Thursday, March 31, 2005

Mustache contest

Do you have an impressive mustache?

The world beard and mustache contest

is being held next fall

Science fair experiment

1001 things to do with liquid nitrogen...

No, Luke, don't try these things at home...

We always have Liquid nitrogen in the office to burn off warts...HMMM...

Narnia update

cool concept art here:


That, of course, is Edward at the White Witch's ice castle...

And HollywoodJesus has a summary and discussion on the Magician's nephew...

This is not the first written Narnia book, but tells why the wardrobe became a portal to Narnia.

Wednesday, March 30, 2005

Cultural bias

A NYTimes essay discovers people who have been through terrible things usually don't need counseling and psychiatry to "help" them...

It would not be the first time that psychological aid was regarded by non-Western recipients as a kind gesture but a bad fit. For the last 15 years or so, humanitarian workers have been exporting the concept of post-traumatic stress disorder and trauma counseling around the globe.

They have rushed in to impose Western "debriefing" - a group therapy technique intended to get victims to express their feelings about a horrific event and to relive it as vividly as they can - without regard to the needs of the victims, their natural healing systems or their very conception of what mental illness might be.

One reason I didn't fit in well when I took a psychiatry rotation among rich yuppies is that I was not sensitive enough to feel they needed psychiatry. I did okay with the REAL mentally ill-- the schizophrenics or severely depressed, for example...

And EVERY culture has ways to cope...often using religion and ceremonies.

The Navajo, for example, held a "sing" ceremony for the codetalkers.

And Catholics always had confession, with imposed penance-- which in the middle ages might include working with the poor in a monastery or going on a pilgrimage...

After 9-11, we saw this type of healing in the many shrines that sprung up in Manhattan, and at the many Catholic funeral masses...

Attention people who hate alarm clocks.

This one runs and hides so you won't hit it

also via boingboing


No, Luke, you can't feed Dane's basketball to the local catfish...

via boingboing

Overblown "drug" data

If you read this, you think half of American kids have druggie parents.

But they inflate the data by including tobacco use (the only "sin" left among the PC) and "binge drinking", which they fail to define (If a person gets tipsy from a couple beers on a Friday night, this is "binge drinking).

Tobacco kills the body, not the soul, but the PC want it illegal. Illicit drugs and abuse of prescription drugs kills the soul but not the body, but the PC want to be high and happy, so want to legalize all illicit drugs...(And by the PC I mean funding by rich people like George Soros on the left and William Buckley Jr. on the right who push to eliminate all drug laws).

The actual statistics are 11%, which sounds about right...alas, it is probably 30 % of our patients, since much of the psychological and even physical problems we see are either drug abuse related or family members stressed by druggie children/parents/spouses....

Tuesday, March 29, 2005

Fashion statement take three

The Birkenstock Nairobi

Via Manolo of course...

Fashion statement take two

Stem cells can cure baldness...

And hair follicles are a good source of stem cells...
Hair is good source of stem cells
Image of baldness
Most people have about 100,000 hairs on their head
US scientists say they found a good source of stem cells - hair follicles.

The fact that hair grows quickly and is continually replenished makes it an attractive source to harvest the amount of stem cells needed for treatments.

This has been a major stumbling block of stem cell research, as well as controversy surrounding the ethics of harvesting cells from embryos.

The Proceedings of the National Academy of Science study shows nerve cells can be grown from hair follicle stem cells.

Stem cells are immature cells that have the ability to become any kind of tissue in the body.

Yul Brenner, call your office....

Fashion notes take one

Having your lips pierced can lead to receeding gums...and leave you toothless...

Ah, but you'll be the trendiest toothless goth in your neighborhood...

Monday, March 28, 2005

Alternative medicine wacko alert...

Dancing lessons for the homeless...

Most American homeless have psychiatric problems or major substance abuse problems...however, the naive teacher claims...

The benefits the activities bring are often the hardest for those living an uncertain life on the streets to attain.

They include relaxation and suppleness, and improved mental and spiritual wellbeing.

Improving the posture is of particular benefit, as it helps to minmise many of the normal aches and pains caused by sleeping rough.

Yup. and it's probably cheaper than finding them a bed...

But the mindset behind this kind of nonsense is not only absurd, but dangerous...

"I think it is important to look at a person as a whole. Homeless people are the worst off and most disadvantaged people.

Yoga for the homeless
Yoga helps relaxation (Crisis/Michael Grieve)

"If you have somebody who is in a terrible way physically, with something like tuberculosis, then something like meditation can make them feel better inside."


But when you catch TB from them, maybe YOU won't feel so well....

Doctor Koch, call your office....

Allergic to kitty?

A new vaccine may make it possible for you to have a cat...

I'd be sarcastic about this, but I've treated some pretty bad cat allergy reactions in the emergency room...

Worried about glaciers melting from global warming?

Do not fear...

Reynolds wrap is here...

Art quiz

Answer: THIS is...

A. An orange crate

B. A four dimension Mobilus strip

C.a statue of Winston Churchill

D. all of the above...

Joy and the help... Posted by Hello
Here are the kids looking for eggs in our front garden Posted by Hello
Then the kids had an Easter egg hunt Posted by Hello
But first, everyone had to sit through a sermon. Posted by Hello
lots of people from their church attended the party Posted by Hello
Lolo and Florinda at Joy's birthday party Posted by Hello

Sunday, March 27, 2005

You're fired....

Too much bad news.

To lighten up, read this link....Manolo thinks Donald Trump is....well, read the whole thing....

Fixing elections, Mugabe style.

The Guardian
reports what I have known for a couple years:

Mugabe is preventing food aid from going to his "enemies"...and will starve those who don't vote for him...

and some in the UK are making a profit by selling him stun guns, used to torture people...

Nope, no human rights violations going on here...just move along...

Good news/bad news

Good news: New Prevnar/pneumonia vaccine for infants saves lives in Africa.

Bad news: It costs $250 for a series of four a country where the average wage is less than a thousand dollars a year

When we worked in Africa, the government subsidized measles vaccine.

Now, measles had about a fifty percent mortality-- it was closer to 90 percent in malnourished kids. And the vaccine cost about five dollars a dose, but the government subsidized it so it only cost us a dollar.

So we split the vaccine dose in half (costing us 50 cents per dose) and asked the mothers to give five cents toward the vaccine...some couldn't afford it...but actually, most could...

