Gift

Take a little ride with me.  Yes, you.  We're going on a trip, you and I.  Close your eyes.  Now imagine a house, a big house.  A beautiful house.  This house has a wide, lush green lawn, quaint blue shutters, and a sparkling pool in the back.  The house sits on a calm, pristine lake and has a private dock where there is a boat tied up.

Unfortunately your own house burned down some time ago, and now you have nowhere to live.  So you look at this house, and you love it.  You want it.  Not only that, you need it.  You see, it's cold outside, and you have no shelter.  Any day now you fear that you will succumb to the elements.  Your desperation is reaching a critical point.

Then one day as you are standing there staring at this dream house, a man approaches you, seemingly out of nowhere.  He has a smile on his face as he confidently walks up to you and hands you an envelope without a word.  He then smiles warmly once again, turns, and walks away.  Confused, you open the envelope, and inside you find a set of keys.  Looking further you pull out a sheaf of papers - a deed.  No, not just a deed, the deed.  The deed to this house.  The deed to this house with your name on it.

What?  What is this?  Has someone really just given you a house??  Is that even possible?  You tremulously try the key in the door, and it works.  The door swings silently open and you walk inside, incredulous at your luck.  The house is fully furnished.  Even the refrigerator is stocked with food, everything you could want.  You start to tear up as you realise that it was just before you got to the point where you thought you might die that some kind benefactor you don't know and will never meet has given you the greatest gift you could imagine, exactly what you need to live.  Someone has given you the gift of another chance at life.

What do you do to repay the kindness of a complete stranger?  What could you possibly do to show your gratitude?  How do you respond?  I'll tell you:

You throw a huge party, you shit all over the house, you tear it apart, and then you burn it to the ground.  On purpose.  THAT is what you fucking do.

Wait, what?  Why would you do such a thing?  What kind of asshole would take such a gift and stomp all over it?

Zachary (not his real name™), that's who.  Why?  Why would he do that?  I have no idea, you'll have to ask Zachary, because he's the only asshole I know with experience with this kind of utter twatfuckery.

It was a typical Saturday night, which is to say that everyone who rolled through the door of my trauma bay, whether he had fallen, gotten into a car crash, was assaulted, or was stabbed in the head, was drunk.  And Zach was no different.  I believe I saw every type of drunk that night, and Zach was a Type 5 Drunk, meaning he thought he was much funnier than he actually was, which was not at all.  Not even a little bit.

After getting the story from the medics (car vs tree, tree wins), we started our examination of Zach from head to toe.  This always involves undressing the patient completely so that we can look at everything.  His shirt was barely halfway over his head when I recognised a tell-tale sign on his abdomen:

A Mercedes Benz scar.

This was no ordinary scar, and I could have recognised it from across the room.  Anyone who knows anything about surgery will know this immediately as a liver transplant scar, and if you didn't know that before, now you do.

I'm going to pause here to let this scenario sink into your brain for a moment before I go on, because I can feel my blood starting to boil just like it was that night.  If yours isn't yet, it should be.

. . .

*deep breath*

. . .

Ok, ready to go on?  I'm going to skip the remainder of Zach's story, because 1) it isn't that interesting, and 2) just thinking about it is enough to make me want to throw my computer out the window (Zachary was fine despite his best efforts to kill himself and everyone around him).  The short short version, the reason I was so angry, is that Zach had killed his original liver with heavy alcohol abuse over many years, he got a new one, and he was now pissing it away by drinking again.

I'm going to pause again.  My apologies.

. . .

*DEEP breath*

. . .

If you haven't figured out why I'm so angry then you haven't been paying attention and WHY THE HELL ARE YOU EVEN HERE.  *DEEEEEEP breath*  I'm sorry, I shouldn't direct my anger at you when it isn't your fault.  That isn't fair. 

