The O.G. Monster Peaces Out September 30, 2014Posted by therealtinlizzy in Uncategorized.
I was emailing Dr. Bongard about Dax’s latest visit to the ER a little over a week ago, likening Dax’s continued existence, particularly this past 4 months since she so brazenly turned away from death’s door back in June, with the quote we all know from The Princess Bride’s Dread Pirate Roberts: “Good night, Westley. Good work. Sleep well. I’ll most likely kill you in the morning” but then 3 years later Westley remains. Dax has been rather like that for a couple years now, but most especially for the past four months: she goes a bit sideways, we’re pretty sure she’s going to check out – then she’s fine and all “what?”, yowling at us with that improbable voice to feed her right now or she’s totally going to call Dax Protective Services on us.
After having been allowed the gift of an extended warranty on Dax this summer, her nine lives came to a close yesterday. I said my final goodbyes and held her in my lap as she peaced-out, the one I considered my ‘daemon’ as borrowed from Philip Pullman’s deft imaginings of the animal manifestation of one’s “deepest essence…attached…by an inevitable thread, like an externalised soul”: Dax, the ridiculously wily, opportunistic, independent husky-greyhound – whose species’ civility and domesticity cultivated by humans over some 30,000 years she lacked entirely having been nixed right the hell out of existence over a few generations of sled-dog breeding and whose name really should have been Loki for the litany of pranks and shenanigans she pulled off (and in some cases survived) over a span of nearly 15 years.
Claire Seekins gets an enormous hat tip of gratitude for talking us into taking that little bundle of never-let-your-guard-down-again home with us back in Feb of 2000 during a span when Angie Williams and I were helping Claire and co. train sled dogs. And for talking us into taking her BACK a few weeks later when Dax was so taxing to our sanity (and possessions) that we gave her back for a week before getting suckered by our sappy heartstrings to take her permanently.
However, while I’m heartbroken and maudlin as all hell stumbling today over the muscle memory and minutia associated with Dax’s existence woven so deeply into the fabric of my life for over 14 years, I leave here a few photos/vids and a top-ten of sorts, a prospectus if you will, of a few of the more glorious exploits of my dearest Monster of monsters Dax: Skijor Racer Extraordinaire, Masterful Killer of squirrels (and other things), Expert Purloiner of Anything Remotely Edible, Professional Destroyer of Things Non-edible:
- Eating a pan of lemon bars that were cooling on the stove (no really, she wrecked an entire pan of lemon bars, people)
- Devouring a bowl full of Hershey’s kisses during her first Christmas visit to my mum and dad’s
- Eating box-elder bugs by the mouthful:
- Ripping a hole in Angie’s grandmother’s quilt (which I later had repaired)
- Chewing the wooden handle off of the coffee table (which we replaced with a metal one)
- Being the most awesome runner, roller-blade and skijor companion (being part greyhound served her well on speed!)
- Shredding a patch of carpet & shredding a lamp (yes, a lamp) at one of Grand Superior Lodge’s cabins when we left her briefly alone to grab breakfast (oh yes, we paid replacement costs to GSP for carpet patch & lamp)
- being regularly mis-identified by the kids in the neighborhood as alternately a wolf or a coyote, and even once as a cat (no idea!)
- Leaving me for years with a parade of jackets and pants with the pockets chewed out due to presence of leftover treats (or the crumbs/remnants thereof)
- Shredding countless dog beds and stuffies over the years:
- Destroying one of the seatbelts in the back seat of the Jetta (required replacement)
- Chomping off the very first of (and eventually the rest of) the tulips that bloomed in the backyard after moving into the house
- Dispatching more squirrels over the years than we could tally (and one raccoon)
- Chomping a crow mid-air as it flew past her
- Receiving a permanent notch at the tip of her ear after getting to up close and personal with Angie’s cat
- An improbable, piercing, ear-splitting yowl that led Claire to overnight a bark collar when taking care of Dax for us one weekend eons ago
- Stealing the sock off of Sean & Andrea’s baby, while somehow not taking the toes with her (whew)
- Getting banned (by us) from the airport off-leash dog park when she was 1 due to refusing to leave with us. We spent about 2 hours chasing her around the dog park and eventually drove down the road to try and prompt her to leave. A couple of years later she eventually grew a thimbleful of loyalty/recall-willingness, and got her dog-park privileges reinstated.