In some countries back then, in the 1970's and early 1980's, they divided the vaccine into one fifth dosage. Yes, some kids still got measles, but usually a less severe case and didn't die.

This vaccine sounds great: But in countries where children die of malaria for lack of a dollar's worth of anti malaria medicine, and die of diarrhea, for lack of a quarter's worth of WHO Rehydration fluid, one suspects this vaccine will be a lower priority than other public health funding...

Attention collectors

Those of you who collect trading cards might want to add THESE to your collection.

It's fun, it's free, it's gross...

via proximaltubule blog

Hey Luke, print them out for your friends...

Carnival of the recipes 32


Bon Appetit!

Saturday, March 26, 2005


I've heard of water births, but this birth

makes you wonder what the mom was thinking...
Here in the Philippines, people understand suffering. Yes, things are "modernizing", but most of the country is very close to nature, and herbal and chinese medicine is widely used, as is massage and other natural treatments. But suffering and death is part of life, seen closely in close knit communities...

This is why there is admiration of courage in suffering. A person may seek a cure, but will stoically bear the pain...

And similarly, there is an identification with the suffering of Christ on the cross.

God isn't way up there, distant. He's part of the family. And Mama Mary is the mother, nearby for all your troubles, and greatly loved.

Historically, this is why a playboy like Ninoy Acquino, when placed in jail and offered an easy "plea bargain" by Marcos (i.e. that would leave him free but essentially eliminate him as a viable political opponant of the Marcos disctatorship), Ninoy said first, it was purely a game, being stubborn...but then he held on. He found courage....and stayed in jail until Marcos finally used the excuse that he needed open heart surgery to get him out of the way.

But then something else happened...Ninoy found the courage to return to oppose Marcos in the presidential election, an act that led to his assasination at the airport, his wife running against Marcos, and ultimately the "people power" revolution that overcame Marcos.

So what does this have to do with Penitants carrying crosses down the streets of Philippine villages?

The supernatural is not so distant here as in the "logical" nations...
Ninoy reportedly had a vison of Christ in jail that gave him the moral strength to oppose Marcos, and the reason that Marcos' thugs did not shoot the praying crowds on the EDSA was that the soldiers said a beautiful lady in white came up to them and begged them "don't shoot my children"...and they didn't...

(Cardinal Sin (!) was once asked if the "Lady in white" could have been one of the nuns...he answered with a twinkle in his eye that he knew all the nuns, and none of them were that good looking.)

So we have the penitents scourging themselves in Pampanga, and reenaction of the crucifixion.

In our town, I haven't seen any cross carrying...But around here, we have people putting up small chapels and chanting the gospels and prayers for 3 days...kept me awake.

And some nearby towns had people carring crosses, and processions singing hymns and carrying statues.

Ah, but we Americans are too sophisticated for that, aren't we?

Well, I wonder why pep rallies for football teams are more "logical" than those celebrating God coming to earth and sharing our sorrows.

As for visions... it is not unusual for patients to shyly relate voices, dreams or visions that happened to them at time of stress...but in the USA, few will tell you about them unless they are sure you will not ridicule them.

There is even a jolly man who sells grills on American TV. I'm old enough to remember when he was mean and hated in the boxing world. What happened? He lost a boxing bout, and was sitting cursing and angry and shouting at those around him, and then he looked up...and saw Christ...

No photos of any of this: my camera doesn't work at night.

and no blogs for awhile: Electricity is off again, and laptop battery is getting low...
is the article about the Penitentes....

Friday, March 25, 2005

th lion of Baguio city Posted by Hello

Not using your treadmill?

Not using your treadmill?

Donate it to the local SPCA so they can let their vampire bats exercize on it...

Not using your old coconut shells? Donate them to the SPCA also...You local octopus needs them to dress up...

both links via boingboing...

With all the bad news I need to lighten up sometimes.

African outbreak

Marburg Hemorrhagic fever has hit Angola

PDF file
on Marburg and Ebola fever here...

I knew an African lab tech who actually survived it...most died...

and notice this paragraph:
In recent months, tens of thousands of refugees from Angola's 21-year civil war have passed through Uíge,

translation: the central government was communist, so they brought in soldiers from Cuba to fight the majority of tribes that opposed them.

Wonder is Stephen Spielburg and others who gush about Castro recognize that his soldiers have caused hundreds of thousands of deaths in this country by supporting an unpopular government that oppresses the majority of it's people? Naaah....the dead are black, so not politically correct...anymore than Ruandans killed under the eyes of UN peacekeepers, or those who starved in Mozambique under that communist government were politically correct...

Of course, the dirty little secret is that the cubans made it possible for the oil companies to operate safely....

Mother Jones, call your office...

Thursday, March 24, 2005

chose life

MS NBC got a PC jesuit to explain why the church does not forbid stopping extraordinary treatment.

As Nat Hentoff remarked, bioethicists are "apologists for death"-- like sophists of old, they are able to explain to us why we can stop
treatment. Alas, what they can't explain is why people should live.

A lot of the discussions on Schiavo are off the mark. If she was dying, I would have no problem with withholding treatment. There is
a difference between killing and allowing to die. Removing a feeding tube is killing, especially removing the feeding tube from a
woman who can swallow food...and if Schiavo could not swallow food, she would have died from aspiration pneumonia long ago...

(One PC newspaper insisted she was "dying" and gave the odds against longer life. I think the chance of living 15 years was 1 in
15,000....hello, she has lived fifteen years)....

So despite reports, she is not dying. She is merely severely disabled. All the arguments about "vegetative" state is nonsense: this is a fuzzy diagnosis that cannot be diagnosed easily, or rather, it can easily be overdiagnosed by hired guns and neurologists (a British Medical journal survey showed it was overdiagnosed 40% of the time). In other words, flip a coin to whether Sciavo is a "vegetable", and then ask: Who devised such an inhumane dehumanizing term? And why?

Language is important. That's why we discuss "A woman's choice" rather than "killing unwanted children in the womb".

Alas, we have had a generation of ethicists, doctors, and the press who now no longer have the moral vocabulary to explain why a
disabled person with little chance of improvement should nevertheless be treated with respect and even viewed with love as a child of God.

And THIS, my friends is a problem.

Peggy Noonan
has the best article on this:

Our children have been reared in the age of abortion, and are coming of age in a time when seemingly respectable people are
enthusiastic for euthanasia. It cannot be good for our children, and the world they will make, that they are given this new lesson that
human life is not precious, not touched by the divine, not of infinite value.

Once you "know" that--that human life is not so special after all--then everything is possible, and none of it is good. When a society
comes to believe that human life is not inherently worth living, it is a slippery slope to the gas chamber.

Oh, but we are such a humane people. We would never do such things...

Except that this week the New York Times had an article praising a Dutch doctor who kills newborn infants...most of the victims had
meningomyelocoels, which can be treated, and who will have a fairly good IQ and fairly good quality of life...something not mentioned in the article.

But they are merely the polite tip of the iceburg. Lileks has been perusing the web, and comments:
Then there are those who brim with passion not just for the state-approved quietus, but with fury for those who oppose it. Fury and
impatience. I’m not talking about the people who regard Schiavo as brain dead and believe her guardian should be allowed to carry
out what he insists are her wishes, without the state’s intercession – I mean those who show up on message boards and comment forums sneering about vegetables-in-pampers, and have a good larf pointing at the christers with their imaginary friend in the sky who tells them that an angel will come down and give her a brain like the Wizard of Oz or somethin’. It’s this combination of nihilism,
cynicism and a flat nasty refusal to even consider the possibility of transcendence, puffed up with that brackish snarkier-than-thou style that makes the Comic Book Guy the patron saint of the Usenet.

Yes. And the bad news is that a lot of our ethicists are merely more polite in saying the same thing...things like "criteria for personhood"...."vegetative state"...."life unworthy of life"...

Who among our bishops has the guts to say: we are judged by how we treat the least of our brethren? And caring for the disabled is not a waste of money but the highest most valuable thing someone can do.

Pearl Buck, the mother of a retarded child, said it this way:
"It can be summed up perhaps, by saying that in
this world, whom cruelty prevails in so
many aspects of can life, I would act add
the choice m kill rather tharn to let live.
A retarded child, a handicapped human
being, brings its own gift to life, even to
the life of normal human being&. That
gift is comprehended in the lessons of
patience, understanding and mercy,
lessons which we all need in receive and
to practice with one another, whatever
we are."

But there is a huge issue that no one really has the guts to bring up: What if it were me. Well, not no one. Charles Krauthammar brings
it up and says he wouldn't want it. He has knowlege of suffering, so should be listened to in this matter...Indeed, who would...but....

What if God wants it? What if it was God's will that you should live completely dependent on others? What if refusing this meant that
your immortal soul -- and perhaps the souls of those around you-- would be negatively affected?

One of my Native American friends was discussing this with her medicine man...she was college educated and so knew all the pro abortion and pro euthanasia arguments. And he told her: "No. It is not the Indian way. We all have a life from the Great spirit, and we cannot take it. We all have a road to travel before we die. "

To a devout Native American believer, A child conceived is in the womb is considered there by the will of God and has a road to
travel. (A Christian would point out the verse "You knew me when I was knit in my mother's womb, you saw the path of my life").

And suffering is for a reason: To make us wise, to purify us.

Ironically, it is LILEKS who points this out-- by quoting Startrek...

I remember being horrified by him as a kid, because it seemed the
perfect smothering claustrophobia nightmare: unable to exist outside a motorized iron lung, face scarred to immobility, unable to
communicate beyond a pathetic beep. But it never occurred to us why he was still alive, why someone hadn’t slipped him the needle
or put a pillow over his face in the dark of night. That didn’t seem like an option.

No. In those days, even Hollywood recognized that sometimes disability and suffering had an ultimate reason, and that all things work to the best for those who love God and hold to his purpose.

But such hard words are rarely heard nowadays...

Yes, we have gone a long way, baby...
land in the center is ours...bought years ago by our family. Note that local squatters have it planted with flowers. Posted by Hello
we just got back from visiting Baguio, the city of the pines up in the mountains Posted by Hello

Wednesday, March 23, 2005

Red Lake take four

Okay; let me tell you about Red Lake.
I worked there for four years a couple years back.
There are many many good people there. But the

joke is that there is marijuana in the water supply,

and the going rate for narcotics at the casino was

five dollars. And of course there is alcohol.
The drugs and alcohol are like a demon that

destroys families.
Most live on commodities and welfare. Younger

people leave for jobs, although the casino is a

godsend in that it does provide jobs. The bad news

is that there aren't many people to visit the casinos

run by the tribe, since there are fancier casinos

closer to Duluth and other population centers.
Most people had large extended families. The

shooter here lived with grandfather and his common

law wife. That again is common. Children are often

abandoned or orphaned, such as here, but usually

taken in by family members.
Unlike white people, no one died alone. If you had

to discuss medical treatment, you often had to

discuss it with 15 relatives and then they would all

say it's up to the patient.
Younger people often were torn between tribal land

and the outside. Older people often rarely knew

white culture, except from schools.
Any time you have culture changing, you get

stresses, and the differences psychologically and

culturally were so different that many turn to drugs

and alcohol. It did not help that many Indian

children were taken from families and sent to

boarding schools where they were made to be

ashamed to speak their own language. But now the

tribes run their own schools...and often include

language classes.
Then there is abuse-- both physical and sexual

abuse of both girls and boys, and often these

children are full of rage...
Children involved in Nazi phantasies often have

abuse in the background...or are

schizophrenic...was he hallucinating? Or paranoid?

or angry?
However, despite all the chaos and anger, most of

the people are good people...
and this tradgedy will probably affect everyone


Red Lake Take Three

None of the articles mention the local indian hospital. But presumably the triage occurred there first.

I have no details on this, but alas murderous outbreaks are not unknown to IHS doctors. I have been through two: One where five died on one of the Sioux reservations in South Dakota, and one where five were stabbed and one died in Red Lake. And mass casualties are not unknown in rural hospitals, although most that I have worked on have been major car wrecks.

I'll summarize the Red Lake incident, partly because it shows how the culture works, and partly to show how a small rural hospital copes with mass trauma.

It was about ten years ago, and I was a GP and not on call. Most of the doctors lived off reservation because white kids can't go to Indian schools. But the doctor on call had to be nearby, and we always had an Emergency room doctor hired from the civilian sector.

What woke me that night was hearing two ambulances going out-- this meant something bad was probably going to come in, so I got dressed, and sure enough, a few minutes later I got a call to get to the hospital STAT...

When we had any "mass casualty" situation, there was a list of everyone nearby, whether on or off duty. I lived there, so usually was called. And any other doctor around was called (sometimes we had temporary doctors, or ER doctors staying over between shifts)... The nurses living nearby were called, as were lab, Xray, all the nearby EMT's (ambulance workers), and dietary. (To supply coffee for staff and family members).

Usually we called the nearby Catholic priest to give last rites and console the family members.(Our priest then was an older, very holy priest...He even had permission from the local medicine man to pray over patients who followed traditional religion). If he was not available, the Episcopal priest was called from the next town. Social workers and secretaries often came to help with family and with paper work. Family were called, of course...and often extended family if we had time...

Walking to the hospital, I knew it was bad, because there was loud crying and shouting at the emergency entrance...relatives were fighting with the security guards keeping them out....

I went in, and found one of our basketball team boys lying dead. They had just stopped the "code" (i.e. CPR). There were three other stab victims waiting for evaluation but were stable, so I examined them while the ER doctor talked to the family, and transfer the body to a room where family could mourn in private.

Three thugs crashed a graduation party, and got into a fight with some of the graduates, and stabbed three or four kids. The dead boy, a champion basketball player, was stabbed in the heart.

The family called the ambulance, but both our ambulances were called west to a very bad car wreck, and the nearest ambulance was 30 miles north, would take ten minutes to get to the graduation party, and ten more minutes to get to the the family placed him in a car and brought him in, alas, DOA from a stab wound to the heart....

I helped transfer two other patients to North Country hospital, one with a small pneumothorax (collapsed lung) and one who was only minor injury (the stab wound did not enter the chest cavity)...we sent them to North Country hospital in the same ambulance, so they could get a stat CT scan and a chest tube if needed...or if needed, blood...(they both were okay). We could put in chest tubes, but had no blood and no surgeon...This meant a lot of phone calls, getting IV's started ( the trip took 28 minutes if the road was clear).

I did this because two minutes later, three critical patients from the car accident came in. One man had pulled out of a driveway onto the main hiway, but didn't see the oncoming car, which couldn't stop, so broadsided his took almost an hour to get him from the very badly smashed car.

The temporary doctor took care of the little girl-- turned out she had a fractured femur, and we stablized her and transferred her about four hours later to get orthopedic treatment.

The doctor on call got her father, who ended up fine but had six rib fractures. (thank God for seat belts). He was admitted for observation.

But the third patient was the critical one, and the ER doctor, who had the most experience with trauma, started working on him. The patient had a severe head fracture, a fracture of his arm and internal injuries. It took an hour for the EMT and fire dept to extricate him from a badly smashed car. The ER doctor intubated him, we started fluids, and we arranged a helicopter to transfer him to Fargo. I didn't help with the case, but his stepmother was my patient, so I spent most of the time consoling her and helping to arrange the helicopter ambulance... (he lived, by the way)...

Now, transfer by ambulance was not uncommon, but in norther Minnesota, you can't always do this. If there is poor visibility, or it's snowing or windy, you can't bring in a helicopter. So you have to send to North Country Hospital and if they can't handle it, transfer either by ground or fixed wing to Fargo or Minneapolis.

Nurses can often arrange this, but doctors have to talk to other doctors to give the details. And our secretaries were the ones xeroxing records to go along.

I don't remember what time I got to bed that night, but it was a bad night.

Living on a reservation shows you really terrible things...but it also shows you people despite these terrible things, despite the rampant alcoholism, despite the despair, still worry about each other and help each other.

No one-- and I mean no one-- died neglected or alone.

Red lake take two.

Indian report here...

Mr. Lussier, the grandfather, was a man who will be mourned. He was a kind guy. Ms. Rogers was also okay...only met her once.

I probably knew some of the kids names here.

But I wonder why no mention that they were probably triaged at the local IHS hospital...not mentioned in either news report.

Three died in Bemidji...and two transferred to Fargo...where they have a neurosurgeon.

''To all those affected, I offer our prayers with greatest respect and deepest sorrow. May the Holy People bestow their blessings on your Nation during this difficult time,'' Morgan said.


sad day in red lake

When a child is released from a mental hospital and kept out of school because he is violent, then what is the psychiatrist's responsibility?
On the other hand, knowing the violence in Red Lake, this is only unusual in that it made the paper...when I was there, we had four kids stabbed at a party, and a couple of murders, usually drug related or fights....
On the other hand, I'm not sure I'd trust the NYTimes doesn't even get the map correct...will have to check the Indian times...

Sunday, March 20, 2005

aggh the world is ending the world is ending...

Trailer is up for war of the worlds...

First starwars in hell, now spielburg doing HG Wells...


Carnival of the recipes take 31

Check the recipes this week at the Flyingspacemonkey

In honor of my grandson Dane, I will post a Marmite recipe...

Marmite Sausage and Melted Cheese Grilled Sandwich
07 Jan 2005, Seamus


Serves 4 people:

  • 4 Sausages
  • Marmite Yeast Extract
  • 4 Thick slices of bread
  • 100g grated Cheddar cheese


Brush the sausages with MARMITE and grill or pan fry until cooked, turning occasionally.

Spread the bread with a little butter and a thin layer of MARMITE.

Slice the sausages in half lengthways and place on top of the bread.

Sprinkle with the grated cheese and place under a hot grill. Cook until the cheese is bubbling.

If you hate Marmite (or can't find it at the local Walmart) substitute Soysauce...

Follow the money


Hospitals can end life support

Decision hinges on patient's ability to pay, prognosis

Yup...which is why there is a groundswell by everyone except the NYTimes to keep Terry Schiavo see, her loving husband didn't remember that she didn't want to treated if brain damaged until after he settled a large malpractice suit that gave a huge amount of money for her rehabilitation...once the suit was settled, he stopped rehabilitation treatment to stop, stuck her in a hospice, sued to stop her tube feeding, and moved in with his girlfriend and had several kids by her...

My clinical take is that if she really was in "persistant vegetative state", she would have died of aspiration old study in the NEJM showed the average life span on a feeding tube for dysphagia is six die from aspirating saliva...if you can swallow saliva, you probably could eat...however, the prodeath people have a neurologist who claims even spoon feeding such a person is "medical treatment"...

Most people in Florida, with it's huge elderly population, have no problem with stopping unwanted treatment---And feeding tubes in terminal Alzheimer's disease or after a severe stroke doesn't really prolong life ...but this case has such a smell of evil that even the local Florida Democrats voted with Jeb to stop this travesty....and the fact that the courts overturned the legislature and that these same local courts will not allow another judge to rule on the evidence--well, you figure something is very very wrong with the decision...and the local Democrats figure that "judicial lawmaking" will end up being a big election issue if they don't put a stop to it...

Peggy's Noonan's says it best: Her essay is here...

Palm Sunday

Yesterday, the neighborhood girls came up asking for bouginvilla flowers for palm sunday.
In most Catholic churches, they hold a procession before mass, although in the states usually it's inside church due to the weather.
They take a statue of Jesus on a donkey and roll it down the street, and everyone waves palm branches and throws flowers in the air to celebrate Christ as king...bouginvilla flowers, being actually a colorful leaf, tend not to wilt quickly so are a favorite to throw...
We arrived at church at the end of the procession, which started 630 am (no photos, sorry I forgot my camera)...and of course the service was a bit long...they read the entire story of Christ's passion at mass, and then, unlike the US, where people are restless, the priest gave a long and passionate service about how Christ loves us.
Actually Filippinos, especially the kids, tend to be just as restless as Americans. But unlike Americans, they move in and out of church when they get restless...and since church is full, there is no problem standing in the back or side...when it is very hot, I stand at the side so I can go out if I feel faint. But since we started going to mass at 7 30 instead of 9 am or 4 30 pm, I haven't had that problem...
The earliest mass and procession today was 430, the mass of the rooster, which is mainly for those who have to work...

Saturday, March 19, 2005

Philippine update

The food poisonings of all those poor school kids was apparantly due to contamination from organophosphate insecticide...

Probably accidentally mixed, since although the cook did not die, two of her grandchildren did.

Second, Belmont club has a report on the AbuSaif prison break attempt...
The good news is that two notorious leaders were killed. The bad news is that they will probably retaliate, and the Holyweek/Easter holidays are this week, so lots of people taking buses, ferries, and airplanes home to the provinces....(abu saif has bombed all three at one time or another).

Greg Sheridan has the background on this group....

Friday, March 18, 2005

looking pretty good for 80 years Posted by Hello

Danny Boy

Article here about Danny Boy

Oh, Danny boy, the pipes, the pipes are calling
From glen to glen and down the mountain side
The summer’s gone, and all the roses falling
It’s you, it’s you must go, and I must bide

But come ye back when summer’s in the meadow
Or when the valley’s hushed and white with snow
I’ll be here in sunshine or in shadow
Danny boy, Oh Danny boy, I love you so

But if you come and all the flowers are dying
If I am dead, as dead I well may be
You’ll come and find the place where I am lying
And kneel and say an “Ave” there for me

And I will know, though soft ye tread around me
And then my grave will richer sweeter be
And you’ll bend down and tell me that you love me
And I will rest in peace until you come to me


I heard "BAM BAM" which woke me in the middle of the night...and then the crying of the kitten at our window....We had a thunderstorm last night...which is unusual, since it is the dry season right now. The electricity is off, and I'm blogging on my laptop battery.

Every morning we go for a walk downtown, but it's raining too hard today.
It's seven am here now.

Guess I'll have to read a book.

And how is YOUR day?

Thursday, March 17, 2005

Modern Art take two

Modern art likes to be different, but it does not have to be disgusting like the art mentioned in an earlier post...

You can make art from twinkies

And from latte...

Wonder if they sell the exhibits when they're done, or just eat them?


If you have lived in the UK, you know about Marmite (in Australia, it's called Vegemite). It's a black yeast paste that tastes like...gluey soy sauce is the closest thing I think of. You spread it on toast or bread...

Well, the latest Marmite commercial is here...but tell them you live in the UK or they won't let you watch it...

It must be good, it's scaring the kids in London...

Wednesday, March 16, 2005

Year of the Rooster

Gift suggestion:Feng Shu underwear...

“If you have a dragon on your underpants you will be protected,” said Law.

(via davebarryblog)

Michael Jordan, call your office...

Health tip

Have a laugh or two and live longer...

Attention Muggers

little old men can be dangerous...

Charles Bronson call your office

The tale of drunken mouse

Got the shakes? Have we got a product for you...

FYI: Parkinson's has resting tremor. Familial tremor and alcoholic tremor is when you move, i.e. intention tremor....

Attention Ebay

The latest fad: Collecting Ex dictator's dentures


The UK art galleries are more into "art" than art.

But feces and burlap sacs are "symbolic" aren't they---not.


Information here...

(Via Ruidosoblog)


Scupture dies...

Actually Mark is wrong. People with Down's have an understanding of art...
like most people, their abilities and disabilities are not "across the board"...People with Down's syndrome have even been known to go to college. Their IQ is on the average 4o points below their parents, so the average IQ is 50-60 that of a 4 to six year old child, but some are higher functioning..

and if she 'couldn't hear" then she had a double handicap...people with Down's usually hear ok. They are more prone to ear infections due to facial abnormalities so may need tube in their ears...but of course, just because you have Downs doesn't mean you can't have another handicap...

And most speak. Due to tongue abnormalities, they are slow in articulating, which is why many parents now teach them American sign language, so they can learn to communicate at an earlier age.

Adults with Down's were rare in the past-- because they have an immune defect, in the past most died by late childhood of pneumonia etc.---but now with penicillin, we see adults, who often live either at home or group homes. They have fewer behavior problems than other forms of retardation.

Medically, many have congenital heart disease. Do you treat them surgically? Ethical discussion...depends on their ability to recover. Nowadays, usually yes. When heart surgery was rare, i.e. when I was in medical school, usually no. I treated one adult with this heart problem...he was sympomatic and becoming terminal with his 30s...

Another common problem is hypothyroidism. It can sneak up on them. Another is they have a high rate of leukemia, probably related to their immune defect. And if they get hepatitis B (which was common in those institutionalized) they tend to get chronic hepatitis B, which is both infectious to others if cleanliness is bad, and also can lead to liver failure.

Finally, people with Downs' tend to get Alzheimer's in their 40's...why is unknown.

