May 2012

There is a phrase that is used in EMS called ‘cookbook medicine.’ It means that the paramedic refers to and blindly applies written protocols or algorithms without thinking about what is really going on with the patient. Any patient who does not present with a problem in a textbook fashion is therefore not treated correctly. For example, a patient who complains of shortness of breath gets Albuterol and Atrovent, even if the patient is not experiencing bronchospasm. To call a paramedic a ‘cookbook medic’ is an insult, meaning that he or she is clueless, and simply following the protocol as if it were a cookbook.

This phenomenon is not limited to paramedics, and I have often taken medical providers to task for this way of practicing medicine. This is where we begin today’s post, and is also the reason behind the lack of posts over the past week and a half:

As regular readers of this blog know, in November I retired from my job as a fire medic so that I could move to Missouri and attend graduate school, so that I could become a physician assistant. We were taking seven classes in the first semester: Radiology, Anatomy (with cadaver dissection), Behavioral Medicine, Molecular Pathophysiology, Clinical Assessment, Physiology, and Problem Based Learning. There were problems within the first month.

Don’t get me wrong, my grades were good. I had an A in pathophysiology, a C in anatomy, and a B in the remainder of the courses. I will use several examples, but please understand that this is not a comprehensive list:

We were being taught to ask questions of the patient from a long list of questions, then we were to use software to search for diseases that match the abnormal responses in order to reach a diagnosis. Staff members would play the part of patients, and the students were literally reading questions right from their notes, without even knowing what they were asking. For example, a woman having epigastric pain radiating to her shoulder that is elicited by eating fatty food (obviously gall stones) was being asked about whether or not she had pertussis vaccinations as a child. I was not up for paying $50,000 to learn how to use WebMD.

Then there was the cluelessness of the faculty, one of whom insisted that all arrhythmia were caused by a malfunctioning SA node. I pointed out that AV blocks, VT, and AVNRT all occur in the presence of a normally functioning SA node. He told me I was wrong. I showed him evidence, including texts and studies. He still told me I was wrong. Another professor (who teaches cardiology) agreed with me. He still insisted that I was wrong.

Strike three was behavioral medicine. Our syllabus was a list of political topics, instead of medical ones and belonged in the poli sci department, not the medical. Here are some of the lectures we got:
Week 1: Using the musical arts in patient care: This was a guest lecturer that showed us how playing harp music would make patients happier
Week 2: “Stress, disease, and the AIDS pandemic” How Reagan and other white males are in a conspiracy to kill gays and discriminate against women. This is not an exaggeration. This is what the professor said.
Week 3: “Let me down easy” this was a video of a one woman play, a liberal look at healthcare and how unfair it is that the rich get better care
Week 4: “Domestic Violence: Vulnerable patients” This was a lecture on how men victimize women and children.
The class was separated into 6 groups, and each group was assigned a topic to research and present to the class as a lecture. Examples of the topics covered: Theories of personality development: male Hetero versus homosexual; Theories of personality development: Female hetero versus homosexual development; Working with and caring for lesbian, gay, bisexual and transgender patients.

So I decided that one semester was enough. I didn’t think that I was getting my money’s worth. I am back in Orlando, and I have some job interviews this week.

The cops here in Florida ignore the same laws that they enforce upon the rest of us. They (correctly) believe that they are above the law. The press here is on the case, and has been for months:
CBS news
Sun Sentinel part one, part two, part three
Miami area Blogs are on it
Orlando area blogs, as well

There are a lot of dishonest, criminal cops out there. I say criminal, because like a criminal gang, they engage in intimidation and retaliation when honest people come forward to make things right. An FDLE investigator recently concluded an investigation in a crash that killed 11 people on the Florida Turnpike, concluding that the Highway Patrolmen were at fault. The tires on his personal car were slashed at his home, and a copy of his report was left under his windshield wiper. It is obvious that this was done by cops, because the home address of law enforcement are kept secret from mere mortals, meaning that the only people who would have had access to this information are other cops.

Thin blue line, indeed.

So this group of people carries weapons, intimidates law enforcement and witnesses, engages in illegal acts, and takes millions of dollars from people. Sounds like a gang to me.

This is scary. You use your firearm in self defense, and not only do you have to defend yourself from the attack, and then defend yourself from the legal ramifications of the shooting, but you also must defend anything that you have ever done or said. This guy is having to defend a myspace page from when he was only 20 years old? Who among us could withstand that level of scrutiny?

What is really interesting here is the statement by Zimmerman’s attorney that “inviting public scrutiny of the contents of this social media account
invites scrutiny of the social media accounts of all parties involved,”which would seem to indicate that Travon Martin’s social media accounts will also be fair game, including the ones that indicate drug and gang activity.

In the comments here, Andy states that buying a $3,400 custom 1911 is less expensive than other hobbies like SCUBA. As a gunnie and as a master diver, I say that he is totally wrong. I added up what it would cost to get quality equipment and training, and tried to see how much I could get if I spent what I would buying a custom 1911.
Open water SCUBA class: $200

Mask, fins, booties, snorkel: $275

2 tanks: $350
Regulator set: $420
Octopus: $70
Dive computer with air integration: $600
Buoyancy compensator: $275
Total: $2,190
Of course, a new diver doesn’t usually buy equipment that is this good. A basic scuba setup can be had for about $1200, plus the $200 certification class.

The cost to actually shoot the gun, like the cost to dive, is extra. Ammo runs about $175 for 500 rounds.  So if you shoot 200 rounds every time you go to the range, and you go once a week, ammo would cost about $3600 a year.

Air fills cost about $3. Hiring a charter boat to take you out would cost $50 for half a day. For that same $3600 it costs to shoot 200 rounds a week for a year, you could go SCUBA diving on a charter boat every Saturday and still have $700 left over.

Sure, you could reload your ammo and make it cheaper, but I can buy my own compressor and do beach diving, and my dives become cheaper still.

I just can’t see spending over $3,000 for a special race gun. To each their own, I guess.