Monday, 13 November 2017

Electricity

There are few things on this oblate spheroid we call Earth of which I am truly terrified.  On the top of my list are nuclear annihilation (which seems more likely with the recent escalation of the Kim-Trump 12-year-old child feud), earthquakes, supervolcano eruptions, and pretty much any reptile, sea life, or insect in Australia (seriously Australia, what the fuck is up with Sydney funnel-web spiders and Irukandji jellyfish?).  But a very close fifth is, as you've probably guessed from the title, electricity.

Despite excellent marks in science classes in school, I still don't fully understand electricity, nor do I really care to.  I zapped the shit out of myself trying to change out a faulty light switch back in college, and since then I try to pretend electricity doesn't really exist (not really).  Even static electricity shooting out of my fingertips every winter has me firmly believing that the world is constantly trying to electrocute me.  My relationship with electricity now solely involves me plugging things carefully into outlets and then turning those things on and off.  And as much as I enjoy fixing things, if those things involve wiring or rewiring or anything involving a fuse box, I leave it to the professionals.  Because fuck electricity.

Fortunately professional electricians exist.  I don't know if these people understand electricity completely, trust it implicitly, or just don't give a shit about the occasional zap that could potentially stop their heart from beating (which, though I am not a cardiologist I understand to be a Very Bad Thing).  Irrespective of how or why they do it, they seem more than happy to fiddle with whatever potentially lethal electrical thing has gone awry.  Unfortunately, however, not all professional electricians know what the hell they are doing.

"Electrocution" is a portmanteau of "electricity" and "execution" originally coined in the late 19th century to describe death by the electric chair.  It has since come to mean any death from electrical shock (as opposed to cardiogenic shock, hypovolemic shock, and "OMG can you believe she's wearing that to a funeral??" shock).  Electrical injuries are particularly difficult to treat because they often combine cutaneous thermal injuries (ie burns), internal thermal injuries (including muscle necrosis), cardiac electrical dysrhythmias, and mechanical trauma from the inevitable fall after the shock.  Thankfully they are also relatively rare, and most are treated at dedicated burn facilities, which mine is not.  Despite this, I still see the occasional electrical injury victim.

Like Lou (not his real name™), who was my patient, and his partner, who was not.  Don't worry, I'll explain.

Lou was driving to a job when he heard over his business radio that his partner had suffered a moderate shock while repairing an air conditioning unit in an attic space.  Wanting to make sure his buddy was ok, Lou diverted to that establishment, where he found his partner somewhat dazed but relatively unscathed.  Apparently his partner hadn't turned off the main power before starting, and at some point he had come into contact with a live wire that was hanging from the ceiling.

Now common sense would dictate either A) your partner turning off the power prior to starting, or B) turning off the power after your partner gets a nasty shock.  As you can easily tell, either way the power gets turned off.  Right?  RIGHT?

Common sense, I am sad to report, is no longer common.

Lou apparently decided to finish the job his partner had started without addressing the live wire hanging from the ceiling that had nearly finished off his partner.  He climbed the ladder to the attic space, reached down to get a tool, and as he stood up he caught the live wire with his forehead.

Hilarity did not ensue.

The shock Lou received was significantly greater than his partner's.  He was predictably thrown backwards down the ladder where various parts of his anatomy bounced off several steps, ultimately striking his head on the floor below and losing consciousness.

And that is where we pick up his story.

Lou had just started regaining consciousness when he arrived in my trauma bay.  He was clearly dazed and confused, a dark electrical burn on his forehead, dried blood matting a good portion of his hair.  Surprisingly his main complaint was his right shoulder.  A thorough workup demonstrated a fractured clavicle, a scalp laceration, a relatively severe concussion, and a small burn on his forehead (obviously).  He had no evidence of a cardiac or skeletal muscle electrical injury, but I watched him overnight just to be sure.  He felt much better, though thoroughly ashamed, the next morning when I sent him home.

