Pre-Advent Meditation

This past weekend was lived without the benefit of the internet.



Sorry, Al Gore.



Having my two year old daughter read a book to ME was far more enjoyable than the best article on the web.



I read an article in First Things, which I shall try to link here(well, part of the article - you have to subscribe to read the whole thing). The author, Joseph Bottum, discusses how the secular holidays have overtaken the Holy Days that are near them. There is no better example of this than Christmas, and here in Dallas Christmas music has been playing nonstop on one radio station since November 1st.



Mr. Bottum makes the argument that all of this hoopla takes all the enjoyment out of the actual celebration. For too many people, by the time Christmas arrives, they are ready for it to be over. These are likely the ones who have their Christmas tree down at the end of the driveway on the night of December 25. Unfortunately we Catholics run the risk of getting tired of Christmas even before it has started.



So I propose that this Advent I will try to keep Advent faithfully, in order to try to create some of that longing for Christ our Savior in my heart - the kind that is expressed in the readings at Mass and in the Liturgy of the Hours. Advent is time to feel the longing that the Prophets had, and that we have lost by taking Our Savior for granted.



Practically speaking this means that Scorpion Stalking Duck will refrain from those frivolous videos which I loved so much. Instead, I shall try to publish serious spiritual pieces.



But don't hold your breath....

Happy Thanksgiving!

We are busy preparing for our Thanksgiving feast tomorrow. Rather than Tur-Duc-Hen, we thought we'd try this delicious bird. Note that Cookie Monster religiously follows his diet.

Giant Scorpion - Prehistoric proof

Here is an article on a large scorpion which could have easily taken out a duck:

http://www.msnbc.msn.com/id/21906979/from/ET/

Advertisment Timeout

Here is an advertisement from a hospital where I once had privileges:

Bloggian Hiatus

Life has been too busy for blogging. I have not had a weekend off since October - getting called in if not already in-house - and no vacation since May. I wouldn't consider two days off to care for my wife after the miscarriage to be a vacation.

But enough whining.

Recently Wifeofdadwithnoisykids went to see a movie which looks at the life of one of the more famous science fiction/horror movie actors. Apparently, this man was friends with a woman who was contemplating abortion after getting pregnant. This actor(who was not the father of the child) entreated her to let the child live, and he promised to raise the child as his own. This is how the story goes, and he ends up caring for the child; the mother makes occasional visits, but the real story is about the relationship between the actor and the child. The actor's name was Bela Lugosi, and the movie is called 'Bela.'

If you get a chance to see it, I encourage you to do so.

Now back to the salt mines....

Blackberry Test

This a test.

Day Number 2

Today we begin day number 2 without the Aardvark.

November Victor Delta, better known as the Aardvark, started making funny squeaking sounds on Saturday night as I took the kids to a youth group meeting.

Being far more knowledgable about cars, my children assured me it was nothing. I did not think so; in fact, I got the feeling it was going to be an expensive squeak.

For now, I get to drive the nicer, newer car to work.

Yesterday was my older brother's birthday. He is a diocesan priest over on the East coast. He truly is living a life of the person of Christ, as he has suffered for his parish. He has been beaten, robbed at knifepoint, and had other sorrows given to him, yet he keeps up his work. God bless you, big brother!

Pray for him and all priests and religious, that they may remain faithful to their vows and stay close to Our Lord.

Blogging has been limited due to a very busy schedule. On top of all that is going on in the Noisykid household, I went and bought a BLACKBERRY! I am trying to learn how to use it, and I have to edit the 57 pages of contacts that were on the old PDA/Cell phone.

Happy Veteran's Day

I am a veteran myself, and I thank God for the opportunities which opened up to me by my time in the United States Air Force. Today I used those skills by working most of the day at the hospital.

I cannot complain, considering the many veterans who are not here to enjoy life on earth.

Thank God for all those who gave their lives for our freedom.

I am reminded of a quote from Richard Adams' book Watership Down, where the sacrifices of our elders, specifically in time of war, are quickly forgotten. It is too late for me to look it up.

Perhaps tomorrow.

(formerly Major) Dadwithnoisykids

#451: Pope St. Leo the Great

Today we consider the wonderful saint, Pope St. Leo the Great, whose feast day is tomorrow, November 10. Pope St. Leo accomplished many things in his life, thanks to the Grace of God, but I did not start this blog to talk about that. Instead I want to tell you about the contribution this man, this saint, made to the fashion world.

You see, at one time it was customary to adorn one's hat or helmet with various decorations which were unique to the wearer. In the case of Atilla the Hun, he loved to wear a rubber chicken on his helmet. He even went so far as to demand that all of his conquests had to wear one as well.

This all ended when Atilla the Hun met Pope St. Leo outside the gates of Rome. Not only did St. Leo dissuade him from attacking the city, but he also reprimanded Atilla for wearing a rubber chicken. Below is a picture of the historic meeting and St. Leo's scolding:



Here is a detail of Atilla's headdress, proving that rubber chickens were in use even in the 500's:



Thanks to Pope St. Leo, rubber chickens never caught on in the fashion world; otherwise I may have had a hat like this one:



Fashion is multi-species, so the following pictures show what might have happened if rubber chickens became popular:











Thank you, Pope St. Leo!

Pope St. Leo the Great, PRAY FOR US!

Post #450: Blackberries, Anyone?

Treo 270
Treo 300
Visor Edge, with cover on left.
Treo 600 and 650 - not sure which is which. I think the 650 is on the right.

Looking over my career as a Geek, I have always had an electronic organizer at my side.

From the 32K Casio Organizer(which is the same size as my PDA with a 1G memory card in it) as an intern.

Then there was something by Sharp, which had a screaming 256K of memory.

Then there was the thing I found in the Air Force Base Exchange, which had 2MB of memory. It also had the original mobile Word and Excel functions which were not really compatible with the computer version. It could only synchronize with one computer - a tremendous example of fidelity in this world gone mad.

The screen did not survive a textbook falling on it as I worked in my office one night on call.

I got a Palm Something, with 8 MB of memory. I learned graffitti.

I got a bigger Palm, and gave my oldest brother the old one. Wifeofdadwithnoisykids realized there was a trend here but could not work out an intervention.

I switched to Handspring and got a Visor Edge. This has to be my favorite PDA of all. Aluminum case. It looked more like a cigarette case. "Cigarette, Mr. Dadwithnoisykids?" Histor the Wise is using it right now.

One day as I drove along, juggling a cell phone in one hand and the Edge in the other, trying to order pizza for pickup, I realized I had a problem. I needed to integrate my PDA with my cell phone.

Our babysitter, who was in the passenger seat at the time, realized I had a problem, too.

"Look out for that concrete post!"

She never rode in a car with me again, even after I got the Handspring Treo 270.

Big.

Clunky.

The company which serviced the 270 didn't cover us out in the boondocks south of Dallas.

The Treo 300 followed.

Then came the Treo 600.

Then came the Treo 650.

Wifeofdadwithnoisykids was still concerned, but knew that the business would allow a new PDA every other year.

I was enabled.

Then one day I noticed that there was another Windows based PDA which seemed to be taking over the palm-based operating system.

I got the XV-6700, which looks more like a vanilla ice cream bar. A QWERTY keyboard slides out to the side, and it has internet access. Now I could get onto websites and look at postage sized pictures of things going on.

Better yet, I could take pictures of things and upload them to my blog. I was never out of touch with my people.

Then, over the weekend, I spent too much time at a cell phone store, waiting for the children's cell phone to get replaced. I noticed that all cell phones have in effect become more than just cell phones. Nowadays all the phones have music and video options; in short, they have ceased to be tools and are instead entertainment centers that fit in your pocket(or purse). I was disappointed, knowing that one day my vanilla ice cream sandwich would melt, or dive into a toilet, and I would need to replace it.

Then I started looking at those really dorky Blackberries....

A Look at Current Medical Issues:

Imagine if you shot your dog, intending to kill it, and it did not die. Then imagine that when it lived you celebrated its life - ignoring the fact that you tried to shoot it.

Forget about imagining. Forget about dogs:

Here is the link, but I recommend reading the story below instead - too many distractions for men on the sidebar:



We're twinseparable! Happy with his brother, the boy who refused to die
By LUCY LAING

They say twins share a strong bond - but the one between Gabriel and Ieuan Jones was unbreakable. NOTE: GABRIEL IS ON THE RIGHT IN THE PICTURE ABOVE.

When doctors found that Gabriel was weaker than his brother, with an enlarged heart,and believed he was going to die in the womb, his mother Rebecca Jones had to make a heartbreaking decision.

Doctors told her his death could cause his twin brother to die too before they were born, and that it would be better to end Gabriel's suffering sooner rather than later.

Mrs Jones decided to let doctors operate to terminate Gabriel's life.

Firstly they tried to sever his umbilical cord to cut off his blood supply, but the cord was too strong.

They then cut Mrs Jones's placenta in half so that when Gabriel died, it would not affect his twin brother.

But after the operation which was meant to end his life, tiny Gabriel had other ideas.

Although he weighed less than a pound, he put up such a fight for survival that doctors called him Rocky.

Astonishingly, he managed to carry on living in his mother's womb for another five weeks - until the babies were delivered by caesarean section.

Now he and Ieuan are back at home in Stoke - and are so close they are always holding each other's hand.

Mrs Jones, 35, a financial adviser whose husband Mark, 36, is a car salesman, said: "It really is a miracle. Doctors carried out an operation to let Gabriel die - yet he hung on.

"It was unbelievable."

"When I felt him kicking madly the morning after the operation, I suddenly knew that he was going to hang on.

"The doctors couldn't believe it when they could still hear his heartbeat the next morning."

Rebecca Jones: 'It's a miracle'

Mrs Jones learned she was expecting twins when she was ten weeks pregnant. She said: "When they told us we were over the moon."

But at her 20-week scan, doctors had some devastating news. One of the boys was half the size of his brother.

They didn't know what was causing it, but somehow he wasn't getting enough nutrients.

Then doctors said his heart was three times normal size and it was likely he would have a heart attack or a stroke in the womb.

Mrs Jones said: "They told us that if he died, it could be life threatening for his brother.

"We had to decide whether to end his life and let his brother live, or risk them both."

They said it would be impossible to keep him alive afterwards as he was so poorly.

It would be kinder to let him die in the womb with his brother by his side than to die alone after being born.

"That made my mind up for me. I wanted the best thing for him."

At Birmingham Women's Hospital, when Mrs Jones was 25 weeks pregnant, doctors tried to sever Gabriel's umbilical cord to cut off his blood supply and allow him to die.

But the cord was too thick, and they could not cut through it.

As a last resort they divided Mrs Jones's placenta so that when Gabriel died, it would allow Ieuan to survive. Mrs Jones said: "I put my hands on my stomach thinking of Gabriel. It was devastating. I had said my goodbyes."

But the next morning Mrs Jones felt Gabriel kicking. A scan showed his heart was still beating. She said: "No one could quite believe it."

Gabriel hung on, and his enlarged heart started to reduce in size. He also gained weight.

Mrs Jones said: "They thought it may be because the placenta had been divided. Inadvertently, it had evened out the distribution of nutrition between them, allowing Gabriel to survive.'

When Mrs Jones reached 31 weeks doctors carried out a caesarian to deliver the twins. Ieuan weighed 3lb 8oz and Gabriel 1lb 15oz. Both were kept in hospital, but since going home they have thrived. At seven months, Ieuan weighs 15lb and Gabriel 12lb 6oz.

Mrs Jones said: "The boys are so healthy, they have huge appetites too. Ieuan is the noisy one, while Gabriel is always laughing, it's like he's just so happy to be here.

"There is such a strong bond between them.

"They are always holding hands and if one cries, the other reaches out to comfort him."

"Doctors tried to break their bond in the womb, but they just proved it couldn't be broken."

Commentary: It appears as if the parent is downplaying the fact that she wanted her infant killed. Dying in the womb next to one's twin or after birth results in the same thing: a dead baby. Perhaps they regret what they have done, but the article does not give any indication of this.

This was probably a case of twin-twin transfusion, where one baby was acting as the 'pump' for both of them. It seems as if this could be used as a means to treat twin-twin transfusions.

Since I seem to be on a medical journal rant at present, read this article which demonstrates how evidence based medicine does not work in some cases. In this case, the study was about parachutes:

HERE IS THE LINK. This sidebar is less distracting for men.

Here is the article:

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

Gordon C S Smith, professor1, Jill P Pell, consultant2

1 Department of Obstetrics and Gynaecology, Cambridge University, Cambridge CB2 2QQ, 2 Department of Public Health, Greater Glasgow NHS Board, Glasgow G3 8YU
Correspondence to: G C S Smith gcss2@cam.ac.uk


Abstract

Objectives: To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

Design: Systematic review of randomised controlled trials.

Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.

Study selection: Studies showing the effects of using a parachute during free fall.

Main outcome measure: Death or major trauma, defined as an injury severity score > 15.

Results: We were unable to identify any randomised controlled trials of parachute intervention.

Conclusions: As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

Introduction

The parachute is used in recreational, voluntary sector, and military settings to reduce the risk of orthopaedic, head, and soft tissue injury after gravitational challenge, typically in the context of jumping from an aircraft. The perception that parachutes are a successful intervention is based largely on anecdotal evidence. Observational data have shown that their use is associated with morbidity and mortality, due to both failure of the intervention1 2 and iatrogenic complications.3 In addition, "natural history" studies of free fall indicate that failure to take or deploy a parachute does not inevitably result in an adverse outcome.4 We therefore undertook a systematic review of randomised controlled trials of parachutes.

Methods

Literature search: We conducted the review in accordance with the QUOROM (quality of reporting of meta-analyses) guidelines.5 We searched for randomised controlled trials of parachute use on Medline, Web of Science, Embase, the Cochrane Library, appropriate internet sites, and citation lists. Search words employed were "parachute" and "trial." We imposed no language restriction and included any studies that entailed jumping from a height greater than 100 metres. The accepted intervention was a fabric device, secured by strings to a harness worn by the participant and released (either automatically or manually) during free fall with the purpose of limiting the rate of descent. We excluded studies that had no control group.

Definition of outcomes: The major outcomes studied were death or major trauma, defined as an injury severity score greater than 15.6

Meta-analysis: Our statistical apprach was to assess outcomes in parachute and control groups by odds ratios and quantified the precision of estimates by 95% confidence intervals. We chose the Mantel-Haenszel test to assess heterogeneity, and sensitivity and subgroup analyses and fixed effects weighted regression techniques to explore causes of heterogeneity. We selected a funnel plot to assess publication bias visually and Egger's and Begg's tests to test it quantitatively. Stata software, version 7.0, was the tool for all statistical analyses.

Results

Our search strategy did not find any randomised controlled trials of the parachute.

Discussion

Evidence based pride and observational prejudiceIt is a truth universally acknowledged that a medical intervention justified by observational data must be in want of verification through a randomised controlled trial. Observational studies have been tainted by accusations of data dredging, confounding, and bias.7 For example, observational studies showed lower rates of ischaemic heart disease among women using hormone replacement therapy, and these data were interpreted as advocating hormone replacement for healthy women, women with established ischaemic heart disease, and women with risk factors for ischaemic heart disease.8 However, randomised controlled trials showed that hormone replacement therapy actually increased the risk of ischaemic heart disease,9 indicating that the apparent protective effects seen in observational studies were due to bias. Cases such as this one show that medical interventions based solely on observational data should be carefully scrutinised, and the parachute is no exception.

Natural history of gravitational challenge: The effectiveness of an intervention has to be judged relative to non-intervention. Understanding the natural history of free fall is therefore imperative. If failure to use a parachute were associated with 100% mortality then any survival associated with its use might be considered evidence of effectiveness. However, an adverse outcome after free fall is by no means inevitable. Survival has been reported after gravitation challenges of more than 10 000 metres (33 000 feet).4 In addition, the use of parachutes is itself associated with morbidity and mortality.1-3 10 This is in part due to failure of the intervention. However, as with all interventions, parachutes are also associated with iatrogenic complications.3 Therefore, studies are required to calculate the balance of risks and benefits of parachute use.

The parachute and the healthy cohort effect: One of the major weaknesses of observational data is the possibility of bias, including selection bias and reporting bias, which can be obviated largely by using randomised controlled trials. The relevance to parachute use is that individuals jumping from aircraft without the help of a parachute are likely to have a high prevalence of pre-existing psychiatric morbidity. Individuals who use parachutes are likely to have less psychiatric morbidity and may also differ in key demographic factors, such as income and cigarette use. It follows, therefore, that the apparent protective effect of parachutes may be merely an example of the "healthy cohort" effect. Observational studies typically use multivariate analytical approaches, using maximum likelihood based modelling methods to try to adjust estimates of relative risk for these biases. Distasteful as these statistical adjustments are for the cognoscenti of evidence based medicine, no such analyses exist for assessing the presumed effects of the parachute.

The medicalisation of free fall: It is often said that doctors are interfering monsters obsessed with disease and power, who will not be satisfied until they control every aspect of our lives (Journal of Social Science, pick a volume). It might be argued that the pressure exerted on individuals to use parachutes is yet another example of a natural, life enhancing experience being turned into a situation of fear and dependency. The widespread use of the parachute may just be another example of doctors' obsession with disease prevention and their misplaced belief in unproved technology to provide effective protection against occasional adverse events.

What is already known about this topic

1. Parachutes are widely used to prevent death and major injury after gravitational challenge

2. Parachute use is associated with adverse effects due to failure of the intervention and iatrogenic injury

3. Studies of free fall do not show 100% mortality

What this study adds

1. No randomised controlled trials of parachute use have been undertaken

2. The basis for parachute use is purely observational, and its apparent efficacy could potentially be explained by a "healthy cohort" effect

3. Individuals who insist that all interventions need to be validated by a randomised controlled trial need to come down to earth with a bump

Parachutes and the military industrial complex: However sinister doctors may be, there are powers at large that are even more evil. The parachute industry has earned billions of dollars for vast multinational corporations whose profits depend on belief in the efficacy of their product. One would hardly expect these vast commercial concerns to have the bravery to test their product in the setting of a randomised controlled trial. Moreover, industry sponsored trials are more likely to conclude in favour of their commercial product,11 and it is unclear whether the results of such industry sponsored trials are reliable.

A call to (broken) arms: Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.

Contributors: GCSS had the original idea. JPP tried to talk him out of it. JPP did the first literature search but GCSS lost it. GCSS drafted the manuscript but JPP deleted all the best jokes. GCSS is the guarantor, and JPP says it serves him right.

Funding: None.

Competing interests: None declared.

Ethical approval: Not required.

References

Belmont PJ Jr, Taylor KF, Mason KT, Shawen SB, Polly DW Jr, Klemme WR. Incidence, epidemiology, and occupational outcomes of thoracolumbar fractures among US Army aviators. J Trauma 2001;50: 855-61.[ISI][Medline]

Bricknell MC, Craig SC. Military parachuting injuries: a literature review. Occup Med (Lond) 1999;49: 17-26.

Lasczkowski G, Hasenfuss S, Verhoff M, Weiler G. An unusual airplane crash—deadly life saver. Unintentional activation of an automated reserve opening device causing airplane accident. Forensic Sci Int 2002;125: 250-3.[CrossRef][ISI][Medline]

Highest fall survived without a parachute. In: Cunningham A. Guinness world records 2002. London: Guinness World Records, 2002.

Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF, for the QUOROM Group. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Lancet 1999;354: 1896-1900.[CrossRef][ISI][Medline]

Lossius HM, Langhelle A, Reide E, Pillgram-Larsen J, Lossius TA, Laake P, et al. Reporting data following major trauma and analysing factors associated with outcome using the new Utstein style recommendations. Resuscitation 2001;50: 263-72.[CrossRef][ISI][Medline]

Davey Smith G, Ebrahim S. Data dredging, bias, or confounding. BMJ 2002;325: 1437-8.[Free Full Text]

Pines A, Mijatovic V, van der Mooren MJ, Kenemans P. Hormone replacement therapy and cardioprotection: basic concepts and clinical considerations. Eur J Obstet Gynecol Reprod Biol 1997;71: 193-7.[CrossRef][ISI][Medline]

Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288: 321-33.[Abstract/Free Full Text]

Lee CT, Williams P, Hadden WA. Parachuting for charity: is it worth the money? A 5-year audit of parachute injuries in Tayside and the cost to the NHS. Injury 1999;30: 283-7.[CrossRef][ISI][Medline]

Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 2003;326: 1167-70.[Abstract/Free Full Text]

Midnight Prayers

It seems ironic that
serving those I love
means separation
for long stretches.
As if my pledge
willingly exiled me
from the one
I could not live without.

Such thoughts occur,
waking from dreams of
engine failures and
screaming passengers.

Gazing at her in sleep
I realize how little I pray
for the one who holds
my heart in her hands.
She needs God's grace
for heroic virtue
is required just to
live with such a man

Never mind caring
for children who reflect
some of his goodness
and features.

So I silently pray
for my precious love
not that she improve
- I don' see how -
but that she continue
to love this often absent
but always imperfect
husband and father.

And loving our children
the greatest blessing
of the union of our hearts
and lives.

In the light of day
far from her side
too busy to call
I pray for her again
that she receive
graces she needs
and one thing she wants
is one more soul

To love and cherish
another child who reflects
some of my goodness
and features.

SMD
11.04.2007

Insomnia

There is a special type of suffering that I experience when I am post-call.

After working until 2 in the morning, and being woken up at 6:45 by my relief, I walked out to my car.

I left all the windows open and searched for some snappy music on the radio.

At that moment every radio station in Dallas started playing nothing but Neil Diamond and Barry Manilow.

Neil.

Barry.

Neil.

Barry.

UB-40 singing songs of Neil Diamond.

Barry.

I had to slap myself to keep on the road.

If only they had played this song, my favorite Neil Diamond song:




Dig that hair.

No polyesters were killed to make this video.

This would have gotten me going, too: