A tale of two surgeons

Sometimes, as an anesthesiologist, I start to feel a little under-appreciated. Many times, you get addressed as "hey anesthesia" because the person addressing you can't or won't remember your name. Now, I know that there a quite a few of us (residents) in our program and we rotate a great deal, but it's a little disappointing when you've worked with one surgeon almost exclusively for a month straight and they can't seem to call you by name. Maybe that's why I like OB anesthesia so much. I always get thanked when I put in an epidural - by the labor nurse, the patient, even the OB doc sometimes.

So I present to you about two surgeons I have worked with in the OR. Guess which one I like working with better.

Surgeon A is an orthopedic surgeon. He works at a busy hospital. I'm pretty sure he know my name. I know that his PA does. As is common for orthopedic cases, there are often drug reps in the room, who have been known to buy lunch. Usually I'm invited. One day, the surgeon decided he wanted some coffee. He asked his PA, the ortho resident, the circulating nurse, the scrub tech and the ortho med student what they wanted in their coffee. He did this while the case was going on and while I was in the room. Did he ask if I wanted coffee? No. Did I want coffee? No. But that's not the point. The point was how crappy that made me feel, he asked everyone in the room but me. That showed me where I stood on his respect-o-meter.

Surgeon B is also an orthopedic surgeon, but at a different hospital. The very first time I worked with him, he asked me my name. When he needs something, the table height adjusted, the patient re-positioned, etc, he asks me to do it by name. When the case is over all people in the room: residents, nurses, scrub techs, and yes, me. It shows me (and everyone else in the room) respect.

All anybody wants from their colleagues is respect. And nothing is more frustrating than being treated as a non-entity. Consider this a suggestion to all you budding surgeons, be more like Surgeon B and less like Surgeon A.

Lockport Memorial Needs Your Help

Who needs a year's supply of spam or a lousy copy of the home game? Lockport Memorial is trying to win:


an MRI!!!!!


Go to this link, view the video for Lockport Memorial, and vote for it. You only have to view the video once to vote. After that, you can vote every day.

Siemens will be giving a brand new MRI machine to the hospital with the most votes. Do your part.

And keep an eye out for the dude with the crystal ball.

Random Appearance of Dorkdom

I'm very glad my students can't hear what goes on in my mind.

Just a few minutes ago, I was walking across my classroom, absent-mindedly playing with my dry erase markers. As I was holding 2 of them, I suddenly found myself holding them like this:




Suddenly, in my mind came blaring:




Boy, do I need sleep.

LOL

This is one of the funniest internet videos I've seen in a while.




Hat Tip: Tiggers don't Jump .

Local for the Sake of Local

One of the earliest advances of civilized society is that of division of labor. It's not possible for everyone to make everything they need. Some, therefore, do some things and others do others.

There is a more important advantage to division of labor - concentration of skill. People who are good at something are free to do a lot of it. People who are lousy at it can just do something else. You can even concentrate people who are good at something together for the sake of efficiency.

"Support Local Business" is a good guideline, but shouldn't be a suicide pact. I love to give local Mom & Pop places a try. If they want to keep my business, however, they need to offer me a better product, or a better price, or a better selection, better service, more convenience or some sort of other real advantage. We go to Valint's for meat, for example, because they offer great price, selection, and quality.

In some cases, however, places use their "local" status as a crutch. Take for example, one of the many annoyances of the hellish year I spent in what passes for a History Department at the University of Buffalo. There were a large number of professors who refused to order their textbooks through the bookstore. They instead used a local shop called "Talking Leaves." This place has prices which made the bookstore look like the dollar store, and a selection of books which ranged from hippie to Stalinist in their subject matter.

What was worse, moreover, was that they were in a lousy location with no parking. I remember watching one graduate student, who walked with a cane, take the bus from UB North to South Campus, hobble across a busy street, and then go down several blocks of broken sidewalk just to get a textbook. Absolutely ridiculous.

There were rumors that the professors were receiving kickbacks from this place. They openly voiced disdain for large chain bookstores. But guess what? The large chain stores offered much better prices, selection, convenience, etc.

There is a long-running cliché about large stores coming into areas and "forcing" the mom and pop places out of business.

Buffalo Bagels.

Mom and pop places that offer value in one form or another stay in business. Those who don't, quite frankly, deserve to die. This is what's known to economists as redistribution of resources to more productive sectors of the economy.

Buffalo in particular is home to a large number of home-grown chains. We have a number of places which have grown due to their great quality, and can now be found everywhere. Ted's Hot Dogs, Anderson's Roast Beef and Frozen Custard, and to a smaller extent La Nova, Bagel Jay's, and several other places have thrived due to the quality of what they offer.

PIzza is the classic example. I cannot recall the name of the particular tome, but about 10 years ago someone was compiling a national guidebook. This guidebook was designed to give a general idea about various places around the nation. In their research, they decided that Buffalo was not a big pizza town. Apparently they were looking at national pizza chains.

As far as pizza chains go: Pizza Hut and Domino's have a few sporadic locations, none of which are within the city limits. There was a single Little Caesar's up until about 10 years ago. Papa John's does not exist. Sbarro's finally made it from Thruway rest stops to mall food courts about 5 years ago. If there are any other national pizza chains, I have never heard of them.

Meanwhile, the pizza section of the phone book is 10 pages long. Even in the most rural parts of Erie County, you are never more than a mile away from a mom & pop pizza place. National chains can't survive because they suck.

This is to say nothing about wings. At the risk of repeating myself: Buffalo Wings do not exist. If you're in Buffalo, you do not call them Buffalo Wings. If you're outside of Buffalo, you don't know how to make them.

Other chains have garnered niches despite the quality. Spot Coffee, for example, used to be our hangout when we were in college. In those days their Delaware & Chippewa location was open 24 hrs. I still remember the look of shock we all had the first time we ever saw it closed. At that time it was closed for renovations.

It eventually went downhill. The coffee was never very good. It was the same charcoal-masquerading-as-"dark-roast" crap which every high price coffee shop sells. What sold it was the atmosphere. That atmosphere changed, but it still has a large enough following to maintain a few locations. It also supplies coffee to a number of other local establishments, including Bagel Jays.

Now, we come to what inspired this rant. I should start by saying that there's no way this particular chain could have gotten as large as it is if there were not a large number of people who were happy with their food. ES1 & I simply happen to not be a part of that group.

I refer, as you may have guessed, to Mighty Taco.

Mighty Taco has a rabid following around these parts. There are Mighties everywhere. I could personally never understand why. Today, I gave it another shot. ES1 likes having a selection of chicken or vegetarian foods. This selection is limited at Mighty. Their beef, moreover, just tastes strange. It's really closer to chunky grease than beef. What's worse, I ordered my Taco hot. I didn't realize they used the Albany version of the Scoville Scale.*

Granted, my experience is limited. I have, however, been thoroughly unimpressed every time I've tried it. We actually prefer Taco Bell. We find the selection and taste to be far superior. Mighty may be a nice local company, but we just don't like their product. Mighty has survived just fine without our business for many years. I'm sure they will continue to do so.

Supporting local places is a good idea if they're worth supporting. If your local mom & pop shop gives you a reason to come in and spend money, then by all means do so. Business, however, is not charity. Don't go somewhere because "you should support local places." If they're a good place, they'll give you a reason to come in. If you don't feel compelled to come in and spend money, don't waste your time. If someone can't compete, they need to find a different line of work. No economy can afford to be swamped with people and companies who just aren't very good at what they do. That's just not good for anyone.






*There are many levels of hot. There is standard American hot. Above that is Buffalo hot. Above that is Indian hot. Above that is real Indian hot. Our friend Caitlyn best described what would be "Super Ultra Mega Unbelievably Hot" in Albany as "almost mild, but not quite as spicy."[back]

Memories please

Taken from blackfelicula

"If you read this, if your eyes are passing over this right now, even if we don't speak often, please post a comment with a memory of you and me. It can be anything you want -- good or bad. When you're finished, post this little paragraph on your blog and be surprised (or mortified) about what people remember about you."

Just for fun.

The Proper Use of a Rubber Chicken

Continuing the Monty Python theme of today, I would like to discuss the proper usage of a rubber chicken.

There was a running gag in Monty Python's Flying Circus in which a knight in a suit of armor would end a sketch by using a rubber chicken to slap someone who was asking for it for one reason or another.* We shall return to the usefulness of this practice later.

It is a sad irony that too many in our society wish to end childhood and innocence at far too early an age, while simultaneously extending adolescence well into chronological adulthood.

Part of childhood and innocence is the fun that comes from holidays. As an adult, you realize the true meaning of Christmas or Easter, or whatever. As a child, holidays mean fun, joy, and wonder.

The fall has always been my favorite time of the year. Apart from the crisp weather, fresh apples, football, bright colors of trees, etc. there are holidays. First comes Halloween, then Thanksgiving, then Christmas. You get one fun holiday after another.

Allow me to quote here C.S. Lewis, from his 1952 text "On Three Ways of Writing for Children":

Critics who treat adult as a term of approval, instead of as a merely descriptive term, cannot be adult themselves. To be concerned about being grown up, to admire the grown up because it is grown up, to blush at the suspicion of being childish; these things are the marks of childhood and adolescence. And in childhood and adolescence they are, in moderation, healthy symptoms. Young things ought to want to grow. But to carry on into middle life or even into early manhood this concern about being adult is a mark of really arrested development. When I was ten, I read fairy tales in secret and would have been ashamed if I had been found doing so. Now that I am fifty I read them openly. When I became a man I put away childish things, including the fear of childishness and the desire to be very grown up.

In other words, to fear childhood is a trait of adolescence, not adulthood. As is the idea of taking oneself too seriously.

It is such people that the knight generally made his target. I hereby propose that this rubber chicken be used to smack any and all who seek to take any of the childish wonder and, more importantly, the fun out of any holiday.

This knight would be busiest around Christmas, of course. On one side are those who think God hates Santa Claus. On the other side are legions of professionally offended people. Not only do they get offended at the idea of someone openly celebrating a holiday that others don't, but for some reason they think that we should give a rat's backside what offends them. To them, I can only reiterate:




But more and more, it seems that the knight would be busy around halloween.

Here we have 2 stories. One is from Chicopee, MA. The other is from Des Moines, IA. Both involve nooses. Both also involve people applying their own biases & neuroses to others, expecting them to care.

The first, involves a Wiccan who is offended by a decoration of a witch on a noose. Wicca, as a religion, was first popularized in 1954 and dates back perhaps to the 1920s. It is based on folklore and guesswork about pre-christian rituals and beliefs. Some of the elements involved are essentially centuries-old pop culture. There appear to be some wiccans who think that they own everything they reference as part of their own tradition.

The idea of witchcraft spans pretty much every culture on the planet going back millennia. Not everything is about you. An ancestor of mine was burned at the stake for witchcraft sometime in the 19th century.** I'm not offended. This woman makes other wiccans, most of whom are simply decent hardworking folk like any other people of faith, look stupid. TFSU and go away. Cue the knight.

The other involves a zombie type thing on a noose. The hangman's knot is centuries old. It far predates the horrors and violence inflicted during the era of lynching. It's primary use was for execution by hanging. To some, however, it is seen as being a racial symbol. Much like the hoax about "picnic" being a racist term, this is nothing more than a ridiculous distraction. A confabulation of perceived offense which attacks the innocent, and drives attention away from real problems. There are real racial problems in this country. A zombie on a rope isn't one of them. Calling completely non-racial things "racist," however, is. Cue the knight.

Indeed, it seems the knight with the with the chicken is going to be very busy. Between Anthony Bourdain and all the people over the age of 5 who wear crocs in public, it seems he just can't get a break. This holiday season is going to be a busy one for him.

So help him out. Get a rubber chicken of your own. The next time someone gets offended by your holiday celebration, you know what to do.




* There is some controversy as to whether it was a rubber chicken, stuffed chicken, or real chicken. It differed from the standard rubber chicken in that it had feathers. [back]


Edited 12:52 PM for clarity and grammar

**I can neither confirm nor deny the accuracy of the charges leveled against her.[back]

Light Bløgging Apøløgy

Mynd you, møøse bites Kan be pretty nasti

This is an apology for our light blogging. My work schedule has been crazy, ES1's has been crazy, and we now have someone else who also requires attention. We'll try to rectify with a little more blogging today.

To those who won't accept our apology, I can only say:

Fun Meme

Self-tagged from Ambulance Driver . (I forgot to give him a hotel tango on the last post as well).

WHAT ARE YOUR NAMES?

1. YOUR ROCK STAR NAME: (first pet & current car)
Sweetums Grand Cherokee

2.YOUR GANGSTA NAME: (fave ice cream flavor, favorite cookie)
Chocolate Peanut Butter Oreo

3. YOUR “FLY Guy/Girl” NAME: (first initial of first name, first three letters of your last name)
NGot

4. YOUR DETECTIVE NAME: (favorite color, favorite animal)
Purple Shark

5. YOUR SOAP OPERA NAME: (middle name, city where you were born)
Marie Cheektowaga

6. YOUR STAR WARS NAME: (first 3 letters of your last name, first 2 letters of your first)
Gotni

7. SUPERHERO NAME: (”The” + 2nd favorite color, favorite drink)
Red Martini

8. NASCAR NAME: (the first names of your grandfathers)
Carmen Carlo

9. STRIPPER NAME: ( the name of your favorite perfume/cologne/scent, favorite candy)
Lucky Heath

10.WITNESS PROTECTION NAME: (mother’s & father’s middle names )
Anna Carmen

11. TV WEATHER ANCHOR NAME: (Your 5th grade teacher’s last name, a major city that starts with the same letter)
Madden Mobile

12. SPY NAME: (your favorite season/holiday, flower)
Winter Iris

13. CARTOON NAME: (favorite fruit, article of clothing you’re wearing right now + "ie" or "y")
Pear Jeansie

14. HIPPY NAME: (What you ate for breakfast, your favorite tree)
Omelet Blue Spruce

15. YOUR ROCKSTAR TOUR NAME: (”The” + Your fave hobby/craft, fave weather element + “Tour”)
The Singing Lightning Tour.

I hereby tag anyone who wants to participate.

Fun Stuff

NameThatDisease.com - Test your disease knowledge


NameThatSerialKiller.com - Test your serial killer knowledge


Am-I-Dumb.com - Intelligence Test

The Researchers Who Cried Wolf.

In order to prove causation, you need to run an experiment. If you do not manipulate the groups yourselves, you cannot, by definition, prove anything.

This is the reason why, for example, cigarettes have never been proven to cause cancer. You would have to force a group of people to smoke and compare their cancer rates to your control. Since this would be considered unethical since everyone assumes causation anyway, no such study has ever been done.

Strong links have been demonstrated again and again. The evidence is heavy enough that most people realize it's a good idea to stay away from them. But unless you can manipulate the groups yourself, you cannot eliminate other factors, and you cannot say that the cancer is because of the cigarettes. Basic research 101.

Apparently, the researchers at Roswell Park Cancer Institute were able to finish medical school while never having taken a basic research methods or statistics class. In this story over at WBEN, they cite an 8% drop in heart attack rates since 1993, and conclude it must be because of restrictions placed on smoking since then.

This would be nice if they actually gave any evidence of this whatsoever. It is a classic fallacy to assume that since 2 things happened at the same time they must be related.

Was the smoking ban the only health related item to occur in the last 14 years? Was there no research or awareness of cholesterol or nutrition? Was there no research on any other method of preventing heart attacks?

No! Obviously, it must be the smoking.

Wait a minute! I left Middle School in 1993. Was that the cause? The World Wide Web was born in 1993! Was that the cause? 1993 was the last time Montreal won the Stanley Cup! Was that the cause?

If the researchers can be so sloppy with the basics when it fits their worldview, how can we expect them to be competent with more complex items? Assumed causation makes frauds like Erin Brokovitch rich while her clients received squat. Assumed causation made charlatans like Rachel Carson into environmental heroes while millions died in her wake.

Correlation cannot prove causation. Simultaneous occurrences do not show correlation. What we have in this story is speculation masquerading as scientific discovery.

The doctors at Roswell Park should know better. If they have evidence that the drop in heart attacks was in any way related to smoking restrictions, they should come out with it. If they're simply going to make assumptions based on anything that fits their belief, they have no business in research. Or, they could go work for the UN which is famous for performing scientific studies that say one thing and then claiming they said the exact opposite.

All too often are people willing to make public policy choices based on the shabbiest evidence. With this many frauds being touted as truth, is it any wonder that people question every supposed danger that comes down the pike? Every false panic weakens the effect of real danger warnings. If you've got evidence, show it. If you're so scared that you need to vilify anyone who questions your work, then just TFSU and go away.