Dax, you will be remembered, and are so incredibly missed – you were the best even though (and probably because) you were the worst.
(Un)comfort zone February 3, 2014Posted by therealtinlizzy in India, navel-gazing.
Ugh – one of the phrases that’s become eye-roll-inducing to me is “comfort zone.” It’s one of those irritating catch-phrases like “think outside the box” or “synergy” or “thought-leader,” and it’s used by everyone from bosses/workplaces to motivational speakers to TED-Talkers to instructors and beyond. I realize that American English speakers (myself included, sometimes to a criminal degree) lurrrrve to glom onto memes and catch phrases – it’s how we do. Not sure what/why it is exactly that some of them eventually become outmoded, and we collectively (or individually) kick them to the nearest curb (e.g., I might actually clobber you if you make use of the above examples un-ironically in my vicinity), but not others.
Anyway – “comfort zone” seems to have become the go-to and most er, comfortable phrase used to capture the very human tendency to habituate to sets of circumstances and cultural norms in which we eventually feel familiar and comfortable. Those looking to challenge or motivate someone(s) to look beyond their familiar ways and patterns often encourage their audience to “get outside of your comfort zone.” Perfectly valid concepts, to be sure. However, in addition to its over-use and having moved into the dreaded realm of catch-phrasery, another reason I find myself irked by “comfort zone” is that it inevitably (by my reckoning/experience anyway) applies primarily to privileged, white, middle-class people, and “getting out of your comfort zone” entails those folks stepping out of their comfy privileged, white, middle-class existence into circumstances that make them uncomfortable and challenge them – which usually means dealing with poverty, black/brown people, lack of resources, etc.
Granted, it wasn’t my fault or choice to grow up where/how I did (a privileged, white, middle-class kid in a fairly homogenous area surrounded mostly by other privileged, white, middle class people), and there’s nothing inherently wrong with pursuing a comfortable life – would be a little sociopathic perhaps to want to have a wretched, miserable life. But making “comfort zone” a smelly, problematic phrase, and the admonishing/encouraging to get out of it, necessarily implies privileged people having the luxury and opportunity of using someone else’s community/misfortune/culture as a means for growing some awareness or compassion, or (in some cases, as I’ve observed) just increasing one’s “thank God I live in the good ol’ USA [or suburbs or other comparatively snuggly location]!.”
I’m not picking a fight – it’s the way it goes being human: we often don’t comprehend or feel empathy/compassion for people or cultures or experiences different from our own unless/until we experience or learn directly about it. That was absolutely true of me earlier in my life, and continues to be (with hopefully a lot more humility and awareness than I possessed earlier in life). I think I’m just nit-picking presently over the point that when even legit “comfort zone” conversations arise (say when a group of mostly white, privileged undergrad liberal arts students is preparing to visit a developing country for a study abroad course) that we first deconstruct those underlying reasons for the familiarity and comfort we feel as people of privilege, and address the condescension, privilege and class-ism inherent in even talking about having “comfort zones” at all.
Sheesh – that was a long preamble prior to posting what I submitted for an assignment last week. We had to submit a post prior to traveling to Mysore centered on our notions about things we predicted might push us out of our comfort zone while there, and upon returning – a follow-up post on if/how our comfort zone ended up being challenged. So now that I’ve returned from the winding alleys of Why I Hate The Phrase “Comfort Zone” – here’s my actual (and ridiculously tl;dr) submission I figured I might as well post here🙂.
Cows and cars – the old and the new in India February 1, 2014Posted by therealtinlizzy in India.
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This post stems from one of our final assignments for the Global Future Physician course: a 250-word (at least) blog post centered on a single photo from our time in Mysore. Hey – I didn’t go entirely overboard, my submission was just a hair under 500-hundred, how’s that for some uncharacteristic brevity?🙂
My phone camera, while mostly adequate for providing a me reference for posterity, didn’t begin to effectively capture the dimension and vibrancy of the sights I viewed in and around Mysore. However, amid the clunky, blurry, badly-lit, and finger-in-frame photos I’ve found some surprising gems, like this one:
The photo above was taken on the final day of our three week sojourn in Mysore, along Sayyaji Rao Road and just outside of the Karnataka State Arts and Crafts Emporium, a few blocks down from the Devaraja Market. Not captured at that precise moment in the photo, beyond the parked autos in the background, was the deluge of buses, autos, bikes, motorbikes, and auto-rickshaws darting, bullying and honking past on their way into or out of the city center. While I became well-acclimated after three weeks to the ubiquitous free-range bovines present even in what seemed the unlikeliest of places, including urban palace grounds and improbably-trafficked chaotic intersections and roundabouts, I never lost my capacity for bemusement at the frequent and mostly unrestricted intermingling of (what I would normally consider) rural with the utterly urban. Hence, a goodly number of my photos capture cows, oxen, water buffalo and goats navigating traffic, trash, temples, and such. The cow in the above photo, dyed with what I understand to be manjalthanni (i.e. turmeric water) and managing a rather impressive, if unintentional, color-coordination with the parking barrier, is additionally illustrative of the practice of decorating cows and cattle for Sankranti, or the winter harvest festival, underway at the time.
This photo also embodies for me a theme I found recurrent in different ways, across a broad spectrum of lectures, site visits, observations and interactions during these three weeks: the juxtaposition in India of the traditional and the modern. Lectures on Hindu religious beliefs and Indian literary epics, as well as visits to numerous temples and sacred sites, demonstrated an India grounded in culture and tradition, while lectures on Indian medicine, healthcare, politics and economics, along with field trips to locations such as hospitals and local waste treatment facilities provided a glimpse into an India very much pursuing modernity. A number of our lecturers discussed different facets of Ayurvedic medicine (traditional Indian medicinal practices dating back two millennia), which many Indians use in complement with Western medicine. Other lectures asserted that while there remain some significant gender-based inequities, much of which is borne out of eons tradition and religion, Indians are by and large in favor of a broad range of family planning methods, considered to be rather modern by Western standards.
I can’t claim to have absorbed nearly enough in my three weeks in Mysore (nor do I perceive that 1.2 billion Indians are anything like a homogenous population) to speculate whether or not this coexistence of old and new is an easy, comfortable prospect for Indians. However, I did come away with an overall perception that not unlike the modern autos speeding and darting around, or sometimes having to yield entirely to, the cattle ambling ponderously through the streets (such as my yellow friend above), the Indians I had occasion to meet and observe, both rural and urban, seem to have established a sort of duality between contemporary pursuits and that which is very much traditional.
So about those rabies statistics… January 8, 2014Posted by therealtinlizzy in India.
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While we’re doing plenty of mucking about in 80/90+ degree sunny tropical weather (with apologies to the long-suffering Minnesotans back home), sight-seeing and sponging up volumes of info on Indian culture, history, medicine and healthcare while here for 3 weeks in Mysore, India, we’ve also been split into small groups and tasked with completing a group project which will be presented to our classmates, faculty, parents, sigs and whatever other strays show up that evening in February. Each group is at liberty to choose whatever topic suits them, although it’s generally assumed the topic will to be in some way, shape or form (however tangentially) related to medicine/health care, and it should be centered on some aspect of Mysore or India generally.
However, as has been particularly highlighted, bolded and underscored for us is the point that whatever our project/research/topic – it shouldn’t end up being something we could just basically phone-it-in on or complete by simply researching it entirely on the internets. We should be working to find and make use of local resources, eg the small army of physicians and SVYM staff at our disposal, the SVYM library, local residents, photos/vids/audio of experiences, interviews, etc.
My group’s project started out looking to explore the public health impacts of the out-sized feral/community dog populations (i.e. acting as rabies and tick/flea-carried disease vectors) and snakes/snakebites on city and rural communities in India. We’ve expanded that topic a wee bit (at least in this data-gathering stage while here in Mysore) to look at other negative public health impacts of human/animal interactions (elephants, jaguars, tigers, etc). However as I found today – the continuing progression/evolution of our group project, as well as the alleys and side ventures along the way, may end up being nearly as interesting as our topic(s) itself.
