DwayneEMTP

Man...just thinking about pot brownies is making me hungry... Oh...the good ol' days... :-)

If you understand all of those things, then you understand that it can cost them tens of millions of dollars to make a move at this point in the process. In the interest of being fair are you then willing to sponsor the move with tax dollars as they're being asked to move secondary to something beyond their control? Or are you suggesting that they should donate that money out of kindness, in the spirit of understanding the feelings of many people, the same way that others have considered the feelings of the Muslim while being accused of the murders of thousands of innocents that there is not a shred of evidence that they were involved in? They fear for their mosque, for thier businesses, for the safety of their families when out in the community, but they are being inconsiderate? That thinking is just craziness to me... So then it's your accusation that the builders and worshipers of the mosque were implicit in the destruction of the Twin Towers therefore planning their celebratory mosque before the destruction of the towers? Man...there's a lot to prove there brother... The mosque was in the planning long, long before any of this. They haven't used our laws against us to build their shrine, we, the hysterical American people are trying to use intimidation and force to move them against their will, as they have no basis to do so within the law. Now you're talking out of your ass brother, as you would move the mosque, costing the followers of that mosque tens of millions, (my guess as to changing the plans and purchasing another suitable piece of property at the cities high population areas.) Though you have no reason to believe that the followers have an connection to the crime yet you will still penalize them for it. I challenge you to validate that with actual teachings from the Koran. Not some Wiki shit, but actual quotes, as well as show how mainstream Muslims apply that hatred to their daily lives in our (Mine, yours and theirs) country. Based on that belief then you have to also believe that all Christians condone child molestation, bombings of public buildings filled with innocent people, and the murdering of doctors. Or do your thoughts of silent agreement only apply to Muslims? Fair enough, though I felt that she was arguing the Doc's statement that there is not central representative body for Muslims, and I still believe that to be true. It was a simple, though unanswered, question I believe. From whom would you have accepted those statements and have believed that they were speaking for the majority of Muslims? I hear you brother, as I've spent way more time on it than planned. Though I don't regret a single minute. No time now for the link, though I'll try and get back to it later. Dwayne Edited to add the second paragraph of my comments and to fix a few grammatical errors.

I never see your posts as attacks brother, and if they were based in logic I wouldn't mind if they were. I had no idea of the Pope's name, but I would likely have gone with John, or Paul, had I guessed. :-) But as the Doc said, I'm not sure it's the same point, as if I hear, "The Pope said...." I assume it really is the Pope, as I'm not aware of anyone pretending to that position, and that he is representing Catholics as a whole. But, maybe I'm missing your point? And yet, wasn't it you that made a comment akin to it being a shame that ground zero should be redeveloped in the shadow of a mosque? I believe one of the most intelligent, American, things that we could have done was to embrace the mosque at it's current location. To show the world that we refused to embrace panic and ignorance. To make the statement that we would ALWAYS come down on the side of justice, to the best of our ability, regardless of the hysteria. But instead, once again, we've chosen to victimize our Muslim brothers and sisters, as we did to the Japanese generations ago, and I believe that we would have had more or less the same response had we been financially able to do so. With most Americans in full support. This has been, in my opinion, an amazing conversation. I've learned from it and hope that both sides continue to be represented for a bit... Dwayne Edited to add text in italics, no posts followed at the time of edit.

+5 My vote for statement of the month, though, as has often been proved, a skill I really suck at. Dwayne

First off, good on you girl for being brave enough to have a contrary opinion. I'm going to disagree with you, and likely in my straight forward way, but I didn't want to take a chance that you would construe that as an attack. I'm truly interested in your opinion. Can you name one for me, without using Google? The doc referenced the Pope, and I'm guessing that we all can agree that he speaks for Catholics. Who speaks for Muslims? Who specifically would you point to for those comments? As the Doc mentioned, I too seem to remember many local Muslim leaders risking their lives to come forward to speak out against the terrorist acts. Risked their lives not by identifying themselves as rebel Muslims and in doing so be targeted by terrorists, but by showing their faces in their local communities as Muslim and exposing themselves and their families to attacks from their neighbors. That truly makes my heart hurt. I think that would apply to all religions as well, not just the Muslims. Again, who are "they"? I could agree here if we're talking about Pakistan. But Afghanistan? No...More Taliban are killed and captured due to the efforts of the village Afghanis than any other way. You're trying to make this a simple, straight forward issue in that country. You seem to believe that you're either Taliban, or not. And that's simply not the case. The Taliban are well armed, with American weapons, (Those given to them to help chase the Russians out of their country) and soulless, in my opinion. When they choose you to fight for them you either fight, or show your hatred of Allah and the Koran, which then gives them the right to rain down any kind of pain, and humiliation, up to and very often including death, upon your family. For people like me, that leaves no real decision to be made. Unless of course you'd allow your family to be molested and killed to stand upon your ideals instead of fight? And I'm curious, though of course it's none of my business, as to your religious affiliations, if any? What do you make of the comments, some from well respected members on the site, that Christians and Muslims are operating from the same playbook? That the Christian Bible and Koran are the same document, yet Christians have used it to cause much more pain and death than the Taliban have even considered possible? How do you respond to those comments? And how then do you not despise Christians even more so than Muslims? For me, I'll simply restate what I've stated before. I will continue to refuse to live my life based on generalizations and stereotypes. I will continue to believe that the world is full of amazing, kind, generous people peppered with assholes. I will continue to choose the unpopular opinion when I believe it to be right. And I will continue to defend my family, my friends, and my neighbors to the best of my ability to do so whether they be white, black, gay, straight, Catholic, Muslim, or Atheist. I will also attack any of those people with a vengeance as soon as I see any sign that they are a threat to my family, community or country. Muslims are believed by many to be evil, violent, sneaky beasts set on world domination. Yet my experience, having spoken and put my hands on literally thousands of Afg Muslims shows little sign of that. Atheists are believed by many to be soulless, amoral, self centered automatons, yet my families future, and my life in particular has been changed forever because of my friendship with akflightmedic. Christians are 'supposed' to be kind, loving, unselfish pillars of the community, yet I've watched them blow up buildings, hang blacks, shoot abortion doctors, all in the name of their God. Micro stereotypes may sometimes hold true, or so it's appeared to me from an anecdotal point of view, but I've never seen the case where they've held up on a macro scale. Chbare could probably give us some quantum string theory explanation for that. But me? Yeah, I have no concrete idea why that might be, though some weak theories do play in my head... We celebrate that evil didn't win on Sept 11, 10 years past. But I disagree. The terrorist showed the world our shallow thinking, and willingness to hate and attack, without serious thought or debate, the first shadow that shows in our window. I believe that that is forgivable in the moment, as we're still just human children evolutionarily speaking, but 10 years later? It shows the world our Achilles heal...and that's a terrible and dangerous thing I believe. Dwayne

As I have yet to see a Christian group actively attacking the KKK..a well known Christian organization. We keep ignoring it, though it's been said over and over, the Koran and the Christian bible are the same document until the time of Jesus. Being male doesn't cause autism, though most autistics are male...Being white does not mean you will become a KKK member, though to the best of my knowledge all (most?) KKK members are white...and on and on and on... What about the Crusades? And wait..wasn't Hitler a Catholic? McVeigh? As chbare states, until you've lived among a nearly entire community of Muslims, as we did in Afg, it is likely impossible to convince you that the evil amongst the Muslims in general is tiny. They are kind, and funny, and loving, and generous for the most part. At least to their ability to be so, the same as any human. And certainly more pious and humble than any other religious followers I've ever met. I love to work these problems through my head but it's become more than obvious that those that choose to obtain their world views from sound bites on the television instead of from real world observation will likely never be swayed. Dwayne Crotchity's type of view will never be cured as he chooses to approach the Muslims the way that he professes that non blacks approach the blacks...if there is one bad, or even enough to justify a stereotype, then they are all obviously bad... Welcome back to the good ol' days of witch burnings and Japanese interment camps... Craziness.... Dwayne

