Thursday, 2 July 2015

Easy call day?

Yes, it's yet another post about the Call Gods, those vicious, evil fucks that fiddle with me and torture me daily and make my life a living hell.  If you aren't interested in reading about them again, I'm sure Jim Carrey is saying something fascinating about vaccines, so feel free to check him out instead.

I often think that the Call Gods are truly the unhappy ones, and they feel the need to spread their unhappiness to everyone they possibly can, because that's the only way they can feel better about themselves.  It's kind of like the schoolyard bully who has such low self-esteem that he teases the other kids in a desperate attempt to boost his own pathetic morale.

But I digress.  You may have noticed the word "easy" in the title, a word that I don't use often to describe my call days.  But every now and then the Call Gods go easy on me for some inexplicable reason.  I tend not to question it, but I always wonder WHY.  Why take pity on me?  Why spare me?  And what kind of horrors will they have in store for me next time?

My call day started off with a bang.  We had a morbidity and mortality conference that lasted from 8 until 9 AM, and after that I trotted off to the lounge for a coffee.  As I was stirring in the sugar, my pager went off for the first time in the day.

Damn it.  Well at least I get my coffee, I thought with a smile as I looked at the pager.  Ah, a fall.  No big deal.

And then it went off again.  Oh, a stabbing . . . at 9 in the morning.  How lovely.

Fortunately neither patient was seriously injured, but it still took me about two hours to get them both worked up, patched up, and discharged.  I looked at my watch and thought, Perfect!  Lunch time!  And what a coincidence that I just happen to be famished.  As I was walking downstairs to get something to eat, my pager went off again.  This time it was two patients being flown in by helicopter after a car accident.

Lunch would have to wait.

And so my day progressed.  Every time my pager went off, it went off twice.  For the first 9 hours of the day, I had 10 patients, all coming in pairs.  I felt a bit like Noah at one point, marching my patients two by two into the trauma bay.  Minus the huge gopherwood boat, of course.

And then at 5 PM, it stopped.  It all just . . . stopped.  Apparently everyone in the city decided to stop crashing their cars, stabbing each other in the neck, and falling off barstools all at once.  With what I thought was just a few minutes to spare, I went downstairs to get a sandwich for dinner.  On my way down I stopped by the trauma bay just to make sure I hadn't missed anything.  But all of my previous patients had been either admitted or discharged, and the trauma bay was gloriously empty and eerily silent.

So I went back upstairs to enjoy my vending machine sandwich as much as a vending machine sandwich can be enjoyed, and I sat down to do a bit of writing.  Four hours later, my pager remained blissfully quiet, so I wasted just a bit of time online (fuck you and all your damned videos, YouTube), and then I lay down to grab what was sure to be 18 whole minutes of sleep.

And exactly 8 hours later I woke up with the sun shining on my very refreshed face.  The first thing I did was grab my pager in a panic, absolutely certain that I had somehow slept through 12 traumas.  But nay, the pager was still empty.  It appeared that the Call Gods had taken pity on me.  I don't know why and I didn't even THINK about questioning it, but I certainly appreciated it.

No wait, I wasn't complaining, Call Gods!  I was complimenting and appreciating you!  Really, I swear!  I . . .

*BEEEEEEEEEEEP*

And there goes my pager.  Of fucking course.  

Fuck you, Call Gods.  Fuck you. 

75 comments:

  1. yesterday was 15 calls in 24 hours. today for the holiday is anyone's guess - it could be silent or we could be running all day. I'm going to be busy for the next 18 hours.

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    1. if my count is accurate, which there is currently no guarantee it is, due to operating on half the sleep Doc B recommends; my department rolled on 38 calls in the last 48 hours.
      happy independence day.

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    2. I believe it. I had drunk neighbors who I wouldn't even trust with a glow stick setting off fireworks all last night. There were constantly police and fire sirens around our area until about 3:00am.

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  2. Pagers? Uhm...it's 2015 now, they now carry cell phones. Remind me not to go to your hospital. It sounds like Third World.

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    1. A paging system can send out a message to 100 people instantaneously, and they are very reliable. Mobile phones are notoriously unreliable for texts and phone calls. Pagers win, at least for now.

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    2. A simple device like a pager could help unaware surgeons to follow up on their patients especialy in an emergency.

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    3. a simple device like a brain could help clueless trolls realize even a blind idiot can recognize them.

      and yes, paging systems used for emergency alerts are guaranteed to get the alert to the recipient in a timely manner. cell phones are not.

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    4. Uhm...you see that blue button on the wall? That's actually better than the paging system for emergency alert. Try it.

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    5. You mean the Code Blue button, the one in each patient room? The one that is used for patients already admitted to the hospital rather than those on their way?

      Tell me John, which patient's button would you press to tell the entire hospital staff that a car accident victim will be arriving in an ambulance? And what will you tell the Code Team when they arrive to that patient's room instead of the trauma bay, which may be on the opposite end of the hospital?

      Yet again you display your stunning ignorance of healthcare. Your trolling has really gotten worse, but it still does give me a chuckle.

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    6. doc: What is it that you did not understand? I called it the blue button because it's used for calling a code. And the team response is actually waaay faster than the 80s paging system technology.

      And why would you push a button for an incoming triage? If the car accident victim is arriving in an ambulance, EMS informs the hospital ER via phone or radio. Everything is done by the ER staff and not the code blue team doc. They're job is to stabilize the patient and that's it. If surgery is needed they call the surgeon on call. Neeeeeext.

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    7. No, John. When a trauma patient is coming, they notify the trauma team: me, the trauma PA and/or doctor-in-training, the trauma nurse, anaesthesiologist, respiratory therapist, ICU nurse, and OR nurse. They don't call me for codes blue, only for traumas. The emergency staff is not involved, except that the trauma nurse is also an emergency nurse.

      Now are you done exposing your ignorance, or are there more stupid comments you'd like to make that I can delete?

      Oh, and it's "Their", not "They're". You're getting progressively dumber, John.

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    8. This comment has been removed by a blog administrator.

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    9. let me see if I understand cornboy's claim correctly: the blue button on the wall of the hospital is much better than an emergency paging system because the blue button is only used for code blue notification of staff inside the hospital in the event of a code-99 of a patient already admitted to the hospital.

      that is a bit like saying a tailboard buzzer is much better than a portable radio, because the tailboard buzzer is only used to let the driver of the apparatus know something is wrong on the tailboard.

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    10. I don't know what hospital you work at but at Cornell Weill in the ICU or any floor aside from ER you will get at least a hospitalist. ICU depending on type has an Intensivist right there and he/she is not in traing. You will also get i. A teaching hospital a ton of residents. But yes in a SICU you will get a trauma surgeon.

      I don't know where you work but I can tell you how it works in most hospitals from PA to NY.

      Non-teaching hospital the hospital will come with the rapid response. He is not in training either. You might get a nocturist in some smaller NYC hospitals but they have been replaced by hospitalist groups.

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    11. Not defending him again but the code blue button rings at the desk as well and at least at all NYC hospital goes out to code team. New tech,

      Why no cell phones? That had to do with analog devices and telemetry. But it is true a pager has less delay but it still can have one. The blue button is the fasts at least from PA to NYC.

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    12. Anon -

      John was implying that pagers are obsolete because the Code Blue can be used as a trauma alert. Yes, hitting the Code button will bring a team of people, but the people who are on the Code Team carry code pagers, and the hospital operator sends a mass page to the code pagers that notify specific people of the location of the code. There may be overhead PA announcements as well, but hitting the Code Blue button doesn't magically summon the correct people to the correct place. It's still a pager system.

      I hope we're all clear now that the Code Blue button is not appropriate in any way for trauma alerts.

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    13. Actually the fastest way and how it starts at least in every NYC hospital and I know what I write is with the calling code with the button. It hits the desk then the desk on that wing sends it out to rapid response which alerts the hospitalist.

      So what start a code with an admitted patient on any floor outside of ER is the code button first most of the time.

      Is John correct? To an extent he is correct. Pagers are controlled devices. Previously only used due to telemtry issues but a pager creates a cheap multi-contact system and the desk sends out page as well as PA system. Rapid response or if needed stroke team which most hospitals divide.

      I am very aware of trauma but trauma is in trauma bay however in SICU it used all the time. SICU in most NYC hospitals run by trauma surgeons and they use blue button. I know this beyond any doubt.

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    14. I will try to explain this one more time, since you still don't get it, John.

      A Code Blue is for a person IN THE HOSPITAL. It is not and CAN NOT be for a person NOT YET IN THE BUILDING.

      When they "call a code", that sends a page to pagers that the call team wears, and it also usually includes an overhead announcement.

      Traumas are DIFFERENT because the patient has not arrived yet when the alert goes out.

      Regardless, both systems use PAGERS.

