't remember who it was so I'm paraphrasing) said that it is sad that to "dirty herself up" she had to look like a cheap hooker.  My thoughts exactly.  When you do that, you lose the "single mother" pity vote.  She out-rocked Jackie, but I still don't like her.  In other words, I'll give her props - she can sing, but it's just not my style.  I hope she grows on me, because I fear she's here to stay.  6/10

4. Brent Keith - Hicktown (Jason Aldean)
I like a lot of country music, but I despise this type of country song, and it is a really really bad choice for Brent.  It does nothing to show off his vocals, and in fact the music is so strong in the background that it is hard to hear anything beyond just the fact that he is, in fact, singing.  Not terrible, but not good enough. 5/10

5. Stevie Wright - You Belong To Me (Taylor Swift)
Here lies Stevie Wright.  She was a good singer, but she bit it.  I had such high hopes for her after her audition, and then this pile of hot mess comes tumbling out of her.  It started off too low and in the wrong key and only got marginally better.  Her voice comes across as weak and shaky and she has poor breath control.  And I'm no expert on facial expressions, but it sure looks like she knows how bad she is doing.  Paula said it best: "It wasn't the Stevie that we fell in love with."  Goodbye, Stevie.  You will be missed.  4/10 (generous because I like her)

6. Anoop Desai - Angel of Mine (Monica)
I love this guy.  I've been listening to his performances as soloist in his college singing group the Clefhangers, so when I heard he was singing Angel of Mine, I had high hopes because he really did a good job with it in his group.  Unfortunately, he came out and sang a kind of flat, boring version of it, without the flair of his Clefhangers version.  Also the background singers really ruined the song.  I still voted for him 5000 times, because he's my homey. 7/10

7. Casey Carlson - Every Little Thing She Does Is Magic (The Police)
She's cute, but I'm not on the ohlookhowhotsheis bandwagon, especially with that terrible haircut.  Luckily, she can sing, right?  Wrong, I guess.  She starts off weak and then goes off key.  Then it gets worse.  Then I throw up a little bit in my mouth.  My wife called it "campy" but I think she's being generous.  But I feel a little bad for her as the judges rip her to shreds and I can see she is right on the verge of tears. 2/10

8. Michael Sarver - I Don't Want To Be (Gavin Degraw)
I'm not a big fan of the original of this song, but with his constipation faces and forced singing, he is killing the song.  And still I want to like him because he seems like a good family man, and I respect that.  Oh, and did anybody else note how much his wife looks like Charlize Theron? 4/10

At this point in what I expected to be an incredibly strong group, I am terribly disappointed.  Perhaps if I didn't put so much stock in a stupid show it wouldn't matter, but as my wife so deftly remarked, "they're dropping like flies."

9. Ann Marie Boskovich - A Natural Woman (Aretha Franklin)
Let me just say that I want to make babies with Ann Marie's voice.  I've been in love with her, hoping she will be my Karen Carpenter (without the sad ending) ever since I first heard her in the auditions.  So when I heard she was singing Aretha, I groaned a little on the inside.  Anyway, she did a credible job, but she doesn't have the type of voice, nor the presence that Natural Woman demands, and I'm afraid she's done herself in.  And yet, even in this terrible song choice, the ease with which she is able to get those smooth vocals out makes me pick up the phone and vote until my fingers are numb. 7/10

10. Stephen Fowler - Rock With You (MJ)
So I'm not entirely sure why he got through to the top 36 after forgetting the lyrics twice and then walking away in Hollywood.  Nonetheless, here he is, and there he goes.  Simon often uses the term "cabaret" to describe a performance.  This is the perfect application for that description.  He sounds shaky and unsure of himself and very very weak.  Incidentally, Simon decided on "corny" to describe this one, and I have to agree. 3/10

11. Tatifreakinana Del Loco - Saving All My Love For You (Whitney)
I know she can bring it when she is not acting completely batty, but does she really think she can take on Whitney?  I sure hope not, because I don't want to deal with her insane fakery and posing.  She reminds me of an ex-girlfriend of mine in that way.  So what do I think of her singing?  Here's what I wrote on my note paper: EXPLETIVE!  8/10 (but I still didn't vote for her)

12. Danny Gokey - Hero (Mariah Carey)
The most pimped contestent gets the pimp spot.  Do you think the producers want to put him through?  The thing is, he doesn't need the pimping with that well-controlled roughness in his voice and impressive range.  Put that together with his Robert Downey Jr looks and pity-vote-generating backstory and he'd have to fall pretty hard to fall at all.  I found him just a little nasal, but it's hard to be hating on his voice.  Also, the arrangement felt very rushed, like he had to barrel through it, which was too bad.  My wife was sitting next to me in a state of rapturous ecstasy, so it must have been good.  8/10


And with that, we are done with one of the more disappointing episodes of Idol that I can ever remember watching.  Nothing in the episode changed my mind about my three favs, but I'm worried that Alexis or *gulp* Tatifreakinana might just squeeke through.  Also, I'm worried that Anoop was a little boring and might not get the votes he deserves.

Prediction: Danny, Alexis, and either Anoop, Michael, or Tatifreakinana get voted through, with an outside chance of Ann Marie coming through.  We will see Ricky and two of the other three mentioned above that don't make it back in the wildcard round.

Incidentally, I've heard that the wildcard round will not necessarily be singers from the top 36.  Does that mean there is hope for David Osmond?

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

ask me

Okay, I will... after I ask everybody else.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Busted ear drumb

Dear patient,

You made a spelling mistake.  The last word has one letter too many, but you'll have to try to figure out if you should remove the b or the r.

Sincerely,

Me

Two Things That Bring Me Joy

In church today we talked about Joy.  Actually, I'm not really sure what we talked about because it is incredibly hard to pay attention when you have two little ones demanding your attention, but I think it is a fairly safe bet that joy was in there somewhere.  Other safe bets include a discussion of the Superbowl, ancient American racing techniques, and jello molds.

But I digress.  Tonight, I found great joy in a new television program that I discovered called "Top Gear," which is a British show.

Now anyone who knows anything about British television knows that they are rivaled only by the Japanese for insanity on film, and Top Gear certainly delivers a lot of insanity (though not quite as much as "Incredible Bonzuke").  The premise of the show is... um... I'm not totally sure exactly, except that the subjects have to include machine-powered locomotion in some form or another.  I've now seen three episodes and I can safely declare the hosts of the show legally insane.  It is a funny show, but not in the laugh-out-loud way you get from The Office or Whose Line Is It Anyway or anything involving Keanu Reeves attempting to play a dramatic role (especially a dramatic role involving an accent), but the guys on the show know no bounds in what they will attempt to do with vehicles.  I saw stunts involving seeing how much air they could get for a mini-cooper with the Lillehammer ski jump, a contest to see who could make the best boat out of a car, and a contest with semi trucks involving driving through mobile homes and brick walls.

In short, the kind of show that only a guy could love (though once I talked my wife into sitting down on the couch and watching, she got a few chuckles in as well).

Before I get onto my other joy, let me tell you about a few other TV programs that I have grown to enjoy: The Chaser's War on Everything (G4 on Wednesday evenings) is an Australian comedy-prank show that takes the whole concept of "what if" to a new level.  Speaking of pranks and what if scenarios, Howie Do It (some channel on some night) is a fairly garden-variety prank show that involves a little too much pimping of Howie Mandel, but nevertheless has some great scenarios.  Good for a little mindless entertainment is the food network show Chopped, which features four random chefs who have to make an appetizer including a bevy of "mystery ingredients" in 30 minutes.  At that point the chef with the weakest dish according to the standard three-judge panel is cut, leaving three to prepare a main entree and then two to prepare dessert.  Think of it as Mini Top Chef but without the cute hostess (unless Ted Allen happens to be your thing.  He's not mine).  I've also enjoyed the new TNT show Leverage, though admittedly I have four episodes piled up on my DVR.  It is kind of like Ocean's 11's little brother - not quite as good, but it makes the team because how can you turn down the star player's family member?  And in case you didn't know that I like American Idol, you will find out very well over the next couple of months as I share my humble opinions with you every week.

Anyway, now that I'm sick of typing, I come to the real joy.  TV is fun, but it can never replace the joy that my family brings to my life.  Watching these shows is fun, but would be nowhere near as fun if I didn't have my wife to watch them with me.  She is my best friend, and together we can pretty much turn any boring old TV show into our own mini Mystery Science Theatre 3000 with snarky comments flying at warp speed, and arguments about who should win really stupid competition shows like True Beauty (Seriously, have you seen True Beauty?  Why do we watch that juvenile, asinine, and ridiculous show?).  I'm blessed with a great marriage to a woman who appreciates my humor, tolerates my death farts (but just barely), gives me my space, but stays by my side, and, lest we forget, is totally hot.

