Assembly Line Medicine

Or alternatively titled: Why I Don’t Watch TV.

Nearly every medical show irritates the piss out of me. That’s why I can’t watch those shows.

Chicago Med doesn’t appear to have any nurses- the doctors do everything.
I saw one show where there was a car accident near the hospital and the doctors ran down the street to the scene, snatched the extrication tools from the firefighters’ hands, and extricated the patient from the car.

This is how it works-

  • the patient comes in and is triaged by the nursing triage team.
  • The patient is taken to an ED bed. The nurse assigned to that bed conducts the initial assessment and orders some basic tests, and maybe even a few medications.
  • The doctor reviews the patient’s chart and orders some additional tests and more medicine.
  • Then we wait for the results if testing and imaging
  • More medications are ordered and the patient is either admitted or discharged

The doctor may appear to see the patient at any point in this process, or may not. There are times when the patient may not even see the doctor until hours after they arrived. It doesn’t mean that the provider isn’t evaluating you- it means that some maladies don’t require him to physically be in the room for most of it.

Not so on TV. On television, the doctors are waiting outside for the ambulance, then they run into the ED with the patient, frantically shouting orders. People see this, and when they come into the hospital are shocked and angered that it doesn’t work like that.

I get at least one patient each day who asks: “So when is the doctor going to come see me? I’ve been waiting for an hour.” In reality, the doctor and I have been in constant contact, you have an IV, blood has been drawn, a CT scan was ordered and done, you have received three or four medications, and we are awaiting the results of all of that testing. It’s remarkably efficient, fast, and maximizes the wise use of everyone’s time.

Even shows about EMS and firefighters is nothing close to reality. I once watched a show where a paramedic needed to deliver a shock to a patient in cardiac arrest, but the patient was lying in a puddle of water. He then placed the paddles on the patient’s chest (paddles are largely a relic of the past) did a handstand on those paddles to get out of the water, and shocked the patient.

I can’t tell you how many times someone has said to me: “Why aren’t you doing X? It always works on Greys Anatomy/Chicago Fire/Rescue 911.” People watch this stuff and think that it’s a documentary.

The few times that my wife tried to get me to watch shows that cover topics in which I have some knowledge, I spent the entire time rolling my eyes and making comments. She doesn’t watch them while I am around any more.

The only thing that all of those shows get right is that there are tons of people who work together that are having romantic affairs. Every hospital seems to have a doctor or two who enjoys diddling the nursing staff, and there are plenty of young nurses fresh out of school who think that they are going to bag themselves a doctor husband, not realizing that they are the fourth or fifth nurse he has bedded this year.

At this point, I just assume that every show on TV is BS. Then there are the people who Google their symptoms or malady and want to know why we aren’t doing what Google recommends, but that is another topic entirely.

Your Truth

Joe brings up a great issue. The left refuses to admit that not everyone has the same opinion as they do. You didn’t vote for Kamala because you are a racist misogynist, not because leftist policies suck. I tried to explain to some people why I voted against Florida’s amendment that would have legalized marijuana. I told them that I voted against it because it only permitted people with licenses to sell, distribute, and grow marijuana, and because it would have meant smelling that nasty shit everywhere. Had they made it legal for anyone to grow it, and mandated that only edibles could be used in public places, I would have voted yes.

Instead of listening to me, they called me names, with ‘boomer’ being the least offensive. They don’t understand that the way to convince someone to give you their vote doesn’t include threats and name calling.

There is a truth in many things, and there are opinions. One needs to be able to tell the difference. Sometimes, “Agree to disagree” is not a viable option.

I refuse to “agree to disagree.” That is stupid. Suppose I came out and said that men should be able to freely rape women, or we should be able to own slaves. Would liberals still want to “agree to disagree?” When someone says that to me, it comes across as some smarmy, superior attitude that basically says “I am smarter than you, and I am your better, but since you, with your obviously inferior intellect cannot see reason and agree with me, I will simply smile at you, and tell you that you have a right to your opinion, you simpleton.”

I won’t “agree to disagree,” because “agree to disagree” is an incredibly lazy tactic. It ranks up there with “everyone is entitled to their own opinion” among dishonest and self-defeating statements made in lieu of actual argument.

The argument could be useful, I suppose, if it meant no more than what it says – mutual recognition of a disagreement on a matter of opinion. Some arguments are intractable – issues of personal taste or the subjective importance of certain values cannot be resolved empirically. In an argument like that, once both sides have expressed themselves as clearly as possible, if there is still no agreement then there is nothing left to do but acknowledge there is a disagreement, and leave it at that.

That is not, however, the sense in which I most often hear the phrase “agree to disagree” used. What is usually meant is “we’re both equally right, both equally wrong.” It is an arch-liberal dodge, invoking the most ludicrous type of relativistic equivocation. If I am holding a flamethrower and you are holding a lit match, it is true that we can both start fires, but pretending that we can just “agree to disagree” about which is better suited to the task of lighting a candle is nonsense.

Two positions, one demonstrably true and the other based on nothing more than feelings, do not share the same level of validity. If we can agree on some basic definitions like “true” and “evidence”, and if we can agree that it is important to have true beliefs rather than false ones, then we can and should examine different ideas. While it might be nice to pretend that this kind of dispute is simply a difference of opinion, it most certainly is not. I refuse to pretend that a poorly-argued position, based on straw men refutations of legitimate questions, holds sufficient validity to be granted any more respect than belief in aliens or the Loch Ness monster. Examples include:

  • Women don’t have, and never have had, penises.
  • If a man truly has a belief that he is a woman, or a woman believes that she is really a man, that person is delusional.
  • Adults shouldn’t be discussing sexual matters with children. Even adolescents are iffy in most cases.
  • Taking one person’s money to give to another isn’t charity- it’s theft.
  • One person’s rights end where another person’s rights begin.

When a person claims that they wish to “agree to disagree” is really saying is, “I want you to agree that my position has just as much merit as yours”, and I am certainly not interested in engaging in masquerading a clear true/false dichotomy as a simple difference of perspective. Truth is not established easily, and that’s a good thing. In a universe where an infinite number of explanations for a given phenomenon are conceivable, we must scrutinize and test to see which ideas are worth keeping and which can be discarded safely. “Agreeing to disagree” is simply asking to lump the good ideas in with the fanciful or debunked ones in some misguided sense of fairness.

Some things are simply so repugnant, and so against freedom and decency that I cannot agree to disagree. The point here is that we live in society that claims to value freedom. There are always those who would abuse those freedoms and hurt others. I won’t play that game, nor will I vote for someone who does.

To the left- that is why I voted the way that I did.


That is also why I don’t have a strong opinion on abortion. The matter of opinion in that debate, where I am concerned, is “when exactly does life begin?” There are good arguments to be made on both sides, and there is no real empirical way to settle that debate (at least not at this point). There is a point, however, when no one can argue that the fetus isn’t a living child. The child has a heartbeat, a functioning nervous and digestive system, and is a fully formed person capable of survival on its own. At that point, abortion is murder unless it is to prevent death or serious injury to the mother (in other words, it becomes a form of self defense).

I also think that this isn’t a Federal issue, not being one of the enumerated powers of the Federal government, so it is up to each state and its voters to determine.

Inside Job

More and more evidence is pointing to J6 being an inside job. If it turns out that the FBI can be proven to have been the driving force behind the events on J6, the only rational response is to eliminate the entire agency and fire every single one of its agents. Take off and nuke it from orbit, it’s the only way to be sure.

We are in the middle of watching segments of our government try to overthrow the legitimate powers that be in order to institute a dictatorial police state. I have been saying this for nearly five years.

It’s Good to be the King

Here is President Biden’s statement on the pardon he issued for his son.

You hear that? The President of the United States, who at the time was a Democrat, says that gun laws are not being enforced. Lying on a 4473 is not a real crime, according to the left.

What If

I have always maintained that using the military to hunt terrorists is not an efficient way of using government resources. We should instead use letters of marque or reprisal. Imagine if Congress had simply issued a letter of reprisal, offering a reward of $1 Billion for anyone who brings Osama bin Laden into American custody to stand trial, or $700 million if they bring in his dead body. His own followers would have brought him in within a month, or in the alternative, a dozen private companies would have competed for the prize.

We would have saved trillions of dollars and nearly a million lives.

This Week in the ED

Holiday weekends are always outliers in the emergency department, and coupled with the cooler temperatures and rain that we had, Thanksgiving was even more so. We weren’t busy, with our census hovering at around 60%. We didn’t get a lot of patients, but the ones we got were sick. In other words, we were a true emergency department and not just a free clinic for welfare queens, homeless bums, drug addicts, and illegal immigrants.

My shift was cancelled on Thanksgiving day because there were only 40 patients in a unit with the capacity of over 100. My wife and I had not made dinner plans because I was supposed to be working. We discussed having a freezer pizza, then decided to go out. All of the restaurants in the area were either closed or full, so we wound up driving to Orlando and eating at Maggiano’s. It was amazing.

I actually worked on Friday. A man came in complaining of flank pain. He had a history of kidney stones, so that’s what I worked him up for. It turns out that it wasn’t stones- when his CT scan came back, he was riddled with cancer.

Another man came in came in complaining of shortness of breath that we diagnosed with lung cancer.