      Are we quite clear now? Because I'm through explaining this repeatedly.

      NO MORE.

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    15. Docbastard, I am not John and you should know that. My IP address is from NYC on ATT. I am attorney for over 25 years and I have an MD as well. So do not pull this John stuff.

      Let me tell you something else. Trauma surgeons who are in level 2 or 1 hospitals are in trauma bay. They only needed to be paged if they are not in the unit which is rare. 12 hours shifts you always have the surgeon in the bay unless he is up in SICU.

      You know perfectly well based on IP this is a NY phone. Get off your calling anyone who contradicts you John. Plus I am female.

      I am waiting for your apology. You are wrong.

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    16. Your comment on an ICU nurse is ridiculous. ICU is ONLY for admitted patients. This isn't John this is a former colleague. You need to understand criticism since you spoke of ICU in you own post. ICU nurse would not be in trauma bay.

      Additionally, yes they DO call trauma surgeons for code blue if it happens on SICU since trauma surgeons run the SICU. Just call any level 2 or 1 and they will tell you that.

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    17. Funny how YOU are telling ME where trauma surgeons are. Last I checked, I'm a trauma surgeon and you are not. Let me assure you, madam, that we do NOT spend the entire 24-hour shift in the trauma bay. We have a lounge and we have a call room, and we can not always hear the overhead announcement. We all carry pagers and we all use them because we all need them. I hope that is now abundantly clear and needs no further clarification, counselor.

      That said, I apologise most profusely for my assumption that you were John, since your tone sounded remarkably like his. However, blogspot does not give me access to your IP address, so I haven't the slightest idea where you live or who you are. So I did NOT "know perfectly well" that you were on a phone, in New York, a lawyer, or female.

      Now you owe me an apology for assuming I did (or should) know that.

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    18. Anon 01:28 - are you actually telling me how my own hospital is run? When there is a high-level trauma, the ICU nurse comes to the trauma bay. It may not be that way everywhere, but in both my hospitals, that's the way it works.

      And in none of the hospitals I've ever worked in, from medical school up through surgical training, do trauma surgeons respond to codes blue.

      I continue to be amazed that you folks think you know how my own hospitals are run better than I do.

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    19. I can tell you beyond any doubt you don't work for Cornell. If you did you would know any photos taken would be immediate loss of privileges on the spot.

      24 HR shift. It is actual 12 hr shifts for surgeon. 24hr during residency that is NY. A trauma surgeon doing a double is completely frowned on.

      Lounge in trauma bay? Lol. Not really in a level 1 or 2. When you are on you are on. At level 1 and 2 you will always have patients in and it rare very rare you could be in the lounge which doesn't exist in or near Bay Area of most level 1 or 2.

      You owe the apology. You assume a falsehood. Plus you stated ICU nurse as part of your team. Sorry not in US. If you mean SICU then yes but they never leave SICU unless they are on shift for trauma bay.

      Then you have never worked at NYU, Corneill, Mt Sinai, Hackensack, any Meridian hospital, UPENN, Barnibas group, Yale or any hospital in the metro area of the east. They All work this way. Sorry you are wrong again.

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    20. ICU nurse will not come down to trauma. Only stable patients go up to ICU. Only time if ever a ICU nurse would come down is if the patient is on pressors and that is Not part of your team. You are wrong again.

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    21. ICU nurse is not going to be on your code call as you were trying to state upon first entry. Only if you admit the patient then she/he will work with you as the admitting doctor. Don't try to pussy foot around since you are wrong.

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    22. You must not work in the US. I am a former general surgeon who has MS so I changed over to law and I know how it works in every hospital.

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    23. Maybe you should ask Kimberly Davis what she does since she just was on in both SICU and trauma bay this past weekend. She ran 3 codes in SICU just on Saturday

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    24. "You must not work in the US."

      DING DING DING! Look at that folks, we have a winner! Congratulations on finally figuring out the obvious, counselor. Not everyone who writes in English lives in the US. For a former doctor/lawyer, that sure took you long enough to figure out.

      Now, about that apology you owe me for calling me wrong repeatedly and for your massively asinine assumption...in fact, I think you owe everyone here a huge apology for wasting everyone's time.

      But if I know lawyers, I think we all know what's coming. Don't we, counselor.

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    25. Anon, you need to play nice or not at all. This is DocB's place and you have no idea who he is or where he works so stop claiming he needs to apologize to you. I'm still not convinced you are who you claim because of how personally you seem to take his thinking you are someone else when he stated before blogspot doesn't use ip addresses. I think YOU owe DocB the apology for cluttering his comments with off topic bs.

