betty windsor throws out the first pitch

I think Cricket is like the Queen’s Baseball. I have no idea. In fact, on this topic, I am blissfully clueless. I think they have flat bats and seem to run around bases. But teams get their asses handed to them with scores like 284 to 6. I think sometimes they score 100 points at a clip, but if that is true, why waste your time getting 6? I think games go on for days, too. I know they break for tea. It doesn’t seem that strenuous so I am unclear why they take such long breaks.

I watched this film to try to understand more, but I kept it muted because sometimes I get angry. It felt like listening to the narration would not be a good idea. So mute and watch:



Did you learn anything? Yeah, I agree, it was kinda long. But when I saw the credits mention Fleetwood Mac, I was very pleased that I kept it muted. I saw FM 3 or 4 times in the late 1970s into the 1980s. Mick Fleetwood made my skin crawl. Stevie Nicks made my pants tight. But now she looks like Mickey Rooney. Go figure. Next thing she’ll be selling Medigap Insurance.

Did you notice that the credits included a copyright claim of MMXIII? Methinks someone needs to go back to Roman Number School. Someone wrote or told me that the reason Roman numerals failed as a system was because it lacked a zero. It’s a good point, but incomplete. I think it failed because MDCCCLXXXVIII is a lot longer than 1888. Plus you have to do math to figure out the number. It’s more of an equation than a number.

I still don’t understand Cricket. And I care even less to understand it now than I did just 30 minutes ago.

taking it like a man

Oh my! I just read some harsh words about Herself. It certainly deserves a “yeah, right” when I write that I often wondered why Herself has never played up or talked about Herself’s role on the Nixon Congressional investigation team. Maybe this is why:

“Because she was a liar,” Zeifman [Herself’s supervisor on the project] said in an interview last week. “She was an unethical, dishonest lawyer. She conspired to violate the Constitution, the rules of the House, the rules of the committee and the rules of confidentiality.”

Oh my! Those are harsh words indeed! The article is interesting reading about how she removed documents from a publicly accessible area and then wrote a legal brief as if the contents of those documents did not exist. Sounds vaguely familiar to what one of her henchman did when he placed documents from the National Archives in his socks in an attempt to steal them.

Is there a there, there? The article again: The [legal] brief [written by herself] was so fraudulent and ridiculous, Zeifman believes Hillary would have been disbarred if she had submitted it to a judge.

Oh my! I am certain these are not good times for Herself. A liar? Unethical? Oh my!

D’jver just want to break out in song?

Mine eyes have seen the glory
Of the coming of the Lord;
He is trampling out the vintage
Where the grapes of wrath are stored;
He hath loosed the fateful lightning
Of His terrible swift sword;
His truth is marching on.

We used to sing that in grade school in the 1960s. Bet they don’t anymore. Where’s the ACLU when you need them most?

I just entered another blogger’s contest. I couldn’t focus on what she wanted, so I randomized my answer. she wrote me! seems pretty cool. she has an iPhone. must be in debt up to her earlobes.

I’m going through my links. Amazing what you find in there, eh? I think these were shorts that amused me some time ago. Seems my link was from a subpage in 2004. Here’s the home page. I just went through 11 pages before my twin popped on line. Didn’t find anything too good. Forget I mentioned it.

When’d I get compromised? Friday? My how time flies when you are trying to rid yourself of being holed by a five-foot camera. Well, I just wanted to share that I seem to be in a repacking mode still. Seems that Fleets stuff emptied the warehouse. Closing off the fourth day without a, a movement thingey. I’ll keep you posted. Yeah, you’re welcome.

I just remembered why I am cranky. In October – maybe even September – I wrote Cyndi Lauper with the full SASE and all that jazz. I nicely asked for a signed pic for my daughter for Christmas. That guy from Dirty Jobs came through. Hell, Drew Carey sent four! Did Cyndi? No. WTF, girl? The link is her address. Somebody harass her. I don’t want to in case she’s just busy and is going to send the pic, and didn’t because I harassed her. I’m smart like that.

the doctor is in ... feb 08

(I am back from a well-deserved doctor’s respite at … well, nowhere. Just been busy with my day job. We have a new case – Red and Swollen Eye in a 61-Year-Old Man. Not sure what to make of it. Let’s start with the pic.)


(Oh, my! Somebody done poked that dude in the eye with a stick or something! Must’ve hurt. What’dya think it could be? Something about this guy looks dirty to me. Let’s get some data …)

BACKGROUND
A 61-year-old man presents to the emergency department (ED) with a 5-day history of pain with associated redness and swelling in his right eye. (“Five days,” you say. Uhunh … scribble scribble … ok.)

The patient had been diagnosed with herpes zoster (is that like Herpes Complex Z? Z?!? Z is like towards the end of the alphabet. That can’t be good) a few days before this presentation; he was discharged to home with a prescription for acyclovir and hydrocodone. (AAH—AAK—PSYCH—AAHPSYCH—LOVER. Acyclovir … got it here somewhere. OK, “first-time or repeat outbreaks of genital herpes.” This boy got sexed in his eyeball. That’s disgusting.)

Since he started taking acyclovir, the pain and swelling in his eye has increased. (Good. Done go have sex involving your eyeball it oughta hurt. At least now we know it weren’t no stick that got stuck there. Damn boy, whatchu thinking? You on the other side of some sleazebag glory hole?) He also reports binocular diplopia and decreased visual acuity. (BI-nocular? He got one eye shut from a getting a dick jammed in it. The only “bi” thing around here is his sexual orientation.)

On the day of presentation, he is nauseous and vomiting (yeah, after you woke up, saw the glory hole, the line of satisfied customers … I am quite sure you were puking), and he cannot open the affected eye (stick, stick, stick, poke, poke, poke. Of course he can’t open it! Hell, he probably passed out from getting clubbed by somebody’s ankle spanker), which demonstrates ptosis (p-p-pu-TOE-s-s-s-sis) of the upper eyelid, generalized proptosis, and mild periorbital erythema with associated edema.

The right pupil is 8 mm in diameter and nonreactive to direct and indirect light. (Still trying to get the license plate off that man club that hit him.) Intraocular pressure in both eyes is normal at 12 mm Hg.

What is the diagnosis? (He got a little excited about his first gay experience, went to a bar, and became a bit too intrigued about what was on the other side of those holes in the wall. Poor guy. Still puking his guts out. He got love clubbed …)

DIAGNOSIS: (See above.) Cerebro-rhino-orbital phycomycosis (CROP)/mucormycosis. (Yeah, the only “crop” he saw was the riding kind when he had the bit in mouth up on stage. Poor dude – the first time can be so humiliating.)

(Alright, alright, we’ll let the fake docs have their say … fine. Be that way. I know how it is with people like you. You know, just a side note – I kinda HAVE to leave this other stuff in. You should see my page rankings for just god-awful diseases. I do have some fraction of a conscious, somewhere, I am sure I do. Well, maybe not, but I read a lot and I know what one looks like. So read on – just remember – they are WRONG. The guy just had a very rough first outing at the club. That’s all.) CROP is an aggressive, invasive infection that is caused by broad, nonseptate fungi with irregularly shaped hyphae from the class Phycomycetes. The genera that typically cause infection are Rhizopus, Rhizomucor, Absidia, and Basidiobolus. The spores of these fungi are ubiquitous and gain entrance to the human body through the mouth and the nose. Individuals who are immunocompetent will phagocytize these spores; therefore, they do not develop the disease.

Infection is most common in immunosuppressed persons, specifically in patients with poorly controlled diabetes mellitus (often in the setting of metabolic acidosis), and in patients receiving the iron-chelating drug deferoxamine. Unlike immunocompetent individuals, whose bodies phagocytize the spores, immunocompromised patients have massive spore proliferation. Mucormycosis is described almost exclusively in patients with compromised immune systems or metabolic abnormalities. The spores attach to the nasal or oral mucosa, where massive germination and hyphae formation occur, allowing the fungus to directly invade the blood vessels. Areas of ischemic infarction and necrosis are seen in the infected tissue. The fungi invade the blood vessel lumina and cause thrombosis through inflammatory occlusion. Infection usually begins in the nasal cavity and the maxillary sinuses, followed by direct invasion of contiguous structures, such as the palate, the orbits, the ethmoid sinuses, and the brain. Orbital involvement occurs when the ethmoid sinuses are affected. Intracranial spread can occur through the ophthalmic artery, superior fissure, or cribriform plate.

Rhinocerebral infections are usually fulminant and have high morbidity and mortality rates, despite improved diagnostic and therapeutic interventions. Mortality rates of 30-70% are quoted in the literature, with higher mortality rates seen in older series. The mortality rate in diabetic patients appears to be lower than it is in nondiabetic patients and in patients with intracerebral involvement. Death may occur within 2 weeks if CROP is left untreated or is unsuccessfully treated. Additionally, until the 1950s, this disease was almost always fatal. Even with recovery, permanent residual effects, such as blindness and cranial nerve defects, occur in up to 70% of cases.

The clinical manifestations of CROP may include orbital and facial pain, fever, periorbital and orbital cellulitis, proptosis, purulent nasal discharge, and mucosal necrosis that appears as black eschars in the nasopharynx, the oropharynx, and the tissues surrounding the orbits and sinuses. These clinical features are not universally seen; therefore, a high index of suspicion is required. Ocular involvement leads to afferent papillary defects and loss of visual acuity. Progressive extension of necrosis into the brain can lead to cavernous sinus thrombosis and abscess formation. The patient may demonstrate an altered mental status, convulsions, aphasia, or hemiplegia.

Patients with diabetic ketoacidosis are most often affected, but opportunistic infections may also develop in association with renal deferoxamine therapy (eg, in patients with chronic renal disease) or with immunosuppression (particularly in patients with neutropenia or those receiving high-dose corticosteroid therapy).

The diagnostic study of choice is computed tomography (CT) scanning of the orbits and sinuses. In affected patients, CT scans demonstrate soft-tissue swelling, sinus mucosal thickening, and bone erosion. Intracranial and cavernous sinus involvement may also be present. Magnetic resonance imaging (MRI), if available, can show extension of the infection into the surrounding blood vessels, orbital fat, and intracranial areas. Urgent biopsy is usually indicated. Necrotic and edematous tissue with neutrophilic infiltrate is frequently seen with fungal elements (which are broad, nonseptate hyphae with branching at 90°).