At one point, we had a brief rush of patients during the 90 minutes that we were briefly understaffed. The morning nurses had gone home, and the ones scheduled for the afternoon hadn’t come in yet. I was covering 5 rooms for that period, and I was OK with that because three of them were empty. Then a line of ambulances came in to give me an asthmatic, a hip fracture, and a woman with a blood sugar of over 500. While that was going on, a woman flagged me down to unhook her father from telemetry so he could use the bathroom. He wasn’t my patient and I was quite busy, but it only takes a minute. I unhooked him and started to leave, and she stopped me to say, “He doesn’t walk well. I need you to walk him over there.”

I replied that I was too busy to do so and left to go see my patients, so she began yelling at me while following me across the department. I told her that she could walk him to the bathroom if she wanted to. It was at that point that she began yelling even louder and started telling me that I am a dick. She then said, “I am going to go get the doctor and tell him what an ass you are. I hope you get fired.”

My response was to call security. I told security to remove her to the lobby until she learns to control herself and act like an adult. Her husband chimed in at this point, saying “That’s my wife. She’s just worried about her father.” Security asked me if I wanted the husband removed as well, and I replied with: “No, he isn’t interfering with my patient care, just her.”

She ran over to one of the ED doctors and began complaining. The joke is on her. Doctors don’t run the hospital, nurses do. People think that because doctors write prescriptions and orders for patient care, that doctors are in charge, but that isn’t how hospitals work.

Anyhow, my charge nurse had to get involved at this point. He pulled me into the medication room and asked me what happened, then agreed with me that her following me around the ED was interfering with my care of my patients. They decided to teach me a lesson by having the father sign out of the hospital against medical advice. All because I was too busy taking care of sick people to be her personal butler. I guess she showed me.

On top of that, I had a patient with COVID, two with RSV, and the funniest one of all. A woman had gotten in a physical altercation with her roommate, and it was so funny I had to leave the room to keep from laughing. It went like this:

  • Doctor: “So why are you here today?”
  • Patient: “I got in a fight.”
  • Dr: “How did that happen?”
  • Pt: “My roommate locked me out of my room and said I wasn’t allowed back in because my pussy is too hairy, so I punched her in the face. She hit me in the face with the remote control, said ‘Merry fucking Christmas,’ then hit me in the face with a fruit basket. I fell and bit her on the toes, and that is how two of my teeth came out.”

It was at that point that I had to leave the room to keep from laughing.

That was my holiday weekend. Now to resume normal blogging…

Nope, not now, not ever.

As you all know, I have been off on vacation for the past few weeks. We went to the Bahamas, then were back for a couple of days before leaving for 5 days to Myrtle Beach. While we were there, I went on a pilgrimage to Palmetto State Armory. I made a few small purchases and wound up $500 poorer as I left. (no firearms, of course) I did see some things there that have me ideas for my next build.

We stayed at a Hilton, and they were posted as not allowing any firearms, which has been Hilton’s policy forever. They don’t allow anyone, even off duty police, to carry. They are hypocritical assholes, because they make exceptions to their “no firearms” policy thusly:

  • Sworn federal, state or local law enforcement officers while on official business and, when off duty, are required to carry weapons in the jurisdiction by statute, ordinance or rule,
  • an exception otherwise made by a Regional Senior Vice President.
  • Insured and/or bonded armored car service employees under contract either to the hotel or to certain hotel guests
  • Airline flight crew members authorized by federal law who have current and valid credentials issued by the Department of Homeland Security/TSA as Federal Flight Deck Officers (“FFDOs”).

The Hilton family owns firearms and has 24/7 armed bodyguard protection. Well, I can’t afford armed bodyguards, so fuck them. I don’t give a shit. Concealed means concealed.

There were numerous businesses around Myrtle Beach that were posted, and signs have the force of law in SC, but again, I don’t care. If I get shot or robbed, those businesses aren’t going to pay for my medical bills, so fuck them.

I am done being nice.

While we are on the subject of being nice, the left is now demanding that the right play nice and play bipartisan games while trying to unite the country. No sale. For the past 8 years, I have been called racist, NAZI, misogynist, deplorable, uneducated, and ignorant. The left censored me and others with my views from social media, threatened to put me in a camp, locked me in my home for months, threatened to put me in jail, and said they wanted me dead. They tried to deplatform me, as well as trying to contact my employer to get me fired. At the same time, the left is saying that they don’t want to associate with members of their own families who didn’t vote like they did. For crying out loud, they have been KILLING people. Let’s not forget all that we have been through since 2015. Remember this shit?

I am not playing nice. As far as I am concerned, I am at war with the left. Sure, I haven’t yet gotten to the point of lethal means of combat, but I am fighting this war with everything that I have short of lethal force. I am not going to be nice, nor am I interested in being united with them. You said that you are my enemy and that you want me dead or in a camp. There is no reconciliation from that.