Our project took a turn for the investigative-journalism today when by happenstance Dr. Sumanth lecturing this morning about public health mentioned in passing the incidence of rabies cases annually in India as 221. That number surprised me, as the stats on the number of annual cases/deaths from rabies in India which our group has been discussing (acquired online from NIH, CDC & WHO’s websites, no less) was estimated to be consistently around 20,000 annually (or 0.2 lakhs, as I’ve learned).
Physics and fiction January 8, 2014Posted by therealtinlizzy in India.
Oy – found that so much was packed into the weekend that I needed some time to just savor it all, to let it percolate and kick around in my brain without diving straight to writing. Trying to get back in gear today in capturing some impressions from yesterday’s field trip, and there were so many – I could barely scribble them down fast enough.
Actually though, first thing’s first: I had the time of my life riding in the back of the van from Mysore to the Vivekananda Memorial Hospital (and back again). I found myself giggling like a ridiculous child on a roller-coaster every time the van bottomed out in a hole – tossing us around like rocks in a tumbler, or each time we passed (i.e. near-missed by improbable millimeters due to government by some local laws of physics entirely different than those which govern U.S. traffic) lumbering cows & oxen, trotting flocks of sheep, bounding goats, strolling adults, darting children, lurching buses, ambling bikes, or small trailers/rickshaws piled comically high & wide with straw (or some reasonable facsimile thereof) at 100km/hour. Seriously – people pay for rides like this at amusement parks.
This vid clip isn’t from yesterday, there would have been no way to capture vid without the pic being so jostled about that you would either be unable to see anything, or you would incur your own motion sickness by-proxy. This snippet is from our drive to visit Bhara Chukki Falls, via paved and mostly smooth roads; however it’s an ever so brief glimpse of what driving is like here. A few rules of thumb:
- everyone drives on the left, except when they don’t;
- the middle line is (or any lines are) superfluous;
- no speed limits (that are enforced) – everyone drives as fast as their particular vehicles go, or that road conditions allow for;
- everyone passes anyone at anytime, regardless of oncoming traffic;
- horns are used nearly constantly as a courtesy/heads-up: eg. “hey I’m going 100 km/hour and passing your flock of sheep on the right.”
Also note – the lower left of the windshield has a sticker with the number 60 on it, which reads: “60 km/hour is the electronically-controlled limit of this vehicle.” Ahahahahaha.
I’m incredibly grateful to the universe that I don’t suffer motion-sickness under such conditions as we traversed yesterday. Even more grateful that I’m able to read under such lurching conditions as the travel time allowed me to nearly finish one of the books I have on loan from the SVYM library. The book, “A Hundred Lamps,” is a collection of seven stories/excerpts “from the works of some of the best known authors of Hindi literature,” each story highlighting snapshots and facets from the lives of Indian physicians and medicine.
The stories touched on a number of topics and historical settings about which I’ve learned over the past week, including (most coincidentally to the fact that I only learned yesterday for the first time some history and background about India’s tribal peoples) a story about a small town/village called Dhingar Gaon which lay in proximity to a large tribal population. The story related the pending advent of a paper mill, slated to decimate the surrounding forests and displace the tribals, as had happened in other areas in the name of “progress.”
Each story varied in its time period and setting, allowing glimpses of India’s history, politics, culture and religion to be seen and understood in the context of characters and the narratives spun around them. While I’m a lover of non-fiction of all sorts too, this book captures why I love fiction – particularly historical and speculative fiction. It allows history, sociology, philosophy, and all manner of topics to be explored via narratives, making what can be otherwise dry topics more engaging and relate-able.
I set out to highlight some of my observations on our school and hospital visits yesterday, and look at the alley down which my reflecting has taken me. More on the visits themselves in another post!
For the love of a calf January 7, 2014Posted by therealtinlizzy in India.
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To be cross-filed under both “things I didn’t need to go to India to find/do” and “animals always trump anything/anyone/anytime anyway” is this befriending of an ox calf when we stopped to admire the view by the shores of a reservoir on the way to our last stop on yesterday’s field trip. Along the flats (not sure if they’re actual flats, not sure if I know what flats actually are – but I’ll call them flats), the local folks had their cattle and oxen pegged out to graze (I assume, hell do I know about local agriculture). This ox calf who was most near to us had a tree branch all caught up in its bridle (or, ropey head-harness thing).