The cornerstone of medical treatment for CROP is the administration of systemic amphotericin B at the highest patient-tolerable dose. Local packing of the involved mucosal membranes with an amphotericin B solution is effective for minimizing local disfigurement. When on the medication, the patient should be assessed for nephrotoxicity, as well as other systemic symptoms of toxicity, including fever, nausea and vomiting, phlebitis, anemia, and electrolyte abnormalities. Liposomal amphotericin B may be more efficacious; it is less toxic, thus allowing higher doses of the medication to be given. Additionally, local irrigation and packing of the areas to aid delivery of amphotericin to necrotic and poorly perfused tissues is recommended, because poor vascular supply may prevent systemic therapy from reaching the fungus and because local irrigation of infected tissue has been reported to be an important adjunct to treatment that may even help prevent disfiguring surgery. Treatment of the underlying disease (eg, hypoxia, acidosis, hyperglycemia, electrolyte abnormalities) and discontinuation of any immunosuppressants are also important. The physician should evaluate any steroid medication, antimetabolites, or immunosuppressants that the patient is taking, and such agents should be discontinued if appropriate. It is encouraged that the advice of an infectious disease specialist be obtained.

Aggressive, emergency surgical debridement of all necrotic tissue is necessary; sometimes, multiple procedures are needed to clear all necrotic tissue. The vaso-occlusive effect of mucormycosis leads to infrequent bleeding of the involved tissue; therefore, debridement of affected tissue until normal, well-perfused, bleeding tissue is encountered is ideal. Intraorbital irrigation of amphotericin B may be considered as an adjunct treatment. Surgery may often be disfiguring. Orbital exenteration, as well as removal of the sinuses, may be necessary. Some authors have suggested hyperbaric oxygen as an adjunctive treatment. Reconstructive surgery after complete resolution of infection should be considered.

Indeed, a multidisciplinary approach is best for the treatment of this condition. An ophthalmologist is required to evaluate for ophthalmoplegia and optic neuropathy. An oculoplastic surgeon can provide an orbital evaluation, as well as perform debridement and reconstruction. An otolaryngologist is required for biopsy or debridement of the nasal and sinus cavities. An infectious disease specialist can provide guidance for appropriate medical treatment with antifungal agents. Internal medicine specialists and endocrinologists are useful for the medical management of underlying systemic etiologies. Neurosurgery may be necessary if intracranial involvement is present. Finally, a pharmacotherapy specialist can assist with dosing of amphotericin B.

The complications of CROP include intracranial invasion, cavernous sinus thrombosis, blindness, occlusion of the central retinal artery, and airway obstruction caused by infections of the head and neck (with spread to the carotid sheath or the mediastinum through the fascial planes). The prognosis of CROP is guarded, with reported mortality rates of 30-70% (as stated earlier).

In this patient, treatment with amphotericin B was promptly initiated. CT scans of the orbits and sinuses demonstrated an air-fluid level in the right maxillary sinus, mucosal thickening of the right anterior ethmoid sinus, and preseptal cellulitis. An MRI of the head showed enhancement of the intraconal fat and rectus muscles of the right eye. The patient received emergency sinus debridement, and a biopsy was performed. Pathology demonstrated fungal angiitis and orbital inflammation that was consistent with mucormycosis. The patient underwent 3 additional operations, including exenteration of the right eye, and received hyperbaric oxygen treatments. After hospitalization for 3 weeks, he was discharged to home in good condition.

site meter follies followed by ramblings

Answer: In this order, ABC News, the FBI, an NPR piece, Wikipedia, Jihad Watch, the Saudi Embassy, me.

Question: What is google’s top seven for “wanted terrorist from yemen”? Returned with july 2005 archive.

Yeah, that’s me, terrorist-hunting superhero. Even more fun, following me is Fox News, CNN, and the NYT. I also come in 20th! I wonder if I could sell my page rankings … CNN can use all the help it can get.

The internet is such a dangerous place to get information.

Seems our sitemeter follies a couple two tree posts below missed one cc: on Poindexter’s e: Talisman Energy, Calgary. Dat boy dun shard are storey un stoopud tings! If’n I had a momma I’d bea telling ‘er! Dang!

Answer: In this order, Food Timeline, What’s Cooking America, Motts, me.

Question: What is Google’s top four for the history of applesauce? Return with stupid clowns with a side of applesauce.

I am the authority on the history of applesauce immediately following Motts? You guys are in trouble!

Answer: I didn’t want to sound offensive, so I googled insensitive penis.

Question: What do I do with this limp dick with which I live?

Good advice inspired by one of my hero’s in this life.


Answer: That right there is my e.a.merkel double barrel rabbit ear shotgun.

Question: What the fuck is a rabbit ear shotgun?

This sounds dangerous, and I think the person who googled such a thing is probably way too into weaponry.

Answer: It removes the need to discuss jock itch sweat and detergents.

Question: What are bunched panties?

I understand googling “jock itch and detergent.” The little buddies can be sensitive sometimes, particularly in the summer months. The addition of “sweat” throws me. I fail to see the nexus to detergent. Sweat is a function of aeration, heat, and exertion. The detergent I use doesn’t make me sweat. I might get hives. I can see that. Sweat? Um, no.

I’m working on a theory here. If I ridicule enough people that visit my site, maybe I can achieve singularity. That point of infinite density the other side of which is completely unknown to science. Is it a worm hole to another part of me? Do I burst forward into something later catalogued as Big Bang Clyde, and through this dispersion of my matter form little galaxies that float around me like a herd of mosquitoes? Am I expanding or contracting? If you look at me with a really powerful telescope, will you see me when I was younger?

What will be my last thought as I lay dying? I suspect something about what I was going to do next like the laundry, or something I wanted to do like rinse my dinner plate. I think the profound thoughts will come in the hours before, provided I am not so cranked up on morphine that I am just watching the walls melt. Will I be alone? I think I will have a dog, so I better use big bowls in case I am not found for a few days.

My Great Aunt Nana was afraid of hospitals and she died in one. That always bothered me. My second cousin Craig lived a year after his fatal diagnosis and no one told me. That continues to piss me off.

My father told my brother and me that if his “dick sill worked” he “would have divorced your mother a long time ago.” I was saddened that he didn’t live until Viagra came on the market or that the whole poker tournament thing came after his death. He was an excellent card player. The last time I saw him alive was at a card game we both played in. I remember finally figuring out his game that night. I guess it was time.

I am getting ready to enter the next phase of my life. I think it will be my last. Will it last 30 years or more?

I just got T.Rex’s Dandy in the Underworld. Marc Bolan and the band were on tour when it came out on March 11, 1977. Six months later he was dead at age 30. I don’t understand why people die so young. He had an exceptionally good time while he was here, but don’t we all?

My skin gets dry in the winter. I started to use this soap I put on a scrungee thing. Seems to be helping. But I reach around to itch my lower back, and I feel hair there. Makes me wonder if I have hair on my ass. I am afraid to look. I am not going to itch there except through clothes to ensure that I gather no information. It is just something I don’t want to know.

Does everyone write poetry at some time in their life?

I lot of us have some perpetual fuck-up we know that makes our life look not so bad. Do those perpetual fuck-ups have someone they know even more fucked up? Is there no bottom to the pit?

I love old pennies. Wouldn’t it be cool to know precisely every story associated with a particular coin from its first use to the present? I pick up every penny I find. I save them. Remind me of my twin.

Time to transit …

acidic spouses and fair use

It was a tough decision, but I finally found a winner: Here is the Spouse of the Week! We long suspected she would win, but we needed to wait until this headline was published: Wife Convicted in Husband's Acid Murder. YES!!!

Let’s peek inside …

Now-widowed Larissa and now-dead Tim owned a chemical lab. They had an assistant, James “The Gullible One in Apparent Need of Money” Fagone. The year was 2003. Larissa, or “Iss” as she was called by her friends, and Timmy were in the midst of a nasty divorce. A double shot – divorcing your spouse and business partner! Talk about your social, economic, and spiritual life going down the shitter in one fell swoop.

Having done my fair share of divorces – both as an attorney and a spouse – I understand thoroughly the financial implications of death when it occurs on either side of the court decree. Seems Iss understood, too.

Here’s how it went down …

Iss: Hey, Jimmy, I got a business proposition for you.
Jimmy: Yeah?
Iss: See that guy over there?
Jimmy: Tim? Your husband?
Iss: Yeah.
Jimmy: Yeah, I see him. He’s, like, the only other person here.
Iss: Exactly.
Jimmy: Hunh?
Iss: You’re not getting it. Focus with me.
Jimmy: I’m trying.
Iss: See that 55 gallon drum over there?
Jimmy: Uh, yeah.
Iss: See this stun gun?
Jimmy: The one in your hand?
Iss: Yes, Jimmy, the one in my hand.
Jimmy: Uh, yeah, I see it.
Iss: Guy, stun gun, barrel.
Jimmy: Guy, stun gun, barrel.
Iss: Exactly.
Jimmy: Exactly what?
Iss: You’re an idiot, Jimmy.
Jimmy: You say that a lot.
Iss: You prove that a lot.
Jimmy: I’m sorry. You gonna hit me again?
Iss: No. Jimmy. I want to give you $2,000.
Jimmy: OK. Do I have to have sex with your pets again while you tape it?
Iss: No, Jimmy.
Jimmy: OK.
Iss: You ready?
Jimmy: Ready for what?
Iss: Guy, stun g-- …
Jimmy: … -un, barrel.
Iss: Exactly.
Jimmy: Exactly what?
Iss: Oh, my f---king lord you are stupid.
Jimmy: You shouldn’t talk about God that way.
Iss: Jimmy, focus with me.
Jimmy: OK.
Iss: I want you to walk over to Tim, use this stun gun on him, then I’ll use chloroform on him, and then you put him in the barrel. Upsidedown.
Jimmy: Why would I do that?
Iss: $2,000.
Jimmy: OK.
Iss: Go ahead and do it now.
Jimmy: OK.
Iss: Hey, Jimmy. You need the stun gun.
Jimmy: OK.

Jimmy: Hi, Tim!
Tim: Hi, Jimmy, what can I d--- ZAP! ARGGgghhh …
Jimmy: Sorry, Tim.

Iss: OK, Jimmy, pick him up.
Jimmy: OK. Upsidedown, right?
Iss: Yes, Jimmy.
Jimmy: OK. Thump! Do I get my $2,000 now?
Iss: In a minute. We aren’t done yet.
Jimmy: That’s that acid stuff, Iss.
Iss: Yes, it is, Jimmy.
Jimmy: Whacha gonna do with it? We got another experiment to do?
Iss: Something like that. Get his feet out of the way.
Jimmy: OK.
Iss: I’m just going pour this hydrochloric acid in here with Tim, and we’re going to time it and see how long it takes for him to dissolve.
Jimmy: OK.

