Monday, July 4, 2011

Global Warming Debunked, AMA Hardest Hit

In February, 2011 medical and public health groups began banding together to explain how global warming has and will take a profound toll on human health. The American Medical Association has been one of several esteemed and respected associations that have bought fully and put their name and reputation behind this theory.

In a Thursday conference call with reporters, the heads of the American Medical Association (AMA) and the American Public Health Association (APHA) joined with a pediatrician and a scientist to lay out what they say is a major public health issue: climate change caused by global warming.

The "evidence has only grown stronger" that climate change is responsible for an increasing number of health ills, including asthma, diarrheal disease, and even deaths from extreme weather such as heat waves, said Georges Benjamin, MD, executive director of the APHA.

David Catron, who blogs at Healthcare BS, commented at the time that:

The American Medical Association is determined to drive its membership down to some point even lower than the 17% of practicing physicians remaining in the group.

His suspicions were proven true when the AMA disclosed that it lost 12,000 dues-paying member physicians last year. Most observers believe this loss of membership is due to the group's support for President Obama's overhaul of the American health care system. They would be only partially correct.

H/T Healthcare BS, Declaration Entertainment


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Obvious Limitations to Interstate Commerce

Are there limitations? Evidently this depends upon who you ask. In this case George Will asks a simple question meant to clarify the absurdity of the Obamacare power grab. The geniuses sitting at the Amanpour's round table illustrates why the MSM has such a hard time clearly reporting the facts surrounding the various Obamacare lawsuits:

Has the congressional power to regulate interstate commerce been so loosely construed that now Congress can do anything at all … Let me ask the three of you. Obviously, obesity and its costs affect interstate commerce. Does Congress have the constitutional power to require obese people to sign up for Weight Watchers? If not, why not?


H/T Newsbusters

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Happy Independence Day- "We Got Him"

Thank you, President Bush:


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Happy Independence Day!

Hundreds of millions of Americans will be celebrating our 235th anniversary as an independent nation today!

There will be several readings of the Declaration (Old Stone Fort in Schoharie, New York), family events, fireworks and parades. The colours will be proudly displayed through out the entire United States in honor of our heritage past and present.

We must spend this day not only in celebration of our country, but in awe of our Founding Fathers. They did not sign a document of independence alone; but one of treason and of death if they failed to succeed. They were our first heroes.

Remember them proudly.

GOD BLESS AMERICA!

Happy Independence Day- President Bush's Perfect Pitch at Yankee Stadium

A strike that rivals any pitch ever thrown in Yankee Stadium.  Feel free to compare with President Obama, who comes second in the video:


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Happy Independence Day- President Bush's Bull Horn Speech at Ground Zero

A two minute speech that is lightyears beyond the vacuous speeches President Obama gives and a speech that is innumerably more touching and meaningful than anything Mr. Obama has ever said:


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Sunday, July 3, 2011

Chavismo and the Dictator! Hugo Chavez has Colon Cancer?

Want to know about hitting someone when they are down? Ask Noam Chomsky.

Hugo Chávez has long considered Noam Chomsky one of his best friends in the west. He has basked in the renowned scholar's praise for Venezuela's socialist revolution and echoed his denunciations of US imperialism.

The president may be about to have second thoughts about that, because his favourite intellectual has now turned his guns on Chávez.

Speaking to the Observer last week, Chomsky has accused the socialist leader of amassing too much power and of making an "assault" on Venezuela's democracy.

"Concentration of executive power, unless it's very temporary and for specific circumstances, such as fighting world war two, is an assault on democracy. You can debate whether [Venezuela's] circumstances require it: internal circumstances and the external threat of attack, that's a legitimate debate. But my own judgment in that debate is that it does not."

This type of speech has to leave a bit of a mark, particularly when going through a new diagnosis of cancer and still trying to run a country from afar.

Much has been speculated over the past few weeks regarding the health of Venezuelan President Hugo Chavez after a prolonged absence from his country seeking treatment for an mostly unspecified medical ailment requiring surgical intervention. By accounts, Chavez urgent surgery in Havana Cuba for a pelvic abscess. Turns out there is much more here than a pelvic abscess.


A very thin and clearly gravelly ill Hugo Chavez finally addressed the Nation tonight from Havana, Cuba and once again lied and raised questions in a clear change of heart about whether to tell or not the truth about what ailment he has been suffering and how it has been handled. Chavez, the eternal improviser, actually read the speech, saying he had a malignant tumor that was discovered after a second operation, which had not been revealed until today

Much speculation at first was related to the possibility of metastatic prostate cancer. This never fit very well for me as prostate cancer generally affects men much older and doesn't generally result in radical prostatectomy, particularly after metastasis. This line of reasoning was bolstered by Chavez himself as he lamented to the Venezuelan people that he hadn't undergone routing health care maintenance. Many speculated that this was in reference to digital rectal exams. This line of reasoning fits better with colorectal screening though. DRE's are still part of the process, but are accompanied by the dreaded colonoscopy. That is a 3 foot tube with a camera on the end that is inserted into one's backside in order to "screen" for potentially malignant polyps. Really not something someone with the perceived ego of Chavez would submit himself to without some profound provocation.

My suspicions were given some credence yesterday when Bloomberg cited Spanish newspaper El Periodico, stating that:

Chavez will have to use a colostomy bag for at least three months, the Barcelona-based newspaper reported. Chavez, who is recovering from two surgeries in Cuba, isn’t able to begin chemotherapy due to the infection, the paper said. The situation is serious because the tumor may have metastasized, El Periodico reported, citing the diplomats.

The first operation for a pelvic abscess was performed by a Cuban surgeon while the second operation to remove the tumor was performed by a Spanish surgeon in Havana the newspaper said.

The Real Cuba adds thoughts and a translation. I don't speak, read, or translate Spanish into English, so I cannot account for the veracity, but it seems in accordance with other sources. Still, it is worth reading over the official source for this. Even in spanish, it is not hard to pick up on the significance

The first operation was a mistake because it was performed after it was erroneously diagnosed that Chávez only was suffering from a pelvic abscess.

