Despite today's recently improved weather, things have been rather cold and rainy around here, even for October. I haven't been out in the field for a few reasons, and laziness is among them.
I am a bit of a closet bookworm, and this often gets worse during the winter. One of my favorite authors, George RR Martin, has a wonderful series for anyone interested in science fiction or fantasy. It is very adult oriented, but the books are gripping reads. Don't just ask me, HBO is just starting the production of the pilot episode. It should be a wonderful addition to the likes of Sopranos, Rome and Deadwood if it gets picked up. The casting seems to be all done, and looks to be perfect.
So if you are also looking for a good book to pick up as the weather cools down, check out A Game of Thrones, the first in A Song of Ice and Fire. If you don't like to read much, make sure to check it out on HBO or DVD, hopefully...
Wednesday, October 21, 2009
Tuesday, October 13, 2009
Melanistic Garters of Ohio
The northern part of Ohio is known for having a few melanistic garter snakes as well as some melanistic massasaugas. I haven't been fortunate enough to see the latter, but I have lucked into a couple garters.
Interestingly, melanistic garters are fairly common in the NE, especially in areas around Toledo. I haven't ever had the pleasure of seeing them there, despite seeing a good number of garters. Both of my examples came from farther south.
The first one I actually stepped on and initially thought it was a small racer.
The second one was found in early March during an unseasonably warm week in Cincinnati. I was walking through the ghetto on the way to my car and noticed this animal basking in a rock wall - what luck!
For the record, every now and then garters sometimes look like this too.
Maybe you should think again next time before saying "just a garter"...
Interestingly, melanistic garters are fairly common in the NE, especially in areas around Toledo. I haven't ever had the pleasure of seeing them there, despite seeing a good number of garters. Both of my examples came from farther south.
The first one I actually stepped on and initially thought it was a small racer.
The second one was found in early March during an unseasonably warm week in Cincinnati. I was walking through the ghetto on the way to my car and noticed this animal basking in a rock wall - what luck!
For the record, every now and then garters sometimes look like this too.
Maybe you should think again next time before saying "just a garter"...
Monday, October 12, 2009
Saturday, October 10, 2009
Waldo
A middle aged guy presented with syncope in our middle acuity area the other night and one of my fellow residents recognized brugada on the EKG.
The pertinent findings are the RBBB with ST elevation in V1-V3. Type 1, like the one picture above, also has T wave inversions. These EKG findings make up Brugada pattern, and when associated with syncope or other clinical characters it becomes Brugada syndrome.
Could have saved this Waldo's life, but he signed out AMA (against medical advice). Brugada is a fairly newly recognized syndrome, and still isn't very well understood. If it is caught, cardiologists can fit you with an AICD and with excellent survival results. If not you are at great risk for deadly arrhythmias. Some sources state it is one of the most common causes of sudden cardiac death in patients with structurally normal hearts.
We now return to our regularly scheduled program...
The pertinent findings are the RBBB with ST elevation in V1-V3. Type 1, like the one picture above, also has T wave inversions. These EKG findings make up Brugada pattern, and when associated with syncope or other clinical characters it becomes Brugada syndrome.Could have saved this Waldo's life, but he signed out AMA (against medical advice). Brugada is a fairly newly recognized syndrome, and still isn't very well understood. If it is caught, cardiologists can fit you with an AICD and with excellent survival results. If not you are at great risk for deadly arrhythmias. Some sources state it is one of the most common causes of sudden cardiac death in patients with structurally normal hearts.
We now return to our regularly scheduled program...
Friday, October 9, 2009
Where's Waldo?
I was enjoying a 3am breakfast after my shift with a good friend the other night and he said something that really rang true for me.
Emergency medicine is "Where's Waldo?"
I don't know if he heard this wonderful analogy from someone else, but I will never forget it.
The gist of it is, the people in an emergency department at any given time are like all the people in a Where's Waldo? picture. The sick people are Waldo. Some of them are obvious, have concerning complaints or abnormal vital signs, and get found right away. Most of them though are lost in the sea of people. You might have a full emergency department, 30 people in the waiting room and 10 new charts in the rack but you need to find Waldo. He is out there, hiding, waiting to be discovered. It is our job to treat everyone with the respect and diligence they deserve but we need to do this quickly and efficiently. We need to find that Waldo.
I loved these books when I was growing up, and this further supports why I love my job.
If I find an interesting Waldo here and there, maybe I will share...
Emergency medicine is "Where's Waldo?"
I don't know if he heard this wonderful analogy from someone else, but I will never forget it.
The gist of it is, the people in an emergency department at any given time are like all the people in a Where's Waldo? picture. The sick people are Waldo. Some of them are obvious, have concerning complaints or abnormal vital signs, and get found right away. Most of them though are lost in the sea of people. You might have a full emergency department, 30 people in the waiting room and 10 new charts in the rack but you need to find Waldo. He is out there, hiding, waiting to be discovered. It is our job to treat everyone with the respect and diligence they deserve but we need to do this quickly and efficiently. We need to find that Waldo.
I loved these books when I was growing up, and this further supports why I love my job.
If I find an interesting Waldo here and there, maybe I will share...
Sunday, October 4, 2009
End of the Season Blues
Loaded the dog up into the car early morning last week after an overnight shift and headed west to meet up with a fellow herper, Curtis. We had a fateful day last fall, one of my best in Michigan, and hadn't been able to hook up since. Cid was still healing up after his little surgery but I wrapped his leg up best I and away we went.
The first spot we hiked was very wooded and despite following a bunch of good sections of trail we never really found any open areas. We found a few Ambystoma laterale, Rana sylvatica, Pseudacris crucifer, and a garter or two. We next headed to another spot, and the day improved drastically.
The weather was perfect, low 70s and partly cloudy. Within an hour or so we turned up four blue racers. All of them were found out and about in a couple different fields. We also managed to scare up some Rana pipiens, Thamnophis sauritus, and another Ambystoma laterale or two.
Cid was back in rare form, and he was even responsible for turning up one of the racers. I noticed him stepping over a blue stick stretched out and realized that it wasn't a stick... Luckily he didn't really notice and the snake just sat there as well.
The first racer, as found basking.
The middle two snakes unfortunately slipped away in the grass quickly without pictures.
Here is the fourth snake, also found in situ right after Cid stepped over it.
It quickly spooked up a tree, and hung around for some excellent photographic opportunities.
I finished the day by getting stung by an insect of some sort. I thought it was a yellow jacket, but the stinger was still visible on my finger, with muscles visibly pumping more venom into me. Correct if I am wrong, but I thought this was a feature more common in the less aggressive honey bees? I should have taken a moment to snap a picture due to professional interests (I waited long enough to show Curtis) but instead flicked it away as the discomfort was growing tiresome.
The frosts are just around the corner...
The first spot we hiked was very wooded and despite following a bunch of good sections of trail we never really found any open areas. We found a few Ambystoma laterale, Rana sylvatica, Pseudacris crucifer, and a garter or two. We next headed to another spot, and the day improved drastically.
The weather was perfect, low 70s and partly cloudy. Within an hour or so we turned up four blue racers. All of them were found out and about in a couple different fields. We also managed to scare up some Rana pipiens, Thamnophis sauritus, and another Ambystoma laterale or two.
Cid was back in rare form, and he was even responsible for turning up one of the racers. I noticed him stepping over a blue stick stretched out and realized that it wasn't a stick... Luckily he didn't really notice and the snake just sat there as well.
The first racer, as found basking.
The middle two snakes unfortunately slipped away in the grass quickly without pictures.
Here is the fourth snake, also found in situ right after Cid stepped over it.
It quickly spooked up a tree, and hung around for some excellent photographic opportunities.
I finished the day by getting stung by an insect of some sort. I thought it was a yellow jacket, but the stinger was still visible on my finger, with muscles visibly pumping more venom into me. Correct if I am wrong, but I thought this was a feature more common in the less aggressive honey bees? I should have taken a moment to snap a picture due to professional interests (I waited long enough to show Curtis) but instead flicked it away as the discomfort was growing tiresome.
The frosts are just around the corner...
Browns
Boy are we terrible. I am very pleased to see DA get the start and Mohamed Massaquoi get involved a bit more. We still have a long way to go, but at least there was some offensive production today. Keep Quinn on the bench... worthless. In Josh Cribbs and Sean Rogers we trust.
Friday, October 2, 2009
Silence
I apologize to my few readers for my recent week of silence. I got engrossed in a good book that ate up most of the free time I had between work.
I did manage to get out in what looks to have been one of the last nice days of the year. Cid made his triumphant return to the field, and all my plans of keeping his little leg dry and clean were quickly squashed. That being said, I just took out his stitches (I wasn't going to pay for something I do on a regular basis) tonight and the wound seems to be no worse for the wear.
We had a great day with a few neat animals. I hope to get pictures up very soon.
I did manage to get out in what looks to have been one of the last nice days of the year. Cid made his triumphant return to the field, and all my plans of keeping his little leg dry and clean were quickly squashed. That being said, I just took out his stitches (I wasn't going to pay for something I do on a regular basis) tonight and the wound seems to be no worse for the wear.
We had a great day with a few neat animals. I hope to get pictures up very soon.
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