Add to that my 22 month old, who is the most amazing source of laughter and happiness for me.  Every single day I am amazed by new things she has learned and new cute things that she does.  Tonight she was putting a blanket over her head and asking where she went.  Then, with the blanket still over her head, she said that she was "happy" and bouncing her head from side to side.  She is also a little jokester - more proof if I needed it that I'm the Daddy.  Granted, a one year old doesn't usually come up with screamingly funny humor, but she sure tries.  Tonight when I put her to bed I said "Goodnight" and she responded by saying "Goodnight Mommy," to which I always respond "I'm not Mommy."  Then she said, "Goodnight Gramma," seeing how far I would take it, so I blew her a kiss and left, only to hear as I closed the door, "I not Gramma!"  I think these stories probably fall in the "you'd have to be there" category, but just let this serve as your official warning that I'm breeding and infecting the world with more wannabe comedians.  But at least I'm infecting the world with dang cute wannabe comedians.

I love my youngest daughter, too, but she is still kind of in that eat drink cry poop phase and I don't have any particular stories that would make you go all melty.  Soon enough, though.

Anyway, there you have my life in a nutshell.  Work, sleep, family, TV, and baring my soul for you, faithful reader.

Who could ask for anything more?

Today's "Reason For Your Visit" - Body Parts Edition #1

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason(s) For Your Visit:

Right index finger
Left shoulder
Neck
Heart
Right Rib Cage
Shoulder
Ankle

And this is just a handful.  I understand that when you want to get seen, you don't want to spend a lot of time writing a novel, but perhaps you could at least specify what is wrong with said body parts.  Are they missing?  Infected?  Cut?  Broken?  Hurting?  Ugly?  Overweight?  Mildly gangrenous?  Is gangrenous even a word?  Does it really matter, after all, it is my blog and I can do whatever I want?  Should I have put a question mark at the end of that last question?  Does anyone care?

Sorry, got distracted.  Anyway, I particularly love the visit from the Tin Man thrown randomly in the middle of that list.  I suppose he probably went to his PCP, but found that he couldn't get in for several days, and since Dorothy was already coming to the ER to have her bunions looked at, he may as well see if we could finally and conclusively end his search.  Lion was going to come for moral support, but he just couldn't bring himself to do it, and I think scarecrow was found wandering aimlessly around in the diagnostic imaging department.  Let's just hope that the Wicked Witch of the West (please visit www.www.com) doesn't find out about the no-drinks-at-the-nurses'-station rule, because so far that is the only thing keeping her at bay.

Typos

No matter what I do, I always type a few words wrong when charting:

alle xtremities instead of all extremities
deneis instead of denies
teh instead of the

What words do your fingers not know how to type correctly?



Image Credit: typolover.com - found via google image search

ER as Primary Care Clinic

I had a long day of triage yesterday, and in true Friday the 13th fashion, had some weird ones.  There was the blood pressure of 201/102 (I'm sure there is a hidden message there, but unfortunately Tom Hanks was otherwise occupied and could not decipher it for me), the chronic back paineur-frequent-flier who suddenly decided that if he announced that he has numbness in his groin, he would get back faster, the chest pain who initially told me that the pain came with deep inspiration and coughing *thank you, back of the line for you, ma'am* and then when it comes her turn for triage, says, "no, the pain is constant and I haven't been sick lately, and I'm not coughing at all.  Oh, and it radiates to my left arm."  My BS alarm was working overtime, but when a patient says that, I have to at least order up an EKG and some blood tests.  I still wasn't about to bump another patient out of a bed for that one (incidentally, not only did the EKG come back NSR, but the social worker made a trip out to see me to let me know that this patient was on "the list" at 4 other hospitals for abuse of Emergency Services and had a list of psych problems longer than my left arm.  So long, in fact, that Happy would have told her to stop smoking.*

But what really got me was how many patients I saw that were sent by their doctors.  It was probably less than 10, but it felt like every other patient.  Some of them were pretty legit, like the possible sepsis, or the asthma exacerbation (although she was speaking in full sentences and was in no apparent distress, her lungs sounded very tight and wheezeful,** and she had only previously had asthma during pregnancy).

Then there was the parade of the others, like the RLQ pain that needed a workup for R/O appy FROM 5 DAYS AGO, the high blood pressure patient that got no workup other than a blood pressure check and a trip to the ER (Dear Doctor, perhaps if you had, I don't know, TALKED TO YOUR PATIENT, you may have discovered that he was out of his blood pressure medications.  I do believe that your medical license permits for you to write for BP med refills.  Signed, Me.), or these gems (from the patient's own "reason for your visit"):

Dr C#$%^ office told me to come in for my Chronic back pain
Referred from Primary PhisicioiN to E.R. (I don't remember the actual chief complaint, but I do remember it was unimpressive enough that I dumped her back in the waiting room)

Then this one made me laugh out loud:

DR A#$%# J#@$@ up and quit on his patients and I need my meds.