Think of the house.  Like in that imaginary scenario, Zachary was given an extraordinary gift - a new liver, and a new chance at life.  There are no two ways about it; without the new liver, he would have died a horrible early death.  But Zachary was saved.  Some poor soul gave his or her own life to give Zachary a second chance, a new life, and Zach thanked his anonymous benefactor by treating his new liver exactly the same way as he treated his first liver: by shitting all over it.

The things I see in my trauma bay often amuse me, sometimes they sadden me, and sometimes they confuse me.  Rarely, however, do they infuriate me.  Zachary infuriated me.

Perhaps I'm out of line.  Maybe I'm just being dramatic and stupid and I'm over-reacting over nothing.

No.  No I'm not. 

Two problems

I've had a few people ask me over the past day or so if I'm ok.  Apparently if I don't post a story for over a week, some people get worried about my health or something.  Allow me to assure everyone quite clearly:

I'm fine. 

But there have been a few problems lately that have interfered with my usual plans for weekly updates. Well, two problems actually.  Two very large problems. 

1) People haven't really been acting very stupid around me over the past weeks.  I know that may seem hard to believe considering what you've read about my clientele.  Yes, there have been the usual drunk drivers, stabbings, falling off bar stools, etc.  But there are only but so many ways I can make the same scenario seem different and interesting enough to warrant another post. 

1) I've been on vacation.  No, I won't say exactly where I was (and who wants a mental image of me half naked on a beach anyway), but what I will say is that I learned that my middle school teacher was right: it IS hot near the equator. 

If you're paying close attention, you'll notice both problems labeled #1.  That's because I can't decide which is the more important reason for no recent update.  Don't misunderstand, I can always sit on a beach and write blog stories, but only if I have good enough material, and only if I really feel like it, which I didn't. 

The fruity drink with the umbrella sticking out the top may have had something to do with my newly acquired apathy.  Hm. 

Regardless, not to worry, though.  I'm back in town and back in business.  And doubtless my subjects will give me plenty of blog fodder in 3...2...1...

Jahi McMath update

It's about that time again, folks: time to revisit the tragic story of Jahi McMath.  In case you're new here and don't know Jahi's story, you can read about it here, here, here, here, and here.  I even wrote a stupid FAQ here.  The short short version of the story is that a 13-year-old girl in California underwent a rather extensive three-part surgery for sleep apnoea and suffered cardiac arrest and brain death back in December, 2013.  She was declared brain dead after multiple separate brain death evaluations by multiple different people as well as by Dr. Paul Fisher, the court-appointed second opinion expert, and multiple ancillary tests confirmed the diagnosis.  Her mother, Nailah Winkfield, refused to accept the diagnosis, so she had her transferred to another hospital in New Jersey (St. Peter's University Hospital) where she had a tracheostomy and feeding tube placed.  She stayed at that facility for 8 months until she was discharged to her mother's care, and has been sustained on somatic support in an apartment in New Jersey since August 2014.

Got all that?  Good, let's move on.

In the intervening 2 1/2 years, we've had sporadic "updates" from the family (and anti-brain death quack Dr. Paul Byrne) claiming that Jahi is alive because she no longer meets the criteria for brain death.  The "proof" for her resurrection has been, shall we say, lacking.  One of the pieces of evidence was a video of Jahi supposedly moving her foot to command, and another was a video of her moving her arm to command.

My last update was over a year ago in March 2016, but it was just a couple of vague pictures of Jahi, still with her eyes closed.  More recently than that in October 2016 a video was posted of Jahi supposedly breathing over the ventilator, again in response to verbal commands.

So what are we to take away from all of this?  What does this all mean?

The short answer: Nothing.

As usual, the "evidence" is meaningless.  How do I know this?  Because it is no longer merely implausible, it is quite literally impossible.

Thanks to Professor Thaddeus Mason Pope's Medical Futility Blog, we now have access to some information that has up until now been mere educated guesses.  A case management statement (whatever the hell that is) was submitted by Jahi's surgeon, Dr. Frederick Rosen, which contains the statements of two experts on brain death, Drs. Thomas Nakagawa and Sanford Schneider.  For a bit of background, Dr. Nakagawa is the division chief of critical care medicine and the director of the paediatric intensive care unit at Johns Hopkins All Children's Hospital in St. Petersburg, Florida, and he has over 25 years of clinical experience in paediatric critical care.  Dr. Schneider is a clinical professor of neurology at the College of Medicine, University of California, Irvine and has been in paediatric neurology practice for 48 years.

These two guys know their shit - THEY ARE EXPERTS.  Both doctors reviewed all available records, starting with her original hospitalisation in California, all the way through the end of her hospitalisation in New Jersey and the release to her mother.  In their statements they disclose some very interesting, and very revealing information.

Dr. Nakagawa describes the several EEGs that were done as ancillary brain death tests (note than an EEG is not a definitive test for brain death).  On December 12th there was no brain activity, and the technician noted that her right arm and left leg were both moving during the EEG.  They also tried auditory and painful stimuli during the test as well as shining a light in her eye, but there was no brain activity in response to anything.  Another EEG was performed on December 17th, and again there was no response to painful stimuli, light touch, or sound.  Yet another EEG was done on December 23rd, which was exactly the same.  This is very important information, because it means that her movements are in fact spinal movements, not caused by brain activity.  Also keep in mind there was no response to sound.  This will come into play a little later.

Nakagawa also goes over Jahi's brain flow scan on December 23, 2013 (page 33) which showed a complete absence of blood flow to the brain, which Dr. Fisher calls "beyond definitive".  Brain tissue cannot survive more than a few minutes without blood, and this was 13 days after her anoxic event and cardiac arrest.  Thirteen days is more than enough time for the brain to die.

He also describes Jahi's clinical exam during her 8-month hospitalisation in New Jersey, and at no time was her examination ever not consistent with brain death.  She never had any purposeful movement, she never opened her eyes, she never had any cough, gag, or pupillary reflex, and she never had any spontaneous breathing.

Drs. Nakagawa and Schneider both talk about the other ancillary tests that were done on September 26, 2014, including MRI, brainstem auditory evoked potentials, upper extremity somatosensory evoked potentials, visual evoked potentials, and EEG.  None of these are accepted ancillary tests for brain death, but they still revealed something very interesting: they were still consistent with brain death.  Additionally, on page 46 of the document Schneider states that the somatosensory evoked potentials demonstrated some integrity of the spinal cord up to the level of C5, but there was no function above this.

It is a medical impossibility that J. McMath is moving in response to verbal commands.  The brain stem auditory evoked potentials test performed at University Hospital on September 26, 2014 . . . demonstrates that as a result of J. McMath's brain death she has no auditory pathways; there were no evoked potentials to maximum aural stimulation.  This test result establishes to a reasonable degree of medical certainty that J. McMath cannot respond to verbal commands because she has no cerebral mechanism to hear sound.

In plain English, the videos of Jahi moving in response to her mother's voice are nothing more than spinal reflex movements, because Jahi CAN NOT HEAR and her brain CAN NOT CAUSE MOVEMENTS because it is dead.  It is now plainly obvious that they simply caught Jahi at a time when her hand and foot were twitching, and they took a video of it while Nailah told her to move.  I don't know if this was deliberately deceptive on Nailah's part, but I suspect it was not.  I believe that she honestly believes Jahi can hear her.  However, she can not.  It is 100% impossible.

In summary, Nakagawa and Schneider exhaustively evaluated everything that had been done to and for Jahi from her surgery up until her release to her mother on August 25, 2014 (there was no evidence that Jahi had been re-evaluated for brain death since that day), and all of the brain death evaluations that were done in California were deemed completely valid.  There was no evidence that anything was awry in any way.  They also both stated, quite definitively, that nothing that had been done since her declaration of death -- no subsequent tests, no exams done at St. Peter's University Hospital, no nothing -- could . . . well, I'll let Dr. Nakagawa sum it up:

There is nothing in McMath's medical records from Saint Peter's University Hospital that would cause a reputable expert in pediatric or adult brain death to question or reconsider the accepted brain death assessments of Dr. Robin Shanahan, Dr. Robert Heidersbach, and Dr. Paul Fisher.

