Tuesday, 5 January 2016

Brain power

In my line of work, I see a lot of people with varying amounts of brain power.  Many of the people with whom I work have plenty to spare, ER docs excluded.  Just kidding.  Mostly.  Anyway, in contrast most of the patients I see have barely enough brain power to survive, it seems.  I have often thought that it is incredibly lucky that certain patients have a respiratory center in their medulla oblongata and pons which breathes for them, because otherwise they would forget.  I'm shocked that some of these people manage to remember to clothe and feed themselves each day.

That said, I'm even more surprised that people like this try to multitask.  I like to think that I'm of above-average intelligence, so walking and reading at the same time doesn't use all the brain power that I have at my disposal.  For others, however, doing those two activities simultaneously will tax their system, overworking the hamster wheel spinning out of control in their heads.  Chances are if these people are doing something while doing something else, something bad is going to happen.  And if they dare try to do something while doing something while doing something else, the shit is really going to hit the fan.

So you can imagine how the hamster living in the head of poor Riley (not his real name™) felt overworked.

LGFD is a common acronym I use as a new trauma patient rolls through my trauma bay doors.  "Looks Good From Door" usually denotes someone who doesn't look like there are any life threatening injuries - a stabbing to the shoulder, a pedestrian struck at very low velocity, a fall from standing position, a low-speed car accident with seat belts and 472 air bags.  Riley certainly fit the bill - he was smiling and laughing as he rolled in, making inappropriate jokes with the rather attractive medic who was trying not to roll her eyes completely into the back of her head at his lame attempts to pick her up.

"Hey Doc, this is Riley.  He's 20 and fell down about 10-15 stairs.  No loss of consciousness, just complaining of bilateral wrist pain."

"I also have chest pain, Doc!" Riley piped up, putting on a fake frown.  "I think I have a broken heart because this pretty girl won't give me her number!"

The poor medic glanced at me plaintively with a look that clearly said "Please kill me now . . . or him", and I gave her a feeble smile in return.

Riley's vital signs were all normal, and his head, neck, back, chest, and abdomen all seemed fine.  But both of his wrists had obvious deformities.  "I think your wrists are both fractured, sir", I told him.  "We are going to get some X-rays."

I quickly learned from Riley's redoubled attempts to pick up the nurses that he was a student at the local university.  He didn't seem very bright to me, since he was completely unable to absorb the fact that none of the women were interested in him.  I saw more eye rolls in the next 45 minutes than I had in the previous year combined.  It could have been the fact that he smelled like a pub restroom, or it could have been the fact that he wasn't nearly as funny, handsome, or charming as he thought he was.

After looking at his X-rays (which confirmed that both his wrists were fractured), I gave him the bad news.  He looked at me and started laughing.  Something obviously amused him, but he wouldn't let us in on the joke.  No one else was laughing, so I was glad that he was able to entertain someone.  Finally his hysterics calmed enough to the point where he was able to share the joy:

"I always knew it was dangerous to drink and drive, but I never knew it was dangerous to drink and walk!  Ha ha ha ha!"

It turns out he had been checking out Facebook on his mobile phone while walking through the train station, and because he had not been watching where he was going he tumbled down an escalator.  And he now had two broken wrists (and no date) to show for it.

Riley had it mostly right - drinking and walking is dangerous, and drinking and walking while not paying attention is even worse.  But drinking and walking while not paying attention and being an idiot is a life-threatening proposition.

59 comments:

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

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    1. For anyone who doesn't know, "Za ch" is John Benton. This is the third time he's inexplicably posted this same comment in the past few hours, meaning he's checking back frequently to see if I'm deleting it or not. I deleted the first two, but I've decided to leave this one up as a testament to both his anti-Semitism and his rabid obsession with me and my blog. I don't know what your intention was, but whatever it was it clearly backfired.

      Well done, John. You must be awfully proud of yourself.

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    3. John Benton isn't even making any sense with his posts. I've got two of them and either he's drunk, high or just stupid. Maybe all three.

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    4. Ignore J/Z, delete him, whatever - he doesn't merit being addressed or explained.

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    5. JB/Z/EA...You have more personalities than Eve! Now, GFU
      for entertainment.

      As for the walking and or driving texting fools, they have shit for brains.

      This current batch of brainless idlers are sometimes referred to as "The know nothing generation." I concur.

      ~ Concerned

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    6. I know this blog is old but come on doc let John comment on all your blogs. I always get a great laugh out of his ignorance and stupidity ;) But just the stupid funny stuff tho

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  4. If I try to read and walk, I may not be using my brain to its maximum capacity, but I'm pushing my eyes to the limit.

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  5. I broke my nose at a bar when I slipped on a step and fell forward into the back of a very skinny girl. But I saved my margarita. Nothing like raccoon eyes for Christmas.

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  6. there is a code we use to discreetly share the word that a patient is intoxicated. amongst ourselves, we refer to it as "preemptive field anaesthetic" - and just so people are aware of it - most ambulance services are not allowed to take the patient's word for it they will be okay if there is preemptive field anaesthetic on board. the patient can be released into the care of a sober friend, but not on their own. presumably the sober friend will notice if they later show symptoms of a more severe injury.

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    1. Ken, why do you have to be discrete? Is it because it could anger the patient? In an emergency, isn't bluntness a necessity? Sounds like you are nicer than I would be, but it is a cute label.

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    2. its because of the listeners in scannerland.

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    3. That's actually a myth. You can't listen to Police/Fire Tactical Channel via scanner. On basic analog yes but not TAC.'

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    4. I'll be sure to tell the scanner we keep in the dayroom it's doing it wrong.

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    5. note: the code we use is NOT the same as our private reference to field anaesthetic - just to avoid confusion.

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    6. Thanks Ken. It makes sense. My dad listened to a scanner constantly. I hated that he did this, but he was blind, and this seemed to pass the time. Knowing everything one says can be overheard figures into word choices. I appreciate your response.

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    7. for the most part it is harmless entertainment for people. any truly sensitive information usually goes by datastream directly to the person who needs it. (I.E. confidential access codes and the like)

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  7. I'm a proud goyim.

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    1. Good grief, John. At least use the singular noun:

      "Goy or Gentile (English /ɡɔɪ/, Hebrew: גוי‎, regular plural goyim /ˈɡɔɪɪm/, גוים or גויים) is the standard Hebrew biblical term for a "nation", including that of Israel."

      I'm thoroughly enjoying watching you make a fool of yourself. Repeatedly.

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    2. I was kinda hoping he referred to himself as a shiksa.

      Wednesday

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  8. In addition to potential injuries, multi-taskers, often young people addicted to their phones and social media, appear to be missing out on actually living in the moment. I see them filming a concert rather than listening to it. Everything is about their online posting and ridiculous selfies. I once chaperoned a high school dance where a girl was texting as she slow-danced with her date??? I have memories, they will have photos. As far as Riley(not his real name™) hitting on every female who crossed his path, sadly, there are many men who engage in this sophomoric behavior. It doesn't work, so I am amazed they continue - maybe not too amazed... Doc, I believe your ER will get more and more traffic from these multi-taskers, alas!

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    1. Paula, I know exactly what you mean. I was at a school play about a month ago where children were singing "We wish you a merry holiday. We wish you a merry holiday. We wish you a merry holiday and a Happy New Year." Children who were addicted to their phones were not even paying any attention.

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    2. Do you think that singing "holiday" was a school policy to remove Christmas from the song? I live in an area where that is not an issue, but I guess it isn't unusual. Why do elementary children even need phones and upper grade students have them out during the school day? I am in advisory position dealing with many Millennials; they would go into shock if they had to leave their phone alone for 10 minutes. I know many of them text while driving. Scary!!

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    3. County of Allegheny v. ACLU. Why is one thing OK to display while the other ruled illegal? I'm just confused.

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    4. @anonymous 6 January 2016 at 00:00 wrote, "County of Allegheny v. ACLU. Why is one thing OK to display while the other ruled illegal? I'm just confused."


      This is a private blog and therefore you need to stop sneaking into the house, scurrying around the pantry, raiding the refrigerator, making a sandwich, leaving it in the living room along with a trail of pellets. It's rude. Why not start your own blog and see who checks it out and leaves comments, John?

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    5. Did you actually read the case? What's so confusing?

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    6. Yes. Because the court ruled that the NTV scene violated the Establishment Clause while the MNR did not. What's the difference? Aren't they all symbols of faith?

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    7. Paula, what I find particularly frustrating about seeing the younger kids and teens caught up in their smartphones instead of real-life experiences is that, too often, their *parents* are present, and allow/condone this behavior. I regularly see parents giving their phones to very young kids during a church service, so they can play games instead of fidgeting...why not let them instead participate in the Sunday School program, where they can have some fun while also learning about their faith while interacting with others? And, as you stated, when it's time to attend a sibling's school program or graduation, too many parents let their kids play with their phones instead of giving just a bit of well-deserved attention to a family member's accomplishment.

      Our kids can't *learn* to appreciate "real life" if we don't *teach* them. :(

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    8. Sunday School program? Are you kidding me? We're not in circa 1950 anymore. HA!"!

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    9. No, gentle reader,I wasn't kidding. Nor did I mean to be exclusionary by using the term "Sunday School." I wasn't even born yet in 1950, but fully realize that different faith communities use different terms for describing the children's activities offered on the same day as their regular weekly worship service for adults. Whatever they're called, they're still out here.

      And, yeah, "gentle reader" is another antiquated term, originating with 19th C. authors, but it's SO much more fun to write than a derogatory nickname :)

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    10. It doesn't matter if you were not born in the 1950s. If you have arthritis and choke down multiple numbers of pills for medication and waking up really early to pop in your dentures, you are still considered as a dinosaur.

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    11. Wow. Uncool. I really hope that one day you don't wake up to find out a real live human being behind a computer screen committed suicide because you hadn't considered what people might be going through. Everybody is fighting a battle no one knows about.
      And as for your comment about being a dinosaur, there are plenty of people in their 30's with arthritis. Also people that are also in their 30's who wear dentures because they've had brain surgeries and brain tumor radiation that destroyed their teeth. Also - there are many conditions in which people, like me, that have wake up and take a handful of pills to treat an incurable illness.
      Think before you type.

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    12. some people WANT to be able to hurt people from the safety of their computer. - and for some people that is the only distinctive thing they do. personally I'd rather be a dinosaur than one of those losers.

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    13. You want my honest opinion? I think suicide is socially acceptable for people with low esteem. The worthless cowards. The selfish weaklings. The ugly coward. An act of weakness. Boo Hoo. Feel sorry for me. Feel sorry for me or I'll kill myself. Go ahead. You'd be doing the whole world a favor.

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    14. Anon - I hope someday you come back and reread that comment. Perhaps then you will realize who the real coward is.

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    15. I just don't have the appropriate emotional response to someone who is thinking of committing suicide and I don't have the skills to imagine what the other person is feeling. I don't think you can call that person a coward since everything is superficial.

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    16. It's called empathy. Try practicing it. We're all human on the other side of this keyboard. No one is asking for your sympathy, just common human decency. That's not too much to ask, but as I've learned today, maybe sometimes it is.

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    17. Housewife - It is most assuredly NOT too much to ask, especially here.

      I don't think I'll have to ask again for everyone to keep the comments cordial. There is no right to free speech here in Bastardia. I am the law.

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    18. You don't know how difficult it is for some people to express and experience empathy. In my world they don't exist. I just don't have the ability to understand someone else's concern. It's not there. It's missing.

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    19. Then you also don't have the ability to comment here. I don't believe you for a millisecond, but if what you're saying is true, you need serious psychiatric help. Goodbye.

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    20. Anon 07:05 - I think what you have just described is one of the key characteristics of people on the autism spectrum.

      You may be aware of this already but if not, you might like to check out some of the information at http://www.autism.org.uk/about/what-is.aspx

      That's a UK link but the information on the condition should be valid anywhere in the world.

      Ugi

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    21. @anon: then it is your obligation to learn how to behave properly in society.

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    22. Not showing empathy is not something a psychiatrist could fix. You can hire a therapist (a psychologist) and listen to what they have to say but that's about it. They don't offer treatments. They don't explain. They just tell you how to react. And they hate to be questioned. Been there done that.

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    23. No empathy? Please contact the Department of Psychology at the University of British Columbia. Dr. Robert Hare may be no longer actively conducting research, but I imagine that someone has taken up where he left off.

      Wednesday

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    24. Anon said:

      "It doesn't matter if you were not born in the 1950s. If you have arthritis and choke down multiple numbers of pills for medication and waking up really early to pop in your dentures, you are still considered as a dinosaur."

      Fortunately, discovering that I am apparently *not* a dinosaur, because I don't meet this new definition, neither disappoints nor surprises me, since I already knew that I was not a prehistoric animal, and I'm clearly not extinct.

      Such is life for those who live under the bridge, where fishing is the only way to pass the time. Sometimes you catch something, and sometimes you don't. ;)

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  9. "It turns out he had been checking out Facebook on his mobile phone while walking through the train station, and because he had not been watching where he was going he tumbled down an escalator. And he now had two broken wrists (and no date) to show for it."

    Somehow I'd feel a little more charitable if he had been walking and reading a book (printed on paper) rather than fooling with his mobile phone, chuckling at half-witted memes.

    He must be a joy to have in one's class. The wit!

    Wednesday

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  10. I was expecting a comment involving self love of some kind from Riley (not his real name™)

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    1. Well, does his inability to take a hint and never changing the script count as self-love, of a sorts?

      W

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  11. Over the past several years, I've noticed that "distracted walking" now poses at least as much of a danger, if not greater than, "distracted driving," both for the preoccupied pedestrian, *and* for the rest of us whose paths they cross, whether we're walking or driving.

    Besides the visually-impaired who walk among us, incessantly using the smartphone to text, post to social media, or check messages every minute, we now have the hearing-impaired also. Too many people are wandering around outdoors with either those big new high-tech headsets (the ones that look like the "earmuffs" used by construction workers wielding a jackhammer) or earbuds used to listen to their podcasts or music playlists on the iPod or phone.

    In a large city like the one in which I live and work, that's a whole 'nother recipe for disaster, and we've seen them here. In addition to plain old accidents, like a teen who was killed when he didn't hear the train coming as he decided to walk across grade-level railroad tracks, and pedestrians in general trying to cross the street against the light in our central business district who don't hear the panicked driver sounding the horn, the "voluntarily deaf" often end up being victimized by street crime, just because they're not aware of their surroundings.

    But, it's not just the tweens, teens, college students, and others we'd categorize as "kids" or "young adults" who get caught up in these habits. I've seen *plenty* of "grown folks" who do this stuff too, ranging from middle-aged professionals to senior citizens. A few years back, a professional colleague of mine, who is currently working in D.C., was walking around downtown on a visit home, and injured her ankle when she tripped on a curb while walking and texting. More recently, a police officer who was off-duty was mugged and slightly injured while she went for a midday run on the jogging path at the city park near her home.

    ALL this stuff is avoidable. Technology can be extremely useful, and also fun...if we don't forget to use common sense too...

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    1. A few years back there was a news story about a teenage girl who was walking and texting and ended up falling into an open manhole.

      It's slowly getting worse now

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  12. I do the walking while distracted. My strategy is to let other people walk ahead of me when crossing the street so if a car comes it hits them first and is stopped before I walk in front of it.

    Crazily, this has actually almost panned out as a car nearly hit a guy ahead of me while we had the right of way on the cross walk.

    Then I see kids from the nearby elementary school just run out in traffic with those same idiot drivers to cross the street because they can't wait for the light. They think it's funny, I just about have a heart attack every time they do it.

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  14. I don't cry. I try to collect facts when somebody dies. That's just me.

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    1. I collect facts when somebody dies. I'd Imagine, Doc does as well. It's part of our jobs. that doesn't mean we stand around insulting them or their families.

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  15. I have no strategy while drinking/walking. Only to walk to wherever I'm going. I do look out for other people and help them out of the curb. I would not go jogging while drinking.

    I was posed with the question: Would the recent drunk frozen guy have survived if he hadn't been drinking? Umm I thought, ETOH does have a lower freezing point than water....

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  16. I use my phone as a phone.... and e-book reader (Because I can have Kobo, Scribd and Kindle apps, which nicely keep my collection when I'm not reading my paper collection) and when I'm out, it stays in my purse. If I hear a phone call coming through or text, I stop what I'm doing when I can, and attend to it. I occasionally text people, but I hate it. I don't drop everything when I hear *DING*.

    When I was 16, I got my drivers license, and my parents made me buy myself a cell phone (I worked fast food, and also paid my car insurance and gas) for emergencies. I never text and drive. If my phone rings, my voicemail says "Hey, its me. Busy, in class or driving, can't answer, I'll get back to you when I can".

    I did have an Apple Watch and hated the fucking thing with a passion. I had to take it off at school/work because of extremely dangerous equipment hazards (ever seen someones watch get caught in an angle grinder? It's not pretty) and excessive heat from the welders, as well as getting in my gloves way.

    I took that damn watch off, which I could read texts, call, do all sorts of crap with... and put it on less and less. Now it's in a pile of junk on my floor.

    We're so addicted to our phones and smart watches... its sad. I wasn't allowed a phone before I started driving, and if I had ever pulled it out while driving my mom would have probably pulled us over, beat me over the head with it, and then make me run over it.

    I just don't get the phone obsession. To be that distracted you break both your wrists... I'm 31, I'm in school (as a welding pre-apprentice) and in the morning, we do a group phone shut off. People walking around welding bays with their phones got out of hand. One guy put his on a hot (and I mean HOT) piece of freshly welded metal (that had "HOT" written on it) and toasted it. Then he had to grind the leftover pieces of his phone off the metal. He was told!

    Practice phone safety... I just don't get the phone obsession. Not even when I lived alone. Some people treat it like you're murdering them when you ask them to turn off their phone.

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