meehawl

I started my rotation today doing an elective in UCSD’s Poison Control unit (”Toxicology”), which the Governator planned to eliminate to avoid increasing the car registration fees he slashed as part of his quid pro quo during the recall election. Anyway, discussion highlights today included poisonous box jellyfish, weird fish, when is a “spider bite” really a spider bite (”almost never”), and how dodgy is it to eat fish bought in the afternoon rather than the morning (”very”).

Tags: Arnold Schwarzenegger, California, medicine, poison, rotations, toxicology by mike
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El Paso County, eight hundred miles up the border, has essentially the same demographics … Yet in 2006 Medicare expenditures … in El Paso were $7,504 per enrollee—half as much as in McAllen … Between 2001 and 2005, critically ill Medicare patients received almost fifty per cent more specialist visits in McAllen than in El Paso, and were two-thirds more likely to see ten or more specialists in a six-month period. In 2005 and 2006, patients in McAllen received twenty per cent more abdominal ultrasounds, thirty per cent more bone-density studies, sixty per cent more stress tests with echocardiography, two hundred per cent more nerve-conduction studies to diagnose carpal-tunnel syndrome, and five hundred and fifty per cent more urine-flow studies to diagnose prostate troubles. They received one-fifth to two-thirds more gallbladder operations, knee replacements, breast biopsies, and bladder scopes. They also received two to three times as many pacemakers, implantable defibrillators, cardiac-bypass operations, carotid endarterectomies, and coronary-artery stents. And Medicare paid for five times as many home-nurse visits. The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine.

Tags: Atul Gawande, El Paso, McAllen, Medicare, Texas, The New Yorker, health care, health policy, medicine by mike
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Michael Jackson Dead - Tour Tickets Available!

NME never one to miss a sales opportunity.

Tags: Michael Jackson, NME, celebrity, fail by mike
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The AMA may be regressive when it comes to health care reform, but it does sometimes display an impressive ability to change. Or maybe not. At its annual meeting, the AMA voted to recommend white coats be banned in hospitals to prevent nosocomial infection spread. Then it decided to reconsider the recommendation (for anti-infection dress codes) until there’s more evidence they work. Or something. It’s as if scrubs didn’t exist. Shades of Semmelweis. It seems that sometimes scientific/clinical skepticism can lead people to disbelieve that improvement could really be that simple.

Tags: AMA, American Medical Association, Ignaz Semmelweis, hospitals, infection, medicine, sepsis, white coat by mike
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Buried on Page 31 of the [US Senate Finance Committee's policy reform document] was a proposal to “Modify the Requirements for Tax-Exempt Hospitals,” which would require nonprofit hospitals to maintain minimal levels of charitable activity, limit aggressive collections, and restrict charges to the uninsured and indigent. The proposed penalties for noncompliance are severe: Hospitals that can’t prove their “community benefit” will lose the tax benefits associated with nonprofit status … $93.5 billion in federal subsidies are provided every year in the form of tax breaks. But research shows that nonprofit hospitals behave no differently from for-profit ones.

Tags: charity, corporate welfare, health policy, hospitals, medicine by mike
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Most settlers take out long-term mortgages on units in multistory apartment buildings. Detached, single-family homes are hard to find in the densely populated settlements. Low-price rentals are often available directly from the state, sometimes for less than $150 per month … according to an Israeli report, many settlements were developed on land owned privately by Palestinians with neither compensation nor consent.

A young newlywed couple is walking to the bus stop: 21-year-old Aharon and his 19-year-old wife, Elisheva. They speak nearly perfect Hebrew despite having grown up in the United States and having settled permanently in Israel just a few months ago, after Aharon completed his army service in the ultra-Orthodox Nahal unit … The couple pay their rent, NIS 550 a month, to the settlement secretariat … Aharon doesn’t look upset when he hears that his trailer sits on private land. It doesn’t really interest him. “I don’t care what the state says, the Torah says that the entire Land of Israel is ours.”

Tags: Baruch Spiegel, Eretz Yisrael Hashlemah, Israel, Nahal, Palestine, colonisation, ha-Aretz ha-Muvtachat, occupation, settlement, ארץ ישראל השלמה, הארץ המובטחת by mike
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Tags: Ayers, Diamorphine, diacetylmorphine, heroin, medicine, morphine, paediatrics, pediatrics, pharmaceuticals by mike
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The Processor Technology SOL-20 came into my life when Darlene went out. … I simply type on the keyboard and the words appear on the screen … It is faster to type this way than with a normal typewriter, because you don’t need to stop at the end of the line for a carriage return … and you never come to the end of the page, because the material on the screen keeps sliding up to make room for each new line … My computer has a 48K memory … after allowing for the space that The Electric Pencil’s programming instructions occupy in the computer’s memory, the machine can handle documents 6,500 to 7,500 words long … I press another series of buttons and store what I have written on my disk drive … The system transfers data from the computer to the disk, or vice versa, at about 1,000 words per second, so it is no nuisance to pause after each fifteen or twenty minutes of writing to store what I’ve just done. Each of the disks in my system can hold about 100K of information … In addition to The Electric Pencil, I bought the software for a computer-programming language known as BASIC. The B in BASIC stands for Beginners (the full name is Beginners All-purpose Symbolic Instruction Code), but I have not yet found a mathematical project for which BASIC is inadequate … hoping for a world in which my sons can grow up to have a better computer than their father had.

Tags: 1980s, BASIC, Electric Pencil, James Fallows, PC, Processor Technology, SOL-20, The Atlantic, home computer, personal computer, word processing by mike
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Two men, one Christian and the other Muslim, commit murder just one day apart in the United States. Both appear to have been motivated by their religious beliefs. The Christian murderer is Scott Roeder and his victim is Dr. George Tiller, a physician from Wichita, KS who performed late term abortions. The Muslim murderer is Abdulhakim Mujahid Muhammad and his victims are Pvt. William Long and Pvt. Quinton Ezeagwula who were new U.S. Army recruiters … The Muslim murder suspect, Mr. Muhammad, is charged with terrorism along with first degree murder … the Christian murder suspect, Mr. Roeder, is not being charged with terrorism.

And of course, since this article was written, another Christian Terrorist (the acceptable term is “White Supremacist“) decided to go spree killing at a Holocaust memorial. Being out of power really seems to prompt the extremists to take extreme, direct action. Brand new, we’re retro.

Tags: Abdulhakim Mujahid Muhammad, George Tiller, Quinton Ezeagwula, Scott Roeder, US Army, USA, United States, William Long, terrorism, terrorist by mike
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A Kansas doctor who managed a late-term abortion clinic in Kansas was assassinated by a lone gunman while ushering at his local church. He had survived earlier bomb and multiple gunshot attempts.

Abortion doctor George Tiller is killed
Abortion Provider Shot Dead In Church
Abortion Doctor Shot to Death in Kansas Church

The terrorists willing to use violence and intimidation to constrain the reproductive options available to women were active in the 1980s and especially during the Clinton regime in the 1990s. They became relatively quiescent during the Bush II regime, possibly because they felt a lot of their goals were in concordance with official executive policy during that time. With the installation of a new regime now not as receptive to furthering their goals, I did suspect a probable re-escalation of violence by fringe elements. With the FBI currently almost completely distracted chasing Islamic targets, it’s going to be a weird few years.

Tags: George Tiller, Kansas, Scott Roeder, abortion, doctor murders, reproductive choice, terrorism, terrorist by mike
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