An ED Physician's Confession: No Winners...And the source of my disillusionment.

In the emergency department we see a smorgasbord of human offerings.  There are the sick, the almost sick, the well but think their sick, and the well but want to get high so act like their sick.  This covers just about everyone.  The trick is to pick out who's who.  As ones ED career careens forward it is easier to label people in the last category.  This is the jaded, hardened perspective and society has only itself to blame. Over the last few hundred years the constitution of the average human has softened to the point of practical putrescence. Current humanity, a loosely referral, expects to be wealthy or at least for some sort of free ride; we expect to be pain free or at least a drug to ease the way; we expect us to immediately stop doing CPR on a dying 30-something cancer researcher to deal with the stomach pain that they've had x 6 months...and they won't leave until it's figured out. And when no narcotics are offered they leave threatening to sue.  It's no wonder after years of enduring this crucible of florid entitlement, that those of us in the trenches may become a nit jaded...a bit fuckin' stupefied at what the festering cross-section of humanity that stagger daily to my ER tells me about the road we're are currently traveling.  In the end we will have become so soft that our flabby constitutions will barely offer us the fortitude to get up and piss in a toilet, while silently weighing the option of just pissing the bed.. The path of least resistance is alway there for us to use as a foil for of what we should be, of the path we should endeavor to ravel.  I fully blame western medicine.  "Do what ever the fuck you want and when you are start to get sick...we'll pump you  full of toxic drugs, pound on your chest and in the best case you may live the rest of your vegetative days in a wheel chair with a tracheostomy and a feeding tube and  your poor family waiting with baited breath to wipe your soiled ass.  Did I mention I was jaded?  Did I sign up for this?  Is this what all ED docs are doomed to conclude at some point in their career or and I just more intolerant than most.  The more I work...the more I see....the more I think that a National Darwin policy should be implemented and let those who choose to ruin their health wallow in their self actuated aftermath.  Why should I spend out limited resources to save these people when  in fact they clearly know the risks of their actions... let them reap what they sow.  And save the true medical care for those unfortunate souls who are struck down by no fault of their own. Hard truth... Life is pain and we all die.  The best we can do is suck it up while alive an die a with shred if dignity.  This latter comment to be sure is more for your family' benefit than yours.  Offering them a relatively calm transition in to death with a show of strength is the best of all gifts.. I sincerely doubt you saw too many Arapaho indians crying at the prospect of their imminent death.  A contrast showing just how soft we've become.  And in the end it will be our undoing. Grow a spine America...before it's too late.

We are Quantum Suicide!

In the space between the words spoken in anger, there is an angry silence almost if not more important that the words.  What is anger?  Anger is frustration relating to misunderstanding.  The misunderstanding of intent, of worth, of need, of action...this is the gulf between the world and both our perception of it and it's perception of us and our mind's perception of itself can be included in this description.  Anger, much like emotional pain can eaisly be dispelled by not affecting out environment, but by affecting our reaction to our environment.

When the student Monk finally realizes that all things are One. That all things are themselves and everything else at once, then the sound of "one hand clapping" changes from literal to figurative.  The sound of one hand clapping is the sound of the wind in the trees.  It is the patter of rain drops on a window.  It is the smile of a baby.  The scream of a woman being raped.  It is the smell of diarrhea.  It is all things.

The notion of Quantum suicide and quantum immortality are flip sides of the same coin.  Our protagonist sits tremulously holding the barrel of a handgun in his mouth, pulls the trigger and hears a click.  Now the general theory of quantum suicide describes a more or less direct link from the random acts of a quantum particle to the macroscopic world.  But this arbitrary connection is not necessary.  You see due to probability, all things will occur at some point.  There is no process in the world that has a 0% or a 100% probability of occurring.  Thusly, even with a loaded gun in the protagonists mouth, there is still a small probability that the bullet will be a dud.  With this the quantum suicide becomes possible.  Say there is a 0.0001% chance that the bullet currently chambered in this gun is a dud.  He pulls the trigger. Well, the universe then fractures into at least 2 universes.  No matter how small the chance this possibility is realized in at least one world.  In this world he simply hears a click.  Pulling the hammer back once more, he fires.....another click, yet another universe.... over and over again most versions of him die, leaving a relative few to go onward.....Quantum immortality.

In my Pants

There's so much to say about the state of the world, everyone's got an opinion. Now with the WEB we can hear every one of them. How to filter out the noise? How about growing a fuckin' brain? With upcoming generations being spoonfed information via the internet, with no thought to it's truth or accuracy. Online postings saying "look at me, I'm important...I'm special" It's no wonder in a world that promulgates anonymity that we should overcompensate by creating a virtual wellspring of self esteem. A wellspring that springs from nothing...from fantasy. From seeing throngs of people who are famous for being famous. It's past from our parents to to their children. From Society to Paris Hilton. We've become a flabby, souless country. Actually, we're not alone...this cancer has spread to every burgeoning culture on the planet, the more nacent the faster it grows..unchecked by humility or responsibility. Look at Japan, it was a box of bone dry tinder that came to close to our flame. They set aside a rich history of honor and accountability for the easy road. And it happened FAST. Look at the Native American cultures of our nation. Empty shadows of a once proud people. Now rotting from inside from a disease to which they had no immunity. Decadence. A grim metaphor to the blanket ridden w/ Small pox given to them by our government, they succumb to the diseases of gambling, alcoholism, money grubbing through top heavy reservation casinos, feeding off their own flesh. Left in the wake is a desperate people longing for the days of quiet solitude and reverance to an Earth that gave up a bountiful offering and asked for only one thing...restraint.

KING o' the Jungle 

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Melding

This country is melding again. We are the melting pot, of course, but ironically we, who have already melted, are quite reluctant to permit current generations of immigrants from doing the same. In other words: we want what we've got and do not want to share it with anyone else. The percentage of spanish speaking Americans is skyrocketing. Do we feel that they will politically and economically push us aside as we did the Native American upon our arrival here? They just may do it. The influx of Asian American to loosely bordered countries like Canada is also burgeoning. As the world's economy starts to depolarize, as it must, or at least shift in polarity; we will see countries and the citizens of those countries begin to spread over the globe and with it the end of the status quo. It simply is the way of things. No empire lives forever. Not even the United States.