He makes the same statement regarding additional tests she had done in September of 2014, none of which are accepted tests for brain death.  Dr. Schneider then says this, which Nakagawa also averred:

There is absolutely no medical possibility that J. McMath has recovered, or will someday recover, from death.

It seems I may have said something very similar many, many times.

So there you have it.  That's about as definitive as it gets.  Comments, as always, are welcome.  But please keep them respectful.

Look of disappointment

Clara looked at me with sad, red eyes, tears welling up and starting to run down her flushed cheeks.  I've seen that look before, many times.  Many, many times.  Usually the look comes when I've told someone her son was just killed and I couldn't save him, or someone whose wife has a terminal cancer that I just can't cure.  But not this time.  Clara wasn't related to the patient, she was the patient.  Her look was indeed one of deepest disappointment and sorrow, but it wasn't because she was sad, and it wasn't because she was hurt.  It was because she wasn't hurt.

If it doesn't make sense yet, it will soon.  I promise.  

My trauma shift starts at 8 AM, and it ends exactly 24 hours later.  Full-day shifts are torture; they are antiquated things that should have been retired long ago, but they persist in many places because we haven't come up with a better system.  The worst part of the shift is theh 7 AM - 8 AM portion, because it's right at the time when most people are driving to work and car accidents are likely, and it's right at the time when I'm counting the minutes until my shift is over.  So when my pager went off as I was making rounds at 7:35 AM and looking forward to my first cup of coffee, I was unsurprised but thoroughly disheartened.  What did surprise me was the mechanism of injury:

"LVL 1 GUNSHOT WOUND TO CHEST. 5 MINUTES"

Wait, what?  Who the hell gets shot at 7 o'clock in the morning?  I quickly trudged down to the trauma bay, my mind running through all the possibilities.

None of them, it turned out, proved to be correct.

Clara (not her real name™)  rolled in looking even more disheartened than I was.  That was . . . strange.  Most trauma victims look in pain, angry, half dead, or giddy (in the case of Drunk Driver type 5), but not Clara.  She just looked . . . blank.  She was staring straight ahead at nothing and no one in particular, her face slack and emotionless.  Then she slowly turned her head towards me, and while I expected a smile, a frown, a scowl, or something, her expression did not change one bit.  She simply looked at me.

"Hi Doc, this is Clara.  She's stable, oxygen sats 100% during transport.  She tried to kill herself this morning by shooting herself in the chest with a hunting rifle."

Ah.  That explained her look of sheerest despondence.

Clara dropped her head and stared at the gurney, her face still impassive.  I was half expecting her to either complain, deny, or cry, but she did none of those things.  She just sat.  While I felt terrible for her and her obviously hopeless situation, it was also a very troublesome situation for me, because I then had to say something that I knew damned well she did not want to hear.

"Hi Clara, I'm Doctor Bastard (not my real name™).  I understand you were trying to hurt yourself, but I need to make it clear to you that it is my job to make sure that you do not succeed."

She merely glanced at me briefly, nodded once, and returned to staring at her lap.

The entry wound was in the upper outer portion of her left breast, and the exit wound was on the outer portion of her left back.  Based on the trajectory (and the fact that her lung sounds were clear and equal), it didn't look to me like the bullet had entered her chest, but obviously I needed to be sure.

Her chest X-ray was completely clear (except for a few small bullet fragments in the subcutaneous tissue), an ultrasound of her chest was normal, and a CT scan confirmed that no major damage was done.  No fractured ribs, no pneumothorax, no injury to the heart.  As soon as I saw the pictures, I walked into the scanner to tell her the good news, which (I realised as I was saying it) she would take as bad news.

I put my hand on her shoulder and said simply, "Hi Clara.  I just looked at your scan.  I know you don't want to hear this, but the bullet did not enter your chest.  There's no major injury."  Before I could even finish, her emotionless expression started to break down.  "It's ok.  You're going to be ok.  We're going to get you the help you need."

With that, the flood gates opened, and Clara started openly sobbing.  "Oh no!  Oh god, no!  I can't do this anymore.  I'm 53 years old, I've lost my husband and both of my kids, and I just can't do it.  I can't do it any more.  I just can't!"  She continued to sob as I tried to figure out what to say next.  What could I say?  Is there anything that could make this hopeless situation remotely better?

Ultimately I decided that there was nothing I could say to her that would assuage anything.  I simply gave her arm one final friendly squeeze, smiled meekly at her, and walked out, while I looked up the name of the psychiatrist on call.

Yes, today is April Fools' Day, but this is not a joke or a hoax.  This is a 100% true story.  Clara is a real patient, a real person, with real problems that are clearly worse than I could possibly imagine, bad enough that I had a great amount of trouble empathising with her.

I'm posting this purposely on April 1 to give everyone a break from the silliness that reigns on this date, simply to remind everyone that life isn't a joke for everyone.  

Nothing

I must apologise for the lack of a post this week, but unfortunately it seems that none of my patients have done anything particularly stupid lately.  Anyone who knows my patients' proclivity for gross stupidity may find this hard or even impossible to believe, but sadly it is true.  I got nothin'.

However, I feel somewhat guilty leaving all of my readers in the proverbial lurch, so in lieu of a stupid patient story this week, I'd like to share a few things that some of my readers and followers have made.

First, we have this little gem by Marc Draco (I assume that is his real name).  In case you aren't familiar with the Dunning-Kruger effect, it quite astutely (and accurately) describes people who are incapable of assessing their level of understanding of a subject and thus deem themselves more competent than actual experts.  Vani Hari (Food Babe), David Wolfe, and antivaxxers are prime examples.  Marc absolutely nailed it with this graphic:

Then there is this one, sent to me by @viva__lala (I'm pretty sure that is not her real name).  I don't know if there is an "emergency bracelet generator" out there, but if there is my 0.121 second Google search didn't turn it up.  

If anyone knows of a manufacturer that would be willing to make these, I bet I could sell at least 10 of these!  

The next one wasn't made by a reader or a Twitter follower.  Actually, it wasn't really "made" per se.  It's just a screenshot of a snippet of a conversation I had with a chiropractor I few months back, and somehow it got buried in my phone.  So I thought this would be the perfect place to deposit it.  I believe it speaks for itself:

And in case you're wondering, yes he meant that.  Whatever "that" is.

Finally, a personal bit of artwork presented without further introduction:

Surely everyone must be wondering what institution could possibly give me a doctorate in bullshit and why I would suffer through such an ordeal.  Well, I didn't.  A similar diploma can be yours all for the bargain basement price of zero, zip, zilch, nada.  Just go to thunderwoodcollege.com, and earn a doctorate for yourself.

Now if you excuse me, I have to go back to hoping my patients start acting stupid again.

Yoots

Before anyone starts attacking me, yes I know it could be spelled "yutes" or "utes", but according to the official script, it is "yoots", so I went with Yoots.  Just like the original patent for toilet paper shows it going over the roll, I consider that orientation to be correct.  And if you have no idea what the hell I'm talking about, go watch "My Cousin Vinny".  Right now.  Go.  Do it.  And do not come back until Vinny and Mona Lisa are driving back to New York.

You're back?  Good.

I've often said that youth is wasted on the young, but then again so did George Bernard Shaw well before I first did (although his exact quote was “Youth is the most beautiful thing in this world—and what a pity that it has to be wasted on children!”).  In fact, I just told my children exactly that just a few days ago (the short version) when they were complaining about some movie not streaming fast enough.  At the time I decided not to delve into what it was like in the time before movie rentals when you just had to watch what as on TV, and then years later what it was like driving to a store to rent a movie, hoping they had the one you wanted, driving back to the store to return it, and paying late fees and fees for not rewinding (aka "The Good Old Days").  So instead I started boringly lecturing them on why they should be outside enjoying the weather, playing, frolicking, gamboling, and cavorting or whatever, rather than staring at a screen (which, ironically, is exactly what you are doing right now and also what I just instructed you to do). 

Regardless, kids should be outside playing, not inside playing, as long as they are reasonably safe about it.  But during their development most kids eventually go from "I'm not sure I can do this" to "I AM INDESTRUCTIBLE!  I CAN DO ANYTHING!  WHEEEEEEEEEE!"  It's the childhood equivalent of "Hey I saw some guy do this in a movie once.  Here, hold my beer".  At this crucial point in their development children lose the ability to judge their own 1) abilities, 2) carelessness, and 3) bravado.

And Travis (not his real name™) is a perfect example of all three.

The first thing that told me that Travis was a completely normal teenager was that he was actively texting as he rolled through the door of my trauma bay.  That prompted my first eye roll of the encounter.

"Hi everyone, this is Travis."  He barely had the decency to look up at the sound of his name as the medics gave their report, but he at least grunted, eyes (and thumbs) still glued to his mobile phone.  That prompted eye roll #2.  "Travis was riding his dirt bike, no helmet, and he lost control, and he fell onto his left side.  He was going about 60 kph (35 mph) when he crashed."

The second thing that told me that he was a normal teenager (and that caused eye roll #3) was his response to that bit of information:

"NO WAY WAS I GOING 60!  NO WAY, DUDE!  I WAS GOING AT LEAST 80!"

I think all the people in the trauma bay, myself included, groaned audibly in addition to rolling our eyes.  Clearly, everything this guy was going to say was bullshit.

Travis then flashed the universal sign for "METAL", grinned, stuck out his tongue, and went right back to texting.  Once again, he wasn't even able to muster up the decency to look at us or speak to us.

I can imagine his text was something lucid, intelligent, and well-thought-out, like this:

Travis seemed completely uninterested and unimpressed by the fact that his left leg had an extra bend in the thigh where it did not belong.  He continued grinning intermittently and making strange grunting noises under his breath as we finished our workup (still texting furiously), which demonstrated only an isolated left femur fracture.  The only thing I could think as I looked at his X-ray was, "I guess the fucking thing is broken."

Fortunately Travis' stay was short and uneventful, so I was not treated to very much of his teenage antics.  I heard about him flirting with several of the nurses, but they were just as unimpressed as I was.  And while he was with us his mother told me of several other not-quite-as-severe crashes he had recently had on his motorbike. 

Once it was time for Travis to leave, I knew I had one more job to do: make sure this didn't happen again.  I had already told him in the trauma bay and the following day that he was lucky he hadn't sustained a serious head injury yet, and he had to wear a helmet whenever riding a dirt bike.  But I decided to drill it into his fortunately thick skull one more time.  With his mother in the room, I told them both that if Travis was going to continue riding his death machine, he at least had to protect his head.  Travis looked at me as if hearing this strange information for the first time, his expression clearly saying this:

Yes. I was serious about that.

Success!

This isn't a personal success story (though I have had several recently), nor is it a professional success story (though I have had several of them too recently).  No, this is a Twitter success story.

A what??

As many of you know, I hate Twitter despite my activity there.  Trying to communicate in 140 characters or less is downright madness, and whoever thought of it should be dragged through a muddy street strewn with horse manure by his toenails, then flayed, tattooed, hanged, and then killed.  To those of you who don't know about my exploits on Twitter, why the hell not?  Go to Twitter and follow me, god damn it.  There's even a little button on the side right over there that makes it easy.  Seriously, go do it now.

Anyway, my Twitter account has metamorphosed of late to become a "Calling Out Bullshit" account.  The bullshit can be anything that I'm not particularly fond of at that moment - homeopathy bullshit, antivax bullshit, naturopathic bullshit, chiropractic bullshit, nutrition bullshit, "cancer is a fungus" bullshit, etc.  You get the idea.

But many people have asked me (in 140 characters or less, of course) why I bother.  Why do I spend (read: waste) my precious time calling out these frauds on their bullshit?  What possible benefit could it have?

@DocBastard oh sweet once again you're fighting a losing battle. Can't beat stupid people, they have years of experience.

— Patrice (@Pattywaffle) March 9, 2017

Well, I'm about to tell you why.

My focus lately has been chiropractors.  I am stunned that chiropractic has managed to survive for as long as it has, considering A) its extremely poor evidence base (it has only been shown to be mildly effective for low back pain), and B) its vitalistic origins.  If you don't know, DD Palmer, the founder of chiropractor, first invented it in the late 19th century purely out of his ass after he supposedly "cured" a janitor of deafness by manipulating his neck.  A stupid light bulb apparently clicked on over his head, because he then hypothesised that "subluxations" (mystical misalignments of the spine) are responsible for blocking the flow of vital energy (whatever the hell that is) and thus are the cause of disease.  To modern chiropractors, it apparently makes no difference that a chiropractic subluxation is not visible on any X-ray, CT scan, or MRI, and indeed has never been shown to exist, nor has vital energy.  It also apparently makes no difference that chiropractic manipulation has never been shown to cure, improve, or otherwise treat anything whatsoever.

That does not stop them, however, from advertising their bogus "adjustments" for everything from pain to asthma to GERD to headaches to paediatrics.

Yes, chiropractors claim they can help children.

I came across Kristen Simpson from Leavenworth, Kansas, USA, who is a chiropractor in the Life Family Chiropractic practice.  She posted this bit of bullshit on Twitter:

Now let's break this down, shall we?  Starting with the array of hashtags: what the hell is a "crunchy kid"?  What is a "well adjusted" baby?  Moving on to the little girl's top - yes, children need to eat.  Children need sleep (a lot of it!).  But "get adjusted"?  For what exactly?  What the hell was this chiropractor claiming her adjustments could do for this child?  Babies need chiropractors in exactly the same way that Olympic athletes need cupping.

Trying to get some answers, I tweeted this at her:

Babies need to eat.
Babies need sleep.
Babies do NOT need to "get adjusted".

BABIES DO NOT NEED CHIROPRACTORS. https://t.co/h7ufo68y8A

— Doc Bastard (@DocBastard) March 8, 2017

I wasn't expecting a reply, since these charlatans people rarely do.  Would you want to be exposed as a fraud on international social media?  I would be mortified, embarrassed, and ashamed.  So instead of responding to the charges, instead of facing her accuser, she did what any reasonable fraud would do in that situation:

She blocked me.

I can't say I was remotely surprised, and I was actually somewhat pleased.  I saw it as a major win, because it can only mean two things:

1. She read my tweet.
2. She had no response.

Since I was blocked, I couldn't continue the conversation with her and ask any follow up questions (SAD).  My followers, on the other hand, were not blocked (at least not initially), and they were not exactly kind, and for good reason:

@lirrmur @DocBastard @drsimpsonchiro I feel physically sick. Not good enough is right, what's is wrong with the parents also?

— Eileen OS (@eosull) March 9, 2017

@DocBastard @drsimpsonchiro mindblowing that these people can present themselves as "Dr" anything. So confusing to public.

— Kenny Young (@Kenny_young) March 9, 2017

@DocBastard @drsimpsonchiro Thanks for shining light on this, didn't realize this type of abuse existed.

— Seoul man (@Monkey3ddd) March 9, 2017

@DocBastard @drsimpsonchiro They see babies as a new revenue stream. Nothing more.

— Christopher Johnson (@ChrisJohnsonMD) March 9, 2017

Why am I telling you this?  What the hell is the significance?  Well if you search for Ms. Simpson on Twitter now, you get this:

That's right, she deleted her account.  Rather than face the music, support her stupid claim, or provide evidence, she bravely turned her tail and fled and is now unable to propagate her ridiculous bullshit on Twitter.

Yes.

And with that, all I have to say is this: