October 22, 2005
Let me backtrack a little for those of you who don't do airway management in paralyzed people on a routine basis.
After you put a patient to sleep, most of the time you put an endotracheal tube in to enable easy and safe ventilation during surgery.
The endotracheal tube has a collapsible plastic cuff at the end inside the trachea.
A little tube runs alongside the endotracheal tube and carries air from the outside into the cuff to cause it to inflate and seal off the airway from the outside world.
The tube ends outside the mouth in a little balloon to which you attach an ordinary 10cc plastic syringe.
That balloon is called the "pilot balloon" (above).
The syringe is called the cuff syringe because it inflates the cuff.
Makes sense, doesn't it?
After you've intubated the patient you remove the cuff syringe and put it in the connector hole in the breathing mask you've used for induction and will be using again at the end of the case.
Note: all this will become much clearer once joeTV goes live and you can watch me do these things — yes, on real live patients in real time, you betcha.
Sure hope I don't kill anyone on camera — that probably won't play very well with my state medical board, not to mention my malpractice insurance company.
But I digress.
The cuff syringe disappears in the frenzy and excitement of induction more often than not.
Where does it go?
I realized early on in my career, after dozens of cases in which I spent precious seconds searching for it, that it simply vanishes — into anesthesia hyperspace.
And ever since then I've been completely comfortable with that concept and simply opened a new syringe to use for the cuff at the end of the case, forgetting about the original.
Sometimes it reappears; more often than not it doesn't.
OK, cut to now and my wonderful treadmill, on which I spend many happy minutes and hours each day reading the day's newspapers.
As I finish sections I toss them over my shoulder (below).
But every now and then I need to go back and have another look at a story or picture, perhaps because another paper mentioned the same thing in a different light or because I'm just a little slow.
The point of this post is that there is a treadmill hyperspace into which stuff I've just read — and I mean in the last 5–10 minutes — disappears.
I wade through the piles of discarded paper looking for the section I've just read
and it's not there.
How else can I characterize this other than that it has vanished through a wormhole similar in character and function to the one in the OR?
But wait a minute: there's another way of looking at the above, isn't there?
Because maybe — just maybe — the wormhole's in my brain.
There are those who believe my brain is a wormhole.
Or a worm–equivalent.
A "W.E." — I like it.
But I digress.
I believe that the universe and our reality is a calculation, nothing more — and nothing less.
Talk about the ultimate zero–sum game.
Ceaselessly we calculate — and thus create — the world around us, until one day our battery expires.
We call it death.
So if, every now and then, we can't locate a syringe or an article we want, hey — it's not lost, it's simply "over there" — in the deepest, most profound sense.
BehindTheMedspeak: Oxysox — 'Official Performance Sock of the National Hockey League'
Oxysox, based in Troy, Michigan, makes a sock (above) that it says boosts calf muscle circulation and aerobic output and accelerates recovery from exertion.
The sock also wicks moisture away from your foot.
Suz Redfearn investigated and reported her findings in Tuesday's Washington Post Health section.
Long story short: Do they work? Maybe.
$14–$20 a pair here.
Condoleezza Rice on 'The power of righteousness'
Today's New York Times features Steven R. Weisman's account of Secretary of State Condoleezza Rice's powerful speech yesterday at the University of Alabama.
Rice, home in her native state, touched all the right notes in her stealth campaign for the presidency in 2008.
"I don't want to run for office, but that doesn't mean some of you can't" — to a dozen children at Brunetta C. Hill Elementary School in Birmingham, where she attended classes until she was 11.
Weisman noted that until 1953, a year before Rice was born, it was called the Graymont Colored School.
Said Rice in Tuscaloosa: "Across the empire of Jim Crow, from upper Dixie to the lower Delta, the descendants of slaves shamed our nation with the power of righteousness, and redeemed America at last from its original sin of slavery."
Does that sound like someone who "doesn't want to run for office?"
Not to me: rather, it evokes Abraham Lincoln with its bold reach, eloquence and power.
I wonder if she writes her own speeches; I bet the answer is yes.
Shades of "the great communicator": in the introduction to her speech at the University of Alabama, with the huge Tennessee v Alabama game on tap, Rice, a fanatical football fan, brought forth a huge wave of applause and laughter when she said, "The Tide is gonna roll, roll, roll."
Here's Weisman's story.