Here is my translation of what the Spanish newspaper is reporting: "Venezuelan President Hugo Chavez is suffering from colon cancer that has perforated the intestinal wall and has caused an infection in the abdomen. Chávez will need, at least for the next three months, a colostomy bag (a bag for stool), according to information from Venezuelan diplomatic reports that El Periodico has been able to review.

These same sources have reported that Chavez was first operated by a Cuban surgeon, who made the mistake of operating him as if he was suffering from a pelvic abscess. A few days later, the tumor fistulized. Given the seriousness of the situation, the Cuban authorities required for a second operation the services of a Spanish surgeon, which was probably José Luis García Sabrido, chief of surgery at the hospital Gregorio Marañon of Madrid, but this could not be confirmed by this newspaper. (My note: This was the same surgeon who traveled to Cuba to check on Castro)

The same report notes that, for now, Chavez can not receive chemotherapy because the infection produced by the first intervention prevents it. After seeing the medical reports, the same diplomatic sources suggest that the patient's condition is "serious" because there are chances that the tumor has caused metastasis."

The speculation is all coming from this video where the Venezuelan president addressed his nation. Interestingly and very much out of character he is addressing the nation by reading a speech.

This was a stilted announcement that was read by Chavez, the first time I can remember him reading from a piece of paper. Coming from him who makes fun of people who prefer to read prepared statements, him the great improvisor never at a loss for words, it can mean only one of two things: he is really sick and was propped for that speech made short and sort of direct; or he did not write the speech at all and somehow was coaxed into reading it. For me it is yet more evidence that we are a Cuban colony.

There is much more to be found and considered at Venezuela News and Views.

Via The American Thinker, Miami Herald reporter Frances Robles adds some interesting tidbits to the saga:

“What struck me is that at one point during his announcement, he misspoke and said ‘evolution’ instead of ‘evaluation.’ He corrected himself, but it was odd that in a video that was so staged — complete with props of the Venezuelan flag and a painting of Simon Bolivar — they did not do a retake,” said Douglas Leon, president of the Venezuelan Medical Federation. “What does that say? To me, it says he can only stand up for about 20 minutes, and they couldn’t let him stand for the time it would take to do it over.”

The presence of an abscessed tumor is not a good sign, said Dr. Thomas J. George Jr., an assistant professor of medicine at the University of Florida and a specialist in gastrointestinal cancers.

“This is usually because the cancer is fairly aggressive,’’ he said. “This could be a variety of different cancers — none of them good.”

The top possibility, he said, would be colorectal cancer, followed by prostate, bladder, or perhaps a sarcoma — a soft tissue cancer.

“Prostate would probably be the best option in terms of prognosis,” George said.

He also said it’s possible that the original abscess drainage procedure itself could have contaminated the area with cancer cells. Treatment, doctors agreed, would be aggressive radiation and chemotherapy.

“Prostate tumors normally do not cause this kind of abscess,” said Leon Lapco, president of the Venezuelan-American Doctors Association and a surgeon at Mercy Hospital. “I would say it’s his colon, the large intestine. It’s the most likely to cause diverticulitis, perforations and abscesses."

If you are at all interested in the goings on in Venezuela consider following the following blogs whose first hand knowledge, insight and cultural perspective will prove to be invaluable in the days and weeks to come.

Fausta's Blog

Venezuela News and Views

The Devil's Excrement

Babalu

Caracas Chronicles

If you have other sources, please add them in the comments! Thanks.....

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Thomas Friedman and Israel


Thomas Friedman has been honored many times over. He has won three Pulitzers for international reporting. He is the foreign affairs columnist for the New York Times, a reward for his yeoman work in eloquently promoting the anti-Israel message of the Times.

President Obama reportedly relies on him for advice about Israel. For many years, Friedman has been recognized as an expert on the region and its conflicts. What is usually ignored is how frequently he gets matters wrong, but does so with great style Few journalists have his record of cute and seemingly clever phrases that sound good, but say little. These statements clearly reveal Friedman’s antipathy toward the Jewish state.

For example, here are three statements about the manner in which Israel has responded to US demands:

“Well, first there’s Israel’s prime minister, Bibi Netanyahu, who has been telling everyone how committed he is to peace with the Palestinians while refusing to halt settlement building as a prerequisite for negotiations”

“ When America asks Israel to do something that in no way touches on its vital security but would actually enhance it, there is only one right answer: “Yes.” It is a measure of how spoiled Israel has become that …. Israel feels no compunction about spurning an American request for a longer settlement freeze”

“Israel, when America, a country that has lavished billions on you over the last 50 years and taken up your defense in countless international forums, asks you to halt settlements for three months to get peace talks going, there is only one right answer, and it is not “How much?” It is: “Yes, whatever you want” .

This is eloquent and powerful language. It is also wrong. Friedman ignores the fact that Netanyahu did precisely what he is recommending when Israel halted settlement building for nine months at the request of the US administration. The result? The Palestinian Authority, led by Prime Minister Abbas, refused to enter negotiations during that period. At the end of the nine months Abbas asked for an extension and Netanyahu, seeing that the freeze had accomplished nothing in the way of encouraging negotiations, said no. (The administration and much of the media condemned Israel for this, but had no criticism of the Palestinians for failing to negotiate while the freeze was in place)

Surely Friedman knows this. The only conclusion possible is that Friedman, given his words, is “speaking flattery–not truth–to power ”

Another example of Friedman’s cleverness disguising persistent fallacy occurred at a recent presentation at the Aspen Institute. On that occasion, he made the comment. (later confirmed in a tweet), that “Mubarak had 30 years to reform Egypt, then he tried to do it all in six days. Netanyahu is Mubarak of Israel”

Never mind that Mubarak’s record in Egypt consisted of 30 years of autocratic rule, while by contrast Netanyahu has been elected by Israeli citizens twice and the vast majority of Israelis think he has done a good job. (The Israeli experience over the last few decades of suffering from terrorist acts by her neighbors is reason enough for Netanyahu’s election)

So Friedman apparently believes that Israel has not changed in thirty years. Really? Thirty years ago, Israel rejected dealing with the PLO, and rejected a Palestinian state. Today, if favors a two-state solution; and accepts negotiations with the Palestinian Authority. Thirty years ago Israel controlled a large swath of southern Lebanon and the Gaza strip. Not today. Thirty years ago West Bank settlements were expanding; last year there was a nine month freeze. Under Ehud Barak Israel offered a Palestinian state that would include most of East Jerusalem. No change in thirty years?

Many critics of Israel claim they are not against Israel, only against its government. (never mind that as a democracy, its government is a mirror of what its people want). Friedman has joined in propagating this supposed distinction when in fact his comments are anti-Israel, and have two goals. They are designed to undermine policies needed for Israel’s survival, and to divide the American Jewish community and destroy support for Israel by American Jews.

Friedman repeats the false line that “if only Israel took more risks and made more unilateral concessions peace would be possible, even quick to arrive.” Rubin points out that we “learned eleven years ago that this was nonsense.” All the risks in the Israel-Palestinian conflict have been taken by Israel; only angry and reflexive anti-Israeli observers believe otherwise. The reality? The real roadblocks to peace are based on actions by the Palestinian Authority

Here is another Friedman distortion, as revealed by Omni Ceren. Friedman stated that “the Israelis and the Palestinians” are the people in the Middle East “most” in need of an Arab Spring. Does this mean that Israel, one of the world’s most robust democracies, needs a democratic housecleaning more urgently than Syria, Libya or Egypt?

And here is another dangerous recommendation. Friedman reportedly suggested that the U.S. “get out of the way” in September when the Palestinians seek unilateral statehood in the United Nations. Friedman has not paused in his clever utterances to consider what such a betrayal might mean with respect to trusting the U.S. on its most ironclad assurances. Or to consider how such a move would further harm the already badly compromised U.S.-Israel relationship.

Friedman is not only wrong, he is hopelessly inconsistent. How can he acknowledge on the one hand that the Palestinians aren’t interested in peace, but still insist that we should tilt the diplomatic playing field away from Israel, our last stable Middle East ally.

Friedman has either not learned the hard realities in that part of the world, or more likely deliberately ignores them. Not so the American people, as demonstrated by polls and by the overwhelming bipartisan enthusiasm expressed toward Netanyahu by the US Congress.

Once again we are told that the people of Israel simply don’t know what’s good for them, and so they need the great wisdom of President Obama, J Street, and Thomas Friedman to tell them how they must come to their senses. We need accurate and honest journalists, not individuals who distort facts to serve those in power.


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Saturday, July 2, 2011

McCotter to Launch 2012 Campaign Today

Michigan Representative Thaddeus McCotter will officially launch his unorthodox campaign bid for the 2012 Republican nomination this afternoon at a rock festival in Whitmore Lake, Michigan. The five-term Representative will follow his announcement by rocking with his own band. He launched his website yesterday.

So what impact will McCotter's campaign have on the 2012 race?

Besides from becoming Michigan's new favorite son in the race, and, of course, increasing the ranks of rust-belt candidates, the Livonia area Representative will have to defeat the plagues of low name recognition, and of running directly from the House, which Michele Bachmann seems to be managing well.

I expect his biggest contributions to be challenging Mitt Romney in Michigan's early primary vote, and adding his talented music abilities into the 2012 field. Perhaps he can even rock with Mike Huckabee on his Fox News show at some point in the campaign.

Mr. McCotter's campaign sure will be fun to watch.

What say you?

Friday, July 1, 2011

The Week in Fracking...

Needless to say, it has been a monumental week for those following the hydrofracking saga taking place in New York. Below are some of the things I have been reading. If you have some links or thoughts of your own, please share.

It is official. The draft SGEIS is released in its entirely. Coming in at a meager 736 pages this will undoubtedly be must reading while celebrating Independence Day! Not to worry if you have other more pressing issues, Andy Leahy, @NYShaleGasNow, is on the case and will provide the abridged version on Monday. No wait, that has already been released....

  • In Reversal of 2009 Report, High-Volume Fracturing Would be Prohibited in NYC and Syracuse Watersheds
  • Drilling Banned Within All Primary Aquifers and on State-Owned Land Including State Forest and Wildlife Management Areas
  • Drilling Permitted on Other Private Land with Rigorous and Effective Protections
  • Advisory Panel on Implementation to Be Appointed

The Department of Environmental Conservation (DEC) tomorrow will release its revised recommendations on mitigating the environmental impacts of high-volume hydraulic fracturing (high-volume fracturing). The recommendations contain these major revisions:

  • High-volume fracturing would be prohibited in the New York City and Syracuse watersheds, including a buffer zone;
  • Drilling would be prohibited within primary aquifers and within 500 feet of their boundaries;
  • Surface drilling would be prohibited on state-owned land including parks, forest areas and wildlife management areas;
  • High-volume fracturing will be permitted on privately held lands under rigorous and effective controls; and
  • DEC will issue regulations to codify these recommendations into state law.

Added, the DEC names those who will sit on the Hydrofracking Advisory Panel.

In case you didn't hear, Two-thirds of Americans want more domestic oil and gas production! This helps Governor Coumo's actions of late.

The national poll of likely voters found that 75 percent do not believe the country is sufficiently developing its own oil and gas resources, while 19 percent of those surveyed said the government is doing an adequate job of developing them.

Almost 50 percent of respondents also said that, given a choice, they would rather see the country develop its domestic reserves rather than cut back on gas and oil consumption. But the question was divided; another 42 percent said reducing consumption was the better policy.

How much is 5 million gallons?

The 5 million gallons of water needed to drill and fracture a typical deep shale gas well is equivalent to the amount of water consumed by:

  • New York City in approximately seven minutes
  • A 1,000 megawatt coal-fired power plant in 12 hours
  • A golf course in 25 days
  • 7.5 acres of corn in a season

While these represent continuing consumption, the water used for a gas well is a one-time use.

About radionuclides contaminating hydrofracking wastwater? Lancaster city water passes the test.

Tests show that Lancaster's drinking water contains no radioactivity from wastewater used in upstate Marcellus Shale natural gas drilling.

City officials last month ordered expanded testing of drinking water taken out of the Susquehanna River after it was revealed that some wastewater used by natural gas drillers was being taken to municipally owned sewage treatment plants, then released into waterways.

Plus there is this ~ Public water safe from radioactivity throughout region

A battery of tests has showed no radioactive contaminants in the water used and produced at 12 of 14 drinking water suppliers in Western Pennsylvania, according to state environmental regulators.

Wastewater treatment plants and drinking water suppliers performed extra tests throughout March, reacting to media reports that questioned whether an increase in Marcellus shale drilling had led to the introduction of radioactive chemicals into public water.

Of the 12 drinking water suppliers, only The Tri-County Joint Municipal Authority in Fredericktown reported any traces of radium-228 at all, and it was 80 percent below the maximum amount allowed, said Katy Gresh, spokeswoman at the Pennsylvania Department of Environmental Protection.

Hold your horses: fracking in NYS is still under review

Rumors have been swirling today that New York is lifting its moratorium on new fracking in the Marcellus Shale. Here’s the reality: the de facto moratorium that has been in place since the summer of 2008 remains intact.

New York's fracking ban to be lifted

Could sanity be breaking out in the Empire State?

Added thoughts from same blog, different post, France, New York and Fracking. I have to add, how did a fellow living in the UK come to such a profound understanding of NYS political travails? Added emphasis is mine.

But, it now seems that New York State will offer the moderate wing all that they wished for, and that more importantly, the industry doesn't really have a problem with that. Full disclsoure? Without any hesitation. Recycled water? Why not? Fix the roads? Of course! Basically any objection can be met and hit on the head. Which will mean the anti shale ultras will be feeling even more mean. They will make a lot of noise: but they will be isolated. The battle in New York State is not left/right Democrat/Republican or green/oil, it is the age old split between upstate and New York City which has been going on for two hundred years already. The shale ultras will go and vote Green and get Republican and really shoot themselves in the foot.

Shale opponents believed their own narrative of the industry as inherently dirty, nasty, short-sighted and evil. Just as the reality of drilling escaped them, so too did the reality of gas and oil companies. The good/bad black/white narrative of evil gas and oil is not only simplistic, it's not even realistic. If any company had found a successful business plan based on poisoning the same people who use the product, I have yet to hear of one. Much of the shale opposition seems to have even less understanding of how a business operates than they do of geology, hydrology, chemistry or physics.

It has taken a day or so, but the gloves are starting to come off, Andrew Cuomo is Horrible. Looking through the comments, there seems to be dissension in the ranks.

Despite Andrew Cuomo’s admirable push for gay marriage, he is a horrible governor. As a “Democrat,” Cuomo has declared war on unions, on the environment, and on everything Democrats theoretically stand for, outside of gay marriage. And again, while his stance on that single issue is to his significant benefit, Cuomo is atrocious.

Cuomo has a clear vision–to be the ultimate centrist, thinking he can squeak through the 2016 presidential primary against other, presumably real Democrats who actually share the vision of the post-1933 Democratic Party and then triangulate himself into the presidency, where he will make us all long for the halcyon Clinton and Obama days, when a Democrat knew how to stand up to a Republican.

Except that I don’t think he can do it. I don’t think the bastard can withstand a Democratic primary, unless we let his single good and admirable position outweigh the fact that he doesn’t care about working-class people or the environment or essentially any other traditional Democratic issue. Certainly I would not vote for Andrew Cuomo for president, not in a primary and not in a general election.

Plus, Calls for Civil Disobedience?

"Citizens now have had an incredible wake-up call. And if they don't want horizontal hydrofracking in their communities, the only thing that they can do is make sure that the draft SGEIS is not adopted in final form," Hang said. "And I think you're going to be seeing civil disobedience, because I think people believed that this is going to be an honest, open process, that the governor was going to do what he said, which is to revise this document and provide good government. And I think it's like people feel they've been kicked in the teeth.

"This is a call to arms," Hang continued. "People really have to realize that the governor has not heard our message, he is not dealing with the substantive technical concerns, and we've got to make more noise."

And lets not forget civility, Fight like hell?

"A road map for the industrialization of the Catskills; the fact that the Delaware River isn't protected is outrageous," said Ramsay Adams, executive director of Catskill Mountainkeeper. "It's clear they haven't developed a plan to deal with wastewater and there's no cumulative impact study. We'll fight like hell to stop this."

Jon Entine delivers a complete take down of the NYT's Ian Urbina recent expose on hydrofracking with Natural Gas "Bubble" Report: Market Tinkering of Shoddy Reporting? Too much to highlight so read the whole thing, particularly if you don't mind seeing some of the shine taken off the "Newspaper of Record".

More on Ian Urbina. Is he the NYT's next Judith Miller? Of 10 sources for the Times articles 8 were anonymous. The two who were revealed turn out not to be the same people they were portrayed! Oops...

The Dallas Federal Reserve corrected the record, saying that Ms. Rogers is an unpaid volunteer on the small business and agriculture advisory council.

Instead the NYT Reporter presented her as an official in the Federal Reserve with an objective, investor protection concern.

The information about the Mr. Berman in the linked article is potentially even more damaging to the NYT Reporter, even edging into potential criminal stock manipulation.

The Interns are Back

July is officially here and it brings with a new batch of interns. Newly minted doctors with freshly pressed white coats, brand new, out of the box stethoscopes and pockets filled to overflowing with pen lights, reflex hammers, and tuning forks will be taking over the responsibility of direct patient care. It is rite of passage that every would be doctor must go through and it doesn't come without risks.

It has been a long held belief that July was not the time to be sick and in a hospital, particularly if you are an intern. Overnight call is one of the most frightening things you are asked to do and even now thousands interns are giving themselves worrying about it.

With this in mind it was nice to come across a request from @DoctorWes to come up with a listing of "Rules to Go By". It is "Top Ten" rules every intern should take to heart. If you read closely, you will find @InpatientMed coming in at number nine. That's me by the way! Crazy people get sick too, is a bit of a mantra for me on the wards and if you have spent any amount of time on the wards, you know exactly what I am talking about. They are all good though and are presented for your reading enjoyment.

For Interns: Ten Rules to Go By

He sat in a crisp white coat, staring at a computer screen, note cards in his lap. Occasionally, I noted him jot a note to himself as he compiled his list. A nurse sat next to him, pounding feverishly on the keyboard as she recorded her nurse’s note. He tentatively moved his mouse, then clicked, still staring.

I recall my first day in clinical medicine: no computer, an ER rotation, a white board filled with names and abbreviated medical problems next to them with little magnetic color-coded labels nearby. Room 1: Head trauma. Room 2: Abscess. Room 3: UTI, Room 4: Rash.

I got room 2. It was the biggest, bad-est infected sebaceous cyst on a guy’s back a newly minted doctor had ever seen. Can you say “softball?” “See one, do one,” they told me. And off I went.

Much in medicine has changed since then, but much remains the same. Medicine is miraculous, terrifying, then rewarding all at once. Fortunately, there’s a method within the madness that can serve to preserve and protect those who first start out. Every doctor has had the fortune to learn from those who passed before them as begin their journey to refine their title of “doctor” (literally, “teacher.”)

I thought it would be interesting to put a few of the “Rules of the Road for Medicine” down on paper (with the help of friends on Twitter) for interns and residents as they embark on their own incredible journey ahead. The list is not exhaustive, but hopefully can serve as a resource for our new doctors as they head off to meet their clinical challenges ahead.

Rule #1: Treat every patient like your mother
Obey this rule and you’ll do the right thing more often than not. If it means staying late, do it. If it means going the extra mile, do it. If people disagree as to a specific approach to care, ask yourself “What would my mother want?” Then go that direction. Be kind. Be respectful. Wear clean clothes, brush your teeth, comb your hair, and look your best. (Note: @DrElizabethLee was quick to remind me that kids are not always kind and respectful, so their age might require a slightly more top-down, “parental” approach.)

Rule #2: There are an infinite number of ways to get screwed
That’s right – not a thousand, not a million, not ten billion – but an infinite number of ways… Check and recheck. If you’re not sure, check it again. Somewhere out there, born 20 years or so ago, there is a person whose sole mission in life is to thwart your efforts to protect your patient. It usually is not intentional, mind you, but it happens. Like the nurse who feeds the patient breakfast when they’re NPO after midnight, or the orderly who accidentally trips and pulls out the IV or better yet, the pacemaker wires. Oh yeah, it happens. So double-tape where single-tape might do. Communicate. Involve the team. If you’ve got a better idea, say so. If someone else has a better idea, defer to them. Park your ego at the door and work to avoid the errors. Everyone will benefit if you do.

- Corollary: “If there’s a test for it, just get the test.” (h/t: @gruntdoc)

Rule #3: Do the rectal.
Surgeons always emphasize this point, but it extends far beyond the obvious. Consider it shorthand for “do the physical.” Trust no one except yourself and what you see, hear, and feel. More often than not, you’ll be rewarded with the satisfaction of finding something no one else has, simply because you made the effort to lift the covers and do the exam.

- Corollary: Believe none of what your hear, half of what you see, all of what you do. (h/t: Benjamin Franklin via @MGKatz036)

Rule #4: Medicine is like life – no “always” and no “nevers”
So research, research, research. Don’t be cocky. Humility is paramount since there’s nothing like the vagaries of medicine and individual circumstances and personalities to take the wind out of your sail. No single person (or website) has all the answers. Attend the lectures while you still can: you’ll never be spoon-fed like that again. Remember: the learning never ends. (h/t @sonodoc99and @shartiga)

Rule #5: Your family is your anchor
Spend time with them. Make them a priority. Surprise your spouse or significant other with flowers, or better yet, carry-out. If safe to do so, leave work to attend the kids’ assemblies at school or their sports games and return later if you still have work to do. Do this and they might even help with your laundry once in a while. (h/t@DoctorNatasha)

Rule #6: It’s okay to say “I don’t know”
… just be sure to add “… but I’ll look it up.” More often than not, someone else might have an idea, so bring in the cavalry. Use the phone and call the expert – even if he or she is in another state or country. Still, if the answer remains elusive, it really is okay to say you really don’t know what to do. Sometime there is nothing you can do. And once in a while when all other options have been exhausted, don’t forget to ask the patient or family for their help to see if they have another idea that you haven’t tried. (h/t: @kevinmd)

Rule #7: If you screw up, say you’re sorry.
Lots has been written on this, and certainly there’s an appropriate time and place for doing so, but take the time to offer your apologies if a mistake occurs. Work to make sure the mistake doesn’t happen again and realize there is an important bond that forms when a doctor sticks with his or her patient through thick and thin. (h/t:@kevinmd)

Rule #8 – Play nice
Nurses, respiratory technicians, physical therapists, nurse practitioners, dietary personnel, pharmacists, and the EMT's/paramedics are your friends – keep them that way. Be respectful, appreciate their skills, and use their expertise. Most important, before you try to lie down on call, ask the covering nurse(s) if there’s anything they need before you retire. It might just save you a page. (h/t: @rlbates)

Rule #9 – Crazy people get sick, too
So be sure to attend to rules #1, #2, and #3. (h/t: @InpatientMed

Rule #10 – Do the dirty work
All you have to do is help with nurse with a digital disimpaction, enema, or cleanup of a dirty bed and you’ll be an instant hero. Word travels fast. After all, believe it or not, you are not above the others. You are part of a team: just one member with a bit more responsibility at times. By helping, you’ll be helped. By caring, you’ll be cared for. And sometimes, your new patients or colleagues might even bring you cookies.

-Wes

By the way, if you are on twitter and don't follow Dr. Wes, you definitely should.

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The Ratification Debate Part One

While it is not my usual routine to write articles in a series, in honor of our nation’s 235th birthday I want to take some time to examine the process that led to the ratification of the Constitution.  Therefore, each of the next three weeks I will post one installment of a short refection on the ratification debate.
Context:
To understand the debate over the ratification of the Constitution it is necessary to first establish the context, for the study of a text without a context is a pretext.
Was the Constitution the first document produced to form the United States of America?  Does it mark the beginning of our nation and its government?
No, before there was a Constitution there was a United States of America.  This nation was not formed under the auspices of the Constitution the Constitution was formed under the Auspices of the United States.
Years before there was a Constitution there were the Articles of Confederation and it was at the final ratification of this document that the United States of America officially was born.  This often over-looked and much maligned document was drafted in 1777 by the same Continental Congress that passed and proclaimed the Declaration of Independence.  The Articles acknowledged the inherent sovereignty of the constituent States while at the same time establishing a league of friendship and perpetual union.
The Articles of Confederation:
The Articles of Confederation were written, debated and ratified during the Revolutionary War when the States were fighting for their lives against the overbearing Imperial government intent upon reducing all of them to mere appendages of the London based bureaucracy.  In consequence, they reflect the lack of confidence felt in any highly centralized state power.  The States were jealous of their ability to control their internal affairs.  These privileges had been won in various ways in the different States but in each of them they had gained the authority of custom and Tradition.  And in every State they were held dear and looked upon as necessary for a free and prosperous nation.  Therefore the Articles while creating a central government that could address such issues as war and peace most of the actual power was reserved to the individual States.
The maintenance of the sovereignty, freedom and independence of the individual States was facilitated by the fact that under the Articles there was no Executive or Judicial branches in the central government only a legislature and that consisted of only one house.  This one house Congress was composed of committees of delegates appointed by the States.  Congress was charged with the responsibility to prosecute the Revolution, declare war, maintain the Army and Navy, establish relations with other government, send and receive ambassadors and other functions such as establish policies for any territories acquired that were not under State control.
In the depths of war the Articles of Confederation were adopted by the Second Continental Congress on November 15, 1777. The Articles actually became the official and original organic document establishing the government of the United States of America on March 1, 1781 when Maryland, the last of the thirteen states ratified the document.
Today we reap the fruits of the reality that winners write history.  For two hundred plus years we have all been taught that the Articles of Confederation were an abject failure.  We are lectured on the fact that they did not have the power to create or sustain a viable nation.  It is common knowledge that if they would have continued in force there would have been wars between the states and a dysfunctional economy.
Yes, this is what we are taught.  This is what every school child for ten generations has learned as the bedrock of civics and the study of American politics and History.  But does the accepted History fit the facts?
What were some of the accomplishments of the Articles of Confederation?
·         The government of the United States was established under the Articles not the Constitution. 
·         The government as established under the Articles successfully fought and won the Revolutionary War 
·         The government as established under the Articles concluded the peace which gained not only the independence of the thirteen original colonies but all the land east of the Mississippi River and south of Canada. 
·         The government as established under the Articles established diplomatic relations with the rest of the world and worked successfully to get the new United States of America recognized as an independent nation. 
·         The government as established under the Articles negotiated our first treaty with a foreign power (France).
·         The government as established under the Articles led all the States to renounce their claims to the western lands.
·         The government as established under the Articles passed the Land Ordinance of 1785 which provided for the survey and sale of the western lands surrendered by the original thirteen states. These sales provided income for the new nation without taxation
·          The government as established under the Articles through the set aside of land established federal support for a public education system.
·         The government as established under the Articles passed the Northwest Ordinance of 1787 which provided the process through which every subsequent State after the original thirteen became States, with full equality with the original States.
·         The government as established under the Articles outlawed slavery in the Northwest Territory.
·         The government as established under the Articles passed a bill of rights that protected the settlers of territories from abuses of power.
This is a very long list of positive accomplishments for a government that is portrayed as an abject failure.  This brings us to the question, “What was the problem?” a question I will address next week.
Dr. Owens teaches History, Political Science, and Religion for Southside Virginia Community College.  He is the author of the History of the Future @ http://drrobertowens.com View the trailer for Dr. Owens’ latest book @ http://www.youtube.com/watch?v=_ypkoS0gGn8 © 2011 Robert R. Owens dr.owens@comcast.net  Follow Dr. Robert Owens on Facebook.

Glenn Beck Delivers Last Show From Behind Bullet-Proof Glass

From Yahoo!:
Glenn Beck began his final show on Fox News where he'll be for the foreseeable future: outside the building--and not on TV.

"We've done some amazing things together," Beck, flanked by at least one bodyguard, told viewers as he showed them the view of the set from the street, noting the bulletproof glass that was installed "for a myriad of reasons."

Beck then rolled a four-minute highlight reel of his greatest hits spanning his two-and-a-half years on the air: Acorn, the 9/12 Project, his Restoring Honor rally in Washington, D.C., last summer. (The montage also included testimonials from viewers found on the street.)

"It's been an amazing ride," he said backstage, surrounded by some of the show's familiar props, including chalk ("We buy by the case," he said). "I've made some amazing friends, namely, you."

Beck spent most of the hour looking back. "We made a lot of enemies on this program," he said, from "the president to the Republicans to George Soros."

"We have not only survived," he said. "We have thrived."
No longer on Fox

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Thursday, June 30, 2011

Executive Hydrofracking Moratorium to be Replaced by Regulatory One

Nick Grealy, of No Hot Air, asks, "Could sanity be breaking out in the empire state"?, while ProActive Network is a bit more jaundiced, finding "some good recommendations and some strange recommendations", with lawsuits on the horizon. While the NRDC Switchboard states "the de facto moratorium that has been in place since the summer of 2008 remains intact".

