Do Age Cutoffs For Ventilator Allocation Favor Guideline Authors?

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As part of an anticipated surge in COVID cases requiring ventilators, our hospital is preemptively preparing a framework to decide on ventilator allocation when demand exceeds supply. In the course of researching the policy, I reviewed several papers on the subject, some of which advised using specific age cutoffs in determining who should receive a ventilator. One paper in particular …

My First COVID Intubation

crispydoc Uncategorized 3 Comments

A couple of days ago I intubated my first critically ill patient with probable COVID (the test takes 5 days to return, so we never know in the moment). I should preface what I write next: Many talented people have taken on unbelievably time-consuming, entirely voluntary roles in order to ensure a robust response. My institution has risen to the …

I Tried The Cellulitis. It Was Delicious!

crispydoc Uncategorized 2 Comments

Dear reader, if you seek distraction as a form of solace, this might be for you. It is not intended to make light of the seriousness of our current pandemic – simply to give your brain a couple of minutes to engage in a different thought process. A month ago, my wife and I tried to pull off the kind …

Psychological Obsolesence

crispydoc Uncategorized 2 Comments

Dear reader, I realize these topics are light fare in comparison with what we deal with on a daily basis during the COVID pandemic. Some posts were written before it unfolded, others are my attempt to engage my brain in a manner other than the apprehension that characterizes many of my waking hours. If you seek distraction as a form …

In Defense Of The Frivolous Distraction

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I was at a conference  in Vegas last week when local manifestations of the global crisis occurred in rapid succession. The day after I departed, our district announced that local schools would close for at least the next two weeks. A day later, an older immunocompromised loved one was hospitalized with a viral pneumonia (thankfully not COVID). My loved one …

Of Drama Geeks And Buried Treasure

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Confessions Of A (Former?) Drama Geek I was a teenage Madrigal. The Madrigals were our high school’s premiere mixed vocal music group, and our Broadway-influenced musical director made sure we had choreography and a mix of classic and contemporary vocal arrangements to make even the most sedate nursing home audience stand up and pop wheelies with their walkers like the …

Goodheart’s Law And The Quest To Quantify

crispydoc Uncategorized 1 Comment

45 years ago, British economist Charles Goodheart inserted what he considered a snarky aside into an otherwise serious academic publication: Any observed statistical regularity will tend to collapse once pressure is placed upon it for control purposes. Was his humor hard to recognize due to his being a British academic or due to his being an economist? Hard to say. …

Conspicuous Frugality

crispydoc Uncategorized 5 Comments

Many folks pursuing Financial Independence (FI) as high income professionals often opt for a lifestyle comparable to average income households, arbitraging the difference in income (greater than households at similar spending levels) and expenses (far less than peers in their profession) to supercharge their investments. A modest lifestyle with high income and financial literacy can combine to act as a …

Can Imbalance Produce Fulfillment in Medicine?

crispydoc Uncategorized 2 Comments

My experience with burnout in medicine reflected a perfect storm (a lawsuit; a toddler at home with a second child on the way; a near-denial on a home loan; and working far more than I wanted due to two years of understaffing). It led me to the path of financial literacy, which in turn set me up to become a …

The Old Bus From A New Perspective

crispydoc Uncategorized 1 Comment

There was a time in life when the poetry and prose of Richard Brautigan brought me great solace. He was widely popularized as a Beat poet, but I always viewed him as a lonely soul who found companionship through his readers. I was one such reader as a high school student. I was alone surrounded by people. I connected with …