7 November 2013 Back in the USSR

Cassi Creek:  Rainy, overcast day.  Yellow and brown leaves are covering horizontal surfaces, making road treacherous.  Given the driving habits of most local drivers, it is not a particularly comfortable or safe day to be walking along the road. 

          Lev Davidovich Bronstein was born on this date in 1879.  Under the nom de guerre Leon Trotsky, he was a primary leader in the 1917 Russian Revolution, also occurring on 7 November.  He was initially a Menshevik but switched allegiance to the Bolsheviks.  He was the first commissar of the Red Army, responsible for creating the Red Army.  Due to internal party politics, he fell from favor after Lenin’s death.  Stalin had him drummed from the Soviet Party, deported, and finally murdered – 21 Aug 1940) I’ve always wondered what the USSR would have become had Trotsky followed Lenin.  While Trotsky was ruthless at need, he was not the paranoid mass murderer Stalin became.

          Historical bits for today:

CMB  

CND

                

6 November 2013 I remember that… But it didn’t sound so dirty then

NSFW

Cassi Creek:  I had an 0800 neurology appointment at Mountain Home this morning.  The drive in was uneventful.  Checked in on time and waited. 

          An LPN did my vitals.  She was suffering a migraine and trying to keep her work cubicle as dark as possible.  She hooked me up to the auto-monitors, got a pulse ox and temp result but wasn’t sure why I had no pulse or BP.  I was wondering, simultaneously, why the auto-cuff wasn’t auto-inflating and crushing my bicep and radial nerve.  I finally noted that the pressure line to the cuff was not connected and handed it to her.  Suddenly, pulse and pressure resulted. 

          Then arrived the resident on Neuro service.  Each time I’ve been seen by neuro a different resident has done the exam.  This young woman was carefully taking an Hx and performing a neuro workup.  At one point, she stopped and said, “I’m trying to remember the cranial nerves.”  Then she regained her focus and finished the exam. 

          Generations of medical students have used various mnemonics to recall the cranial nerves. 

The cranial nerves are:

·         I - Olfactory nerve

·         II - Optic nerve

·         III - Oculomotor nerve

·         IV - Trochlear nerve

·         V - Trigeminal nerve/dentist nerve

·         VI - Abducens nerve

·         VII - Facial nerve

·         VIII - Vestibulocochlear nerve/Auditory nerve

·         IX - Glossopharyngeal nerve

·         X - Vagus nerve

·         XI - Accessory nerve/Spinal accessory nerve

·         XII - Hypoglossal nerve

The old mnemonic I learned decades ago was “On Old Olympus' Towering Top, A Finn And German Viewed Some Hops”

Like every other group involved with anatomy, the actual study of anatomy, medical students will take such a memory device and personalize it to render it more memorable to them.  The easiest way to do that is to change the tool from socially correct and safe for use in a patient’s room with family present, into something ribald, politically incorrect, and just plain vulgar.  If it helps, it helps. 

            The increasing numbers of women who now enter med schools  has made some dents in the social and cultural practices related to medical education.  Language and behavior that were still common practice during my clinical rotations and hospital jobs might result in censure in today’s hospitals and schools.   This is not a proclamation that women are never vulgar or politically incorrect.  I’ve known many RNs and female MD’s who could embarrass a statue and never miss a beat in charting, suturing, etc. 

            The difficulty in remaining a dinosaur  is in figuring out who is easily offended and who fields such comments and drives back at the pitcher. 

·               I didn’t offer a cranial nerve mnemonic this morning.  She appeared to be a first year resident, doing good job of examining and listening.  It wouldn’t have been fair to meet her admission of need to recall information with either

·         Oh, Oh, Oh, To Touch And Feel Vagina God Vaginas Are Hot,

·          or

·         Oh, Oh, Oh, To Touch And Feel Various Guys' Veins And Hotdogs

·         Political correctness demands this post be gender preference neutral.

More examples of such devices can be found at http://en.wikipedia.org/wiki/List_of_mnemonics_for_the_cranial_nerves

Not all examples cited should be used in polite gatherings.

For today’s history item:

5 November 2013 Leaves that were green turn to brown

Cassi Creek:  The upper sides of the valley, defined by east and west ridges, have almost all changed from their brighter autumn colors to the dead brown of winter.  Walking along the road on today’s hike with Mike, I had Loki on lead as always.  The crunch of dried leaves followed her footsteps when she left the pavement to explore something that she might want but that I most certainly did not want her to have. 

          By the weekend, we may have enough rain push through to dull or deaden the leaf noises. 

For the history files:

I recall seeing this Dust Off helicopter. 

I also recall seeing this aircraft or one of its next of kin several highly appreciated times.

4 November 2013 “The dog has not been fed in years

“It’s even worse than it appears, but it’s all right!”

Cassi Creek:  We’ve survived the initial two mornings since the DST change.  The urge to turn off the alarm and bunker in for another hour remains strong. 

          Here’s another paean of praise to our “oh, so noble and wise Congress.”  With the onset of November, arrives the onslaught of cuts to the social safety net.  While some of our populace fattens with each day that passes, that same segment is all too willing to disenfranchise the people who put their lives on the line to serve in our armed forces.  Once disenfranchised, attacking the stability of their families and their economic capacity to feed their families while deployed or called up for reserve or NG duty prior to deployment. 

          Congress would do well to recall who controlled the Emperor’s throne in the Roman Empire.  The Praetorian Guard, officially there as palace guards, learned that they could express their discontent about compensation and their concern about the quality of leadership in the Empire. 

          If I were a member of Congress, I’d be damned certain that no member of a military family went to bed hungry, that no veterans lacked a safe dry place to sleep or access to high quality health care.  But as it stands today, when I hear a politician saying “Thanks for your service!” I immediately start looking for the bloody dagger aimed at my back. 

For the history folks:

Note how exposed the bombardier was during flight. 

The two links below document that many of the men who crewed the planes never returned home. It was far from easy, never safe, and the odds against going home increased exponentially with each mission.

http://www.flickr.com/photos/dougsheley/4492196094/in/set-72157607350503756

http://www.flickr.com/photos/dougsheley/4537301592/in/set-72157607350503756

3 November 2013 Which two columns are the farthest apart?

Cassi Creek:  Still shuffling through hundreds of images detailing WWII nose art. 

          One of my favorite comic strips when I was growing up was Milt Caniff’s “Steve Canyon.  Caniff first came to fame with the strip “Terry and the Pirates.  That strip evolved into another, “Male Call” designed for the troops in WWII.

          The B-17 “Bit O’ Lace used a graphic design penned by Caniff.  More information about the artist, Caniff, can be found at:

http://en.wikipedia.org/wiki/Milton_Caniff

For a closer look at the B-17 “Miss Lace,” 

http://www.bates-r-us.org/abitolace/

Various Caniff characters from "Steve Canyon"

02 November, 2013 No borders and no boundaries

Cassi Creek:  “The sky is gray and white and cloudy….

          Quick trip into Johnson City this morning.  The sky was as mentioned above..  The line quoted above aptly describes the appearance of the mountains as they spear against the clouds.  The wind that blew through Thursday night has stripped a lot of the foliage from the trees.  We’ve reached the peak of the fall leaf season. 

          Nothing else to add today.

For the historians.

1 November 2013 Just gotta poke around

Cassi Creek Espionage between nations is as old as human kind. 

City dwellers spy upon rural folks to see how the crops look.  City states snoop on the affairs of other city states.  The Vatican spies on everyone, as does Mossad.  The Soviets carried out very successful espionage campaigns against NATO nations, the U.S., China, and the Warsaw Pact nations.  The Soviets and East Germans had massive internal espionage networks. 

          Not to be outdone, the FBI did its best to convince the Boy Scouts to serve as junior spies, hunting for communists in their neighborhoods.  The BSA decided not to play along until the target became open homosexuals. 

          Espionage is much easier than we would expect because of our innate tendency to gossip about others.  That’s not going to change.  Anyone who thinks that privacy still exists at a personal level in today’s world has eaten one too many kind veggie burritos in the parking lot. There’s always information flow on Shakedown Street.

          High winds kept us sleeping lightly last night.  They arrived and departed with the sunset and sunrise.  We were lucky, had no damage.  Down valley there was one Bradford Pear split and fallen.  Mike, our down stream neighbor woke up to find 20 feet of pine tree fallen across his deck.  Once again, we were lucky.  There are large branches in the road all the way down valley.

For the history majors: