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Member since: Sat Mar 29, 2008, 10:11 PM
Number of posts: 40,985

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Whistling Past the Graveyard

Note to the hosts: I have long standing permission from the blog owner to quote anything I wish from this blog.


Posted by Betty Cracker at 4:40 pm

Valued commenter Loneoak has a front-page post up at TPM that shares a front-line perspective on medical crisis preparedness:

I have a perspective tying together today’s big news brouhahas. My wife is an ER nurse at a major urban hospital owned by the Hospital Corporation of America, the hospital chain once run by Rick Scott. It’s the largest for-profit medical system in the world, and is of course also notable for its ‘creative billing’ practices in the largest Medicare fraud settlement in history. Scott was booted from the CEO position following that fraud investigation, so he’s not directly responsible for current conditions in those hospitals.

But it is obvious to those who work there that the combination of lax training and toxic labor relations ‘leaders’ like him have brought to the company are emblematic of a big problem for US hospitals if a major outbreak of ebola or other infectious disease occurs. My wife’s ER has an ‘ebola cart’ with some lightweight protective gear and written instructions for putting on a PPE, but the instructions are a loose bundle of papers and the pictures don’t match the gear in the cart and has inaccuracies that put them at serious risk. It’s an object of gallows humor for the staff. That’s the totality of their training or preparedness so far. As we all now know, PPEs are not easy to put on and take off correctly. Even though nurses all have experience with standard droplet control (they see TB and HIV all the time), ebola is a special case. They have gone months and months without a nurse education director because no one wants to deal with their management and take the position. Her coworkers are clear that they will refuse to treat an ebola patient because they have woefully inadequate training in the correct procedures and lack proper gear.

And yet the head of infectious disease at this hospital went on the local news to proclaim the hospital was ready to receive ebola patients safely. They obviously didn’t bother to speak to a single nurse on the front lines. I’m not particularly panic-y about ebola, even though obviously the family members of ER personnel have a lot at stake in ebola preparedness. But I think that this situation will be the weak link in any major national response. So many of our hospitals are run by lunatics like Rick Scott who seek only the highest profit margin. They do not invest in training, they build charting mechanisms that are good for billing but not treating patients, they constantly fight with their unionized employees, they lie to the public, etc, etc. We like to imagine that competent, highly-skilled medical institutions like Emory will save us, but we have way more Dallas Presbyterians in this country than we have Emorys. You can see exactly this managerial incompetence—and toxic labor relations—woven through the statement released by the nurses at Dallas Presbyterian today. Also see the head of National Nurses United on All In With Chris Hayes for a similar perspective.

To put it bluntly: we’ve entrusted our national medical system to the managerial competence and goodwill of the Rick Scotts of the world, and that is much scarier than a podium fan.

Emphasis mine, where Loneoak nails the crux of the problem. Rapacious knaves like Scott and like-minded armies of MBAs have hollowed out our national institutions across the board. As alarming as it is to get a glimpse of the true state of our “first world” healthcare system, that just scratches the surface of the rot.

We all had a ringside seat when the geniuses who run our financial institutions were revealed to be bumbling thieves several years ago. And before that, we were treated to the sight of our political class wielding the world’s most fearsome military like a brain-damaged spider monkey with an AK-47.

One of my great-uncles, a World War II vet, public health official and endlessly curious and intelligent man, surprised my then-high school kid self by telling me that this country was on the express bus to Banana Republicanstan back when Reagan was sworn in.

By god, you were right, Uncle Billy. You were right.

The elites; the administrators, the managers, the big wheels completely blew it in Dallas

And the grunts performed valiantly while hampered and hindered by decision makers that push the envelope of outright malevolence.

Think about that, the elites, the coaches had months to plan for this and then they fumbled the ball and Ebola picked it up and ran for fifty yards, a first down and a couple of injuries to the defense. Because the coaches did not prepare their players mentally or physically, something they are paid a great deal of money to do.

If a workplace is screwed up it's not the fault of the workers, it's management, they are the one with the authority and they are the ones with the responsibility for how things are accomplished. They sure as hell take the credit if things go well so they get the blame too.

The management structure of the American health care industry has shown itself to be incompetent, I don't for one moment think it's in any way special these days.

By Darwin's Bushy Beard it's the Peter Principle all the way down!

Ebola: At this point I would trust the nurses union before the 'authorities"

Of everything I've read about this Ebola epidemic in the American media what the nurses union said sounded the most clear, forthright and no nonsense to me.

The authorities on the other hand have been vacillating and prone to ridiculously bad judgement, the CDC has been bad enough, getting driven by politics rather than medicine but the hospital management is off the charts bad judgement and it was driven by one word, greed.

Kicking down and kissing up: Signs of a classic authoritarian

There is a common misconception about authoritarians, they want to rule everyone. In fact a classic authoritarian is obsequious and servile to those perceived to be of a higher social status or possible utility while at the same time being extremely harsh and strict with anyone they judge to be their social inferior and of no utility to them.

Watching the reactions in the M$M to this Ebola story has been interesting, every time there has been a screwup their first reaction is to blame the lowest status person they can find (unless they can somehow make it Obama's fault, they do have another agenda).

First it was the triage nurse did not pass on that Mr Duncan had been in Liberia, it took a couple of days for that to be shot down. But notice that the fact the doctor who signed him out missed it too has been entirely dropped like it never happened. Notice also that the the fact the doctor treated what he diagnosed as a viral condition with antibiotics has been dropped from the conversation.

Next it was nurse Pham, she had "breached protocols", again it took a few days for them to get slammed upside the head with the fact that for all practical purposes there were no protocols for some time after Mr Duncan was returned to the hospital. They implicitly believed the management story and did not bother to do any investigation with lower level employees.

Now it's nurse Vinson, the authoritarians exploded with rage at nurse Vinson for traveling but when it is revealed later the same day that the CDC was consulted and assented to the travel their rage was instantly muted rather than directed at the perceived social superior.

Watch for this reaction, if someone's first instinct is to believe that some little person screwed up hugely and the institution is blameless there's a decent chance you are witnessing an authoritarian in action.

Appreciation thread for the health care workers who are on the front lines

There's been a lot of bashing of health care workers in general and nurses in particular in the last few days, much of it based on erroneous reporting blaming nurses for mistakes made by executives in charge.

Anyone who will take care of an Ebola patient deserves our gratitude and appreciation, I don't think all of us would or could do that.

Here's to nurses, doctors and all the others who actually take care of us when we are sick.

Posted without comment


It's been a long time and I had forgotten why I stopped doing it

Arguing with conservatives I mean...

So against my sober better judgment I went over to Discussionist and made myself a screen name and plunged in, started arguing with the other side.

It's too easy, if you're reasonably good at this stuff and have your facts, rhetoric and snark down pretty well after a while the replies start slowing down and eventually they come to nearly a complete halt.

That's the way it used to play out back in the day when I could find a conservative site that didn't automatically ban liberals. Currentevents was one of my hangouts for while and it got to the point I could post almost anything no matter how inflammatory and not get replies from conservatives. I posted for a while at Reihlworldview too and basically the same thing happened there, conservatives just stop replying to you if you're not nasty and stick to facts, logic and maybe a little snark to lighten things up. There were more sites I went to but those are the two I can remember for sure the names of.

It's kind of fun for a while but it's a bit like pulling the wings off flies, it feels a bit cruel to taunt people who can't really fight back. I guess that attitude is why I'm a liberal and not a conservative, they'd never say something like that.

Detect known exoplanet with a DSLR and telephoto lens

Here's some science you can try at home, kids!

It's amazing what you can do with enough raw computer power and extremely modest instruments.


My target was HD189733b, which seems to be one of the easier transits to capture. It is also right next to M27, making it easy to find. I used the ETD (exoplanet transit database) site to determine transit times for my location. For my location, WV, there was a transit starting at 3:45am local time, ending at 5:35am local time on May 13th.

I used an unmodified Canon t3i and a Nikkor 300mm f/4.5 telephoto lens stepped with a 72-52 step down ring to about f/5.7. I took 15 second exposures every 30 seconds at iso200.

I then loaded 272 canon raw files into iris to register and align the images, and then used the automatic photometry tool in iris to generate the raw data. I used 4 reference stars on plus the HD189733 target star. I then ran 5 reference stars for a baseline. Here are the resulting light curve plots.

Meteorite trail photos

I've been going through my sky shots that I took for my contest entry and so far I've found two meteorite trails out of maybe five percent of the total shots I've looked at so far..

Nothing spectacular but they are kind of hard to get...

On The Beach

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