Spinal Reflexes and Brain Dead People

In a recent post, I mentioned having learned that “There’s an area of your brain that handles a reflex to turn your head and look before you even form the question ‘What was that streak of orange and roaring noise?'” While this is true, it’s a relatively complicated reflex. There are some reflexes so important that they are completed before any message is sent to the brain at all! A good example of this is pulling back from something that hurts you. You’ve already reacted to the hot pan in your hand or the LEGO you stepped on in the dark before you ever think “Ow!”

One way this was demonstrated in lab was with a short film of a frog that had been “pithed.” It used to be done commonly in some science classes but by watching the film, it didn’t have to be repeated in every lab, every semester. The college saves money, fewer frogs die, we still learn. This procedure does render the frog brain dead: the parts of the frog that say “Heart, beat!” or “Lungs, breathe!” still work; the parts that say “I’m hungry” or “I like lily pads” or “Ow!” are gone. Over the course of this short film, we watched the frog react to painful stimuli using nothing more than spinal reflexes (regrettably, I can’t find a Youtube clip in English that demonstrates well). We were reminded by the narrator several times that the frog is not feeling anything, is not “trying” to do anything. The parts of the brain that feel or try were gone. It’s just reflexes.

At the end, the lab instructor — an older lady who had initially trained as a nurse in Brittain’s Army — told us that we needed to remember this film because those of us going into patient care were likely to someday encounter brain dead patients and their families, and their families would be desperate to attribute reflex movements to improvement in their condition. In fact, she remembers that the first time she saw these reflexes in person, “It scared the bejabbers out of me!”

And this brings me to the sad story of Jahi McMath. Last month, tonsil surgery went wrong for Jahi. She experienced severe bleeding, cardiac arrest, and brain death. She is currently on a ventilator — the part of her brain that would say “Lungs, breathe!” doesn’t work anymore either. The brain death was confirmed by no fewer than 5 licensed physicians, 3 of whom were selected by the girl’s family. She’s actually been declared dead. Nevertheless, the family has hopes that she will get better and wants her transferred to another facility. One doctor says he thinks the girl is not brain dead because “he visited Jahi’s bedside and observed her responding to her grandmother’s voice and touch with a squirming movement.”

Now, I’m not a neurologist, but I think I’ll take the word of multiple neurologists and other doctors over the word of one pediatrician who thinks he saw something that can be explained by simple spinal reflexes.

Talks to allow transfer this unfortunate young lady to another facility are ongoing at this moment. In the highly emotional words of the hospital’s lawyer: “It’s horrible that this child has died. It’s also horrible that it’s so difficult for her family to accept that death.”

In Closing: pre-employment credit checks; college education; sequestration; “reality” TV; deliberately hard maybe?; “Hi guys!”; Bill!; and doge.


Return to BloodShorties Lake

You can thank Drew for the title inspiration. It’s sometimes tough to keep thinking of Shorties titles!

Beating the same drum: so here’s today’s tab dump on the freaking mess that continues to be the NSA, DEA, FBI, and Edward Snowden.

And now for something completely different: a nice selection of  health, health insurance, and healthy diet links.

Armchair economist: yeah, still collecting choice bits on the economy and how it effects Joe Average for you. But hey, at least Congress gets plenty of vacation days. After all, they work so hard preventing legislation.

Oh Look: the Duhpartment of Research has been at it again.

I can’t bring myself to spend that: Average price of a new car is now over $31k.

Education Official has Moment of Sanity: Huh, maybe school should start later.

On Libertarianism and Property Rights: Seriously.

Don’t you think you should have read the book before writing about it?:did read the book, thank you. I wasn’t required to. I wanted to as part of a research project. How about we stop focusing on the fact that there was a lot of racism years ago, and celebrate the improvements that have been made to medical care, medical privacy, and race relations since then? Not saying everything is perfect, just better. How about we temper praise for the author compiling primary source materials with the fact that it’s hard to find any scholarship on the subject not filtered by her findings and bias?

Speaking of medicine: Gin and Tonic and the British Empire.

Shhhhhhh: A judge has thrown out the right of the US to maintain an international no-fly list.

And Finally: a couple of nice videos to waste your time.

Back to School Time is Back to the Vaccine Debate Time

So my local CBS affiliate is trying real hard to do the fair-and-balanced two-sides-of-every-issue thing.

In one corner, we have a highly respected local pediatrician who works in a local hospital pointing out that he’s seen 4 cases of whooping cough in the last 2 months, adding “Vaccines are one of the most important advances in the field of pediatrics in the last fifty years….”

In the other corner, we have a “Holistic Physician” — whose degree, source of expertise, and workplace are undisclosed — saying whoa, just hold on a minute, there are “factors to take into consideration as to if you should vaccinate, when you should vaccinate and what are the alternatives to vaccination.” Apparently “holistic physicians” believe you can prevent measles and other diseases with a proper diet. Seriously.

A little research shows that this “doctor” is a chiropractor, with online reviews that range from good, up to “sounds like it might have been written by a staffer”, down to abysmal. As nearly as I can tell, the scope of practice for chiropractors in Nevada does not include prescribing rights or the ability to perform injections. That would of course include administration of vaccines. At least he’s not a “Naturopathic Physician.” Remember kids, ND means Not a Doctor.

At least nobody brought up that discredited “research” showing vaccines “cause” autism.

Look folks, here’s the alternative to vaccines: your kid could get sick and possibly die from a completely preventable disease. Vaccination doesn’t take long to do, the complication rate is very low, and your kid’s school probably requires it anyway. In this day and age of protecting kids from the imaginary predator around every corner, what excuse is there for not getting it done?

So what’s next, local news? What topic can you pretend there are two sides to present and take up a few minutes of airtime? Here’s an idea for you: Murder! Police and safety experts say it’s bad, but killers say some people just gotta get whacked. You decide!

In closing: “Hey, calm down!”



Medical Problem: the Law of Supply and Demand is Still in Effect

As we all know, all too soon we Americans will be required to purchase health insurance from the highly profitable corporations that got us into the health insurance “reform” debacle. Even people who should know better think we just have to have mandatory insurance to abolish pre-existing conditions because after all “people would buy insurance on the way to the hospital!” Clearly people who can say this with a straight face have never attempted to purchase health insurance.

Here’s the problem, as Massachusetts has already found out. All those newly insured people? They are going to want value for their money! They are going to want to see a doctor! We already have a physician shortage — which is being made worse by Baby Boomer retirements. Nevada has had a shortage for a decade, and it’s not getting better (don’t get me started).

Now there is news that — officially — it’s not going to get better for at least 4 years. It seems that even though medical schools are churning out doctors, those newly degreed docs with six figures of student loan debt sometimes can’t find residency programs! No residency, no full license, no insurance reimbursement, no job as a doctor. What a waste. Gee, your doc doesn’t seem so greedy now that you know what bills he’s facing, does he?

Want to bring down medical costs?  You’d better find a way to make more doctors, more ways to train them, and better ways to pay for their education.

In Closing: a couple comics; the cat film festival will return for a second year; oh well then I’ll just try not to look like a dissident; if anybody finds any follow-up on FPS Russia, please let me know; oh the things musicians will argue about; and duh.

Music Monday: He would have turned 257 yesterday

Rock me, Amadeus.


In closing: as true as this is, the other half of the solution involves prison time for supervisors and managers that ignore the law; facts can be twisted; work out before breakfast; how to cancel almost anything; hahahahahaha what planet are they from that they think doctors set their own prices??; 150 things really smart people are worried about; what kind of moron texts his girlfriend to say the baby isn’t breathing instead of calling 911??; deadliest jobs in America; Fluffy’s Dream Home.

No Reason to Subscribe to Fortune

Let’s cut to the meat:

[I]f America fails to enact historic, structural reforms in spending, an entirely new source of revenue will be needed. And it’s likely to be enacted in haste and near-panic, as the only option to forestalling a crisis. “The gap between revenues and outlays will be simply too large,” says J.D. Foster, an economist at the conservative Heritage Foundation and a former budget official under President George W. Bush. “Three points of GDP need to be closed to make budgets sustainable. Either government spending gets back near where it used to be, or we’ll need an completely new type of tax.”

The new levy will need to be big, so big that the most probable choice is a European-style value-added tax or VAT. That looming revenue machine is the phantom in the room, the tax that’s still invisible to most Americans, but that threatens precisely the group that’s supposed to emerge from all the deal-making as the Great Unthreatened, our middle class.

Now then, let me explain why a VAT — particularly a hastily enacted VAT — is absolutely not going to happen. It’s called the 16th Amendment:

The Congress shall have power to lay and collect taxes on incomes, from whatever source derived, without apportionment among the several States, and without regard to any census or enumeration.

Congress has two ways of taxing us. The first is a tax based on the number of people in the state. It should be obvious that it’s not entirely fair to make your tax bill based on state population without regard for your ability to pay (it seemed like a good idea in the 18th century), so the 16th Amendment had to be passed to make income tax legal. I am not a lawyer or a constitutional scholar, but I don’t see a damn thing in the Constitution or Amendment 16 that makes a national sales tax legal.

Anybody who wants a VAT had better start working on an amendment to the Constitution. That cannot be done in haste.

This article is supposed to scare you and I into insisting on austerity rather than implement this improbable, middle class “crushing” tax. Heaven forbid we should raise additional revenue through higher taxes on the wealthy at the rates they were under Reagan, or Nixon, or heaven forbid Eisenhower (all “conservative” Republicans of their day). Nope, easier to frighten you into giving up the things your taxes have paid for: well maintained roads; safe water coming out of your tap and safe food available at your local grocer; police and fire services; public schools that make sure businesses can hire literate employees anywhere in the nation; a minimal retirement income you already paid for. Nope, gotta cut back somewhere.

