A Loaded Basketball

Written by Tad. Posted in Kooks

A 23-year-old non-English-speaking Vietnamese man came in with a scalp injury. Through an interpreter, he said he was playing basketball earlier that evening when he ran, head-on, into the basketball standard. He careened off and ran into a nearby fence, which he also hit with his head before landing on the ground.

His friends took him home, shaved the area around the cut and made a compress of tobacco, which they placed in and around the wound. They then decided he should get it checked out and brought him to the emergency department.

When his laceration was numbed and explored, a piece of metal was felt in the wound. X-rays and a CT scan showed a bullet embedded in his skull. He also had underlying brain damage. I called a neurosurgeon to take him to the operating room to repair of his injury.

When confronted with evidence that he had actually been shot, he stuck firmly to his basketball story. I noted that he didn’t exactly fit the profile of a basketball player. He was just over five feet tall and was wearing flip-flops.

Could he have been shot while playing basketball and not realize it? More likely, he was involved in some sort of shady activity that resulted in his being shot and just didn’t want anyone to know about it.

New Firehose Bags

Written by Tad. Posted in Trauma Strap Bags

It has been fun to try to think of ways to combine trauma straps with firehoses to make new bag designs. Here is what I came up with recently.

This bag accentuates that printing that is interspersed on the firehoses:

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This one is striped. It matches Shari’s shirt!

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This one is striped with blue trauma straps:

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Amish Puff Chocolate Chip Cookies

Written by Tad. Posted in Cookies

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My friend, Judd, has 80 gigabytes of digital cookbooks he has collected online. He culled from them the dozens that were cookie cookbooks and shared them with me on a thumb drive. Here is a simple but fun recipe I tried that made a different take on a chocolate chip cookie.

Recipe By:

Field Guide to Cookies

Yield:

64

Ingredients:

6 cups all-purpose flour
2 teaspoons baking powder
2 teaspoons baking soda
2 teaspoons cream of tartar
1 teaspoon salt
2 cups softened unsalted butter
2 cups light brown sugar
1 cup white sugar
4 large eggs
4 cups semi-sweet chocolate chips
1 cup sugar
2 teaspoon ground cinnamon

Directions:

1. Sift the flour, baking powder, baking soda, cream of tartar, and salt into a bowl and set aside.

2. In a stand mixer, cream butter and sugars on medium speed for several minutes until light and fluffy.

3. Add the egg and mix well.

4. Add the flour mixture and mix on low speed just until combined.

5. Add chocolate chips and mix just until they are mixed in evenly.

6. Make dough balls 1 tablespoon, roll in hands, then roll in cinnamon-sugar mixture.

7. Place on a plate, cover tightly with plastic wrap and refrigerate dough for at least 30 minutes. (See Notes)

8. Preheat the oven to 350ºF. On Silpat- or parchment paper-lined cookie sheets, place dough balls 2 inches apart.

9. Bake for 8 to 10 minutes, rotating sheets halfway through, until golden brown.

Notes:

As in most cases, I am not sold that chilling these made any difference. First, even after almost an hour, they balls were really not chilled all the way through. Also, I baked one not chilled and it seemed no different than the chilled ones. Chilling, especially after rolling them out, really makes it a lot more hassle to make these.

I was not too convinced of their “puff.”

Wasabi-Lime Lace Sandwich Cookies

Written by Tad. Posted in Uncategorized

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I recently made these cookies again and they were so good, I wanted to remind you about them and challenge you to give them a try. They sound pretty weird but they are, really, some of the best cookies I have ever made. And they are not at all hard to make.

Here is a picture of our son, Philip, and our grandson, Hunter, showing off a plate of them they made for Fathers’ Day.

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We Make a Mess

Written by Tad. Posted in Kooks

The other night, we had a serious trauma patient come in. She was eighteen-years-old and crashed her car off the freeway into a ditch. She was unconscious and severely injured. The whole team moved together to try to save her. I helped an emergency medicine resident pass a breathing tube as the surgeons put in IVs, gave her blood and stabilized her for CT scan and the ICU. I read in the paper two days later that she had passed away. This is what the floor looked like in the trauma room after she left:

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“Housekeeping to the Trauma Room” is a pretty common page heard overhead.

 

Black with Rectangular Bottom

Written by Tad. Posted in Trauma Strap Bags

I came across a rectangular sheet of relatively rigid plastic. It was just the right size to form the bottom of a bag so I used it, just as it was to reinforce the bottom of this bag. I sewed it in between two layers of black straps so the bottom is not only rectangular, which is unusual for my bags, but is also stiffer so it stands up straight.

Also, this is the first bag I have sewn since the county changed recently to black and orange rather than yellow-green straps. Since I can only use what they bring me, I now have lots of black to inspire me.

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Rape and Threats of Suicide

Written by Tad. Posted in Kooks

When a rape is reported somewhere in our county, police investigate and, if they think a forensic rape exam is indicated, the patient is brought to our emergency department for that exam. The victim is not seen by our emergency physician unless some issue comes up that the specially trained Sexual Assault Response Team (SART) nurse is not able to deal with.

Recently, while the SART nurse was doing the exam, the patient said that being raped had made her suicidal and, when she got back home, she was going to kill herself.

This information was passed to me and I went to talk with her. She was emotionally upset, as you can imagine. She admitted to saying she was going to kill herself but she had just said it because she was upset, not because she was going to follow through on the threat. She just wanted to go home.

This put me in a tough position. By law, if I think patients are suicidal, I have to place them on a psychiatric hold and get them to our psychiatric emergency room for help. If I don’t do so, I have broken the law. This also offers a challenging moral dilemma. If I sent such a person home and she did kill herself, I would certainly be at fault and would feel terrible about it.

We see people all the time who come in on a hold with clear documentation of suicidal behavior who totally deny it once they get to the emergency department. They either change their minds or they lie because they just don’t want to be on a hold. Was this patient like them or was she really just upset and misunderstood by the SART nurse? I had to decide whether to believe that she had just said something that she didn’t mean and let her go home or put her on a hold and send her to emergency psychiatry.

After talking to her for quite a while, I told her I was obliged, under law, to send her to psychiatry to get her help that would not be available if she just went home. When I told her that, she pleaded and begged to be allowed to go home. When that didn’t work, she went ballistic and started hollering and screaming that she was just going to leave.

When she went off, the staff called security. Soon, three big guys in blue uniforms were standing at the door of her room, which only made her more hysterical.

You can imagine how bad I felt. First, she is raped, which is horrible. Now, instead of the calm, understanding environment we try to provide victims of rape, we are threatening to tie her down to a gurney with leather restraints. It made me feel really bad, though I recognized I made the right decision, given the circumstances presented.

Fortunately, she quieted down and went peacefully off to talk with the psychiatrist. When she got there, she was calm and cooperative. She told the psychiatrist she felt safe and was glad she was there. She acknowledged she really needed help.

 

Trauma Strap Chimp Swing

Written by Tad. Posted in Trauma Strap Bags

Susan took trauma straps with her to a chimpanzee reserve in Gabon. She shared these pictures of baby chimps swinging on the straps. What a great use of these straps that otherwise would have ended up in the trash!

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Sincere Apology

Written by Tad. Posted in Kooks

I was just looking back at my last few posts. They are pretty sad. I decided to share this with you as it lifts my heart a bit.

This is a letter that was mailed to our department from a patient. I think it speaks for itself:

To the Emergency Room Staff of The Medical Center

My name is John Smith. I was a patient at your hospital the night of July 4th, 2008. I am writing this letter to apologize for my verbal and physical abuse to the members of the staff working that night. I have to admit that I do not remember much of what happened that night due to being extremely intoxicated. I am told that I made threats to kill and that I was spitting on staff members. I cannot capture with words how sorry I am for saying those hurtful things and spitting on people that were only trying to help me. I am extremely embarrassed about my behavior and will be paying for it for a long time to come. You guys have a hard enough job as it is and the last thing you need is some drunk kid making that job even harder. I obviously was having a problem with my drinking and it turned me into a person that I never want to be. I have a long road to recovery ahead of me. I understand that forgiveness might be out of the question for some of you, but I hope that in time you can find it in your heart to forgive me. I would never knowingly want to hurt anyone that is trying to help me and feel a great amount of shame for acting as I did. I just want to say sorry and thank you, thank you for helping somebody who needed it whether they knew it or not.

 

Copyright © 2014 Bad Tad, MD