Poor Jimmy was convicted in December 2006 of first-degree murder and sentenced to life in prison without parole. Looks like Iss will get the same.

You just have to love a spouse that refuses to out quietly. I think the dissolving-in-acid was a nice touch.

We aren’t done yet. This notice appeared with the article: “Copyright 2007 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press.”

That seemed broad enough to piss me off. “Fair Use” came to mind. “Screw you, AP” also flashed by.

Let’s go to a rather reliable source for such issues, the U.S. Copyright Office. US Code 17 Section 107 lists four considerations for fair use:

1. the purpose and character of the use, including whether such use is of commercial nature or is for nonprofit educational purposes;
2. the nature of the copyrighted work;
3. amount and substantiality of the portion used in relation to the copyrighted work as a whole; and
4. the effect of the use upon the potential market for or value of the copyrighted work.

Is my work commercial? No. I generate no income from this blog. The ads to the right are de minimus and if measureable, the amount attributable to this post is 1 divided by infinity, so zero.

The alleged copyrighted work was publicly distributed. I found it on the open internet. That does not defeat the alleged copyright, but it does put into perspective the nature of the work – it is intended to be read by the general public.

How much of their work did I use? A very small percentage. In fact, many other sources are available both subject to copyright and not (court docs). I, um, I read at least 25 different sources, filling my head with each, before I composed the vignette above. I merely chose to link to AP because I detest them and believe they need the business.

Do I affect their value? Oh no, they trashed that a long, long time ago. Have I touched their potential market? Yes. I increased it by linking to them.

A little more for the USCO: “The 1961 Report of the Register of Copyrights on the General Revision of the U.S. Copyright Law cites examples of activities that courts have regarded as fair use: ‘quotation of excerpts in a review or criticism for purposes of illustration or comment; quotation of short passages in a scholarly or technical work, for illustration or clarification of the author's observations; use in a parody of some of the content of the work parodied; summary of an address or article, with brief quotations, in a news report …’” Yeah, that’s me, particularly the I’m-your-clown part.

AP pisses me off. Stick your pseudo-broad copyright claims.

try banning stupid people instead

I was listening to 101.5 FM out of New Jersey yesterday. The DJ was discussing some list of banned words published by the Department of Defense. I made a note to find the list, but have not been successful. I did find, however, extensive references made to a book by Diane Ravitch called, The Language Police, which is a compilation of terms not allowed in textbooks by the various departments of education around the country. I found two sites, here and here that provide excerpts of her glossary. Just remarkable. To be fair, it seems that Diane was appalled herself – she was not advocating banning these terms, just reporting on it.

Some examples …

Adam and Eve (replace with "Eve and Adam," to demonstrate that males do not take priority over females). Really? Is this like an Affirmative Action thing? Will we someday say that “Eve and Adam” demonstrates that females take priority over males, and then revert to “Adam and Eve” for a period of time? How about “the first two people on Earth, one of each gender.” Ah, but there are writings that suggest Adam had a wife before Eve. She must not have wanted to let him masturbate during her menstrual cycle or something (see a couple of posts below).

Boys' night out (banned as sexist). Really? But it is a real thing. Boys do have a night out. I don’t think you ban a concept – that’s dumb. I suggest you just add a corollary for the female counterpart – “Sausage Run.”

Busybody (banned as sexist, demeaning to older women). I find this interesting. Unlike above, there is no gender reference in the term and, further, the basis for banning the term includes an age reference which is also missing from the term. Do we use “interloper”? Do we say, “that crotchety old bag can’t mind her own business” (substituting the male gender and proper age reference as applicable to the precise situation)?

Courageous (banned as patronizing when referring to a person with disabilities). You must be kidding. Can I use the word to describe a soldier that raced into enemy fire to save his fellow soldiers? It’s not the word, just its application to the handicapped (which I am sure is on the list somewhere)? What do I say – your example of living life to the fullest is like the attributes of a lion? Doesn’t it take “courage” to overcome obstacles?

Dialect (banned as ethnocentric; use sparingly). A “dialect” is a variety of a language that is distinguished from other varieties of the same language by features of phonology, grammar, and vocabulary, and by its use by a group of speakers who are set off from others geographically or socially. “Ethnocentrism” is the belief in the inherent superiority of one's own ethnic group or culture. So you are suggesting that if I refer to someone’s speech as being a dialect, I am inherently declaring my superiority. Do y’all sense an asshat close by? When someone speaks the English language poorly, I do not refer to what they say as being indicative of thie “dialect,” rather I refer to them as “grammar retards.” Use of local phrases like “soda” or “pop,” or “sneakers” or “tennies” is not an indication of intelligence, but region from which a person hails. You people are idjits, and give me adjita.

Drunken, Drunkenness (banned as offensive when referring to Native Americans). OK. Won’t use it for Indians. I’ll reserve it for the Irish.

Egghead (banned as offensive; replace with "intellectual"). What?!? You have to declare this? Did you find a textbook with the term “egghead” in it – or are you just sensitive to the childhood beating you took because of the conical shape of your head?

Fairy (banned because it suggests homosexuality; replace with "elf"). But elves ain’t got wings! Damn. Do I have to write, “winged female elf without the usual bull-dyke stocky build”?

God (banned). See you in Hell, or Hades, or that hoax tossed out there by the intelligent-design idiots of an afterlife in perpetual agony because you’re on fire due to your shitty life.

Founding Fathers, the (banned as sexist; replace with "the Founders" or "the Framers"). But they WERE dudes!

Inspirational (banned as patronizing when referring to a person with disabilities). So I can’t say to the guy with two fingers, no intestines, and only half a face that his subsequent career as one of the most moving writers I have ever read is inspirational? WTF?

Little person (banned as offensive; replace with "person of small stature"). Step right up! 3 for a dollar! Toss the person of small stature through the hoop and win a prize!

Lumberjack (banned as sexist; replace with "woodcutter"). But they ain’t cutting wood – they are cutting trees. Treecutter? Or is that a crack against persons with AIDS?

Middle East (banned as reflecting a Eurocentric world view; replace with "Southwest Asia"; may be acceptable, however, as a historical reference). I have no idea with “Southwest Asia.” Is it anywhere near the Middle East? I’m about ready to puke. Did anybody ask the Arabs if there want to be tossed into a pot with the Asians? Something inside me hears a “how dare you insult [whatever his name is – that guy with the bomb in his towel, PBUH].

Old (banned as an adjective that implies helplessness, dependency, or other negative qualities). Old? You can’t say old? Um, “not young”? “Senior citizen (or resident or person)”? You can’t say “old”? But he IS old! Can’t you smell him? Man, all urine and impacted fecal matter and yeast and ear gunk. Puke!

Paraplegic (banned as offensive; replace with "person with paraplegia"). What is “paraplegia”? Is that like a paraplegic? I don’t want to learn new words – or use three when one will suffice. Is an “amputee” now a “person with an amputation”? A “drunkard” a “person in a perpetual intoxicated state”? A “butler” a “person who butles”?

Polo (banned as elitist). Yeah, thanks, Prince Charles. Hey, ladies, polo is a sport. So you have to ride a horse and usually only rich people play it. Only rich people own race cars – do we ban “race-car owner”? Is “polo shirt” banned, too? I would call it a “golf shirt,” but golf is quite the expensive sport – elitist, too? “What kind of shirt is that?” “Oh, just something I threw together!” “Fairy …”

Satan (banned). Heh, heh, heh. Good luck with that. Let me know how it works out for you. He will become all too real as the flames of Hell lick your ass.

Snowman (banned, replace with "snow person"). They ARE men – by design. You ever put tits on a snowman? Not only is it gay, they fall off! Isn’t that insensitive to women with breast cancer?

Sufferer of cerebral palsy (banned as offensive; replace with "person who has loss of muscle control"). OK, this is stupid. You are telling me that every person in every medical situation that has a loss of muscle control HAS cerebral palsy? I’m a DOCTOR (I.MD), you know. This replacement phrase is factually wrong. What is the problem with you people?

I teach. I read textbooks all the time. I think I may write a lecture about an old, egghead, drunken, little person American Indian playing polo against a bunch of Middle Eastern lumberjacks that suffer from cerebral palsy. They’ll all be tossed from their horses and become paraplegics and will discuss with their cute dialects God and Satan as they make fairy snowmen. It will be an inspirational story of courageousness. Maybe they can have a boys’ night out, all dolled up like Adam and Eve, and chit-chat about our Founding Fathers and the busybodies they encounter.

I’ll write an invitation to the visiting team, “Dear Camel Jockeys …”

Enough.

happy thanksgiving from the palestinian authority

I frequent life is israel several times a week. The link is to a specific post, but just click his header for the main page.

What I find amazing is the bald-face lying of the Arab community. "What? Us? We are peace-loving, PBUH, yadda yadda, yadda." They are actively at war. Period, end of story. Any liberal simpleton that tries to suggest otherwise is not merely an enabler, they are a co-conspirator. There is no desire within the Arab community to resolve anything in Palestine. Letting them rot keeps them angry - and the anger is directed towards Israel. Just think what the several HUNDRED millions dollars Yes-Sir Are-U-Fat possessed in his personal coffers could have "solved" if he hadn't stole it.

These people will continue to fight until they are killed one by one. Everyone knows they are fighting, but are unwilling to resolve it. Just look at the garbage Israel took because they built a wall. Stupid.

Want to see these clowns at war? Check out the video. Notice the truck driving by - there is open knowledge of these actions. The "I don't masturbate because Allah told me so" crowd is setting up rocket launchers to toss missiles into Israel. At least Sinn Fein had the decency to use the cover of night (mostly).

when can i masturabte?

There are just some things that you just cannot make up. I cut nothing below – full and complete. You have all the links.

J.W. from Canada writes, “As-Salamu `alaykum. I got married four months back. I am a Muslim and try to follow Islam to the best of my ability. During the time of my wife's period (which is usually seven days) I get sexually aroused a lot (she’s had like THREE periods, pal. Get a fricking grip – oh yeah, that’s what you are going to ask. Sorry, got ahead of myself.). I would like to know if, during this time, it is permissible for me to masturbate (smile)? If not, is there any other option?” (There’s the neighbor’s sheep, a mud hole, a rotting tree by a creek bed, your sister.)

Counselor Ahmad Kutty responds:

Wa `alaykum As-Salamu wa Rahmatullahi wa Barakatuh. (Same to you, pal.)

In the Name of Allah, Most Gracious, Most Merciful.

All praise and thanks are due to Allah, and peace and blessings be upon His Messenger. (Yeah, yeah, yeah, cut to the chase.)

Dear brother in Islam, thank you so much for your concerns about your religion and Allah’s law even in what concerns your sexual life with your wife. (Gotcha. You get paid by the word, buddy? Talk!)

As for your question, it should be clear that masturbation is generally considered forbidden (except for the quite amazing exceptions noted at the end of this post) in Islam since it is deemed to fall under the category of sexual satisfaction outside the framework of marriage (don’t tell me that you’re about to say everything has to be with her, are you? Everything?). However, mutual masturbation between the man and his wife (here we go – so I can’t yank my pud, but she can? Where do I sign up? PBUH) is not haram; rather, it is permissible because it is a part of the enjoyment which Allah has allowed (nice guy, that Allah). Allah Almighty says: “Those who guard their chastity (i.e., private parts from illegal sexual acts). (why is there a period to the left and a capital E to the right? Your God seems to be a grammar retard.) Except from their wives or (the captives and slaves) (gotta love the fact subsumed in evidence, eh? It is perfectly fine to have captives and slaves. You people are bizarre.) that their right hands (I’m left handed; when I use my right hand it feels like someone else is doing it – is that ok?) possess,—for them, they are free from blame.” (Al-Mu’minun: 5-6)

In response to your question, Sheikh Ahmad Kutty, a senior lecturer and Islamic scholar at the Islamic Institute of Toronto, Ontario, Canada, states (oh, the above was like scripture, and now we get the sermon? I’m into it.):

“We are not allowed to engage in sexual intercourse with our wives during their menstrual period (why not? Give me a good reason. Name ONE. That’s why somebody invented soap and water.). However, there is no taboo on gaining sexual satisfaction from them through other ways (tell me more!). The Prophet (peace and blessings be upon him) (double that if he is going to elaborate on “other ways”) was once asked, “What is allowed for a husband from his wife during menstruation?” (Somebody asked him this? Where's that humungo thighed Mrs. Clinton & her Fabulous Question Planters when you need them? This dude is walking around like a fricking prophet and people asked him about banging their wives? You people hate Jews, but, c'mon, they had a bit more decorum with Jesus, right?) He replied, “Everything except sexual intercourse.” (I LOVE this guy – “everything”) Just as there is no taboo on intimate touching, fondling, caressing, et cetera, there is no prohibition on spouses masturbating each other, et cetera. (I think “et cetera” is Muslim for “yadda yadda yadda.” That Mohammed said that?!? That is so funny. The dude is walking around like he’s the Christ and talking about jacking off. So hip! Did he wear headphones and sunglasses? So, we already learned that she can take the yoyo for a walk. You mean I can just say, “This side’s bloody, flip it over”? That’s cool with you? So provided a slave isn’t available, I can just crank her up the ass and you have no problem with that? You people spent too much time in the desert with camels. Trust me on this one. I bet the etymology of “animal husbandry” is a bit further east than Greece or Rome.”)

Although you are not allowed to masturbate yourself, your wife can masturbate you without incurring any sin (You’re repeating yourself. On purpose? For emphasis? OK, ok. I’ll talk to her and said you said so. "Um, jerk me off, PBUH." That's all, right? I say that and we're cool?). So satisfy yourself through halal (lawful) (I thought "halal" was deep fried and served in a pita. Learn something new everyday.) ways; we have sufficiency in what Allah has made halal for us so that we do not need to turn to that which is considered as haram (unlawful).” (I thought "haram" was a bunch of chicks - or as you call them, "captives." Let’s summarize, she can yank it, I can flip her over, I could do a slave, I could kidnap somebody so I have a “captive.” I didn’t see any prohibition on her blowing me – I mean, “everything” is a pretty broad term. I can toe fuck her? Just can’t bang her. Got it. What an amazing religion to discuss such real issues. And you think we are too loose? Tell me, when I clip my toenails, right to left or left to right?)

Excepted, with slight modifications, from: www.muslims.ca

You can also read:

Islamic Ruling on Masturbation. Can I? Short answer: Yes (hunh? I thought you just said, no.), but only if you aren’t married (ah! So stay single and the sheep are safe.), if you think you really need to bang some married girl (so even if I am married, I can do it if that woman over there is driving me to the point of distraction. What an incredible religion you people have.), or if you are releasing sexual tension rather than achieving sexual desire (now, talk about wordsmithing. Tension not desire. Well, I get really tense sometimes – does that work? Hey, I’m tense, I took my Viagra and she’s late from work - yank yank yank. And that’s OK? Listen to me, boys, create a flow chart of your rules. See the spirals and feedbacks? There’s no flow (menstruation aside). Your rules are creating asshats. Settle down. Relax. Masturbate. Don’t be so uptight.).

My Husband Does Not Satisfy Me in Bed: Can I Masturbate? Short answer: No. So what if we Muslim men have short dicks and no sense of foreplay. Deal with it. (Figures. Always the guys with small dicks writing rules telling women to “deal with it.” How about this, bub – pull your own pud, I can’t find it! The coke bottle and tweezers must be in the slave’s room.)

If you are still in need of more information, don't hesitate to contact us. Do keep in touch. May Allah guide us all to the straight path! (Yeah, ok.)

Allah Almighty knows best. (I am speechless.)

Trip Points

I got issues. Funny, eh? Three words that set the tone. Some things are instant piss-me-off-no-matter-what-the-current-mood issues.

Broadcasting political votes. I was on some web site off the Blog Carnivals site. The post was something – forget now. But a few posts down he writes that he just voted in the local city council elections, and then proceeds to name for whom he voted. A friend of mine said once, when asked for whom he voted in a recent presidential election, “One of the beautiful things about America is that not only can we vote for our leaders, but we don’t have to tell anyone for whom we voted.” I thought the statement was elegant.

I think that people that broadcast their votes are idiots. Talk about issues all you want. Make your position on abortion or baby seals or rain forests known all you want. But to consider that some politician, who by definition sells their soul to the highest bidder, is actually an answer is incredibly naïve. They are as complex and contradictory and evolving as any other person. You work on a campaign and have sold your soul, too, then your opinion doesn’t matter.

Vote if you want to, but shut-up about it.

Stupid people that don’t know they are stupid. I cannot fathom these people. The layer that always comes with it – and it is this portion that trips me – is the arrogance. We all have limitations, physical or intellectual or spiritual or whatever. The trick in life is to know your limitations. I cannot deconstruct music. I can’t choose clothes that go together without picturing those garanimal tags. I can figure out a lot of stuff just in my mind, such as numbers, some physics, law. Other things I can conceptualize but cannot execute well until I do it and screw up – the second time is always better with household repairs, car repairs, etc. I get there; it’s just a matter of being patient with myself.

So then you get people who are convinced of their intellectual superiority. They have the world by the balls. Then they do something stupid, and other people are materially changed through their arrogance which is followed by lies. Then you talk to them to try to understand, and they sputter, and lie more. Then the arrogance comes into full bloom like a rancid flower next to a thick green pond. Then the fake supplication. Then the continued fake supplication – and words mean nothing, only actions. So watch carefully, and you see the continued stupidity. And what pisses me off (yes, I am referring to a very specific situation in my life right now) is the continued collateral damage of which the person is too stupid to see. Telling them is pointless. I work incredibly hard not to turn full barrel and leave behind a charred hole. Humorously, the cranially vacant one thinks I already have. It is to laugh ruefully.

Liars. I detest liars on every level. I never forgive (that’s not a problem, is it?) and always filter every subsequent transaction for decades through those putrid waters. Ironically, I act spitefully, lying, too. I dwell in the brackish waters. I never trust again. Never. If you lie to me, then they are no longer any rules. Yes, the foundational lie needs to be fundamental. But once that floor has been compromised, the hole created is as if a claw-foot tub dropped through it from an upper floor, followed by my specious carpentry skills. The hole is, at best, repaired with a jumble of boards, overlapping haphazardly with darkness appearing through the many gaps. One cannot walk past the hole without consciously avoiding the space or tripping over a jutted-out board; to walk on those same boards is folly for now and evermore. I gather information slowly and patiently for years if necessary. I suspect the worst in every transaction, particularly when older paths are tread again. It is, perhaps, a deep character flaw in me. It is, equally, something I will never devote even a micron of effort to resolve. Never lie to me. I will never forgive you. Not in the ensuing hours, days, or decades. Until the day I die, I will never believe you, and will always assume the very worst in you. Always and, as they say, in all ways. The seed of distrust spawns a seed of hate. Regardless of subsequent interactions, those seeds are cherished and nurtured by me. Always and in all ways. It will never change, and I will gladly die a lonely and miserable death to maintain my own variant of arrogance. It requires no effort on my part – that’s the humorous aspect. It simply is as it is, like a drawing with a crooked line: drawings are not changed, merely observed; I am not the artist, just the patron; the artist’s portfolio will always contain that drawing, whether they claim it to be destroyed or not – it was within them at one time, and will always reside as a part of their talent set. Always and in all ways.

Loudmouth anything. Guess what? Illegal aliens are here illegally. They have violated the law the same as a thief. People die in wars. When folks join the military, they do so knowing and accepting the risks in return for remuneration – be it cash in hand, educational benefits, or lifelong healthcare. They are in a war theatre because they offered to go there and were trained to be there. You support the military – as long as they are not doing what they are trained to do? An abortion is either murder or the cessation of the autonomous subdivision of a mass of cells. I have my opinions; you are encouraged to have yours. Mine are informed to the level that is comfortable for me; I hope yours are the same. Mine are not printed on a sign that is carried in public, nor screamed at passersby, nor is my body interfering with the stream of commerce to get my point heard. I do not need your sign, voice, or body telling what your opinion is. I just don’t care. I bailed on news reporting because all they cover are idiots like you. It may be just my concentric world, but I have observed a direct and negative-slope relationship between your {ahem} “forceful” presence and your intelligence. Just – shut – up, and keep your face out of my face, your body off the bridge I am crossing (unless you’re a jumper), and your poor grammar to your home-bound scribblings. Don’t even get me started on actors and actresses that have a proclivity to memorize words written by someone else and to delivery those words with a proper range of affect provided someone is off-camera telling them what to do and, based upon the sharing of copyright royalties, think that somehow they possess opinions worthy of educating the masses. The only reason that they are not complete assholes is because there are obviously a few missing pieces. And this includes rock musicians, too. You made your money in music. We never paid you to tell us what you thought. So now that you don’t need our money any more doesn’t give you the right to use the stage we paid for to voice your opinion. Get out the guitar and perform, monkey boy – the rest is of no interest and just makes you look stupid.