I've had people say "how can you tell if they have alzheimers when they are retarded"...dumb question. Most of these people function like a 6 year old child but have a fairly good memory..., and when they start forgetting, having temper tantrums, getting confused, you worry about Alzheimer's disease.

Chris Burke, call your office...

Tuesday, March 15, 2005

Kinder, gentler weapons


Dave Barry suggests that we use them on people who use cellphones in public...

(Via Davebarryblog and gizomodo)

No, Luke, you can't use one when you're mad at Madeline...
Fred outside our house, looking down the street. It gives you an idea of what the area looks like now... Posted by Hello
New car arrived today... Posted by Hello

Hannibal Lector take two

Tragic climax to the failed prison escape...this morning, the press here thought that they had settled peacefully, but it fell through...


China is replacing their metal manhole covers with plastic ones...seems that the local theives are stealing the covers and selling them for scrap metal...

240 000 were stolen last year in Beijing alone. But no body saw the theives...hmmm....

And I thought Manila was corrupt.

Erap, call your office....

Slum clearance

This happens every couple of months...luckily the only casualties were some pigs...

The official "cause" is a candle...the neighbors complain it was due to shabu addicts...

But often the "cause" is a landlord who sees this as a easy way to clear his land...

Open lots are prone to be used for all sorts of things. We used to have goats and caribou grazing across the street (now traffic is too heavy, and few vacant lots are left to make the risk worthwhile). But we still have garbage left and then burned in the lot across the street. And in the lot between our house and the large new supermarket we now have a man who has a shanty built from scrap wood. We see him washing in the morning....he's fairly young, so I suspect he's an outsider looking for work, and has no local family. No theft yet from our house...

After Mt Pinatubo we had a lot of this, but these people have been resettled.

However, with "globalization" and with our town now officially a "city", our provincial town is slowly changing...

Maybe we'll move to the farm if it gets worse...On the other hand, we have Jollibee nearby, a "supermarket" and the old outside market within walking distance, we have a park to jog in and for nightime parties two blocks down, and the old town hall across the street is being made into a hospital...

Hannibal Lector update

Whenever I hear about how europe cries "human rights abuse" that prisoners in Gitmo are shackled etc. I remember the movies Silence of the Lambs and Con Air.
Well, Gloria hasn't seen the movies and so the result is this: LINK
As a result of kindliness, we have a policeman dead, and "guarantees" for "having their grievences aired" (by "Media interviews after arrest), and "speedy court cases"

I mean, just because they bomb buses in Makati, behead priests, children, and foreigners, and hold tourists for ransom doesn't mean that they don't have the right for their side of the story to be broadcase on ABC....

Luckily this is the Philippines, so the court cases won't have Johnny Cochrane...

Johnny Taliban, call your office...

Monday, March 14, 2005

Say NO to ponchos

The famous Manolo saw Martha Stewart dressed in a dingy poncho, and now is promoting a NO PONCHO oath to prevent furthur photos of similar atrocious fashion trends.

The Manolo No-Poncho Pledge
“I (insert the name here) swear on the head and/or the grave of my sainted granny to never wear, buy, knit, crochet, or fashion from the old throw rug, the poncho. And if the poncho it is given to me as the gift, I will graciously thank the giver and then, when she has left, put the poncho into the dog’s bed and/or the trash as the case she may be. Only by doing these things faithfully can I help end for the good of the humanity the scourge that is the poncho. So help me Manolo.”

Manolo says, it is indeed sad that is has come to this point.


Bluetooth spy rifle

You think laws protect you against snooping by the FBI...

but wireless is insecure...,.. to teenaged computer nerds who want to spy.

(via boingboing)


Cigarettes, the only evil in the modern world

I sometimes tease my patients that the only vice we are alowed to show negative judgement against is smoking (not promiscuity, not stealing, not drug use, not adultery, but smoking tobacco).

Ah, you don't believe me?


Notice, he's not condemned for his support of Stalin's gulag, but for cigarettes.


Starwars in hell


Trailer here

Sunday, March 13, 2005

Cassava or pesticide poisoning?

The latest news about the 29 children dead of food poisoning from a Cassava baseds snack is that there is a question if it was due to poorly prepared snack, since cooking etc destroys this poison, or if it was contaminated by an organophosphate pesticide found in the house of the one who prepared the snack.

It seems to be the usual confusion, since symptoms are different... and to add to the confusion, the some patients had different symptoms, and some responded to different antidotes.

Organophosphates cause dilated pupils, paralysis, sweating, anxiety, muscle spasms, tearing, vomiting and diarrhea. You treat it with atropine. Most Emergency room docs see mild cases of this, usually a gardner who doesn't spray correctly. Children are especially prone to symptoms, as are animals...(our kittens developed mild symptoms from overdoing flea shampoo one year...luckily, we washed them off, and they quickly recovered).

However, Cassava poisoning is not unknown link link

Symptoms as described by Dr. Golden of Aberdeen University are mainly neurological:
Symptoms of cassava poisoning - known as "Konzo" have been described in detail. There is a sudden onset of spastic paraparesis affecting mainly women and adolescents. There is no flaccid phase to the illness, the reflexes are exaggerated with clonus, strongly planter-flexed feet and a scissors-gait in those that can stand. The condition is not progressive and there are no sensory signs or symptoms.

Konzo is common in African countries that use cassava roots as a primary food source. I never saw any cases when I worked in Africa, since people ate rice in one and maize porridge in the other country....Like in the Philippines it was an occassional snack/food supplement only... However, in countries with very poor soil like Mozambique or Malawi it is a primary calorie source-- alas, not very good in vitamins, so was associated with malnutrition/vitamin deficiencies. However, during the civil war in Mozambique, there were many deaths from poorly cooked cassava.

More information here...on acute poisoning, and HERE
is a link to the need for long term rehabilitation of chronic poisoning symptoms.


Friday is recipe blogging...okay, it's Sunday morning here, and we've been to church already.
(7 am mass before it gets hot).
The recipe today is for Goto
500 g  Tripe (goto)
2 tb Cooking oil
2 cl Garlic, crushed
1 Onion, chopped
1 Chorizo de bilbao (Spanish
Sausage), sliced
1 c Tomato sauce
1 Red or green pepper
1 c Cooked gabansos (chick peas)
2 c Broth
2 Potatoes, cubed and fried
Salt to taste.
1 ts Vetsin (MSG)

Clean and boil tripe in salt and water until tender. Cut into small pieces
and set aside. Fry the garlic and onions in hot oil. Add the chorizo de
bilbao and pour in tomato sauce. Drop in tripe, pepper, garbansos and
potatoes. Simmer until sauce is of desired consistency. Just before
removing from the fire, season with salt and Vetsin.
Actually, our cook's recipe is slightly tomato sauce, just tomatoes....If you don't like tripe, here's a link to Orange Flan...yum yum calories...

Feminine attire

The Good news: the Slutwear look is out....
The Bad news: The Sixties look is back in...

In the Philippines, women are very feminine...(Iron butterflies)...
But in reality, we still are in the boonies, and so most women on the street wear teeshirts and shorts or slacks...

And the music here is still the seventies and eighties...

Austin Powers, call your office...

What? No Pepperoni?

From Improbable Research comes a report of the latest home decoration fad: Sausage rugs...

Dominic Moynahan, call your office....

Attention Robbers

French Fries are dangerous

Friday, March 11, 2005

Attention Henri Mancini

This is why that tune keeps repeating over and over again in our brains...

Catchy songs

Researchers have previously argued that catchy songs work by causing a "brain itch" that can only be scratched by repeating the tune.

The Dartmouth team asked volunteers to listen to excerpts from familiar and unfamiliar songs with lyrics or instrumentals.

These included the Rolling Stones' Satisfaction and the theme tune from The Pink Panther.

Snippets of the music were removed at different points during the songs and replaced with silent gaps.

The researchers used a brain scan called functional magnetic resonance imaging to see which parts of the brain were active while the volunteers listened to the tracks.////.....
We found that people couldn't help continuing the song in their heads, and when they did this, the auditory cortex remained active even though the music had stopped."

If they did this in Guantanamo, the ACLU would have a fit...but luckily for terrorists, they only play acid rock down there...

long distance phone call

Now ET can call home...
Doy's oldest daughter Posted by Hello
eating seconds and thirds Posted by Hello
There's still a little ice cream down in the bottom of the cup... Posted by Hello
Florinda and latest granddaughter Posted by Hello



I have posted earlier about Tommy, who had hydrocephalus from his meningomyelocoel and whose family was so horrified about his appearance that they essentially disowned him.

And I have posted earlier about the so called “vegetative state”, which is over diagnosed in almost half of the cases, and the diagnosis is used as a cover up that these people are still alive, but in the opinion of many PC bioethicists, better off dead, so like sophists they have elaborate arguments on how to justify making them dead.

In my long years of medicine, I have seen many severely brain damaged patients, but few who were completely unresponsive except in the obviously dying. As I explain in earlier posts, if they have that much brain damage, they usually die within six months of aspiration pneumonia, even with a feeding tube…

But when I worked with the retarde, we had another patient with severe hydrocephalus, who was indeed the client who was closest to what one would call a “vegetative state”…

George was very spastic, and had a huge head. A CT scan showed an empty skull, except for a small line of cortex that was probably only 1 cm thin. (The cortex is the thinking part of the brain). George mainly lay there like a lump. He was blind, and did not respond to sound, unlike most of the patients…No brain, most would say. A vegetable.

Well, not quite.

Massive hydrocephalus is not something we see nowadays but in the past when they didn’t fix hydrocephalus, such cases were seen…and in the book “Intern” by Dr. X, he relates the story of a college student who was having headaches, and when they did a pneumocenphalogram they found her cortex was only about 1 cm.

Now, George was spastic, and barely responsive, but he had enough cortex to have seizures…and he had enough cortex to feed him with a spoon.

You see, two years before I started working at that institution, George developed a huge bedsore on his back. Theoretically this was due to neglect—you prevent bedsores by changing the position of the body frequently, and by special mattresses that don’t put pressure on the bony areas. But a bedsore can develop in 1 to two hours in high-risk patients, and high-risk patients include those with poor nutrition.

So to heal the sore, they assigned George his own feeder. It took one hour to feed George, and he was fed four times a day.

And he probably had a good swallowing reflex, because in the four years I worked there, he only had one episode of pneumonia.

But my opinion of George changed one day, when I went into the ward and heard a melodious voice coming from the bathroom. I originally thought it was Vincent, or one of the other “high functioning” patients, but when I wandered in there, I was amazed to find George, who was being bathed, singing a tune. Not just moaning or vocalizing, but on key…in a patient who never responded to noise.

“Oh, he sings all the time” the aides assured me, “He likes his bath”.

So much for vegetable George.

But there is another story about George.

As laws changed we needed to find his family. Many families had little contact after their children were sent to institutions, since back then doctors said their children would never do anything, so they should forget about them. We assumed this was true about George, but needing family directives about living wills etc. we searched out his family and found a sad story.

George’s mother was blind, and his father had limited sight.

When she had the baby, the staff notified social service to take him away from her, and she was not told where he was sent. They assumed that since she was blind, she could not care for him—which was probably correct, given his severe handicaps.

But it might have been because in those days blind people weren’t supposed to be able to be independent and care for their own children.

Anyway, George’s mother had another child, who she managed to keep and raise successfully. But her heart always wondered about George…and when she was contacted, she eagerly came to see him.

And the picture stays in my mind: a blind mother, stroking her child with love, and George humming quietly in response…

superbowl commercials

Ifilm has the superbowl commercials on line...

Hollywood vs disabled take two

I have had several posts complaining that Hollywood's bias against the disabled and toward the idea it's okay to kill the disabled is good...

What I didn't know is that the woman who inspired the film "Million dollar baby" alive and well.

Like the boxer in Million Dollar Baby, Katie Dallam was a Missouri girl who grew up in poverty. In 1996, Katie began boxing. After just two months of training, her trainer urged her into a professional match and Katie stepped into the ring with a far more experienced boxer. By the end of four two-minute rounds, the referee stopped the fight, but it was too late. Katie had received 150 blows to the head and was comatose by the time she reached a hospital. Doctors told Katie’s sister that she “probably wouldn’t make it, and, if she did, would most likely be a vegetable.”

But Katie survived. She had to relearn how to walk and read. And her injuries affected her vision and memory. Deeply depressed, she attempted suicide. But instead of helping her sister kill herself, her sister, Stephanie, moved Katie into her home.