I get a bit miffed when doctors in other specialties suggest how I do my job, but I admittedly get a rather severe eye twitch when non-doctors do it.  Despite this, before Lou left the hospital I felt entirely comfortable reminding him to turn off the goddamned electricity before working on it.

I also made sure to note which company he works for and made a mental note never to hire them.  Any professionals working on my power lines need to know what the hell they are doing and, you know, not die in my house.

Monday, 6 November 2017

Texas

I was supposed to be publishing another stupid patient story today.  I didn't think I would be writing about this.  Again.  I thought the death of 58 innocent people in Las Vegas a month ago would be enough to stimulate the United States government to talk about gun control.  To at least get a conversation started.  I thought surely something, anything would happen, something would get done, some conversation would get initiated in Washington DC that would lead to some kind of change.

Then over the next few weeks, the furor over the shooting withered.  Then it died completely.  Instead of reading about potential gun control legislation, I read about a new US tax bill that was introduced.  Whoopdefucking doo.

And now there is yet another mass shooting in the US, this time in Texas.  As of this writing, at least 26 more innocent people are dead after a young man walked into a church and started shooting parishioners.  Among the victims are a 5-year-old, the 14-year-old daughter of the church's pastor, and a pregnant mother and three of her children.  As shocking as that may be, this isn't even the first mass church shooting in recent memory.

I'm going to repeat that in case you didn't get it the first time: THIS IS NOT EVEN THE FIRST MASS CHURCH SHOOTING IN THE PAST TWO YEARS.

How the hell is this possible?  How does the American government allow this to continue, time after time after time? 

Because the American public, and their government, just don't get it.  Within hours, gun nuts immediately piped up, defending their precious guns. 
This seems to be one of their favourites, especially after several people were run over in Edmonton a month ago, in Barcelona back in August, and in New York City a few days ago.  On the surface it seems like a valid argument.  But if you think about it a little deeper, the argument boils down to "Crazy people who want to kill will find a way to kill.  Either ban everything that can kill, or don't ban anything."

Really?  Is that the best you can do?  First of all, you need a licence, registration, and training to operate a car.  You need none of those things to buy a gun.  Of course you can steal a truck and use it for whatever nefarious purpose you choose, but that doesn't change the fact that you don't need a licence, registration, or training to buy a gun in the United States.  That is absolutely unconscionable.

Second of all, cars are essential for everyday life.  Guns are not.

Third of all, this guy didn't use a truck.  He used this:
Can anyone explain to me why an American citizen needs one of these.  Anyone?  Are you protecting your family from home invaders with one of these?  Are you hunting with one of these?  Are you going skeet shooting with one of these?  Oh, perhaps this is the reason:

Really?  REALLY?  Yes, that's how the second amendment reads, because that's what the second amendment was originally about.  But this is 2017, not 1791 when that amendment was written.  In 2017 the United States government has hundreds of thousands of soldiers in their army, navy, air force, and marines with the most high-tech weaponry on the planet.  Oh, and in case you didn't notice, they also have fucking drones.  You really think that rifle is going to protect you from drones?  Apparently he does:
Because according to gun fanatics, the solution isn't just more guns, it's more BIGGER guns.  I can't even muster an appropriate response to that.  I just can't.

Then there was this bit of singular stupidity:

I fed this through my Idiot to English Translation Engine, and this is what came out:
People break laws, so you may as well not even make laws. 
Which is quite possibly one of the stupidest arguments against gun control I have ever seen and much stupider than my imagination could have ever dreamed up.  Anarchy as the solution to crime.  Speechless.

So after two horrific mass shootings barely a month apart, surely US politicians are ready to talk about gun control, right?  Right?
Prayers?  These people were at church.  They already had prayers.  Prayers aren't going to stop mass shootings. 

And President Trump (I still can't believe that phrase is real) said this:
Mental health is your problem here.  This isn't a guns situation, this is a mental health problem at the highest level. It's a very, very sad event.
Mental health is the issue with any murder, because only an immoral waste of carbon and oxygen would murder another human being.  But if you give that waste of carbon and oxygen a gun, you make it much easier to take a life.

Or twenty six.

Or fifty eight.