So what gives?

The New York Department of Environmental Conservation was required to release its Supplemental Generic Environmental Impact Study (SGEIS) on Friday July 1. The details of which were released by surprise today. Fred Dicker of the NY Post claims that "Cuomo Administration insiders said they believed details of the report were being released Thursday by environmental activists at DEC, who opposed the findings." This may in fact be true, but if so it was poorly coordinated as there is virtual silence, for now, from the anti-fracking brigade.

It tuns out the rumors are true! The NY State DEC will issue new recommendations in its hydraulic fracturing review, the full report will be presumably be presented tomorrow, but the general findings can be found at the NY DEC website.

  • In Reversal of 2009 Report, High-Volume Fracturing Would be Prohibited in NYC and Syracuse Watersheds
  • Drilling Banned Within All Primary Aquifers and on State-Owned Land Including State Forest and Wildlife Management Areas
  • Drilling Permitted on Other Private Land with Rigorous and Effective Protections
  • Advisory Panel on Implementation to Be Appointed

The Department of Environmental Conservation (DEC) tomorrow will release its revised recommendations on mitigating the environmental impacts of high-volume hydraulic fracturing . The recommendations contain these major revisions:

  • High-volume fracturing would be prohibited in the New York City and Syracuse watersheds, including a buffer zone;
  • Drilling would be prohibited within primary aquifers and within 500 feet of their boundaries;
  • Surface drilling would be prohibited on state-owned land including parks, forest areas and wildlife management areas;
  • High-volume fracturing will be permitted on privately held lands under rigorous and effective controls; and
  • DEC will issue regulations to codify these recommendations into state law.

These recommendations, if adopted in final form, would protect the state's environmentally sensitive areas while realizing the economic development and energy benefits of the state's natural gas resources. Approximately 85 percent of the Marcellus Shale would be accessible to natural gas extraction under these recommendations.

DEC Commissioner Joseph Martens said, "This report strikes the right balance between protecting our environment, watersheds, and drinking water and promoting economic development."

The ban on high-volume fracturing in the New York City and Syracuse watersheds represents a reversal of the Department's 2009 draft report, which would have permitted drilling in those watersheds. The New York and Syracuse watersheds are unique in that they are the only unfiltered supplies of municipal water in the state and deserve special protection. The prior report also would have allowed high-volume fracturing surface drilling in primary aquifers and on public forests, wildlife areas and parkland; the 2011 report reverses all of these recommendations.

There will be more opportunity for review and comment on the Department's recommendations. DEC plans for a 60-day public comment period commencing in August. There is no administrative or discretionary moratorium on high-volume fracturing. By law, no permits may be issued until the public comments are reviewed and considered and the final Supplement Generic Environmental Impact Statement is released.

DEC enforcement and oversight of high-volume fracturing will be rigorous and effective. No permits will be issued until DEC has the proper enforcement capacity in place to monitor all fracturing activities.

In preparing the new recommendations, DEC engaged independent consultants to perform research, sought further information from the gas drilling industry, considered more than 13,000 public comments and studied other states' regulations and experience, including site visits by Commissioner Martens and DEC officials to Pennsylvania incident sites. Since September 2009, DEC staff has spent approximately 10,250 hours updating the document. The 2011 version contains more than 900 pages, including more than 150 additional pages of data and analysis compared to the 2009 version.

The DEC review has resulted in recommendations for rigorous and effective controls on high-volume fracturing on private lands. The "state-of-the-art controls" include rules to regulate eight specific parameters: Protecting Drinking Water, Properly Handling Flow Back Water, Taking Local Governments & Communities into Account, Identifying Fracturing Fluid Chemicals, Protecting the Air, Conserving Habitats, Making Sure We Get It Right - Community Impacts Still Under Study, and Appointment of Advisory Panel to Develop Implementation Plan. For specifics on each of these, please see the DEC website.

It seems obvious from the requirements that hydraulic fracturing for natural gas will not take place any time soon in New York State. The DEC seems to have effectively replaced an executive moratorium with a regulatory moratorium. Cuomo would be right to sign off on this plan as soon as possible. It may anger the anti's for a while, but they will eventually realize that the Governor is giving them a gift.

The realities of the situation will likely take a while to sink in, so I look forward to the wailing, gnashing of teeth, name calling and outright lies to blossom forth from the bosom of progressive environmentalists everywhere and I look forward to documenting it, even as I rue the economic opportunity New York will miss out on!

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My Endorsements for the Republican Nomination

I endorse both Jon Huntsman and Gary Johnson for the 2012 Republican nomination for President. Both are not crazy and I think both would make good presidents.
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Romney Video: Obama Isn't Working

Photos: The Creepiest Trees on Earth

There are some things in nature and in the wider world that are disturbing. Humankind has definitely produced plenty of ideas and goods that have creeped out many. However, one element that is not usually thought of in this context is arboreal life.

So now we're going to pick out some of the highlights (or if you prefer, the lowlights) from the world's creepiest trees. Not for the faint of heart or aboraphobes:








We get these from a compilation at Environmental Graffiti. For the rest, check out here.

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The Month in Review

June has been another busy month on Pundit Press. Our articles have reached across the blogosphere again. We're at 215 subscribers, 123 Twitter followers, and 116 followers.

In the last month we've had 338 articles.


Danny Butcher: 60 articles, up from 4. This is 17.5% of the total.
Aurelius: 101 stories, down from 123. This is 29.6 of the sum.
Mr. K: 41 pieces, down from 54. This is 11.5%
Thomas: 97 articles, down from 146. This is 28.7% of the total.
Unlikely Hospitalist: 31, from 35. This is 8.9% of the month's articles.
Fenway Nation: 5, up from 1.
Dr. Owens: 4, the same.
Dr. White: 1, from 2.
Kaptain Krude: 1, from 4.
Joe C.: 0, from 1.

This month, we received 61,188 pageviews.

Top articles of the month:

1. Unexpectedly Compilation by Aurelius, with 11,618 hits or 19.1% of the total.
2. Ewww: Picture of Weiner Cross-Dressing Released by Aurelius with 3,370 hits, or 5.5% of the total.
3. Opponents to Natural Gas Make Very Strange Bedfellows by Unlikely Hospitalist with 3,156 hits, or 5.2% of the total.
4. Congressman Weiner 'Oiled Up' by Thomas with 1,766 hits, or 2.9%.
5. VA Cemetery to Veterans: The Word "God," "Jesus" are Offensive, no Longer Allowed by Aurelius, with 1,581 views, or 2.6% of the month's total.
6. O.J. Simpson Admits to Killing Nicole Brown Simpson and Ronald Goldman in Self Defense? by Unlikely Hospitalist with 1,433 hits, or 2.3% of the total.
7. Article about Lara Logan's assault by Aurelius with 1,271 hits.
8. Explicit Pic of Anthony Weiner's Weiner Leaked by Aurelius with 1,163 hits or 1.9% of the sum.
9. Weiner writes Woman: "ridiculous bulge in my shorts now. wanna see?" by Aurelius with 1,154 hits, or 1.9%.
10. "Unexpected" Compilation Redux by Aurelius and reader JB with 966 hits.

Mr. K's top article was Obama Betrays Britain on Falkland Islands with 326 views.

Danny Butcher's top article was Economic Storm Brewing Around Obama with 280 hits.

To Those that Linked to Us

We would like to thank the following for linking to us:

  • WCBM
  • Michelle Malkin
  • Instapundit
  • Gateway Pundit
  • The Blaze
  • Atlas Shrugs
  • Ace of Spades
  • The Telegraph
  • The tomb of the unknown blogger
Top Contributor of the Month

This month the top contributor was Danny Butcher, who came in full force this month. Last month it was our stalwart, handsome veteran Mr. K.

Some interesting notes:
  • This is Danny Butcher's first full month.
  • We are very disappointed in Joe.
  • We introduced a new feature: Pundit Press Question.
  • Osama bin Laden is still dead.

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U.S. Senate Confirms Petraeus 94-0

The United States Senate just voted 94-0 to confirm General David Petraeus as the next Director of the CIA. Senators "debated" the nomination for nearly two hours before unanimously supporting President Obama's second consecutive defense related appointee. Leon Panetta was confirmed 100-0 just last week.

General Petraeus is one of the few individuals in modern America that could be unanimously supported without considerable debate, and no one could possibly argue that he doesn't deserve such an honour - as he has overseen our military's definitive victory in Iraq and our ongoing military success in Afghanistan. 

America is blessed to have such a patriot always willing to put his country first.

What say you?

Breaking: NY State to Lift Moratorium on Fracking

So says a banner at the NYT that was posted via its twitter feed an noon today. As of now there has been no confirmation from the NY DEP.


The New York Times
NYT NEWS ALERT: New York State to Lift Moratorium on Hydraulic Fracturing

Politics on the Hudson has more:

In a one-line crawl on the top of its website and a blast from its official Twitter account, The New York Times is reporting that the state will lift its moratorium on hydraulic fracturing for natural gas.

But Gov. Andrew Cuomo’s office quickly moved to knock the report down, with a spokesman Josh Vlasto calling it “baseless speculation and premature” in an e-mail.

The one-sentence was added as a “Breaking News” item on the top of its website at noon: “New York State to Lift Moratorium on Hydraulic Fracturing”

As of 12:40 p.m., it remains there. A full story hasn’t been added yet.

The state Department of Environmental Conservation is up against a July 1 deadline for a second draft of its Supplemental Generic Environmental Impact Statement—a massive document that will guide the permitting process for hydrofracking in the Marcellus Shale.

By executive order, the process is set to remain on hold in New York until a final version of the document—not the upcoming draft—is set in stone, so a lift of the moratorium would be a major surprise, to say the least.

The upcoming draft is set to be followed by at least a 30 day comment period, as directed by a separate executive order from former Gov. David Paterson, and extended under Cuomo. Shortly before the NYT alert moved, a DEC spokesperson said there “will be ample time for public comment and it will not begin until sometime after the document is made available to the public.”

I will continue to add more as events warrant and my time allows.

Update:

Cuomo Will Seek to Lift Ban on Hydraulic Fracturing

The Cuomo administration is expected to lift what has been, in effect, a moratorium on hydraulic fracturing, a controversial technology used to extract natural gas from shale, people briefed on the administration’s discussions said.
Administration officials are discussing maintaining a ban on the process inside New York City’s sprawling upstate watershed, as well as a watershed used by the city of Syracuse, according to people briefed on the plan. But by allowing the process in other parts of the state, Gov. Andrew M. Cuomo would open up New York to one of the fastest-growing — critics would say reckless — areas of the energy industry.
When the decision will be made public is less certain. On Friday, the State Department of Environmental Conservation is due to release a long-awaited study of the process, widely known as hydrofracking. But it was unclear if the Cuomo administration would use the occasion to announce its broader policy plans related to the issue as well. The report will likely include recommendations, and then there will be a period for public comments before a final determination can be made.
Hydrofracking has spurred intense protests from environmental activists, who say it threatens the cleanliness of ground water. The process involves injecting large volumes of water, mixed with sand and chemicals, deep into the ground to break up rock formations and release natural gas. It is legal in a number of other states, including Pennsylvania.
A primary concern among environmental groups has been the leftover waste water that can be contaminated with toxins buried underground, including naturally occurring radioactive elements or carcinogens like benzene.
Drilling for natural gas has been promoted as a way to reduce dependence on imported energy, even as it burns more cleanly than coal.
Josh Vlasto, a spokesman for the governor, said it was “baseless speculation and premature” to say the state’s current moratorium on hydrofracking would be lifted.
Ian Urbina unavailable for comment!