A Nurse With Attitude

Where Dark Cynical Humor, Nursing Issues, and Politics Seem to Merge

Archive for the month “February, 2012”

All Surgeons Are Not Created Equal


Contrary to popular belief…all surgeons are not great…and that probably goes for your personal surgeon too.  Almost all are adequate,  most are good, some are excellent, and a very few would be considered great or among the best. Unfortunately, very few people go out and hand-pick their surgeon like they may do for their barber, baby sitter, or even their family doctor.  Most of the time you are referred to a surgeon by your family care physician. He will assure you that the person they are referring you to is “very good,” or even “the best in town”. Referring physicians usually have some type of personal, or most commonly a financial relationship with the surgeon to whom they refer patients. Maybe the surgeon just took the referring physician and their family skiing inAspenand they are repaid by having all of the physician’s breast biopsy patients sent to them. If primary care physicians only referred you to surgeons they thought were the best, then 90% of all surgeons would be out of a job.

 I work as team lead for the Neuro-Surgery department and I’ll tell you a true story of two surgeons. One surgeon…lets call him “Dr Goode” who was not only an excellent surgeon, but equally as good of a person. “Dr. Badd” on the other hand had all the ethics of a used car salesman and charm of rattlesnake, and was maybe only slightly better of a surgeon than an actual serpent. Dr. Goode was always busy, patients loved him, and everybody referred to him. Dr. Badd received most of his patients from the ER, and he performed surgery on almost everyone who came through the door regardless of prognosis or outcome.  In contrast, Dr. Goode was up-front and honest with his patients. If any of his patients had a truly terminal illness and surgery would not greatly extend the lifespan or enhance the quality of life of his patient, he would tell them the truth and recommend hospice or comfort care.  This was not always the popular route and some of his peers were quite unhappy with his honesty.  Dr. Goode always strived to become a better doctor and he kept up with ever changing medical science. He decided to expand his scope of knowledge by undergoing extra training and education and eventually started doing spine surgery and other procedures usually reserved for orthopedic doctors. Well, the Ortho doctors were some of Dr. Goode’s biggest referrers.  They suddenly felt that Dr. Goode was infringing on their business? This, coupled with a negative PR campaign by Dr. Badd, caused a large part of Dr. Goode’s referral business to dry up. And guess where all the referrals went… to Dr. Badd. These doctors were sending all of their patients to a surgeon they knew was not good, sacrificing their patient’s health and safety for the fear of losing money, all to spite a superior physician. 

   By the way, when one of these doctors had a family member or loved one that needed surgery…guess who they called?




Happy Presidents Day


 I went to Alabama this weekend to see my family.  I have a sister down there with four kids.  The littlest is Ben.  He’s ten years old.  We were eating breakfast and I asked him, “You know what’s tomorrow… the 20th of February?”

He answered, “Why it’s Presidents’ Day!”

I asked him: “What does Presidents’ Day mean?” and I waited for something about Washington or Lincoln.

He replied, “Presidents’ Day is when President Obama steps out of the White House, and if he sees his shadow, we have another year of unemployment!”

You know, it really hurts when hot coffee spurts out your nose!

How we “saved the Environment” back then

Yes, contrary to what you may think… I am concerned about the Environment!

Checking out at the store, the young cashier suggested to that I should bring my own grocery bags because plastic bags weren’t good for the environment.  I apologized and explained, “We didn’t have this green thing back in my youth.”

The clerk responded, “Yes, because of your irresponsibility, it’s our problem today. Your generation did not care enough to save our environment for future generations.”

She was right, our generation didn’t have the green thing in its day.

Back then, we returned soda bottles and beer bottles to the store. The store sent them back to the plant to be washed and sterilized and refilled, so it could use the same bottles over and over again. So they really were recycled.

We walked up stairs, because we didn’t have an escalator in every store and office building. We walked to the grocery store and didn’t climb into a 300-horsepower machine every time we had to go two blocks.  Back then, we washed the baby’s diapers because we didn’t have the throw-away kind. We dried clothes on a line in the sun, not in an energy gobbling machine burning up 220 volts.

Kids got hand-me-down clothes from their brothers or sisters, not always brand-new clothing.

Back when I was a kid, we had one TV, and one radio, in the house, Not a TV in every room.  Our TV had a small screen the size of a handkerchief, not a “big-screen” the size to cover the whole wall.

In the kitchen, we blended and stirred by hand because we didn’t have electric machines to do everything for us. When we packaged a fragile item to send in the mail, we used wadded up old newspapers to cushion it, not Styrofoam or plastic bubble wrap. Back then, we didn’t fire up an engine and burn gasoline just to cut the lawn. We used a push mower that ran on human power. We exercised by doing  hard work so we didn’t need to go to a health club to run on treadmills that operate on electricity.

We drank from a fountain when we were thirsty instead of using a plastic bottle every time we had a drink of water. We had refillable writing pens instead of buying a brand new pen every time.  We replaced the razor blades in a razor instead of throwing away the whole razor just because the blade got dull.

Back then, people took the streetcar or a bus, and kids rode their bikes to school or walked instead of turning their moms into a 24-hour taxi service driving them everywhere. We had one electrical outlet in a room, not an entire bank of sockets to power a dozen appliances. And we didn’t need a computerized gadget to receive a signal beamed from satellites 2,000 miles out in space in order to find the nearest pizza joint.  But isn’t it sad how the current generation laments how wasteful we old folks were just because we didn’t have the green thing back then?

Surgical word of the Day

Fracture…. Or more specifically Calcaneous fracture.  This is the rather large heel bone in the back of your foot.  This bone is responsible for most of your weight bearing, and can effect your gait forever if it doesn’t heal properly.  This fracture is rather common in the Northwest.  Most men, and a few women,  usually climb up on the roof to clean, put up Christmas lights, work on their rain gutters and inevitably falls off their ladder.  I got a sad fellow last night who had fallen off his house and suffered  bilateral calcaneous fractures. The older orthopedic surgeons call this a “whorehouse fracture” because it was common in the western days.  A lot of men would suffer this fracture when they’d jump out of the second floor of a whorehouses, barefoot, to escape the long arm of the law.   For us, it is a relatively simple fix. We place a few heavy cannulated screws into each heel to hold the heel bone in place in order to heal.

A couple of these to break up the emergency surgical monotony and it’s a good night.


Hey it’s my birthday.  I turn fifty today.  When I think about it and all the things that has changed since I was a kid,  I feel older than ever.

When I was a kid, adults used to bore me to tears with their tedious diatribes about how hard things were when they were growing up; what with walking twenty-five miles to school every morning….Uphill… Barefoot…BOTH ways…Blah, Blah, Blah.  And I remember promising myself that when I grew up, there was no way I was going to lay a bunch of  hooey like that on my kids about how hard I had it and how easy they’ve got it!   But now that I’ve hit the ripe old age of fifty, I can’t help but look around and notice the youth of today.  Wow, you’ve got it so easy!  I mean, compared to my childhood, you live in a damn Utopia! And I hate to say it, but here goes…”you kids today, you don’t know how good you’ve got it!”

*  I mean, when I was a kid we didn’t have the Internet.  If we wanted to know something, we had to go to the library and look it up ourselves, in the card catalog!

*  There was no email.  We had to actually write somebody a letter – with a pen and paper! Then you had to walk all the way across the street and put it in the mailbox, and it would take like a week to get there!  Stamps were 10 cents!

*   Child Protective Services didn’t care if our parents spanked us.  As a matter of fact, the parents of all my friends also had permission to whip us. Nowhere was safe.

*  There were no MP3’s, Bit Torrent or iTunes.  If you wanted to “steal music”, you had to bicycle to the record store and shoplift it.

*   You could also wait around all day to tape it with a cassette tape recorder off the radio. Most of the time, the DJ would talk over the beginning of the song and screw it all up!  There were no CD players, and we had only tape decks in our car.  We’d play our favorite tape and “eject” it when finished, and then the tape would come unwound rendering it useless.  Cause, hey, that’s how we rolled back then, baby!  Ya dig?

*    We didn’t have fancy crap like Call Waiting!  If you were on the phone and somebody else called, they got a busy signal, that’s it!

*  There weren’t any freakin’ cell phones either. If you left the house, you just didn’t make a call… or receive one for that matter. You actually had to be out of touch with your “friends”. OH MY GOSH!!!  Think of the horror… not being in touch with someone 24/7!!!  And then there’s TEXTING.  Yeah, right.  Please!  You kids, out there, have no idea how annoying you are.

*  And we didn’t have fancy Caller ID either! When the phone rang, you had no idea who it was!  It could be your school, your parents, your boss, your bookie, the principal, the collection agent… you just didn’t know!!!  You had to pick it up and take your chances, mister!

*  We didn’t have any fancy PlayStation or Xbox video games with high-resolution 3-D graphics!  When I was much older, we got the Atari. (And that was really only for the rich kids).  It had games like ‘Space Invaders’ and ‘Asteroids’.  Your screen guy was a little square so you actually had to use your imagination.  There were no multiple levels or screens, it was just one screen.. Forever!  And you could never win.  The game just kept getting harder and harder, and faster and faster until you died!  Just like in real life!

*  The TV, we only had three channels, two of which were snowy because the antenna was pointed the wrong way.  To see what was on, you had to use a little book called a TV Guide. You were screwed when it came to channel surfing!  You had to get up and walk over to the TV and twist the knob to change the channel!  NO REMOTES!

*  There was no Cartoon Network like you have now.  You could only get cartoons on Saturday Morning from 6am to 9am.  Do you hear what I’m saying? We had to wait ALL WEEK for cartoons.

*  We didn’t have microwaves.  If we wanted to heat something up, we had to use the stove… imagine that. I know it sounds foreign, but to use the stove, you had to actually pay attention and stir things to keep them from burning.  Crazy.

*  And our parents told us to stay outside and play… all day long.  Oh, no… no electronics to soothe and comfort.  And if you came back inside… you were assigned to doing chores.

*  What about those comfy car-seats, and child booster seats? – oh, please!  When I was a baby, I slept in a dresser drawer on the bench seat of the 68 Impala next to mom. When I was old enough to sit up, mom threw just you in the back seat and you hung on.  If you were lucky, you got the “safety arm” across the chest at the last moment, if she had to stop suddenly, and if your head hit the dashboard, well that was your fault for calling “shot gun” in the first place.

See!  That’s exactly what I’m talking about! The kids today have got it too easy. They’re spoiled rotten.  They wouldn’t have lasted five minutes back in 1970’s  or any time before!


JT (The Old Curmudgeon)

Super Bowl Sunday

Albert Einstein walks into a party.  An attractive woman walks up and says, “hey,  you’re Albert Einstein” And he say’s “why yes I am,  and if you don’t mind me asking… what’s your IQ?”  She says, “it’s 192″  He say’s, that’s wonderful,  we can talk about physics, time, space and the things to come”.  Just then another party member walked up and introduced himself.  Albert asked, “hey, what’s your IQ, if you  don’t mine me asking?”  The man said, “why it’s 120”.  Albert said, “that’s really good, we can talk of politics and current events”  Then another man came to the group,  Albert asked, Hey, what’s your IQ?  The man responded proudly, “why it’s 46”  Albert said after careful thought,  “hey…. How’s them Seahawks?”

I don’t have anything against sports.  And no, I’m not a nerd or a “Neapolitan Dynamite” kind of guy.  I’m 6ft and 180 lbs. I played college baseball and I ran track.  I still run a 10k once in a while just to stay in shape.  I just don’t see the purpose  of sports.  I play sports, I am very competitive. I just can’t sit on the couch or in a bench and watch other people  play.  The only sports that I ever watched was when my own kids were part of the team.  With that said, I don’t eve know who’s playing with the “Super-Bowl”.  When I see people paint themselves up and pay thousands of dollars on sport stuff, I automatically think  it’s a mental deficiency.  It’s kinda like when someone uses large amounts of profanity, I naturally think that that person has had a severe stroke disabling his speech center or possibly he was just born naturally stupid… with an inability to fully utilize a broader vocabulary to get his feelings across.

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