You truly want to find the synonym for religious atrocities, that would have to be Christian, wouldn't it? Certainly Christians have maimed, tortured, humiliated and killed more innocent people than Muslims have even considered. And the line of consciousness idea of 'what's the first thing that pops into your head' as a way of accurately describing groups of people is not only ignorant and inaccurate, but should really be reserved for the games of the young, mentally infirm, and those joyfully chemically altered in some way...and sometimes, perhaps in the hands of mental health professionals.. But yeah, mostly the first three, which I have every reason to believe have you signed on their membership rosters...But I thank you validating the points above. Dwayne

Welcome to the City. We can always use another nurse here! Just try not to take the knuckle dragger crowd to seriously believes that nurses are nothing more than scared little butterflies fluttering around afraid to step without a doctors orders... Most of us know better... Good to have you! Dwayne

Ditto. Unfortunately there is no way to break the link between hate and fear. I've told the story a million times about the loving, kind people of that country, only to see peoples eyes glaze over with sympathy for my ignorance. When people are afraid, they are incredibly motivated to find a common enemy, regardless of the actually culpability of that enemy. It's unfortunate that in this case education has little chance of winning out over hysteria until, likely, several more generations have past. Surprised to still be at war? No...as non of the war making concerns the falling of the Twin Towers. What I am most surprised and disheartened by is that more has not been done to show that being Muslim and being a terrorist are not synonymous. Dwayne

Good response Ugly... And yeah, trusting patients is almost always a bad idea in my opinion. Not from an adversarial point of view, but from a psychological one. They are afraid of everything most often. They are afraid that if they tell you the truth that you won't think that they are sick enough to be taken seriously. They need help, and want desperately for someone to take them seriously, so they exaggerate. I don't blame them one bit..but I still have to figure out a way to wrangle the truth from them. And that must begin with distrust. Or they feel really sick but are afraid that if they admit to all of their symptoms that you'll start IVs or do other unpleasant things that they are terrified of. So they lie about the acuity of their issues. Again, I have to distrust them if I'm going to care for them. Or they are aware that they have done this to themselves with drugs, alcohol, foolish actions and believe you will ridicule them, or not care for them properly if you know...so they lie... See the theme here? Normally believing someone a liar is a disrespectful thing...but when we understand that most of these patients feel that they MUST lie to get cared for properly, then hopefully we can see them in a different light. We must care for them enough to distrust nearly everything they say until we can verify it empirically In this instance, House is right. Where he is wrong in my opinion is that not every set of symptoms should initially be diagnosed as Lupus. :-) And an afterthought. You had verified circulation and sensory patency, yet your capt was able to get these patients to move their limbs. What did he gain from that? What might have been lost? I'm curious as to your opinion of the cost/benefit to his intervention. After all, verifying pulse/sensory doesn't necessarily mean you get to keep it, right? Dwayne

I can't tell you how glad I am to hear that. If it pays back even in a small measure what you've given me on these forums then I'm glad for that. It's really good to see you back man... Man...great point. I read my ass off before going into cardiology in the hopes that I could somehow catch up. We were blessed to be taught cardiology by a very eccentric physician and I'd ask questions like, "But I know that X is supposed to happen but what if a leprechaun is dancing by, startles this patient into an electrical junction box that shocks him on accident.....!" (Hopefully not such stupid questions, but probably so.) and she would say, "I need you to trust me here. I promise that I'll spend all the time you want on that question, but can you trust me for a few days and believe that that is not a good place for you to be yet?" She was giving me the same advice.."I need you to back off. You're confusing yourself by trying to speak Mandarin, when I need you to master English first." I love this advice for one simple reason. The unstable patient is telling that they are trying really hard to die. At the time that you recognize this, one thing becomes very obvious. You must do something to stop it. And I think that you will be surprised at how clear things can become when you move from, "Maybe I should do something" to "Something MUST be done right now." For me, it truly is a game changer. It makes things calmer, and more clear. You're options have been narrowed for you. I'll bet a punch in the arm that you're spot on. What an excellent thread. While all were dreaming of being flight medics, from the very first I always wanted to be a remote medic. Thanks to my friends here I've done a lot of it, and it has been all that I'd hoped. The one thing that I find is dangerous about it is that though I get to do a lot of interesting things and follow them to a resolution, the number of acutely unstable patients is small. I can't imagine staying even remotely current, or even relevant, without these conversations. Thank you all for taking the time to participate. Dwayne

