Shoe Money Tonight

Occasional ramblings by an anesthesiologist/mother (and sometimes her husband).

Wednesday, August 29, 2007

Musings on Inappropriate Behavior

I've been thinking a lot about inappropriate behavior at work, especially in light of a few incidents that have recently (in the last few months) cropped up in my presence. One was based on the behavior of nurses and the other the attitude of an Ob/Gyn attending physician.

The first incident basically amounted to a series of comments made by a nurse about a patient and the patients family after the patient was asleep. It was a young man having a circumcision at later than the usual age in this country. She assumed it was the decision for the procedure was made for cosmetic reasons and then went on a rant against the parents for not doing it sooner. She proceeded to talk about how gross it was to see an uncircumcised penis, and how any parent who doesn't circumcise their son should go look at the 80 year olds at the local VA to see how nasty and infected they can get. When reminded that many Europeans don't, she then made a comment about European's lack of bathing. Maybe I'm a little sensitive, because I've had experience with the other side of the coin, if you know what I mean, but I found her whole attitude inappropriate.

But that's nothing compared to this story.

Female, middle aged coming in for a gyenocologic procedure. A resident noticed the "refused" box is checked with regard to blood products. In a conversation with the pt, she reveals that she is studying to become a Jehovah's Witness and as a result does not want blood products. The attending is informed and proceeds to spend the next 10 minutes lecturing the patient, saying things like "we'll only use blood as a last resort" and eventually browbeating her into changing her decision. I was watching this incident and couldn't help but notice the look on the patient's face. I have no doubt she acquiesced out of fear and pressure from her doctor. Now the argument could be made that the patient was not fully rooted in her beliefs and that's why she changed her mind, but watching the behavior of that attending, I would also not be surprised if the patient was implying that the surgery would be cancelled if the patient did not change her mind. Frankly I was appalled at the attending surgeon's behavior. The odds of the patient actually requiring a transfusion were incredibly low and the discussion was almost unnecessary. It was almost as though the attending wanted what they wanted at all costs. As far as I remember from my ethics classes, a patient has a right to refuse any treatment. And, unless I have a question about their competence I have to respect their wished. Now I might have asked the patient if they were sure about their decision, but what galled me about this is the length of time the attending spent pressuring the patient to change her mind.

Any thoughts?

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Sunday, August 26, 2007

Further Diocesan Incompetence

Well, my days of not taking Bishop Kmiec seriously are certainly coming to a middle.

Fresh off my complaints about the Bishop's obfuscations and fabrications regarding the "Journey of Faith & Grace," comes another story which demonstrates that the Bishop has once again blundered his most basic obligations to the community.

I make no bones about the fact that the overwhelming majority of people in the church, and on the staff of Catholic schools are dedicated, hardworking, good people. Mathematically speaking, the numbers of bad apples in the bunch amount to little more than a rounding error.

When you do have a bad apple, however, it is just that much more important that you get rid of them. In a public school, you would have to deal with union issues*. In a private school, Catholic or otherwise, you can eliminate teachers as you see fit.

If one wheel on your car falls off, you can argue about how well the other three are performing until you're blue in the face; your car is still heading for the ditch. Likewise, it does no good to argue how great the majority of your teachers are if you don't deal with the ones that are putting your students at risk.

Witness, for example, the debacle at Buffalo Seminary a short while ago. A teacher was caught in the parking lot of the Walden Galleria mall. The school claimed that they had no inkling about this teacher. In the immortal words of Col. Sherman T. Potter: Buffalo Bagels. I know for a fact that they were warned about this guy by another teacher in 1996! The leadership at that school failed in their basic duty to protect students, then feigned innocence. As a result, I invoke the Klingon punishment for treason - no member of my family will even consider attending that school for 3 generations. I will also tell this story to anyone who even considers sending a daughter there.

Now the diocese itself has a scandal. The scandal is not that the incident happened. The scandal is in how the Diocese handled it; or rather how they did everything they could not to handle it.

A computer teacher and class f-3 dirtbag couldn't keep his hand of the girls in the middle school in which he taught. The incidents stemmed back to as early as Fall of 2002. The complaints were swept under the rug. The principal laughed off complaints by other teachers. The Diocese, which had just enacted a supposedly tough new policy on such things, failed to act according to their own policy.

What makes this most egregious is that the Bishop couldn't even be bothered to talk to the father himself. Instead, he sent his lawyers.

What we have is a Bishop who claims to be for openness and transparency, but again and again operates in the shadows and lashes out at anyone who dares to question his actions.

If even half these allegation are true, there need to be some serious consequences.

Patricia Muscatello, the principal, should be given precisely 2 minutes to clear out her desk, and then be escorted out by security, and handed over to the DA as an accessory. Never again should she set foot in any school.

The Bishop has once again proven that he cannot be trusted, and has again done serious damage to the credibility of the Diocese. Diocesan leadership is in desperate need of a wholesale cleanup. Kmiec, Keenan, and probably a whole host of others need to be gone yesterday.