      This is the internet and anyone can claim anything at anytime and not have to prove anything. DocB has proven himself and no one has a clue who you are so maybe you should get off your high horse.

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    26. I was trying to play nice. Then he called me John. I had no idea he was not in the US.

      Oh and yes he owed an apology when anyone who disagrees is John.

      I don't see where he has proven himself. I read through his blog nothing shows me he is a trauma surgeon.

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    27. Absolutely correct - you had no idea. You made a stupid assumption, and you look appropriately stupid for continually insisting that you were right without knowing the facts. Congratulations on still not apologising.

      But it is good to see you now throwing up the "OMG DOC IS FAKE!" defense, which is always the last desperate attempt by someone who knows he has lost.

      Now go run along, John.

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    28. don't forget flooding the board with crap and declaring victory. if this particular anon is not a cornboy sockpuppet, it must be his long lost twin.

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    29. This comment has been removed by the author.

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    30. It's hard for me to understand how even an experienced surgeon could honestly claim to "know how it works in EVERY hospital."

      Sure, someone who's practiced in the northeast region of the USA can speak to her own experience with various hospitals in NY and PA. Doctors who've worked in other locations, or in other types of hospitals that may be staffed and managed differently (for instance, corporate-owned vs. university-associated) may have worked with slightly different protocols. But, unless one has actually *worked* in "every hospital," claiming that entire body of knowledge is quite a stretch!

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    31. "I know how it works in EVERY hospital" is quite a claim to make, even for an experienced surgeon. While someone who's practiced in the northeastern portion of the USA can certainly speak to her personal experiences and observations related to a number of hospitals in NY and PA, that's not "every" hospital, even in the USA. I live in a different area, in which some of our designated trauma centers are the larger, corporate-owned hospitals, two are university-affiliated hospitals, one is a public health facility, and several others are smaller community hospitals. While it's reasonable to assume that all hospitals are expected to comply with reasonable standards of care, I think it's also reasonable to assume that each will develop its own policies and procedures, related to how communications and notifications are done, "who does what" in terms of how staff coordinates its interactions and response to patients, and such. Suggesting that you can't really be a trauma surgeon if the hospital at which you work has a lounge doesn't make much sense either...

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  3. Doc, I know you've worked with GSW penetrating wound.

    In your opinion which is more deadly. A 22 cal GSW to the chest fired from a distance of 10 inches or a 9 mm GSW to the chest fired from the same distance of 10 inches. Let's say the right upper area of the chest.

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    1. Doc, I'm still waiting.

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    2. Give the guy a break! Maybe he's taking a nap during a rough stretch.
      Also, maybe he realizes it's a dumb question and doesn't want to dignify it with a response.
      Just saying.

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    3. If you know physics the answer is there.

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    4. Benton, go away. Fail troll bait is obvious.

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    5. This comment has been removed by the author.

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    6. Anon - my apologies for not being at your beck and call. I will try to be more available for you and your off-topic questions in the future.

      Oh wait, I forgot to answer your off-topic question. Oopsie.

      Delete
  4. Guess the Call Gods got tired and needed a break.

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  5. Doc, I just realized that you're a contract employee. Why?

    Why would you allow them (corporate owned hospital) to dictate what they want from you? Why not be your own boss with your own solo practice? On second thought, those corporate owned hospitals would probably take business and patients away from your practice, so you really have no choice but to find employment as a contract employee. That seems to be the new trend nowadays.

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    1. More fail trollbait.

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    2. I don't understand.

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    3. What in the world are you talking about? Contract employee? Corporate-owned hospital?

      If this was an attempt to get me to divulge private information about myself, it failed. Next time try not being so obvious.

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    4. Interestingly, people who attempt to go into the business of saving lives as an independent owner-opertor tend to find themselves at a significant disadvantage in competition with organizations with multiple employees.

      something to do with that whole "must be available at all times" thing.

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    5. Hey doc, have you ever flirted with nurses at work?

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    6. Hey doc, do you think some nurses are mistaken? You know. The ones who thinks doctors have lotsa, lotsa, money in their bank account and anyone with an MD behind their name is fair game, regardless if they're morbidly obese and owes $300,000 medical debt. Is it the title thingy that makes nurses behave this way? But then again what do I know.

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    7. John, your bait is obvious and will just get you deleted again.

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    8. Deleted? No. Ignored? Yes.