We were advised while here most definitely to not touch/approach dogs due to their feral state (feralocity?) and on account of their being rabies vectors. I figured my risk for rabies-via-calf was low, and as our faculty grown-ups didn’t attempt to stop me, I approached said adorable snuggly calf and fished the branch out of its face/bridle. It was a bit jumpy/shy to start, but once the branch was removed, it was all friendly lovey-dovey (or possibly desirous of me merely as salt-lick?).
So, the answer to your inevitable question of whether I hiked all the way to India just to befriend a calf: a solid yes. My cousin on facebook asserted that clearly I should be pursuant of a career as a veterinarian rather than a physician. My response to that: it’s exactly because I’m a super weepy bleeding heart hippie over animals that I couldn’t deal with being a veterinarian. But serve as doc for humans? Somehow I find that prospect utterly palatable and doable.🙂
Of lectures, palaces, temples and trash January 3, 2014Posted by therealtinlizzy in India.
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My postings have been few and far between this past year, but for the next few weeks while I’m traipsing around southern India, this is going to be mainly a travel/documenting/lecture-logue. Not terribly interesting for the wider world, but a useful means for me to capture, sift & sort some of my comings/goings and thoughts thereof. </disclaimer>
Today’s morning class/lecture/discussion started with our daily debrief from 8:45-9:45 where we have the opp to reflect as a group on the previous days lectures & activities, questions, issues, etc. Today’s debrief session was broken into small groups, mine led by Dr. Susan Pleasants, one of the two U of M faculty (along with Dr. Mike Wootten) heading up this earnest rabble of future-physician wannabees (myself included). Our debrief conversations covered a variety of topics from yesterday’s lectures on corruption in India and food security presented by Dr. Balu. After our 10:00 tea break (daily breaks in lectures at 10:00am and 4:00pm for chai tea and biscuits), we settled in for a lecture from Dr. R S Rajan (who, in addition to being a retired cardio-thoracic surgeon, is also a retired brigadier general in the Indian navy) providing an overview of the Indian healthcare system.
Among much other new knowledge sponged up from the lecture, I was pleased to gain from Dr. Rajan’s lecture further insight into Ayurvedic medicine, as well as clarification on what I’ve been able to learn so far about it. He described briefly the origins of Ayurvedic medicine and how it became, and continues to be, the holistic approach it is for treating the health of an individual in the context of their life and specific circumstances.
Dr. Rajan asserted that while Ayurvedic medicine is not useful for addressing emergent/acute or surgically-needful conditions (eg. appendicitis, bone breaks), and that although most Ayurvedic treatments haven’t been scientifically assessed for their efficacy, it can be (although not always is) practiced in line with the principle of “primum non nocere”or “first, do no harm.” Dr. Rajan shared one instance where an Ayurvedic remedy has been found to be clinically effective. The Ayurvedic remedy for high blood pressure Rauwolfia serpentina (aka Indian snake root) was found to contain the compound reserpine, and in the 1950s was shown to be effective in managing high blood pressure and in synthetic form remains in use today.
After class and then lunch (all super tasty vegetarian meals here at the Swami Vivekananda Youth Movement hostel!), we headed out for a field trip to visit Mysore Palace and the Chamundeshwari Temple.
Canis indianis? December 31, 2013Posted by therealtinlizzy in India.
It’s 2:30 on Monday afternoon where I’m at here in Mysore, India, (hey wait no it WAS 2:30 pm on Monday when I started this post, then due to circumstances and classes and misbehaving internets it is now actually 1 hour into 2014!) for a three week study abroad course through the University of Minnesota. (I time traveled 11 & 1/2 hours into the future in the process of getting here; also too, who knew there were time zones of half hours? I did not!)