*Indeed, my major problem with teacher's unions in general, and mine is no exception, is that they fail to make a distinction between protecting a good, or inexperienced, teacher from railroading and blocking the removal of a bad one. Back to top

Update 8/27/07: Included link to story in Buffalo News. Also, as ES1 pointed out, the principal has, in fact, resigned, though she claims that this incident had nothing to do with it.

Thursday, August 16, 2007

Interesting for so many reasons

As I was scanning the news headlines online I came across this article. I found it interesting for a number of reasons.

First, the woman had identical quadruplets. They were conceived without fertility drugs. To have a multiple birth and have it not be related to fertility treatments is a feat in and of itself.

However its another part that I find most interesting. The headline states "Canadian Woman Gives Birth to Rare Identical Triplets." That's not the interesting part. What I find most interesting is that she gave birth to these children in Montana . Why did she come to Montana? This is a quote from the article:

"The Jepps drove 325 miles (523 kilometers) to Great Falls for the births because hospitals in Calgary were at capacity"

As someone living in a border city, this is not so odd to me as it seems. More than once I've been called to put an epidural in on a woman transferred from Canada due to a lack of beds. More recently, the local newspaper profiled a Canadian man who came her for treatment of a brain tumor. This is the story in brief:

The man had a seizure about one year ago. Rather than wait the 4 months for an MRI, he came to Buffalo for the scan (after having the trip arranged by a company out of Vancouver that specializes in arranging medical treatment in the states for people willing and able to pay for it). It showed the presence of a tumor that was likely malignant. So he went back to Canada with those results, only to find out that it would be three months before he could have a biopsy performed. So he came back to Buffalo and had the biopsy done (and the tumor removed) one month after the MRI. Now he's facing huge bills because he didn't get pre-authorization for the treatment. He felt it wasn't worth bothering to spend the months waiting for that to happen.

It is stories like these, especially that of the Jepps, that make me concerned about the idea of a nationalized system for health care, especially proposals modeled off Canada and Great Britian. Canada's rationing of health care is so great that they have to send pregnant women out of the country to give birth because there aren't enough "beds" in the province to treat them.

I have the sinking feeling that if we tried a national or universal health care system we would find that it put up more barriers to healthcare, rather than increasing access.

I have blogged about this before. Please see my earlier post here .

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Too cute

I saw this video linked off Fat Doctor .

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Wednesday, August 15, 2007

New Levels of Media Incompetence

This photo is all over the blogosphere right now.

The caption says that this woman claims these bullets were fired at her house.

Yes, people are actually that mind-numbingly, ground-poundingly, mouth-breathingly, "believing-that-searing-meat-actually-seals-in-moisture"-ingly stoopid.

People actually believed this.

People expected other people to believe this.

People are so convinced of the evils of the United States that they are willing to believe that a woman's home was pierced by two bullets which are still inside the casing and are in pristine condition.

This is not a question of lack of firearms training. ES1 has never seen a firearm except in the holster of a police officer, and she knew immediately what was wrong. Anyone with the most basic knowledge of how self-contained rounds work would immediately know what was going on. Hell - anyone with a basic knowledge of chemistry and physics knows that fire will burn things, and flying through walls will scratch them.

Between this, or the Red Cross Ambulance fraud, or the Reuters doctored photo scandal, is it any wonder that people don't trust reporters? After all, if they are duped by the obvious, if it happens to fit their narrative, how do we expect them to treat news which doesn't fit their worldview?

Answer: They don't. With the exception of a handful, like Michael Yon, reporters pretty much ignore the stories of our own, while swallowing the proverbial buffalo bagels of the enemy wholesale.

Update: An analysis by Confederate Yankee shows that the rounds aren't even military. They're civilian. I wouldn't expect anyone without the expertise in this area to recognize the difference, but it does show that there wasn't even a shred of truth in the original photo. (Updated 8/17/07)

Monday, August 13, 2007

No Confidence

Consider this my official declaration of no confidence in the Bishop of Buffalo, Edward Kmiec.

Last January, ES1 discussed her depression over the demise of our parish, St. Rose of Lima in this post. It was depressing, but inevitable. The local population is being driven out by high taxes and red tape. With fewer people, the diocese cannot support as many churches. There are 2 large churches which both lie a stone's throw away from St. Rose. St. Rose is a small parish. It's only logical that we would be on the chopping block.

If we had just been told that, we would have been able to accept it. We can handle the truth. The diocese, however, thinks otherwise.

We were told that the parish wasn't bringing in enough money. During the last Catholic Charities drive before the closing of the school, our donations dwarfed those of parishes 2 or 3 times our size. Our new pastor, who had refused to move into the rectory until it was repainted, announced that the parish was broke. He began a sermon by saying "We have only $8 in our checking account." What he neglected to mention is that there was plenty of money in the savings account. He simply hadn't bothered to make a transfer.

The most egregious deception, however, occurred at a school board meeting, approximately 1 week before the announcement of the closing of the school.

We know people who were on the schoolboard at St. Rose. At the meeting, they were spoken to by Kevin Keenan, the Director of Communications, and official diocesan spokesman. They were told that no decision would be made about their school until the end of the next school year. They had plenty of time.

The next week, we were told that we would be closing.

Never has there been any word from the diocese explaining their discrepancy. The diocese said that the parishes which were closing were doing so because of their own failures.

The Diocese of Buffalo deliberately lied to its parishioners, then attempted to cover themselves by deceiving the public.

Now, we have a new story.

According to WBEN, our local radio news station, there was a heated exchange between Bishop Kmiec and Bill Parks. Mr. Parks is the chairman of a group which is attempting to stop church closings. Both sides agree that there was a heated discussion. Parks alleges that Bishop Kmiec lost his temper and began to pummel him in the chest.

I do not know Mr. Parks. I was not present at the event. I generally give clergy the benefit of the doubt. Bishop Kmiec, however, has long since worn out any benefits I may have given him.

Nobody disagrees that there are too many churches for our current population. We need to close some of them. The logical candidates, of course, are the smaller ones.

What I object to is the deliberate obfuscation and deception by this diocese.

The overwhelming majority of priests I have encountered, especially Jesuits, are dedicated, hard working, wonderful men of God.

It has been known for years that the Catholic Church has had difficulty recruiting new priests. The greatest damage has not been the fact that they are stretched thin. The greatest damage is the fact that they have been forced to retain a few incompetents.

The priest who was sent to St. Rose would never be tolerated in a more vibrant parish. What the short-sighted diocese has failed to realize is that if you treat people this poorly, you will drive them away from the church. In an age in which you are having difficulty filling the pews, you cannot afford to have any but the best in the pulpit, even if that requires fewer pulpits.

People will cram into pews like sardines if they know the man at the altar is a man of faith and wisdom who will do everything in his power to bring you closer to God. People these days, however, are just too gorram busy to waste an hour listening to a self-righteous person who is only trying to cover his own backside.

This could have been an exercise in the Church coming together to deal with the harsh realities of today, while focusing on what is truly important. Instead, the diocese's "Journey of Faith and Grace" has been shrouded in secrecy and falsehoods. They refuse to answer questions. The Bishop then becomes violent towards those who confront him. The conclusion many will draw is that he could not win on the merit of his arguments.

Enough is enough. Our trust has been violated too many times. Our intelligence has been insulted too many times. The fact that a man has earned the title of "Father" does not mean he can treat parishioners like infants.

My faith in God, Jesus, and the Church as an institution is strong. My faith in our local leadership is gone. I cannot believe anything that comes out of the mouths of Edward Kmiec, or Kevin Keenan. This is an untenable situation.

The Catholics of Western New York deserve transparency. They deserve to be told the truth. They deserve to know the whole story of what is going on.

This diocese deserves better leadership. The time has come for a new Bishop and a thorough housecleaning.

Update: The diocese claims that Mr. Parks was looking for a confrontation, despite the fact that there is a photo of him and the bishop being friendly. At this point, if Kevin Keenan told me my face was on fire, I wouldn't believe it until I looked in a mirror.

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Friday, August 03, 2007

Of Mice, Men, & Chili Chefs

Our family has been going to the same butcher for 2 generations.* One of the great things they make are some really nice single serving chicken pot pies.

The secret, you see, to becoming a good cook, is to always have a backup. You don't have to be afraid to experiment if there's a backup plan. That way, if something goes wrong with your experiment, you're not going to starve. When you can let go of your fear, then you can (try to) reach for greatness.

For example, you can decide that you want to improve your chili skills. You can decide that since every one of his recipes you have tried so far have been successful, why not try Alton Brown's recipe for Pressure Cooker Chili, from his landmark episode The Big Chili.

Now, you can decide that since you don't have a pressure cooker, you can instead use the modification of making it in a dutch oven, then placing it in a 350ยบ oven for 6 - 8 hours.

You see, since you have a backup, it doesn't matter if you make a mistake. Even if you put the lid on wrong, so that the steam vent is open during baking, you still will have food.

So when you open up the lid to check on your chili and find it looking like this:

[click for a larger display of the glorious badness]

you will still be able to have a nice yummy dinner waiting for you with little extra effort. The last thing you want to do when you've put a great deal of effort into a disaster is to then have to do even more work for dinner.

The lesson: always have a backup.

Oh, and, check your gorram lid.

In other words, our parents also go there. [back to top]

Updated 8/16/07 to correct image links

Thursday, August 02, 2007

The Best Gorram Hat Ever!

Today, we stumbled across the story of Heather Hill. A woman with an autistic daughter, she knits hats, scarves, and other items, and sells them to raise money for her daughter's therapy. She also sells knitting kits.

What made this most significant for us?

This hat.

If you don't recognize it, nothing I tell you will make any sense.

This might help:

...but then, if you don't know the reference, you're probably even more confused.

You gorram loyalist...

Hat tip: Derb over at the Corner.