Friday, May 21, 2010

Tuesday, May 11, 2010

The Life and Times of an Intellectual

So I've been pretty busy with rotations...even though I haven't made posts or comments, I of course have been reading the blog. I was working in the ER for the past month working from 11 AM to 11 PM, which needless to say sucked because all I did was work and sleep. Being the small town that it is, I didnt see anything too interesting, although there was a little bit of excitement. Got to stitch plenty of people up which is kinda fun, other than that there was one code which was also kinda fun. Basically an 86 year old lady was brought into the ER feeling weak. We put her on a bed and while asking her questions she went unconscious. She stopped breathing and had no pulse, but she still had a rhythm on the heart monitor. This is called pulseless electrical activity, where the heart is beating but not in a way to pump blood through the body, so it requires CPR. The thing is the doctor working that night is kind of an idiot and was arguing the fact that the person was not in PEA, because the heart rhythm looked normal. By definition PEA can be any rhythm, there just isnt a pulse. Long story short this guy waits like 10 minutes and the lady eventually decompensates into a heart rhythm that requires shocking (get the paddles, "clear" etc.). So after that I start CPR and immediately feel multiple cracks as I break a few of her ribs, "if you dont break ribs you arent doing it right." Anyway, the lady ended up dying after doing cpr and stuff for about 45 minutes. I honestly think if I were in charge she may have lived, oh well.

On a different note, one day I was buying dinner with my debit card and it was declined. I knew I had money in my account so I was confused. I came home and found that my account had been hacked and google ads had spent like $1500 from my account. My bank was able to reimburse the money eventually, but still it was a hassle. I havent really watched porn since I started dating my girlfriend about 6 months ago, so I dont think that is the culprit. I think I probably got some kind of keylogger virus from one of the sites I download movies from. Just to be safe I reformatted with a downloaded copy of windows 7 ultimate. Ironic? Hope not.

As far as my current situation, I'm finally out of the small town of Petersburg that I'd been living in for almost a year. I'm in Wheeling, WV for a month doing an anesthesia rotation. Its far better but still this will hopefully be the last time I'll have to work in WV. Next month I'll be back in Va beach for 6 weeks working with boski's doctor. Thanks bosk. Been living with my girlfriend for like 3 months as well. Trying to set things up so we work in the same area.

A couple of things about the healthcare system that I thought were pertinent and kinda funny that I read on a medical blog I frequent at times (http://thehappyhospitalist.blogspot.com/):
Neighbor: These allergies are killing me
Happy: That's terrible. I hope you feel better
Neighbor: I tried Zyrtec but it wasn't doing anything for me. So my doctor prescribed xxxxxx (in audible drug name )
Happy: Does it start with an X
the drugs name is Xyzal
Neighbor: Yes it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec that the company slightly changed the formula and now they get to sell it as a patented medication at ten times the price for the next ten years
Neighbor: Oh, I didn't know that. But you're right. It was $110.
Happy: Did it help you with your allergies?
Neighbor: Nope.
Happy: I guess you just wasted $100
Neighbor. I didn't waste anything. My insurance company paid for it
Happy: Actually, we all paid for it with higher premiums
Neighbor: walks away.

You see it all the time. With Obama's healthcare plan, medicaid will be one of the primary ways that doctors get paid, as those who cant afford private healthcare get it paid for by the government. Of course the government doesnt compensate as well, and therefore doctors have little incentive to accept these patients other than out of the kindness of their heart.
" I make $1 on every Medicaid patient I see in the clinic. If I see four Medicaid patients an hour, I make $4 an hour. I don't work for $4 an hour."

Saturday, May 8, 2010

My Thoughts on the BP Oil Spill Pt.1

Instead of posting a small bit on the BP oil spill in response to Boon's previous post, I figured I would post a little more on my take on the overall event. Although this sounds stupid to say, any of the things that I post on this blog are my thoughts and not that of my company. Additionally, my knowledge of "upstream" (which is exploring for new oil/natural gas wells and producing from those wells) is very narrow, so I cannot give any sort of in depth analysis on how things work, etc.

So, where do I begin. Just to start, I think that what is going on in the Gulf is a very bad situation. On the scale of 0 to 10 in terms of what the consequences of the event are, I'd put it at an 8. The consequences of the event are 11 dead (worst offshore incident in U.S. history) and a large environmental impact that will cost billions of dollars in the end to recover from. The worst offshore disaster ever was the Piper Alpha incident, which killed 167 people and had a total economic impact of $3.4 billion. A ~30 minute video recaping the Piper Alpha event can be watched via YouTube (I recommend watching).







In terms of BP, this isn't the first tarnish on their record. Although I do not remember this when it occurred, they had an explosion at their Texas City refinery in 2005 that killed 15 people and injured 170 more. A video (quite long) covering the investigation to this incident can be viewed on the link below. This is an hour long, but I feel this is one of the best videos that give insight into how much risk this business takes; it also how important the proper operation of safety critical devices are. This event is the most infamous internal to the petrochemical world and has lead to significant changes to the current U.S. petrochemical regulations.




The reason I posted these videos (if you watched them or not) is to highlight that it typically takes multiple failures on physical equipment, engineering, and organizational levels to result in a very severe event as the videos listed above and the current BP incident in the gulf. This is a very big thing to understand because of how society currently thinks. The current society thinks there is one thing/person/company to blame and that all it takes is more oversight to make things better.

So what I am I getting at with all this rambling and video posting? 1) This event is a very significant event and will likely re-shape the offshore oil industry in the U.S. from now into the future. 2) This likely wasn't one thing that failed. It will be a combination of multiple things, potentially including some type of organizational or management problem (work systems). But realistically, until an OFFICIAL investigation is performed, we won't know the true cause of the incident. I don't trust a 30 day investigation that will be put together for the government to sit on Capitol Hill and tell the U.S. why this happened. 3) This industry is extremely dangerous and the consequences of a single event are huge.

I actually am going to dip out for now because this took longer than expected, but I will continue posting my thoughts tomorrow. This was more of a ramble post, but it gets the discussion going.

Friday, May 7, 2010

what's term say

about the BP oil spill?