- Rice, in Alabama, Draws Parallels for Democracy Everywhere
Secretary of State Condoleezza Rice, in an unusual evocation on Friday of her own past to make a point about the contemporary world, visited the segregated school that she attended and the university where Gov. George Wallace barred the door to blacks, declaring that Alabama had progressed by "light years" since those days.
It was a dramatic setting for her message, repeated for months in Muslim countries and elsewhere, often in the face of considerable skepticism: it is possible for Iraq and other societies to throw off their legacies of violence and oppression to become viable democracies.
"Across the empire of Jim Crow, from upper Dixie to the lower Delta, the descendants of slaves shamed our nation with the power of righteousness, and redeemed America at last from its original sin of slavery," Ms. Rice said in a speech at the University of Alabama in Tuscaloosa.
She was accompanied by the British foreign secretary, Jack Straw.
"By resolving the contradiction at the heart of our democracy, America finally found its voice as a true champion of democracy beyond its shores," Ms. Rice went on, criticizing skeptics who doubt that democracy is possible in the Muslim world for repeating the errors that whites had made about blacks in the civil rights struggles in the United States.
In returning to the place of her childhood, Ms. Rice was dipping into American domestic issues for the second time in recent weeks.
Among other things, she found that schoolchildren in Alabama were just as interested in whether she would run for public office someday as Sunday talk-show hosts were in Washington. (She also visited hurricane victims last month in the New Orleans area.)
"I don't want to run for office, but that doesn't mean some of you can't," Ms. Rice told a dozen children at the library of Brunetta C. Hill Elementary School in Birmingham, where she attended classes until the age of 11.
She said that it was the first time she had visited the school since then.
Until 1953, a year before Ms. Rice was born, the school's name was the Graymont Colored School.
Organized by her staff, the day was intended to go beyond the weight of the past and to underscore Birmingham's emergence as an educational and medical center with a visit to the university's medical school.
She spoke at an audience of the Blackburn Institute, named after a mentor of her father's, John L. Blackburn, who was in the audience.
The institute is a kind of honor society at the University of Alabama, but as Ms. Rice noted afterward, the loudest applause came when Coach Mike Shula of the university football team, the Crimson Tide, gave her and Mr. Straw autographed footballs.
They plan to attend Saturday's game between undefeated Alabama and Tennessee.
Indeed Ms. Rice, a fanatical football fan - she once had herself awakened in the middle of the night in Jerusalem to watch the end of a Super Bowl game - punctuated her speech introduction with "The Tide is gonna roll, roll, roll," to huge laughter and applause.
The serious part of Ms. Rice's message seemed aimed at multiple audiences.
In an interview before the trip, the secretary said she had wanted to travel more with foreign envoys out of Washington to show them the country and get to know them better.
Mr. Straw, she said, was a good choice because his parliamentary constituency in northern England is now 25 percent Muslim.
She said that whenever she mentioned to audiences around the world that the United States did not mean to lecture other countries about democracy because its own history was flawed, "it's been appreciated."
"I think of it as not talking about myself but talking about me as an example of a very American story," Ms. Rice said.
"It helps to bridge this sense that when we talk about democracy or democratic promotion, that we're somehow lecturing."
Interspersed during the day with Mr. Straw was the serious business of discussions about Syria and plans to take up the new accusations in a United Nations investigation of Syrian involvement in the assassination of former Prime Minister Rafik Hariri of Lebanon.
But most of the time it was an occasion for Ms. Rice to talk about herself, about the South and about democracy.
She spoke of "impatient patriots" who brought democracy to the South, to former Communist countries after the end of the cold war and to Asia and Latin America.
"Now is not the time to falter or fade," Ms. Rice said at the university.
"We must remain confident, as one American abolitionist was, that 'the arc of the moral universe is long, but it bends toward justice.'"
But don't take my word for it: watch and listen to Rice's speech here.
Official guitar of bookofjoe
You knew it was only a matter of time.
Order yours here.
[Via Shawn Lea and everythingandnothing]
BehindTheMedspeak: Vitamin C Shower
Do you believe in magic?
'Cause then this new shower technology (above) is likely to work for you.
It's just like magic.
From the website:
- VitaC shower filters contain 210 grams of pharmaceutical grade [why does that term always create a frisson of excitement in the backwaters of my mind?] Vitamin C, capable of neutralizing chlorine in 23,000 gallons of water.
Since different attributes of water will affect actual results, the lifetime is dependent on the temperature, pressure and quality of the water.
VitaC shower filters are capable of working continuously up to 100 hours.
The flow rate of the showerhead is roughly the same before and after the VitaC shower filter is installed.
It works universally as long as the regular showerhead can be used.
Let's see — suppose you spend ten minutes in the shower, on average.
You'll get 100 x 6 = 600 showers with Vitamin C raining down all over your body.
Say you take one shower every day — why, that's 20 months, well over a year and a half, of vitamin–enhanced showering.
All this can be yours for $49.99 here.
But perhaps you're not the showering type, preferring a more leisurely soak.
VitaC bath tablets were designed with you in mind.
From the website:
- Vitamin C dechlorination bath tablets are comprised of ascorbic acid, citric acid and sodium bicarbonate.
This powerful formula is designed to neutralize chlorine and chloramines in bathtubs or spas.
As VitaC bath tablets dissolve, the vitamin C becomes effervescent and begins to fizz.
One VitaC bath tablet is capable of neutralizing 1 ppm chlorine and chloramines in 100 gallons of water, eliminating the dry itchy skin caused by chlorine in bathtub or spas.
Great for a Luxury Bath!
for $29.95 here.
You know what really mystifies me about this product?
Why The Sharper Image isn't selling it.
Pretty amazing technology with a cool twist (or turn, to be more precise): simply place it on whichever side has the function you want.
Measures 2.5" x 2".
And no — for a lousy $3.79 for all this tricked–out tech you're not allowed to ask whether or not the two required AAA batteries are included.
Get a life.
Vlasic No Sugar Added Sweet Gherkins — A pickle without pity
Last evening I was at my neighborhood Kroger laying in provisions for the upcoming football–focused weekend (can you believe my beloved UCLA Bruins are still undefeated? "BEAT SC!" — sorry, me lapse) at bookofjoe world headquarters when I espied, where I usually find my favorite sweet pickles in the whole wide world — Vlasic Sweet Gherkins (above), as advertised on the label always "Tiny, Sweet, Crunchy" — Vlasic No Sugar Added Sweet Gherkins.
Who moved my pickles?
And did they put them in the cheese section?
But I digress.
I was kind of baffled, standing there staring at the jar of pickles.
How could a sweet pickle have "no sugar added?"
Isn't that an oxymoron?
I mean, did they figure out a way to genetically modify the pickle plant — 'cause that's where pickles come from, everyone knows that — to be sweet instead of bland?
I stood there, transfixed, for a few moments.
Then I emerged from my fugue state and got on with the business at hand.
I decided anything new is worth trying once so I put a jar in my shopping cart.
Now, you're saying, "Hey, stupid — why didn't you just look at the ingredients on the label?"
And I say to you, because that's not how we do things here.
Sentence first, verdict afterwards, as Lewis Carroll wrote so memorably.
I mean, I'm not looking for low–cal or no–cal treats — I just want my MTV and my delicious "tiny, sweet, crunchy" pickles.
After I got home and unpacked and put them in the fridge I went off to do other stuff (but different from the day before) while they chilled.
A watched pickle never gets cold — everyone knows that.
Then, just now, I tried one.
First of all they don't even look right — the green seems less intense.
The texture's all wrong — they don't crunch right at all, instead being rather soft and bendy in the mouth.
And the taste is Diet Coke gone pickle.
Into the trash with this loser product.
I looked at the label, dear reader, as you wanted me too, before I tossed them: "Sucralose."
is more like it.
But you know what?
You know how, when you're outside trying to do something and you've attached an extension cord to get electricity to where you're doing it, the extension cord has a habit of disconnecting when you pull on the junction of it and the appliance's cord?
Never again if you've got one of these nifty items.
From the website:
- This unique device saves you time and aggravation by preventing accidental uncoupling of electrical cords.
Simply snap the Protect-A-Cord around connected area and plugs stay put.
Allows your cord connection to pass easily through sawhorses, weeds, hedges, ladders, etc.
Can be stored at end of the power tool or extension cord when not in use.
Made of durable plastic.
But perhaps mademoiselle needs a secure electrical connection that can withstand the elements.
The Watertight Cord Connector (below) is just your ticket.
It connects two extension cords by clamping them firmly together within a watertight gasket.
However — as noted on the website, the connection, once made, cannot be easily undone.
Some connections are like that.
Therefore the Watertight Cord Connector would be most useful not with an appliance or tool but, rather, two extension cords.
This device costs $3.95 here.
And that, friends, completes today's exploration of the cord connection space.