Not sure of the story behind that one, but he earned himself a trip to see the PA and get a couple days' worth of meds and a referral to a new PCP.

I'm also amazed at the number of patients sent in by their dentists for antibiotics.  The Dentists know that we cannot do anything more than give a handful of Vics and some penicillin.  I'll never understand why they can't have the patient come in to the office, sit in the chair for 1 minute to have their teeth glanced at, and then walk out with a prescription and an appointment for a week or two later.***

Finally, there was the direct admit patient who was told to come to the ER to be evaluated "in case there is something I missed."  I would comment on that one, but I don't swear.



* Incidentally, I'm actually on Happy's side in the stop smoking debate, but it is still fun to joke about because he takes it so seriously and Nurse K takes her exception to him so seriously in turn.  Calm down, children.
** made-up word for the day.
*** Okay, so I do understand it, and it is spelled M-E-D-I-C-A-R-E but it is still dumb.

I Survived Friday the Thirteenth

...and all I got was this lousy headache.

12 hours of triage with no backup is rough.

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Tachacardyla

Needless to say, I was quite surprised when I saw this one.  I'm sure you are consulting your reference books as we speak (okay, as I type and you read.  Okay, I typed this long before you read it, but you are ruining my point here with your nitpicking).  And yes, you are correct in your conclusion that the Tachacardyla did indeed go extinct in the late Jurassic Period.

Unfortunately my digital camera was broken and someone erased the security tape, so you are just going to have to believe me when I say I was there.  I saw it.  I will never be the same.

American Idol Top 36

So for all of you medical types that are just dying to know what it is that Braden thinks about the top 36 on American Idol, I say:

Tatiana?  Really?
Nathaniel?  Really?

Otherwise, I don't have too much beef with the contestants chosen, but still, even at the final 36 there were some contestants that we've never even seen before and others that we've only seen glimpses of.  What's wrong when I know Tatiana's bra size, but I've never heard of Ricky Braddy or Arianna Afsar or Jeanine Vailes?

So for what it is worth, from what I remember of the singers, my favorites so far are Anoop Desai, Danny Gokey, Stevie Wright, Anne Marie Boskovich, Brent Keith, Scott Macintyre, Matt Giraud and my wife says we liked Kai Kalama, but I don't remember him.  I seem to remember liking Felicia Barton, too.

But herein lies the problem:  Anoop, Danny, Stevie, Brent and Ann Marie are all together in the first week of competition, and they are only going to advance the top male, top female, and next top vote-getter, meaning that at some of my peeps aren't going to make it.  If I have to choose, I take Anoop, Danny, and Anne Marie.

In fact, that is my top five for the whole competition so far.  I hope the two that don't make it in round one will get through in the wild-card round.  Perhaps as I get to know the other contestants, I'll change my mind.

And for those of you keeping score at home, I find Nick Mitchell (Norman Gentle) funny and entertaining, and I don't mind him going to the top 36 to break up the monotony in a good way, but I hope he doesn't make the top 12.  I take my top 12 very seriously.

We now return you to your regularly scheduled ER blog.

I Scored 79 on the CIPC!

Yay!  I can move to Canada!

If you go to the Canadian Immigration Points Calculator, you can determine if you are eligible to move to Canada.  Good to know, just in case.

To get into the US, you only need to be able to swim and dodge bullets.

Shameless Baby Bragging Pictures

I don't often post pics of the family, but sometimes I can't help myself.

Here is the youngest all dressed up to go out last night (and apparently also ready to lecture at the local university):



And here she is in her bassinet, laughing at yet another great joke by Daddy:



And here is the older girl dressed up to go out (in our mess of an entry hall):



I don't know what I did to be blessed with the two cutest, sweetest kids in the country - I would say the world, but I hear that there is a really sweet kid in Zimbabwe - but somehow I got them.  Little one has grown into the most mellow baby ever.  She'll wake up and then just chill while looking around pondering the deeper meaning of the universe.  Older one is always surprising us with new words she is learning and she always says "please" and "thank you" and "excuse me," even when she is mad.  There is nothing cuter than an angry 20 month old saying "no thankee, Daddy."

My wife is hot, too, but she wont let me post a picture of her on my blog.  So in place of that, here is an approximation:



See what I mean?