Unable to go back to her counseling job, Katie took up an earlier interest and began painting again.

Seeing Million Dollar Baby gave Katie nightmares. But it also led to her decision to talk with others about life after a devastating brain injury. As Katie told the New York Times, the fictional coach in Million Dollar Baby “took the easy way out by killing [the boxer] rather than having to deal with what her life would have been like.”

Katie’s sister, Stephanie, is convinced the film writer, F. X. Toole, now deceased, based the film on Katie. Too many similarities, she says.

If this is true, it indeed shows that the film is propaganda on the line of "ich klage an".....indeed, given yesterday's LATimes article, it suggests that killing of disabled is the REAL agenda behind what is called "assisted suicide"...

Joseph Mengele, call your office...

Thursday, March 10, 2005

falling cat experiments

Go HERE and go to the link "excerpt".

You will find the "falling cat" experiment film, and other nonsensical experimental data...

The riddle was finally solved by the French doctor Étienne Jules Marey. Marey was a tinkerer who invented all sorts of mechanical devices, including a film camera that could capture a cat falling at 60 images a second. At a demonstration of the film, some physicists still doubted that the rotation was possible without the cat repelling in some way. But one physicist took a closer look at the pictures and realized the cat’s trick.

The movement occurs in two phases: First, the cat turns its forequarters toward the ground, then—in the same direction—its hindquarters. Changing the position of its paws between the two phases allows the cat’s front and rear to repel off each other. The cat uses the same principle as an ice skater executing a pirouette who pulls her arms in for fast spins and extends them to turn more slowly. The cat does both moves simultaneously: it pulls in its forepaws and thrusts out its hindpaws. That way it is able to quickly make a half-turn of its forequarters toward the ground, while its rear end turns only a little in the opposite direction owing to the resistance created by extending its hindpaws. To bring its hindquarters around, the cat reverses the procedure, thrusting out its forepaws and pulling in its hindpaws.

Haile Berry, call your office....

Balanghoy poisoning

a favorite snack has killed a score of grade school children in the .... link
Cassava root is a widely used food product, but is poisonous if it's not prepared properly...

We eat cassava snacks here all the time (FYI: Cassava is used to make Tapioca, so you probably have eaten it too...) and don't even think about being poisoned...and I ate Cassava (mainly foufou) when I worked in West Africa, and never saw a case of poisoning when I worked there... most cooks know it is poisonous and are careful to prepare it properly. In this case, the plant probably had a high percentage of poison, and wasn't fully cooked...and since the cook also died, it was probably an accident.

Prayers for the children and their families....
kids had a great time too... Posted by Hello
food, glorious food... Posted by Hello

Tuesday, March 08, 2005

Differential diagnosese take two

Next time you have someone complaining of hoarseness, remember this study...

Kareoke laryngitis is part of the differential diagnosis...

X ray tales

Did you ever wonder why you have to wait so long for your routine x rays?

THIS might be why...

Steve Erwin, call your office.

Differential diagnosis for headache

Don't forget to include this in your differential diagnosis next time someone comes to the office with a headache...

From Davebarryblog

Photos anyone

On a lighter note, Dave Barry has a lot of photos from his trip to England....
and he links this if you want to waste time...

Ich Klage an

LA Times admit films are "popularizing" the idea we should kill disabled people...even though "assisted suicide" is usually touted as only for terminally ill people with untreatable pain...and they mention the difference, but not very well, toward the end of the article.
Culture of death anyone?


Hans Bethe died...

Gee, I haven't read about him since college days...

Monday, March 07, 2005

HIV in Africa

A lot of the publicity insists we need to give expensive HIV drugs and condoms and voila, HIV will disappear from Africa.
This report says whoa: it's more complicated than that...

In a second situation, which would be medically focused, prevention measures would not be stepped up, so anti-retroviral drugs would be easier to obtain than good nutrition and clean water. In this approach, government leaders would fail to get ahead of the AIDS epidemic, and Africa's poverty and underdevelopment would deepen. Keeping such services at today's level would cost $4 billion a year by 2025.

Yup...sounds about right.

What you don't know is that that is what your tax dollars were doing for years.

When I was in Africa 20 years ago, every village had a pill lady, but NO CLEAN WATER, (major cause of child death was diarrhea) NO anti malaria medication or mosquito spraying, no cheap vitamins for pregnant ladies, and many had no certified midwives, immunization clinics, or even health workers to give out WHO rehydration fluid to treat diarrhea...

Our hospital got outside money to provide all these things in the villages served under our hospital...but many areas of Africa still don't have them, especially since much of the aid money goes to Swiss bank accounts of government officials, or cannot reach people because of war or because governments like Zimbabwe's Mugabe prevent aid from reaching political opponants...

pain hurts

NYTimes now finds some people without vioxx are hurting...and would take it despite the tiny increased risk of heart attack...but they still haven't figured this part out:In the meantime, patients and doctors are weighing the risks and benefits of this class of drugs - known as cox-2 inhibitors, or coxibs - which since 1999 has become enormously popular and profitable but has never been proved to be more effective than older drugs like ibuprofen, commonly sold as Advil or Motrin. Some patients say they respond better to one drug than another, old or new. But the coxibs were developed as alternatives to older anti-inflammatory drugs, which can cause ulcers

Yup. Our tiny clinic had an average of three GI bleeds a year from Motrin or similar "NSAIDS", and quite a few anemia/minor bleeing/stomach pain...the last patient we lost of this was a druggie with cirrhosis, who saw a different doc, who gave her an NSAID instead of a narcotic or a Cox A, and she bled to death from her esophogeal varices...

Of course, I've seen two GI bleeds from Cox A, both in people who had GI bleeds from NSAIDS...

And then we see narcotic abuse if we give them cheap tylenol 3 ...

Of course, they could take tylenol plain, which doesn't work very well, and you would need to take 12 a day instead of one Vioxx...

which none of my little old ladies will do, too many pills.

Sunday, March 06, 2005

Frankenstein watch

Stanford University's ethics committee has approved taking the brain cells from an aborted human being and putting it into a mouse so they can "experiment" on the mice

The article claims, "It comes at a time of growing confusion in America over the limits of stem cell research...."

No, there is no merely shows the extent of the collapse of what now passes for medical ethics...

Saturday, March 05, 2005