We All Shine On

John Lennon was murdered 34 years ago today. Here’s a documentary about his last day, December 8th 1980. I saw it originally in December 2010 on the 30th anniversary his murder. It’s noticeable for the interview that begins around the 27 minute mark with Dr Stephen Lynn, the Emergency Room doctor who attended to John when he was brought to Roosevelt Hospital that night. From an emergency medicine perspective, he tells us that Lennon, in the attempt to save his life, had a thoracotomy – every EM clinician will understand what that means. He retells the story in such a way that you re-realise the horror of his killing.

“More productive, Comfortable, Not drinking too much, Regular exercise at the gym…”

Apple, WWDC and Health

Next month I’ll be in London for one of the Monty Python reunion shows. In their 1983 movie, The Meaning of Life, Michael Palin played an condescending hospital manager who wanted to make sure everyone appreciated the machine that he had bought, the one “that goes ping”. The joke was based on the notion that hospitals-know-best and that technology was one way that healthcare can assert its power over patients.

31 years later and the iPhone in my pocket outstips any machine the hospital has that goes ping. For instance, the computers in my hospital run Windows XP Professional, an operating system from 2002. Meanwhile yesterday, Apple announced Health, an app that will come as standard in iOS 8, the next revision of Apple’s mobile iPhone/iPad operating system. It’s not the do-everything, life-saving app that some people will have been expecting, but it’s a subtle statement of intent and when taken into consideration with Apple’s announcement HomeKit and SDK extensibility yesterday, there’s a smart long game ahead.

Let’s break down what all that means:

Continue reading

There once was a note, listen…

The first in an occasional series about apps and software I use

Microsoft OneNote
Three years ago I ditched my laptop and committed to the iPad full time. It wasn’t initially planned that way: My trusty 2006 MacBook was kept charged and ready just in case. But it went unused for days, then weeks, then months and went from being trusty to dusty.

Continue reading

Why must we wait so long, before we see?

Here we go again…

There is a story in the news, this time from Australia, about charging patients who “shouldn’t be in the emergency department”. Here’s someone tweeting about it:

The Sydney Morning Herald reports:

…state-run hospitals will be given the power to impose a fee of about $7 to stem a potential rush of patients from GP clinics to free public hospital emergency rooms.

Continue reading

I Don’t Know What To Do, I Need a Rendezvous

Why is Apple buying Beats? Opinion #31247
(This post has nothing to do with medicine.)

I’m an Apple customer for many years. I’m also one of those fans who happily watches all the keynote presentations and follows the popular Apple news and rumour websites.

So like many, I was perplexed by the news that it seems Apple will be buying Beats for $3.2 billion in the next week or so. Why would they do that? Beats headphones are divisive in that you either think they are (a) a worthy expense which marks you out as a discerning audiophile and fashionista or (b) an idiot tax on people who put style over substance. Interestingly a lot of people also think (b) applies to Apple fanboys like me, and yet somehow it seems from the online discourse that Apple fans and Beats fans are mutually exclusive.

So why would Apple buy Beats?

Continue reading

Sit inside a bottle and pretend

As March gives way to April, it’s time to update my #50Podcasts plan to listen to 50 podcasts (at least) in 2014.

To catch up I watched 6 of Dr Amal Mattu’s ECG of the Week cases on YouTube – I haven’t watched any of them this year. If you are unfamiliar with them, please rectify that straight away. I was lucky enough to have a full day’s teaching from Dr Mattu at an ECG symposium at the ICEM conference in 2012. He has the rare pairing you want in an educator: extensive knowlegde of the underlying subject, but he carries that knowledge in a way that doesn’t intimidate the audience.

The cases are usually under 15 minutes and cover a random facet of ECG pathology each week. I will endeavour to keep up with them for the rest of the year.

I also listened an old ercast on Trauma arrest, which was as good as always.

March also had the smaccGOLD conference from the Gold Coast in Australia. Smacc is social media and critical care and it is a conference which is only in its second year, but through being very social media-smart, has a strong presence and dedicated following already. I was watching a feed of the opening ceremony which stayed open long enough for almost all of Dr Victoria Brazil’s (@SocraticEM) opening talk on teamwork and interaction. It’s important to have “tribal pride” as part of an ED team, but you should not be in competition with other tribes, you should be in competition with what’s possible.

There is something fantastic about watching a conference live from Australia while following the tweets of the attendees and others enjoying it around the world. More smaccGOLD talks recorded at the 2014 conference should come online in the future. In the meantime, check out the feed of prior smacc podcasts. smaccChicago is planned for May 2015 – I really hope to be there this time.

Finally the EMCrit podcast is one that’s flown under my radar till now, there’s over 100 old podcasts to explore.

So, in total I got 8 podcasts done in March, putting my current total at 14/50.

I’ve got to change my ways, dress for business every day

I regularly have to look at CVs for new doctors looking to work in the hospital. In many of them, the candidates point out that they are “proficient in Microsoft Word, Excel and Powerpoint.”

Well done! That’s great! However, in this day and age, claiming in a CV that you can use Microsoft Office is equivalent to saying you can set a video recorder. There was a time when it was impressive, it’s not impressive anymore.

Continue reading

Equilibrium imbalanced again

As it’s the end of the month, it’s worth checking in on how my #50Podcasts plan is going. I only managed 3 podcasts in February, and they are the three most recent missives from ERCast. Always well worth checking out, the best one was the thrombophlebitis edition, proving that globally there’s still grey areas in parts of PE/DVT/thrombophlebitis management.

This brings my grand total of 2014 podcasts to six. I need to do a few Amal Mattu ECG casts to catch up.

Continue reading

Every chance, Every chance that I take, I take it on the road

It has been an interesting few days as the hospital I work in has been in the news for overcrowding. There sometimes feels like there’s a disconnect between overcrowding and patient safety. On one hand, the international evidence repeatedly shows that ED overcrowding has a negative effect on patient outcome, with increased morbidity and mortality. On the other hand, we are all working in busy EDs, and many patients are getting timely, appropriate care from hard-working staff in spite of these pressures. We are hanging on, doing our best, etc, etc.

The disconnect is because while overcrowding does increase patient risk, it doesn’t change the outcome for every patient. The best way to explain this is by the speed limit analogy.

Continue reading