Liars. Did I mention liars? Lemme check … oh yes, I did. Well, double it.

Sportcasters. How many times can they misapply the word “brilliant”? Look, pal, these athletes practice a lot. What they do on the field is muscle memory, with the rare exception of some quarterbacks and pitchers – but even they are mostly muscles remembering previous motions. It is all trained auto-pilot. Brilliant? Ever hear them talk? You associate “brilliance” with that? They make rap stars sound like accountants. I love sports, so I ordinarily mute the telecast and listen to music or silence. The overwhelming majority of athletes would be in prison if they didn’t meet the “physical freak” criteria. Most retired guys sell insurance or cars. Brilliant? C’mon. Just shut up and call the plays as they happen. And the very worst thing these clowns do is point out “celebrities” in the audience. Just frigging shoot me.

The list can go on … gonna bail for now. Probably to be continued …

cosmic dancer

I was looking up at the sky and idly thinking what would happen if, say, some space-originated hunk of iron (with a typical density of, say, 8000 kg/m3) with a diameter of something like 100 meters, crossed into the atmosphere at, like, a 45 degree angle at a speed of roughly 50 miles/second, and then slammed into some sedimentary rock (with a density of something like 2500 kg/m3) about ten miles or so from where I sit. Would I be safe?

When in doubt, go to the internet. It just so happens that there is a Earth Impact Effects Program just waiting for your variable inputs – and mine!

If you just want the math behind the results, go here. Otherwise, read on – looks like I’ll be ok. Maybe. Wait, no. I think. Not sure. Sounds bad, actually.

First, there is some garbage about, “Energy before atmospheric entry” being 1.36 x 1019 Joules = 3.24 x 103 MegaTons TNT. I could not care less what happened before entry. I want to know about the impact on my ass where it sits – and I may not be a math or science or space guy, but I do know that energy before entry won’t blow down my walls.

We next learn that one of these things will slam into whatever I said it slammed into about once in every 56,000 years. That is not comforting. I checked the records. Ain’t nothing hit about ten miles up the road in the last 56,000 years. I know the probability is calculated as “average interval between impacts of this size somewhere on Earth,” but that is stupid – how am I supposed to figure that out? If it ain’t local, it didn’t happen – a true Appalachian attitude. Got a problem with that? Wanna squeal like a pig? Here piggy, piggy! So adjust the 1:56,000 for the proportion of the Earth’s surface up the road those ten miles. Something-a-helluva-lot-bigger-than-56,000 – still didn’t happen. So there.

There is a spot of good news in that the thing that’s gonna hit will start to break up about 128,000 feet away. That’s like over by Hazleton, a couple two three miles away. No problem. That’s the town that hates illegals. Good thing Jerry Farewell is dead else he’d be screaming, “God’s revenge!” That’s the guy that whacked off in front of prostitutes, right? Bet he’s already bought his season pass to the porn drive-in in Hell. All forty foot penises and sweaty asses – he forgot all about Heaven by the second half of the first double feature. He’s hooked up with some sleazy pharmacist already and is popping Viagra like they’re Tic Tacs. “If your erection lasts more than four hours, seek prompt medical attention”? Hell, no – he’ll be counting on it! Probably trying to negotiate a lifetime movie pass for him and his 12-year-old, um, son (that boy over there in the dress and pink bow – the one that knows the true meaning of Hell).

Here’s the best news. The resulting complex crater will have a transient diameter of 2.83 miles with a depth of one mile, and a final diameter of 3.47 miles and depth of 0.309 miles. With a decent rainy season, I may have another fishing spot pretty close. The volume of the target melted or vaporized is 0.0159 miles, and roughly half the melt remains in the crater, where its average thickness is 13.3 feet. Fishing may not be too good for a millennium or so until the iron content fades, but I’m patient. Also, tain’t no hole close to ten miles. I could not care less what happens over there.

So what do we see? Visible fireball radius of 2.71 miles, with the fireball appearing 61.6 times larger than the sun. We’ll see it for 56.9 seconds. That’s long enough to get a video camera and say all sorts of stupid things like, “Wow, do you see that? Thelma, go get me a beer! Shut-the-fuck-up-and-get-me-a-beer! I’m taping it, dumbass, you can just watch the tape!”

What’s really cool is the effects of the thermal radiation: Clothing ignites, much of the body suffers third degree burns, newspaper ignites, plywood flames, deciduous trees ignite, and grass ignites. Very cool! When! When! When!?! 0.0618 seconds after impact. Wow! Sucks to be them. Distance, as in ten miles, does make the heart grow fonder, eh? No, wait, the thermal radiation effects can’t be for ground zero – that would be a hole. This affects me? This sucks! You mean their hole is going to become my problem? WTF? At least I don’t read newspapers, so I don’t have to worry about that part. Won’t have to badger the boy to cut the subsequently non-existent grass, either. One less thing to worry about. That’s good. Wait. In 6/100s of a second it will get to me? That’s kinda fast. Could that really be ten miles away? But if like this thing slams into the back of your head and leaves a hole about three miles wide, what the hell is someone calculating that the newspaper would combust? Gotta be ten miles away. This really sucks. Let me try some math to see if I can figure this out. If a train leave the station traveling northbound for 6/100s of second and travels ten miles, toasting all the grass and newspapers along the way, how fast is it going in MPH? Damn. Um. Wait, I know this one. Um. Let’s see. If I take miles/hour, and substitute 10 for miles, and the fractional hour in that lower thingey on the other side of the slash. No wait. I don’t know. Gimme a minute! Um. OK, I think I’m right. 6/100s of a second, figuring 3,600 seconds in an hour is 0.00001667 hours or something like that. OK. 10/that number I just said is 600,000 MPH. But the speed of light is the theoretical maximum speed, and that’s 186,282.397 MP--, MP--. Damn! Miles per SECOND. OK, if a train leaves the station traveling northbound at 600,000 MPH, toasting clothes and trees in its wake, how many miles will it travel in a second? Um. 600,000 miles divided by the number of seconds in an hour, right? This seems familiar. Um. 600,000 / 3,600 = 166.67 MPS. Is that right? If I take 6 times 16, that’s 96, close enough to 100 (being one second) and then 10 times 16 is 160 … OK. Rough check correct. So the, what were we talking about? Thermal radiation, right – yeah, in less than a second it would fry everything around me. Damn. “On second thought, Thelma, here, you hold the camera. I’ll get my own beer.”

There would be a touch of seismic activity, of course, but I’ve ridden out a 7+ before. Let’s see what this would do in light of being 10 miles from the epicenter. I would feel it at 3.22 seconds after impact. Not bad. Would still be locked into the drop-and-roll thing to put my clothes out – or laughing my ass off as Thelma did it as I watched comfortably from inside with cold beer in hand. Richter 6.9 – pussy strength. What does Mercalli say about damage here? Damage negligible in buildings of good design and construction; slight to moderate in well-built ordinary structures; considerable damage in poorly built or badly designed structures; some chimneys broken. Damage slight in specially designed structures; considerable damage in ordinary substantial buildings with partial collapse. Damage great in poorly built structures. Fall of chimneys, factory stacks, columns, monuments, walls. Heavy furniture overturned. Piece of cake. Except that it followed the radiation thingey. This is beginning to suck. For Thelma.

There will be an air blast, too. Good – time to cool off. Get to me about in 48.8 seconds at 69.2 psi and a maximum velocity of 1,130 mph. Ouch! Multistory wall-bearing buildings will collapse. Wood frame buildings will almost completely collapse. Multistory steel-framed office-type buildings will suffer extreme frame distortion, incipient collapse. Highway truss bridges will collapse. Highway girder bridges will collapse. Glass windows will shatter. Cars and trucks will be largely displaced and grossly distorted and will require rebuilding before use. Up to 90 percent of trees blown down; remainder stripped of branches and leaves. OK, this really sucks big time.

Before we get too depressed, we have to remember that ejecta is going to come. When? Approximately 57.4 seconds after the impact. So Thelma cooks in situ, add a little shake to the bake, turn on the cosmic-sized hairdryer, and then I have to dodge shit?!? How big? Average thickness of 36.5 inches and mean fragment diameter of 14.4 feet. That could hurt. Better go inside – Thelma can take care of herself. Are her clothes off yet? Didn’t mess up my hair, did it? I’m trying to grow it out. Damn!

This really blows. Maybe I should move about ten more miles away.

killing you softly with my words

A favorite word of mine through the years has been, “non-sequitur.” I suspect the hyphen is not correct because it is taken directly from Latin (so “non” is a word rather than a prefix) meaning, “it does not follow.”

Although it is a favorite word (or two-word combination) of mine, I cannot ever remember uttering it in context. Seems to me to be not quite fitting of coal trash to have such a robust lexicon. When I think of such things, I recall leaving the courthouse one day (I had a hearing of some kind in a neighboring county). I walked past a group of lawyers that did not give me, a lawyer from away, even a nod. One was saying to the group, “… not sure, I mean, he couldn’t even propound an appropriate inquiry!” Wasn’t a reference to my courtroom work (I’m a good propounderistarianer), but I thought as I walked by, “… douchebag. They don't give out nickels for big words anymore.”

I use my share of long words, but as one of my graduate students wrote on a course eval, “You use a lot of big words, but you use them all correctly. It’s refreshing.” And, to me, therein lies the issue. Words communicate. The simpler the word, the more likely your message will be communicated. Sometimes longer words are needed – just be sure to know what they mean before you use them.

Little shit drives me nuts: “We are doing this to insure we get it right the first time.” Insure, as to financially underwrite? “That” is limiting; “which” is not. But, to me, misuse at this level is just lazy, and it’s OK to be lazy. We all are in some areas of our lives including, big time, me. However, when people go out of their way to use words they do not understand just to use a big word, then you know they are not trying to communicate, but to impress.

“Impress: to press (a thing) into or on something.” Isn’t that what Charmin is for?

Could we say, in light of the above, that one who uses big words for the very sake of their length and that flushing sound one hears typically from behind a closed interior door in a residential environment is, empirically, the antithesis of a non sequitur? Methinks, without measureable trepidation of the prospect of contradiction, that such is an accurate manner in which to describe the state of affairs. In short, if you do not know the difference between “didactic” and “pedantic” then do not use either.

Naw, not being a dick, just tired of pseudo-intellectuals.

Alright, enough pompous bullshit. Soapbox to the right; me to the left.

Here’s a good story: “In 1386, the tribunal of Falaise sentenced a sow to be mangled and maimed in the head and forelegs, and then to be hanged, for having torn the face and arms of a child and thus caused its death. … As if to make the travesty of justice complete, the sow was dressed in man's clothes and executed on the public square near the city-hall at an expense to the state of ten sous and ten deniers, besides a pair of gloves to the hangman.” – E.P. Evans, The Criminal Prosecution and Capital Punishment of Animals, 1906 This site is full of good stories.

Good rule from my twin: if it wasn’t food a hundred years ago, it isn’t food now.

This sounds good:

Autumn Roasted Vegetable Salad

Ingredients

1 (8 oz.) yam, peeled and diced to 1-inch
1 (6 oz.) granny smith apple, peeled, cored and diced to 1-inch
1 (6 oz.) red onion, diced to 1-inch
2 tbsp. olive oil, split
salt and pepper to taste
2 tsp. balsamic vinegar
1 tsp. Dijon mustard
1/2 cup sliced California Ripe Olives
2 cups mixed baby greens
1/4 cup of chopped toasted cashews

Directions

In a large mixing bowl, toss yam, apple and red onion with 1 tablespoon of oil. Season with salt and pepper and scatter on one or two roasting pans in an even layer. Bake in a 450˚F oven for 20 minutes until golden. Remove from heat and allow to cool for 10 minutes. While cooling, whisk remaining oil, vinegar and mustard into mixing bowl. Toss in California Ripe Olives, baby greens and cooled vegetables. Top with cashews and serve. Serves 4. Courtesy of The California Olive Industry.

If you get off on articles that begin, “Almost one billion people throughout tropical and sub-tropical latitudes are infected with hookworms. In the countries affected, hookworm infection is often the major contributor to irondeficiency anemia, a direct consequence of the parasite’s bloodfeeding activities” then you can read the rest here - The bandit, a New DNA Transposon from a Hookworm - Possible Horizontal Genetic Transfer between Host and Parasite. The article is focused on DNA analysis. I can’t bring myself to show a pic of the things, but go for it if you like.

I started reading some articles on why lethal injection is “inhumane,” and then got sidetracked to other issues. Data from Amnesty International: In 2006, 91 per cent of all known executions took place in six countries: China, Iran, Pakistan, Iraq, Sudan and the USA. Based on public reports available, Amnesty International estimated that at least 1,010 people were executed in China during the year, although these figures are only the tip of the iceberg. Credible sources suggest that between 7,500 to 8,000 people were executed in 2006. The official statistics remain a state secret, making monitoring and analysis problematic.

Iran executed 177 people, Pakistan 82, and Iraq and Sudan each at least 65. There were 53 executions in 12 states in the USA.

Um, we set the internal toaster oven to "bake" for 53 people and you’re on our case? Shoo, fly, go away! Shoo!! Seems to me you’ve got more than enough work to do with China. Better go pout at the UN, eh? Further, if the 7:1 to 8:1 holds for China, you gotta know, brother, that is also good for Iran and the Sudan.

And don’t you just the love the opening crack – “91 per cent” in six countries. They are using a base of 1,591 executions. Wouldn’t “88 per cent in five countries” sound better? Narrow the culprits to just FIVE! Ah, but that would leave the US off the list.

How’s this for another twist? In point 11 not quite half way down: China reports executing about the same number of people in 2006 that the United States has executed for the past 30 years. That is Amnesty’s data, but not the way they want us to view it.

Here’s another set of data, different source, same year: China, at least 5,000 (approximately 8,000 according to Liu Renwen, Professor of the Chinese Academy of Social Sciences); Iran, at least 215; Pakistan, 82; Iraq, at least 65; Sudan, at least 65; and United States, 53.

China’s number essential the same – a guess as to the total. Iran creeps up over 20%, and joins Iraq and the Sudan with the qualifier, “at least.” Seems the US role is shrinking by the article.

Want an observation? Where is Russia in all this? Ah, they have a moratorium on the death penalty. Why? Last paragraph of the link – Russia committed itself to scrapping the death penalty in 1997, when it signed a protocol to the European Convention on Human Rights. Money. Follow the money. It is routed in trade with the EU. Remember Russia in the 1990's? They were in economic freefall.

Butt hay, who needs the death penalty when you can murder your undesirables? But, Clyde! How can you say that! It, it, it’s so cold! Blow me – here’s the data:

Russia murders per 100,000 population: 201 (#5 on the hit parade)
US murders per 100,000 population: 42 (#24)
Weighted average for the world: 100

Gee, maybe there’s something to the theory.

Where did I get started on this tangent? Oh yeah, the “inhumane” nature of lethal injection. Here’s the scientific article saying it’s bad. Read it all, then come back and read this:

I grabbed this at random from Dead Man Eating:

SOUTH DAKOTA LAST MEAL
ELIJAH PAGE
July 11, 2007

Last Meal: Page had a final meal request of steak with A-1 sauce, jalapeno poppers with cream sauce, onion rings, and a salad with cherry tomatoes, ham chunks, shredded cheese, bacon bits, and blue cheese and ranch dressing. He wanted lemon iced tea and coffee to drink and ice cream for dessert.

The skinny: Page, 25, was executed for the torturing and killing a 19-year-old man following a robbery.

It was South Dakota's first execution in 60 years.

More skinny: Page and two other young men were convicted of killing a 19-year old "friend," near the town of Spearfish in the rural west of South Dakota.

The victim was kidnapped at gunpoint, then tortured for almost 3 hours before his death. He was forced to drink acid, repeatedly kicked and beaten, stabbed in the head and torso, and forced to remove his clothing in an icy creek.

His body was not found until a month later.

Upon his arrest in Texas, Page admitted his involvement in the murder. Page later pled guilty, received a death sentence, and waived appeals.

Accomplice Briley Piper, age 19, also pled guilty and was sentenced to death. Accomplice Darrell Hoadley, age 20, is serving a sentence of life without parole.

Last words and such: Asked if he had any last words, Page replied, "No." Asked if he understood the question Page responded, "Yes, no last words."

I really hope he enjoyed his jalapeño poppers. I wish I knew what flavor ice cream he asked for.

I also hope the execution procedure was a complete fuck-up, totally in line with the scientific article linked above.

Yes, the death penalty is retributive. Ain’t got nothing to do with general deterrence. It does, however, help the recidivism rate, eh?

the bad in "bad predictions"

I am somewhat reluctant to even write this post, let alone publish it. I found an article, the “Top 87 Bad Predictions about the Future”. I enjoyed reading it, but let’s retitle it, “Top 85 …”

It’s a good list except for the two political cracks. George the Elder “no new taxes” completely blows off the fact that the dems in Congress blatantly and publicly lied to set him up. They said the increases in taxes would be offset by decreases in spending, and the margin would dollar-for-dollar reduce the deficit. It was a political trade in the best interests of the country. Geo the Elder bit – then the dems bailed and crucified him. Not only did they not reduce spending, they increased it. A-holes top to bottom. The other crack is about Iraq and WMDs. Everyone thought – including Clinton – that they were there. We all had evidence they were there (just ask the Kurds), the UN required proof of destruction, and Iraq refused entry to sites to allow us to prove out their words – yeah, the Iraqi government lied plenty of times before, so they had no veracity on this topic. So this statement by Franks is on par with the rest of the list – space travel, light bulbs, television? I really detest political and social agendas buried in otherwise worthy reading. Childish of them. Degrades their work.

I’ll press ahead anyway because I am … um … me. Screw ‘em. Ain’t no lib with a sign that reads, “Bush lied and people died” gonna take away my fun. How’s this for a sign, “I have my head stuck so far up my ass that I can fart out my ears.” What a copy? Establish your lib credentials to me and I will have the sign made and shipped to you.

Onward.

«I see no good reasons why the views given in this volume should shock the religious sensibilities of anyone.» Charles Darwin, in the foreword to his book, The Origin of Species, 1869. Actually, I agree with him. It was not his work, but the abuse of it that has caused such turmoil. His work speaks only of evolution, not a word about creation. He can write all he wanted to about apes-to-men, but there was no fossil record of it and he admitted the same. He did say it existed, but just hadn’t been found. That was his scientific mistake. He should never speculate. Not good science. He found evidence of intra-species evolution and should have limited his speculation. Oh well.

«They couldn't hit an elephant at this dist-» Last words of Gen. John Sedgwick, spoken as he looked out over the parapet at enemy lines during the Battle of Spotsylvania on May 9, 1864, then promptly took a fatal shot. Here’s the full story: His corps was probing skirmish lines ahead of the left flank of Confederate defenses and he was directing artillery placements. Confederate sharpshooters were about 1,000 yards away and their shots caused members of his staff and artillerymen to duck for cover. Sedgwick strode around in the open and was quoted as saying, "What? Men dodging this way for single bullets? What will you do when they open fire along the whole line? I am ashamed of you. They couldn't hit an elephant at this distance." Although ashamed, his men continued to flinch and he repeated, "I'm ashamed of you, dodging that way. They couldn't hit an elephant at this distance." Just seconds later he fell forward with a bullet hole below his left eye. – Bet that left a mark, eh, John?

«... good enough for our transatlantic friends ... but unworthy of the attention of practical or scientific men.» British Parliamentary Committee, referring to Edison's light bulb, 1878. Ironic that the symbol for having an idea is now a light bulb above a head.

«There is no reason anyone would want a computer in their home.» Ken Olson, president, chairman and founder of Digital Equipment Corp. (DEC), maker of big business mainframe computers, arguing against the PC in 1977. This caught my attention because I graduated high school that year. About six years later I bought my first home computer. I wonder if the statement is given more weight than he meant. It could have just been some marketing territory thing, a put-down of an upstart competitor.

«Lee DeForest has said in many newspapers and over his signature that it would be possible to transmit the human voice across the Atlantic before many years. Based on these absurd and deliberately misleading statements, the misguided public ... has been persuaded to purchase stock in his company ...» a U.S. District Attorney, prosecuting American inventor Lee DeForest for selling stock fraudulently through the mail for his Radio Telephone Company in 1913. What amazes me is when people think outside their profession. I understand the drill – for some trial work, I had to prepare to go (and did) toe-to-toe with docs and other professionals, attacking them in their field of expertise. But here, raising money to conduct scientific inquiry does not seem to rise to the level of a crime. It could have all been in the delivery – “I guaranty this can happen. Your returns on these investments will be no less than six-fold.” Those statements would be worthy of indictment, but would not make good fodder for a bad-quotations list.