You know what's ironic to me about this thread? Not just the question, but that Asysin2leads is here. I made nearly this exact same statement at nearly this exact same time. I was working, going to school, doing clinicals....I'd just come out of Pharm thinking, "Shit..if we'd just shut down school for two weeks I think maybe I could get caught up..just two friggin' weeks!" But of course we didn't..we sailed right into cardiology. I was exhausted, and disgusted with myself...I was too tired, but much, much worse, I was simply to stupid to understand it. I couldn't get it... And in that thread I was lucky to have Dust, and Ak, and Asysin2leads and Asys said something like, " I know it seem impossible, but it's not. I know it seems like it's all just a jumble in your head now, but that's going to change. One of these days it will all come together, just all of a sudden, and it will be a beautiful thing." Now, remembering that probably seems silly to many, but it's truly the reason I didn't quite medic school. His posts are always smart, and intuitive. He didn't know me from Adam so had no reason to blow smoke up my skirt. But most importantly, I couldn't think of a single purposely bullshit statement he'd ever made. Nothing. So I trusted that he was telling me the truth. I truly hung on that statement for weeks...until one day..pretty much from one day to another, it was as if someone hit me in the head with a board (again) and knocked all of the pieces into place...and it was friggin' amazing..just like he'd promised. Any information I needed was simply there when I needed it. I couldn't imagine a cardiac issue without wondering how the pulmonary system might be involved..etc, etc. I felt like a friggin' genius! (Of course a million things have happened since then to show me that I commonly compete for the position of village idiot, but still). The point is...he was right for me, and I know beyond any shadow of a doubt that he is right for you too. But you have got to back off of the "I'm going to fail!" bullshit...or you will in fact prove to be your own Prophet. All of that is a waste of time, and a waste of energy, and you are smarter and better than that. I know that for a fact. You didn't know the answer to this question so you're an idiot? Yet I didn't see a concrete answer from anyone else in this thread either...a whole thread of people that make me feel like a monkey fucking a football anytime I want to disagree with them. So maybe this wasn't such an easy question? Suck it up princess. And in this case you'll have to suck it up by backing off...take a deep breath Brother, get your mind off of 'what if' and back to a place where it is in the best possible shape to learn and understand new things. All else is just pissing into the wind, right? You've made all the right choices. You've taken all the right paths. You've proved yourself over and over again here to have grown in ridiculous leaps. You got this Brett....There is not a single doubt in my mind. Dwayne

I guess I don't understand the transition part... From EMTP to NRP, what is the transition? Not that I'm worried, as I've not found the NR to be seriously challenging in the past, but am curious if I'm missing something here... Dwayne

How are you faring with the fires girl? I was thinking of you the other day and hoping you were fire free... Dwayne

Hey Joel, Welcome to the City man! Good to have you here. Be brave, jump in, participate....it's good to have you. Dwayne

Yeah, I'm calling bullshit on the story, particularly the nonchalant part, as I don't know of any medic, and I've been blessed to know some really smart and confident medics, that would be nonchalant when confronted with a choking victim that has gone unresponsive. The most important point for me here is this...Though I completely get where you're coming from, I see no reason here that you should be criticized at all. I think that this is a great question and I'm grateful that you've brought it here. Now, as often happens I may be proved wrong here, but I know of no magic head/neck movement guaranteed to clear an airway blocked by a foreign body, and if there was such a movement I'm confident it would be taught to medics before cops. Though I've only had two choking/unresponsive calls (I've been sent on a bunch that turned out to be something else), one ped, one adult, in my short career, I can tell you that I didn't enter those scenes confident in my ability to create a positive outcome...there are just to many variables involved... Dwayne

I wonder too if you may have been rushing due to your captain being there and didn't connect with these patients as well as you should have? From your posts I'm comfortable with your intelligence and commitment and this doesn't sound like the kind of issue I would expect you to have unless you were in a hurry maybe... But as the doc says, different people sometimes get different responses and some patients, for whatever reason, are committed to making you look like an ass. I used to hate going into the ER having missed relevant meds during my assessment and history so I developed this, sometimes ridiculously, thorough montra of asking... Do you take any meds every day? Are there any meds that you're doctor has told you to take that you've chosen not to? What meds have you taken in the past? Why did you stop taking them? What do you take when you get a headache? How about a stomach ache? Do you take any herbal remedies for anything? Have you taken any medicine, for any reason in the last 3 months? After having gone through all of this, and getting either 'no' or 'nothing' over and over again as I'm dropping one patient off in the ER I hear him start to rattle off his cardiac meds to the doc...I look over at him with a look on my face like..."Really??" and he says, "What?! I didn't know you meant those!" I've come to believe that when these things happen off and on that it's just the EMS Gods kicking you in the balls and reminding you to pay attention to business, but when it happens regularly, (say...twice in one night?) maybe they're telling you that your assessment is getting weak in some way. Dwayne

It's hard to imagine why EMS would have told them to hold off using an AED. My guess would be that they'd guessed that he wasn't really dead...but I still don't see the advantage of telling them to hold off... Otherwise, it's a great story to show why we do in fact need more AEDs. I'm amazed actually that it's not a requirement when opening a public gym.. Dwayne

Yeah, I don't know... A two dimensional image of a three dimensional injury doesn't really say that much to me..though those more educated in xrays see more maybe.. Dwayne

I absolutely get what you're saying Herbie, but see it a little different based on one fact. The shelter, and the preachers, are using my money to buy the sandwich and shelter that they are holding hostage until the needy succumbs to their wishes. Due to their tax status, much of what is being given away has actually come from taxless profits from their church which means that I have paid their share of taxes, which also means, to my little pea brain, that I own at least part of that sandwich, right? Not to mention (why do we say that about things that we are in fact about to mention?) that some (many? I'm not sure) are wholly, or nearly so, subsidized by government (read: My) money, and therefore not theirs to bargain with. If I offer a needy person $100 dollars with the understanding that they have to allow me to try and convince them of my beliefs, then I have no issues with it at all. If you give me $100 to help the needy and I still force the needy to allow me to try and convert them to my beliefs, which in this case are radically different than yours, without your permission, I have issues with that. See? Dwayne

My main issue, amongst many, with most, though not all, of the 'devoutly' religious that I know... http://www.angryduck.com/pics/God_Is_Amazing.htm My brother in law is one of the most educated Christians I know. If there is a God I believe that he is the blueprint that we would all be meant to follow. If you want to talk religion, he is more than happy to share his joy with you, if you're not religious, he's not at all confused your lack of faith. I would have no issues if that was the stereotypical Christian. Religion always makes for interesting conversation... Dwayne

When we run out of Democrats? Dwayne

Tina and Ole are driving down a back road when Tina starts to get a little bit frisky.. Ole says, "Tina if you don't stop that we're going to have an accident, or we'll have to stop and just take care of business right now!" Tina asks, "But where would we do it Ole? You're 6'4" 260 lbs, we can't do it in the cab. And you've been hauling pigs in the truck so we can't do it in the back, what should we do??" Ole says, "Well, it's a beautiful day...I'll pull over and we'll do it under the truck!" And so they do... As they're having an aerobic nap Sven comes along..he asks, "Ole, what in the hell are you doing down there! Thinking fast Ole say, "I'm working on the muffler!" Sven says, "Well you dumbass, you should have been working on the brakes because your truck is a half a mile down the road!"

Cool as hell... But, is it just me, or was anyone else thinking, "Man, I wish I had that kind of free time!" Dwayne

As has been stated by myself and others over and over... You love the bluster and propaganda, but continue to have no interest in the hard questions... That is why we continue to consider you a troll.. Dwayne