If you know me, you probably aren’t all that surprised that one of the first things I took note/care of in making my way in/through my new surroundings were the populations of free-range dogs. The view out the bus windows during the middle-of-the-night ride from Bangalore to Mysore showed a landscape scarce of humans but frequented by stray/feral canines. My initial impulse on seeing these canines so apparently abandoned and disconnected from the direct human contact, companionship and intervention that I’m used to States-side was to feel downright troubled, concerned, earnest, bleeding-heart and more than a little judgmental along the lines of “wtf – why don’t they do something about this – it’s dismal, callous and cruel to just leave dogs to fend for themselves and bereft of human companionship?”)
Exploration of the area around the hostel this morning also revealed an abundance of alternately lounging and meandering, tongue-lolling feral dogs.
As I’ve had the opportunity so far to observe them singly, in pairs, in small packs, interacting with each other or just existing as part of the landscape, it occurs to me they actually seem rather self-sufficient and generally getting along quite well being semi-estranged from humans; they certainly don’t seem sad-panda at not being, er, lapdogs. In fact, the canines I’ve observed, including two I just watched trotting through the adjacent lot, overall seem well content with each others’ company and minding their own business.
There’s obviously much more to this issue than a quick cursory “oh good – they seem fine and happy, so all is well, my conscience is off the hook”, and certainly more to consider in terms of overall good/benefit (or lack thereof) to the health and well-being of humans and dogs in having such roving bands of feral canines be the norm in heavily populated ares. However, it does give me at least initially pause to consider caution in knee-jerk projecting my American sensibilities of human/canine relationships onto this area & culture.
Tumbling onto the scene in southern India, particularly in a learning opportunity like this, prompts all sorts of ponderings and observations, which indeed are legion in my neural muck presently. But go figure that my first thoughts go to the animals.
Happy New Year from the other side of the globe.🙂
Annual Outing to the British Arrow Awards December 15, 2013Posted by therealtinlizzy in Uncategorized.
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Tonight was our (we figured roughly 8th or 9th?) annual outing to see the British Television Advertising Awards, or British Arrow Awards as they’re now dubbed, at the Walker Art Center. I can’t recall by this point how I stumbled into/onto the BAAs in the first place; I suspect it was simply a random thing happened upon while casting about for some bit of entertainment for my birthday one year. In any case, the BAAs are now an annual thing for Ang, Jen, Lisa and I, so that no matter how busy the holiday season gets or how lives shift about, the intent is to always be able to at least slot in some quality catching up over dinner and the Awards.
The Awards themselves are an hour of award-winning (according to some UK jury of People Who Judge These Sorts of Things) ads run on British television. A number of the ads are quite frank and edgy, in some cases gut-punching, and inclusive of content much more provocative than anything that would be shown in the U.S, including ads addressing:
- the importance of reporting child abuse
- potential impacts of closing a women’s shelter
- how the UK National Lottery apparently helps to support veterans. Seriously, people – I’m not even British and I don’t engage in lotterying, yet I’m utterly compelled to find some way to play the UK National Lottery due to being emotionally obliterated by this 2 minute spot centered on the memories of a Vietnam War veteran.
- “Excuses” for texting-while-driving. I’m all for throwing these sorts of scared-straight PSAs at Americans, but sadly no – Americans have far too delicate of sensibilities to be subject to such frank unpleasantries
- I’ll cautiously and with copious amounts of OMG-TRIGGER-WARNING/WATCH-AT-YOUR-OWN-RISK-FOR-PTSD/FUUUUCK-HUMANS-SUCK-SO-HARD disclaimers for an ad showing the horrid practice of shark-fin harvesting/poaching against which my eyelids snapped shut faster than my fingers autopilot to flip the channel on a Sarah McLachlan-serenaded ASPCA ad. I grant them an A+ for effect, but see also prior entry re: delicate-American-sensibilities
Happily – here are two friendly unicorn chaser ads, which I’ll kindly embed for your convenience:
- Sheep dog herding pub dudes:
And then there are those ads which serve as perfect studies in compare/contrast varying degrees of clever, amusing, creative with dim, derp, lowest-common-denominator:
- Example of the former
- Example of the latter (there were actually like 6 or so variations on this dim-witted, race-to-the-bottom theme, all of which inexplicably won awards)
See what Durex did there: woo-sex-is-teh-awesome CAN co-exist with a cheeky sense of humor WHILE not insulting half of the human species! See what Axe did there: chicks are teh dumb AND it’s-hard-out-there-for-a-dudebro-amirite. And while there’s plenty of the lowest-common-denom dim derp dudebros to keep Axe making bank long after my sexytime lady bits retire to an old folks home, it would be nice if there weren’t so many of them (dim-derps, not ladybits) dishing out Arrow Awards or curating ads into the shorted compilation of the Arrow Awards the Walker shows.
Other points of interest, honorable mentions or bits-to-be-mocked:
- Divinely-handsome Hugh Jackman getting slapped repeatedly, by possibly everyone on the planet including your mom
- An ad which succeeds quite ably in convincing me that Land Rover owners/drivers are utter douchcanoes
- A touching ad that takes you down the garden path, British style
- To be filed under “Shots to the Nuts Are Pretty Much Never Not Funny”
- A sappy-yet-endearing bit devoting most of its time to drenching and soggifying its subjects while doing a bang-up job of making me want to go buy a loaf of wheat bread
- And the award for “Seriously Man, You Realize It’s 2013 and You Don’t Have to Eat Bricked Food Right?!” goes to an advert for Weetabix
All in all a pleasant way to share an evening with friends, even with emotional roller-coaster/PTSD-inducing ads.
The Stab Room September 5, 2013Posted by therealtinlizzy in future physician.
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I mentioned in a post awhile back that I took up being a volunteer minion for a few shifts/month at HCMC in the emergency dep’t. Having been there over a year now, I was given the opportunity back in May to train as recorder/scribe for the stabilization room, to which of course I said yes please.
The stabilization room (referred to by staff as the “stab room”, pronounced stabe) is HCMC’s trauma/critical care area – a secured/closed off area of the emergency dep’t. I haven’t yet ascertained all of the minimum level of criticality factors that triggers a visit to the stab room. Certain circumstances are no-brainers for being stab cases: a car crash victim, biker hit by a car, heart attack victim, patient found unresponsive, possible stroke victim, etc. However there are plenty of bloodied up, in-bad-straits folks who come into the ED via ambulance who don’t merit stab-room attention and are instead placed in one of the team center rooms (referred to as “cubes” by the staff, I suppose because the rooms are square-ish glass-doored rooms stacked one next to the other).
As an aside, anyone who’s ever been to a doc knows how klunky or unintelligible medical vernacular can be. Certainly medical lingo can serve a useful purpose when time is of the essence and strings of conditions, procedures and medication jargon can be whittled down to a more expeditious short-hand. To quote Danielle Ofri in What Doctors Feel on the language of medicine:
“A typical first line of hospital admission might read 82 WM w/PMH of CAD, CVA, MIx2, s/p 3V-CABG, c/o CP, SOB 2 wks PTA. BIBA s/p LOC. No F/C/N/V/D.”
I’ll spare you the verbose version of what that translates to, but suffice to say 309 chars shortened to 75 in the zippy pace of an emergency department can be a handy time saver for docs and staff across multiple patients over minutes, hours, days.
But I’ve also noticed some hospital vernacular that isn’t particularly shortened or efficient, it seems just needlessly not-how-real-humans-communicate. In HCMC, each of the separate care areas of the ED are referred to as “team centers.” As per above, obviously inside-baseball medical jargon is needful as a means for med professionals to communicate with one another. However, when it comes to the interface between medical-side folk and patients, it seems there would be some forethought to humanizing some details. Say, for example, when a name is chosen for a place where patients are cared for and where patients and families need to navigate to/from and all of the rooms & hallways look alike to those not familiar with the layout of the ED area. The designation “Team Center” might well refer to a collection of offices or conference rooms or a break area. I mean – one knows what those words mean, but nothing about “Team Center X” implies anything human-relatable in a healthcare or hospital setting. Might as well call them Sponch Zones (“Sponch” is the actual awesome name of a friend’s cat) or something equally meaningless.
Anyway, back to the stab-room. While the whole large room is an open-plan area, it’s partitioned into four areas, or “bays,” which can be curtained off from one another as needed. While each bay is equipped to treat most any cases that come in, each is geared slightly differently: one for trauma cases (accident victims, shootings, etc), one for medical cases (heart attacks, stroke, etc), one for pediatric cases, and the fourth for burn cases.
Most often there are med students on duty for any given shift who record as part of their learning/training, but when there aren’t any available or on duty, the red shirts like m’self get to record. And even if there’s a med student recording, I’m able to stay and simply observe the case.
Stab room recording entails scribing anything/everything medically relevant about a particular case from the time the patient comes through the stab room doors until they’re sent off for scans or to another dep’t (or declared deceased). When the EMS folks roll in with a patient, they rattle off all known info on the case or their encounter thereof, all of which has to be captured. This includes any/all of the following that is known (and there are times when much isn’t known): how the patient was found, who found them, all known circumstances of the incident/accident, meds or procedures administered by the EMTs, vitals, blood glucose levels, level of responsiveness, pupil reaction, etc. In the first minute or two the recorder needs to capture this flurry of info while the docs, nurses and HCAs get to work on the patient. From there on out, vitals (blood pressure, heart-rate, respiration rate, and oxygen level) are to be logged at least every 3 minutes, along with each occurrence of a procedure or admin of meds.
When there are no stab cases to record or observe (which is most of the time during any given shift), I just do the usual volunteer minion tasks and rounds. Incoming EMS interfaces with someone at the main desk in Team Center A to call in the impending arrival and a summons to the stab room occurs via overhead page, e.g.: “stab room personnel to the stab room, 6 minutes out, trauma.” This triggers all of the docs, nurses, PharmD and HCAs scattered among the 3 team centers designated as stab room staff to convene. Good on them for going with non-obfuscated verbiage for the pages.😉
Arriving in the stab room I grab a clip board and paperwork and stand by for any further info EMS has sent ahead, find out from the stab room nurse (truly the Knower of All Things) and scribble down who’s the resident, attending doc, nurses (so many people, so many names to learn) for the case, along with any info already known.
On one particular occasion, all we knew about the case coming in was the type of trauma suffered, and that EMS was administering resuscitation attempts en route. There was a med student to record, so I just stood off out of the way to observe. When I observe, I take the opportunity to scribble notes on meds/procedures I don’t understand so I can look things up later (bless the internets). Sometimes there’s an opp to ask one of the med students or staff at the time, and sometime’s the time to just scribble notes to look up later (if I’m actually recording o’course I always ask).
Anyway, I watched the nurses unpack a bag of equipment I didn’t recognize, so I looked for any brand name or lettering that I could look up later. There was a flat but curved chunky sturdy piece of plastic that I guessed would go under a patient’s torso that had the letters “LUCAS” on it. Separate was a clunky mechanical device with curved “arms” and a plunger-like protrusion. What I soon observed was that the pieces together are a device which automatically administers chest compressions to a patient:
Within a few minutes the EMS came through the doors wheeling in the unresponsive patient, who at first glance appeared to be self-administering chest compressions with the EMS’s LUCAS device. The patient’s wrists were fastened to the sides of the device (to keep the torso/body geometry in optimum position for effective compressions? Or perhaps just to keep the arms of an unresponsive patient from just hanging about?) in a manner which moves the arms along with the compressing motion of the device, creating the queer illusion that the patient is self-administering the compressions. Having not known that such a device existed, and knowing that EMS was administering resuscitation efforts en route, I guess I had no reason to expect anything other than that one of the EMTs would be atop the patient still administering chest compressions when they wheeled the patient in. Makes me wonder how long those LUCASes have been in use in the field. Bet the internets would tell me that too.
Here’s a vid that provides a demo of the LUCAS, pretty cool actually:
I’ll keep it to those generalities on what sorts of cases I have the privilege of observing/recording in the stab room, being very cautious to stay on the correct/appropriate side of privacy and propriety. But suffice to say, it’s an order of magnitude more of a learning experience being in the stab room versus just the usual volunteer duties. It’s nice actually to be able to get to do both, as I do still enjoy being a regular red-shirt in the ED: stepping briefly into folks’ varying degrees of upset or just really-bad-day to contribute a smidge of not-suck, even if just for the moment or few I interact with them. But having the opportunity to see trauma care as it happens, and a practical context for learning terminology, procedures, methods, interactions, medications in a practical = really awesome.