«Space travel is utter bilge.» Richard Van Der Riet Woolley, upon assuming the post of Astronomer Royal in 1956. ”Bilge” is such a great word. American Heritage provides the following: “1. The rounded portion of a ship's hull, forming a transition between the bottom and the sides. The lowest inner part of a ship's hull. 2. Bilge water. 3. [Slang] Stupid talk or writing; nonsense. 4. The bulging part of a barrel or cask.” I am singularly unsatisfied with this list of definitions. The slang doesn’t seem to have a basis in the rest. Here’s the etymology: c. 1513, "lowest internal part of a ship," also "the foulness which collects there," variant of bulge "ship's hull." Ah, that makes sense. It is “stupid talk” as in “foul words.” So I wanted to see when the guy died (December 24, 1986) to get a lift out of what he saw in his lifetime, and I found the complete quote: "It's utter bilge. I don't think anybody will ever put up enough money to do such a thing . . . What good would it do us? If we spent the same amount of money on preparing first-class astronomical equipment we would learn much more about the universe . . . It is all rather rot." Ah, while there is a history in the guy (in 1936, reviewing P.E. Cleator's "Rockets in Space", he also said, "The whole procedure [of shooting rockets into space]...presents difficulties of so fundamental a nature, that we are forced to dismiss the notion as essentially impracticable, in spite of the author's insistent appeal to put aside prejudice and to recollect the supposed impossibility of heavier-than-air flight before it was actually accomplished"), the “bilge” quote seems to be taken out of context. I am becoming less enamored with this “list” as I go.

«A rocket will never be able to leave the Earth's atmosphere.» New York Times, 1936. Back on track. Nothing like the stupidity of the NYT on display to brighten my spirits. Commercial: “I read the NYT because it gives me a view of the news not available anywhere else.” Yes, but the problem with the “view” is that the sources are specious, the writing usually opinion appearing off the op-ed pages, and they have this kiss-my-ass attitude about anyone that differs with their world view. While I don’t mind, as a general statement, a KMA attitude, I do mind when it is them because, well, they are them. Know what I mean? They can kiss my ass.

«Atomic energy might be as good as our present-day explosives, but it is unlikely to produce anything very much more dangerous.» Winston Churchill, British Prime Minister, 1939. Fundamental problem: A politician speaking not of politics, but of science. Shudder.

«A man has been arrested in New York for attempting to extort funds from ignorant and superstitious people by exhibiting a device which he says will convey the human voice any distance over metallic wires so that it will be heard by the listener at the other end. He calls this instrument a telephone. Well-informed people know that it is impossible to transmit the human voice over wires.» News item in a New York newspaper, 1868. Is this the NYT incognito?

«Rail travel at high speed is not possible, because passengers, unable to breathe, would die of asphyxia.» Dr Dionysius Larder (1793-1859), professor of Natural Philosophy and Astronomy, University College London. [I had to correct the spelling of his first name from the source post.] It seems the comment was related to an assessment of a plan to have the government fund the construction of a broader gauge railroad track. An informative bit: “Brunel himself suggested that the opinions of other engineers should be sought and he was unlucky enough to be saddled with a Dr Dionysius Lardner who displayed a remarkable talent for drawing incorrect conclusions from observed data. Lardner attributed the poor performance of the company's best engine to the excessive air resistance of the wide locomotives and concluded that the broad gauge was inherently inferior. However, Brunel and Gooch found that it was back pressure due to misalignment of the blast pipe orifice and not air resistance which was the cause. After some hasty modifications to the engine they were able to haul nearly three times the load on but one third of the fuel used in Lardner's tests.” So, the statement was an extension of his (albeit incorrect) conclusion based upon observed data. Not as egregious as presented.

«The idea that cavalry will be replaced by these iron coaches is absurd. It is little short of treasonous.» Comment of Aide-de-camp to Field Marshal Haig, at tank demonstration, 1916. But, sir, when you hit the tank with a bullet, it goes “tink!” as opposed to the “ooooff!” you get from a horse or rider!

«Fooling around with alternating current is just a waste of time. Nobody will use it, ever.» Thomas Edison, American inventor, 1889 (Edison often ridiculed the arguments of competitor George Westinghouse for AC power). There are many quotes by Edison that I have read over the years of this ilk. The boy seems to have been a singularly disagreeable fellow. I suspect he was widely disliked by all but his fellow megalomaniacs of the time.

Alright, I’m done. But I did learn something … on balance, the article wasn’t fair. Oh well. Good thing I don’t pay for column inches.

the doctor is in

OH YEAH, BABY! The doctor be IN! No intro. Straight to the pic – this just came in moments ago. Here you go:

(Hand raised – bouncing in seat.) Pick me! PICK ME! I got it! I KNOW THIS ONE! Know that with no more data! This boy done got the scratch! He been doin’ some ho’s and shit! Been banging and shit with the nasty girls! See where that is, way up along the top part? WTF wrong with this man? He ain’t using no rubber! He be just banging and banging and banging! Dumb motherf—ker. Serve him right. I hope his dick falls off. Stupid motherf—ker out there making it nasty for the rest of us.

Let’s see what this man has to say for himself …

BACKGROUND. (“Background” shit – this man doing ho’s with no rubber. Get the f-ck outta here. Alright, alright. I’ll shut up. Let the man say his piece, lying motherf—ker.) A 52-year-old man (52! You should know better, stupid motherf—ker. Where you head at, besides buried in some ho’s twat?) with no clinically significant medical history presents to the emergency department with a chief complaint of a “rash” on his penis (A rash? A RASH?!? You dumb motherf—ker, that be the scratch and you know it! You trying to get free medical or sumptin? F—cking lying piece of sh—t you be.). The patient states that the rash first appeared 1 week before presentation. He denies any dysuria, urethral discharge, pruritus or pain in the area of the lesion. This is the first time he has had such a rash (lying piece of shit, you be lying like a motherf—king rug). He admits to having had several recent sexual partners(ho,ho,ho, motherf—ker wit no rubber).

On physical examination, his vital signs are normal (you check for a brain?). The patient has a well-demarcated, ulcerated lesion (always is) on the ventral aspect of his penis (see Image). The lesion is not tender to palpation (never is). No other lesions are noted (better hope not, mofo, else that dick be falling off!), and no discharge is observed from the urethra (just wait.). The findings of his testicular examination are unremarkable (“Hey baby, whachu doin after work? Maybe you and me go steppin’ out. I gots some blow with your name on it.” "Not with that dick you ain't steppin' out wit nobody like me."), with the exception of bilateral prominent inguinal lymphadenopathy (that means sumptin be big down there that ain’t aposta be big, like Swollen Nut Syndrome. This stupid motherf—ker be sick!). The remaining physical findings, including the cardiac and abdominal findings, are unremarkable.

What is the diagnosis, and what empiric treatment is necessary? (The boy gots the scratch. Give him some penicillin and a handful of rubbers. Better check him for The Drip and Crabs. I hopes he’s gots them all. Serve him right. Dumb motherf—ker.)

(I’ll just let the answer run. I don’t care nuttin for this jackass.)

ANSWER. Primary syphilis: Syphilis, an infectious disease caused by the spirochete Treponema pallidum, is usually transmitted by means of sexual contact; the usual route of transmission is the skin or mucous membranes of an uninfected sexual partner coming in contact with the mucosal ulcerations (eg, in the genital area, mouth, or anus) of an infected partner.

In the United States, the rate of primary and secondary syphilis declined by 89% from 1990 to 2000; however, in November 2005, the Centers for Disease Control and Prevention (CDC) reported that the number of primary and secondary cases of syphilis had been increasing, from 2.6 cases per 100,000 population in 2002 to 4.7 cases per 100,000 population in 2004 (an increase of 87%). This rise was partially attributed to increased rates of infection among men who have sex with men, who in 2004 represented 64% (up from 5% in 1999) of all cases of primary and secondary syphilis in the United States.2

Primary syphilis manifests as a nonpainful ulcer (chancre) at the site of infection. The lesion is usually on the genital area, but it may also occur on the lips, tongue, cervix, or anus of the infected person. This lesion usually develops within 3-4 weeks after infection, but it may occur as long as 3 months after. The primary lesion spontaneously heals in 3-7 weeks, and it may go unnoticed, especially if it is on the cervix or anus; therefore, infected individuals may not realize that they have an infection. Unilateral or bilateral regional painless lymphadenopathy is also a characteristic finding of primary syphilis.

Secondary syphilis is the next phase of the disease, developing 4-10 weeks after the primary lesion appears. This phase is marked by nonspecific systemic complaints, such as fever, headache, fatigue, and lymphadenopathy. A characteristic rash that consists of round, discrete, nonpruritic macules on the trunk and proximal extremities and penny-sized, reddish-brown sores, appears on the palms, soles, scalp, and face in this phase. These sores may coalesce to form highly infectious lesions called condylomata lata. Symptomatic secondary syphilis also spontaneously resolves, and the disease then enters a latent period where few if any symptoms are seen; the latent phase is divided into “early” and “late” periods. Symptoms may recur in the early latent stage (during the first 2 years of infection). The disease then goes into the late latent phase, when patients remain asymptomatic and noninfectious.

About one third of patients with primary syphilis develop a form of the disease called tertiary syphilis, which is a chronic inflammatory process that progresses over years and decades and results in varied symptoms and physical findings, including mental illness, blindness, heart problems, and eventual death. Cardiovascular syphilis can cause devastating damage to the heart, including aortic endarteritis with medial necrosis and aneurysm formation. Gummatous syphilis manifests as coalescent granulomatous lesions affecting the bones, joints, skin, or almost any part of the body. Finally, symptomatic neurosyphilis can lead to meningitis, brain parenchymal infection, endarteritis, or stroke.

Standard treatment for primary syphilis or for syphilitic infection <1 year after exposure is benzathine penicillin G 2.4 million U given by intramuscular (IM) injection. Alternate regimens for patients allergic to penicillin are a 2-week course of doxycycline 100 mg given orally (PO) twice daily (BID) for 14 days, tetracycline 500 mg PO 4 times daily (QID) for 14 days, or ceftriaxone 1 g given IM or intravenously (IV) once a day for 8-10 days. A recent study also demonstrated efficacy with azithromycin 2 g PO as a single dose; however, the authors suggested caution in applying this finding to patients in the United States, because the trial was conducted in a geographically limited area outside of the US, and because macrolide resistance has already been demonstrated in the US.1

If the patient was infected for >1 year at the time of presentation, benzathine penicillin G (2.4 million U IM once a week for 3 consecutive weeks), or doxycycline for 4 weeks is recommended. Neurosyphilis requires treatment with aqueous crystalline penicillin G 2-4 million U IV every 4 hours for 10-14 days. Patients with neurosyphilis should also be followed up every 6 months for 3-4 years for cerebrospinal fluid (CSF) and serologic testing.

Given this patient’s allergy to penicillin and current social situation, he was treated with azithromycin 2 g PO instead of a 14-day course of doxycycline. The ulcerative lesion was swabbed and sent for darkfield microscopy. Rapid plasma reagin (RPR) and Venereal Disease Research Laboratories (VDRL) serum studies were also ordered. A urine sample was sent for Neisseria gonorrhoeae and Chlamydia polymerase chain reaction (PCR), and the patient was counseled about concomitant sexually transmitted diseases (STDs), including HIV. He was referred for HIV testing and given a fast-track follow-up appointment for the laboratory results.

The Doctor is In

I went through my old e’s and found that I have almost 20 of these case studies. So I have some catch up to do. I sure hope none of my patients died in the interim. That would be bad. I think.

Today we have, “Altered Mental Status in a Homeless Man.” Let’s start, as we always do, with the photographic evidence.

This here thing-a-ma-bob with the squiggly lines is called an “electrocardiogram.” It’s called that because of a little known story. It's a good story. Let me tell it to you.

It seems that a clerk in a Western Union office in Cheyenne, Wyoming, in or about 1884, was sending a telegraph message.

. .- - | -- .
.. | .- -- | ... . .-. .. --- ..- ...
. .- - | -- .

(If you're out of pratice with Morse Code - you have to do one line at a time.)

A bandit rushed! He was a particularly cruel bandit with yellow teeth and small feet. He told the clerk to give him all the money – he said, “Give me all the money!” The clerk said he didn’t have any money, except the few bits people paid for telegrams to be sent. “Well then,” said the bandit, “send one of them there electric telegrams and tell somebody to bring money here! Now!” The clerk agreed:

--. --- - | ... --- -- . | .-- .... .- -.-. -.- | .--- --- -... | .... . .-. .
... -- . .-.. .-.. ... | .-.. .. -.- . | .... --- .-. ... . | -.-. ..- --
-.-. --- .-- .--. --- -.- . | .. ... | .- | ...- . .-. -... | - --- | - .... .. ... | --. ..- -.—
... . -. -.. | - .... . | ... .... . .-. .. ..-. ..-. | --..-- | | .--. .-.. . .- ... .
- .... .. ... | --. ..- -.-- | -- .- -.- . ... | -- -.-- | .- ... ... | - .-- .. - -.-. .... | ..--.. | | | .... ..- .-. .-. -.-- | ..--.. |

“You be typing a lot, little man,” said the bandit.

“I am telling them to bring a lot of money. That takes extra words,” said the clerk.

“Oh,” said the bandit.

Soon the sheriff could be seen in the distance with his posse and the bandit knew he had been duped.

“Why, I oughta send YOU as a telegram!” he spit through his cracked lips with breath that smelled like he had sex with his horse in lieu of breakfast.

Then the bad bandit smiled a terrible smile. He tied the clerk to his chair – arms, legs, and neck – and gagged him with a dirty oil rag. He took out his Bowie knife and CUT the clerk’s shirt open with a flourish. He did a pirouette and clasped his hands together as his pants got tight across the middle section. He paused for a moment. His eyes glossed over. He looked at the clerk intently. "You married? Involved?" Drool leaked out of his mouth.

With a snap of his head, his eyes cleared. “You got a needle and thread?” he asked the clerk. The clerk nodded towards the cabinet on the far side of the wall. “Thanks,” said the bandit.

The bandit rummaged through the cabinet and found what he needed. He went to the desk, took the telegram button thingey that you hit to make that tap-tap-tap sound, and then sat in front of the clerk.

“This is gonna hurt. Sorry,” said the bandit. He threaded his needle. The clerk’s eye was wide open (he lost the other in a terrible accident that the family refers to simply as, “The Baking Soda Incident,” then they all lower there heads and they shift uncomfortably in their seats). With the swiftness of a mule on crack chasing the candy delivery cart, the bandit disconnected the wires from the telegram button thingey, tied them a few inches apart on the thread, made an incision with his Bowie knife just below the clerk’s rib cage, and reached up in there with the needle in hand.

He sewed the wires to the clerk’s beating heart in mere seconds, then used a blanket stitch to close the wound.

“Now, I want you stay in this chair for a few days. Drink lots of fluids, and come see me if it isn’t healing properly, OK?” said the bandit.

With his eye as round as a dollar coin and face as pale as a bucket of chalk dust, the clerk, through his gagged mouth said, “Hhm-uh.”

The bandit stood still, tilted his head, and listened intently. “Can you hear it? Can you?” he said.

“Hrmph vtoph,” the clerk seemed to say.

“You. You’re an electrical-heart-telegram! I made a fun—”

Before the bandit could finish his sentence, ”Zing” came a .50 caliber slug into the back of his head. The sheriff had saved the day! Unfortunately, the posse opened fire at the same time, and the clerk took no less than three pounds of lead from his belt up.

A little over 50 miles away in Laramie, Wyoming, a clerk was hunched over his desk. He was transcribing the dots and dashes he was receiving from Cheyenne.

“What the fuck is that?” his boss said over his shoulder.

“Can’t make sense of it, sir. Sometimes I think it says … wait … it just stopped.”

“Must’ve been rats chewing the line. Throw it away.”

“Yes, sir.”

The story spread to the universities on the east coast. Collectively, they thought it was rather amusing, but may also hold scientific value. So they got some government money and perfected the technique on prisoners.

The name of the procedure was changed to reflect the Latin base more illustrative of the seriousness with which they viewed themselves – electro-cardio-gram, or “ECG,” for short.

OK. Where was I? Oh, yeah, this guy’s ECG:


Notice how the lines kinda go up, and then down, with flat spots in between. Might be important. Note, “Lots of flat spots on the telegram thingey.”

See those little rises? Those are called “P waves.” You can calculate the Atrial rate from the distance between them. Them big spikes are called “R waves,” and have something to do with Ventricular rate. I have no skills with which to apply such knowledge, but I am pretty sure it has something to do with his heart.

Note, “Patient has a heart.”

OK, enough with the pictures. Let’s go interview the guy!

BACKGROUND. A 38-year-old man is brought by ambulance to the emergency department. The patient was found lying near the stoop of an apartment building (he was asleep? Why are you bothering the dude? Let him relax?). The paramedics were unable to obtain any history from the patient en route because the patient has an altered mental status (maybe because his “altered mental status” was REM sleep?!?).

On arrival, the patient’s vital signs are an oral temperature of 95.72°F (35.4°C) (a little cool), a blood pressure of 88/40 mm Hg (relaxed), a heart rate of 38 bpm (very relaxed), and a respiratory rate of 24 breaths/min (deep sleep, ok?). His oxygen saturation could not be obtained. The patient appears to be a homeless, disheveled man and looks older than his chronologic age, with a faint smell of alcohol on his breath (so he had a beers, found a nice doorway, and went to sleep. You people running low on patients or high on residents? Can’t you just let the poor man sleep?). He can be aroused but does not follow simple commands (neither do you, numbnuts, until your first cup of coffee. Did you give him a cup of coffee?). He has intact gag and corneal reflexes (“gag reflexes” WTF did you people do? You crammed something down his throat, he gags, you write “normal” on the chart? WTF?). His pupils are equal and reactive to light. No obvious signs of head trauma are noted, and the examination of his oropharynx is unremarkable (so … nothing wrong with the guy? I reiterate – why did you drag his ass in here? He was sleeping!!). The results of his cardiac examination are significant for marked bradycardia (smoker, lived outside – got a problem with that?). A lung examination reveals rhonchi in the right lower lung field. The patient’s skin is cold, and his blood glucose level is 104 mg/dL.

An electrocardiogram (ECG) was performed before the physical examination (see Image).

What is the diagnosis and treatment? (Drunk, asleep, no coffee.)

HINT. The patient’s rectal temperature is 87.7°F (31°C). (Here we go with the rectal again. You drag this guy out of bed, cram something down his throat to make him gag, and now you stick something up his ass to check his temperature?!? What is wrong with you people?!? But, hey, we have something here. Several degrees lower. Think, Dr. Clyde, think. Seems familiar. Think. New Hampshire. Snow bank. 1981. Drunk. I GOT IT! He has “Cold Ass.” Used to get it all the time when I got drunk and slept in doorways. What’s the problem here? Just give him a cup of coffee and maybe a hot shower.)

ANSWER. Hypothermia secondary to alcohol use and environmental exposure: The patient’s ECG demonstrates the classic abnormalities associated with hypothermia, the most evident being profound sinus bradycardia. … (We’re done here. Cold Ass. Drunk and asleep. Move on.)

(Only because I like you people, I’ll leave the rest of the text intact. Remember – Cold Ass.). In addition, all leads show classic Osborn waves (J waves seen at the junction of the QRS complex and the ST segment). As always, the ECG must be interpreted within the clinical context; in this case, the apparent elevations of the ST segment should not be misinterpreted as evidence of myocardial injury. Other common ECG findings associated with hypothermia that are not seen on this tracing include atrial and ventricular dysrhythmias, as well as prolongation of the PR, QRS, and QT intervals.

This case features the most common etiology of hypothermia (ie, environmental exposure or accidental hypothermia). Other conditions often coexist, such as infection, metabolic abnormalities (eg, hypoglycemia), drug or alcohol overdose, and endocrine problems (eg, hypothyroidism); on occasion, any one or a combination of these conditions may also be the etiology.

In general, the life-threatening cardiovascular complications of hypothermia are cardiogenic shock and malignant dysrhythmias. Typically, rewarming the patient is sufficient to restore normal myocardial contractility and cardiac rhythm. For patients in shock who do not respond to resuscitation with warmed intravenous fluid and other passive and active rewarming techniques, low-dose dopamine is the recommended agent because of its inotropic and peripheral vasoconstrictive effects. Atrial dysrhythmias are generally associated with a slow ventricular response; therefore, treatment with digoxin or calcium channel blockers is not warranted. Bretylium has long been recommended for the treatment and prevention of ventricular dysrhythmias, though little evidence supports this practice. The use of amiodarone has increased in recent years as a result of shortages in the world supply of bretylium. For refractory bradydysrhythmia, external noninvasive pacing is recommended in favor of transvenous pacing because insertion of pacing wires into a hypothermic ventricle can potentially cause a fatal dysrhythmia.

Hypothermia is often diagnosed before an ECG is performed; however, the ECG can provide important clues to the diagnosis and yields critical information regarding the overall severity of the patient’s condition, from an electrophysiologic standpoint.