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    9. Fail bait is still fail.

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    10. Yes, Doc, I'm sure you could totes rake in the dough with a solo practice marketed to high net worth trauma victims.

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    11. Contract? Not in most hospitals. Trauma surgeons bill independently. The trauma practice usually makes a contract with the hospital because they run SICU. Usually renewable yearly.

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  6. It really is better not to feed trolls. Especially, this one.

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  7. Woah, what's with the troll fest here? Go back under your bridge, troll. No billy goats here.

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  8. John can't even bring himself to post under his own name now, instead trying to slip in numerous comments, almost all of which I've deleted with great alacrity. I've kept a few which demonstrate his cluelessness nicely.

    John, you're not doing yourself any favours. You may as well give it up, because I guarantee you will not win.

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    1. This comment has been removed by a blog administrator.

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    2. You can't hide yourself, "John."

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    3. John - Your off-topic comment was deleted. Again.

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    4. the problem is that he considers any attention to be a win.

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  9. Anyway to permaban IP? ~~

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    1. Not on blogspot, sadly.

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    2. In these times, that approach isn't as effective as it used to be, anyway. Back in the day when most people's internet access was only available through a home and/or work computer, connected through a phone line modem or other hard-wired setup, banning an IP address was a pretty useful way to eliminate unwanted postings to newsgroups, bulletin boards, and other forums. But in the wireless age, we have internet access through smartphones, tablets, and notebook PCs, and WiFi is available everywhere from the corner coffee shops, to the waiting room at the auto repair facility, to hospitals (for visitors). So, the chances of a troll or other unwanted commenter being able to be *regularly* identified by association with a particular IP address aren't that good any more.

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    3. You only need one. If you know how to change IPs, it's easy.

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    4. It's pathetic that someone would be so noxious that he'd *have* to keep changing IPs. It's even more pathetic that he'd want to do so.

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    5. Actually, posting from various IP addresses can happen routinely, without any deliberate intention of concealing one's identity. It's just a function of how many of us use today's technology during a typical day. Here's a real-life example.

      I have two smartphones with internet access (one personal, one for work). Both have different internet service providers.

      Both these phones also have WiFi capabilities. I use WiFi on both the phones at my office, and also when visiting family members and colleagues who have internet service in their homes and offices.

      My office computer has its own IP, but my home computer has a different one.

      Point is, even though I'm NOT interested in misrepresenting myself online, anything I post could originate from one of several IP connections.

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  10. Hey Doc,

    Do you dislike answering off topic questions, even if they are well meaning and the people asking them are not trolls? For people who want to stay anon and not have to write emails and tweet you, this is an convenient way to get responses.

    Thanks.

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    1. Yes, I dislike off-topic comments. It may seem petty, but that's the way I feel about it.

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    2. Dear troll, I've emailed my off-topic comments (since I usually ask my physician when I have questions) to the good Doc before, and since I don't just troll and waste his time, I've received answers in a very timely manner (thanks for taking the time out of your busy life, Doc!)

      So there is really no need to spam this comment section.

      BTW, have you ever heard of that great feature in a hidden corner of the Internet that let's you create email accounts without giving your real name? You could easily send your mail identifying you just as raging_justin_bieber_fan@your_provider.com

      Delete
  11. I'm a social worker in a level one trauma center. Last night (this morning I guess) at 2:40 this am I was sitting in my office with my feet up on my desk reading an US Weekely when I thought, "if I make it to 3am I'll be golden. At 2:48 my trauma pager went off and it was bad. Very bad. Fuck you call Gods.

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  12. The poor troll is in a narcissistic rage and can no longer post here, so he's taken to libeling DocB on the Jahi McMath "Keepers" page, aka the Keep Jahi McMath on Life Support (sic) page, which is just about the only place he hasn't been banned from posting. This morning's precious troll turd claims trauma surgeons can't touch any thoracic structures because they're "only" lowly general surgeons. With every post the troll makes he further exposes his ignorance.

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    1. where, as I understand, they are ignoring his ravings.

      Delete
    2. Yup. Pretty funny, really, since there's no real audience for him there. The regulars have no real interest in medical information, whether it's accurate or troll drivel. That site is just a forum for sharing prayers and positive thoughts among those who still believe that Jahi will be miraculously healed. They couldn't care less about our Doc B, whether or not Dr. Beecher was high on LSD when he worked at Harvard, or whether brain death was "invented" by the pharmaceutical companies to sell more meds!

      Delete

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