In Closing: scientific method suggests that when your experiment doesn’t work, you change the hypothesis; what a sleeze; let’s not lock kids up in solitary; wealth gap grows; agreed; women will die because their parents are afraid they will think sex is ok; I find it hard to believe that’s cost effective; “Just how many female-headed single-parent families with two children under 10 are there in the United States making $260K/year, anyway?”; and wouldn’t that be a waste.

Gridlock and Opportunity

The next session of Congress is either going to be complete gridlock, or an era of great bi-partisanship. I say this based on this chart from Nate Silver. In case you’ve forgotten, that’s Nate “the man who got all the numbers right when everybody else got them horribly wrong” Silver:


Let me point out the obvious. It takes 218 votes to get most things done in the House of Representatives. Neither the mainstream Republicans nor the Democrats (with or without the Blue Dog crowd) have those votes. The Tea Party has become a de-facto third party. To get anything done, there will have to be a coalition and/or a compromise: either between the two parties, or with the Tea Partiers. This should be obvious to both Mr. Boehner and Ms. Pelosi. The President already said it out loud. As Mr. Silver points out, on this and pretty much every bill in the next session, Mr. Boehner “will need to win the support of at least some liberal Democrats. And a bill that wins the support of some liberal Democrats will be an even harder sell to Mr. Boehner’s Republicans. For each vote that he picks up from the left, he could risk losing another from his right flank.”

Nobody knows if the glass is half-empty or half-full. Was Mr. Boehner’s ill-named “Plan B” a symptom of his increasing irrelevance, or an attempt to enter a Post- Norquist political world? Will the 113th Congress be a more sane and bi-partisan body, or a place where the right hand and the left hand quite literally don’t know what the other is doing? Let’s hope for sanity.

In Closing: military research saving lives on battlefields and eventually on American streets; why re-invent public education with things we aren’t even sure work when we can just crib off Massachusetts?; yeah, it turns out there were good guys with guns at Columbine and it didn’t help (at least the good guys didn’t injure more students); and maybe this deserves more thought.

Turkey Sandwich Wars

As nearly as I can tell, it started with a regional chain called Capriotti’s and a sandwich known as The Bobbie. It’s basically “Thanksgiving Dinner on a sub bun”: Turkey, cranberry sauce, stuffing, and mayo. Delicious if a bit carb-heavy.

Then a local sandwich shop called Eddie D’s threw down with their own version. As Eddie himself put it, “I call it the Robert, because it’s the Bobbie’s daddy.” It’s served hot with turkey, melted cheese, stuffing, cranberry sauce and you can order it with hot gravy. Also delicious.

Expect some variation to come to fine dining near you and then eventually filter down to the casual dining set. The other day I was exposed to Marche Bacchus’s take on the Thanksgiving sandwich. Their version features housemade cole slaw, swiss cheese, caramelized onions, and cranberry coulis. A huge improvement over the turkey panini they used to serve.

I think this trend could be the next Slider of the culinary world.

In Closing: Iceland wants banksters in jail; and that’s why they fear Occupy; why is this not an election talking point?; food safety rules delayed; she gets it (BTW, love the content hate the font); walking changes linked to cognitive decline; loose lips sink viruses; upscale pawn shops (because the economy is so great); spoiled; doesn’t everyone need an espresso maker in their car??; seriously; the mayor is a cat; and why we wear pants.

I Don’t Know Where to Start

Alright, so we had an interesting local news story. Most of the news stories were based heavily on what was in the local paper:

A North Las Vegas man was arrested last week after being accused of posing as a doctor, sedating victims and then [sexually] assaulting them when they were unconscious.

Now, that’s bad enough. He claimed to be licensed in Mexico and that’s “good enough,” right? Sure, blame good old fashioned medical board bureaucracy for keeping this “licensed professional” down.

Worse than this: known victims do include grown women and a 5 year old boy. What. The. Eff. This is wrong on so many levels I can’t even speculate. I haven’t the faintest idea what was allegedly done to this poor child nor why nor even how it was discovered. And just think, these are the known victims. The police are pretty sure there are unknown unknowns victims too.

But to me here’s the kicker. These crimes happened in the “doctor’s” home. These patients were so desperate for inexpensive medical care that they were not only willing to overlook his unusual licensing (assuming they did know enough to ask), but they were willing to go to a “clinic” run out of some guy’s living room.

The days of the old country doc seeing patients in a spare room were over decades ago, except in our underground economy. In the other economy, anybody can buy a white coat, start a “clinic,” and potentially assault, disfigure, or otherwise injure their patients. Sometimes, they even kill them.

And that’s why we need universal health insurance instead of mandatory health insurance.

In Closing: two new blood types; Jeb sounding almost reasonable; and just say no to police searches.