2025- freedom*

Today is the 4th of July and our nation’s independence day.

The asterisk? Well, let’s talk about it.

According to Merriam-Webster Dictionary, the asterisk is used as an indication of the omission of letters or words.

Independence through resolution in three parts: separation from the British Crown, a call to form foreign alliances, and a plan for confederation. Seems simple enough.

This means that we were separating from England and all that entailed, looking for friends that were not England, and grouping together. This grouping of people is also known as a confederacy.

No, not that one. The original one.

At the time the new country was a group of people who wanted to leave British rule and strike out on their own. With their own laws and their own ways of doing things. Where no king could wave his fat white hand and make nonsense rules for everyone.

Sound familiar? America just had a multi-million people nationwide protest on June 7, 2025 about it.

At the time to be a voting member of this new society you had to be a land owner, white, and male.

And that was it.

Women need not apply.

Slaves that were forcibly brought here from Africa and sold to these men need not apply.

Men who did not own property need not apply.

In the nearly two hundred and seventy five year history, these marginalized groups have fought and bled and died to be seen as a citizen. As a voter.

Strides were made. And the rich white men were not happy about it.

White men who were not property owners were granted the right to vote in 1787.

Slaves earned their ability not to be owned by another human with the 1863 Emancipation Proclamation.

Black men earned the right to vote in 1870.

Women earned the right to vote in 1920.

Poll taxes that were just racism by another name were abolished in 1964. As was segregation.

America has a checkered past and those of us who were not thought of or dismissed as not a person in the original documents has fought for every single step along the way.

And those who don’t think women are people or black people are people or native Americans are people have fought tooth and nail to maintain their grip on control.

Inch by inch, legislation by legislation, the rights that were bled for and wept over and fought for are being taken away by rich old white men who remember the “good old days”. When non white people were property of the whites and women were kept under their husband’s thumb.

That is the meaning of the asterisk in today’s post title.

Freedom for old rich white male property owners.

Crickets for everyone else.

Cookie Thursday 7/3/25- Devil’s food cake mix with Andes mint chips

Last week it was too hot to cook.

This week I was going to make red velvet cake with chips made out of frozen frosting. Well, I have the frosting chips made and in the freezer.

But I put the red velvet cake mix somewhere safe.

I have no idea where I put it.

I made Devil’s Food cake mix cookies with Andes mint chips instead.

And if that isn’t an analogy for our current political shitstorm I don’t know what is.

The red velvet cake mix cookies with white frozen frosting chips was supposed to be patriotic.

Instead I made a deal with the devil. Not unlike more than 50% of our elected representatives and senators.

Can’t be witty right now, I am too mad.

I think I’m going to go kill a lot of the undead monsters in the computer game.

North Carolina is going Surgical Smoke FREE

dun-dun-DUN–dun-dun-DUNan–dun-dun-DUN-dun dun

This is the opening guitar riff of Smoke on the Water by Deep Purple. Go to YouTube and check me. You know that I am right.

It was 8 years ago that I recognized that other people, often with less years in the OR, would react to the shall we say unsightly odors of some surgeries. Smells would hit me later in a case than others. A surgeon and a tech would react to the smell of an appendix or open abdomen and it wasn’t until it was closer to me such as when I was collecting the specimen that the smell would make it to my scent receptors, and I would become aware of what they were talking about.

This was a very gradual awareness, brought on by what I assumed was a very gradual over- exposure to the bovie smoke.

Let’s talk about the effects of surgical smoke. It has been compared to smoking 30 unfiltered cigarettes per day. Surgical smoke also contains arsenic, smoke particles, people particles (live tissue fragments), e-coli, SARS-Cov-2 (aka covid), toxic gases, benzene and hydrogen cyanide. It can cause a decreased sense of smell, asthma, allergies, chronic bronchitis, chronic sore throat, and even chronic lung diseases.

Forthwith I became aware that my sense of smell had been altered by 23 years in the operating room. Many of those years were in heavy surgical smoke plume cases- total joints, plastic surgery, and open abdomens.

Surgical smoke is created by use of an electro-cautery device, most often a bovie. This piece of electrical cautery equipment was named after the Dr. William T. Bovie who developed the electrical cautery machine in 1926. This was used to stem the bleeding cause by incisions and surgery.

In 2018, Rhode Island became the first state to enact legislation to ensure that all hospitals and free-standing ambulatory centers used a smoke evacuator in the OR. Many other states joined them- Arizona, Colorado, Connecticut, California, Georgia, Illinois, Kentucky, Louisiana, Missouri, New Jersey, New York, Ohio, Oregon, Minnesota, West Virginia, and Washington.

AND NORTH CAROLINA!!!

We make the 19th state that has elected to protect their nurses, scrub techs, surgeons, and patients.

Smoke free is a misnomer. It is a short hand way of saying that the surgical smoke plume is contained at the site of surgery with smoke evacuation.

However, Governor Josh Stein just signed it into law. To go into effect January 1, 2026.

The hospital system I work for started mandating surgical smoke evacuation during covid. Because, as you may have noticed above, covid is carried by surgical smoke.

Did I write this legislation? No.

However, I have written, and spoke to surgeons, and written legislators, and called legislators, and signed petitions. Basically, we kept up pressure. I even used surgical smoke legislation in the Health Care Policy and Ethics class that I took fall semester 2023. This was when the NC legislature was waffling about it. I did presentations and wrote papers about the dangers of surgical smoke and the importance of going smoke free. I shared the papers and presentations with anyone who asked.

I needed this win today.

Oh, happy day!

Tuesday Top of Mind 7/1/25- Congratulations, senate! You have invented a new kind of stupid!

The song Congratulations from Hamilton begins with Angelica yelling at Alexander “Congratulations, you have invented a new kind of stupid. A damage that you can never undo kind of stupid.”

I was on tenterhooks all weekend. Waiting out the inevitable.

So this terrible bill has been top of mind all weekend. Which is exhausting.

You know, when exactly 50 of our senators bent over and took it. And said “Thank you, daddy, might I have another.”

A gross analogy but these are gross times.

This is when fifty of our senators did the unthinkable and consigned their constituents to the wolves.

Yes, some of them held their noses and voted.

Yes, three senators crossed the aisle and voted against the big ugly bill. Albeit for different reasons.

Rand Paul of Kentucky opposed the bill because it will add TRILLIONS to the deficit. And that was just a bridge too far. Not because of all the women and children and disabled people who will be tossed off the Medicaid roles. No. Because of money.

Thom Tillis of North Carolina (troll that he is) found at least one of his balls and voted against the bill. Because he knows what we all know, that many North Carolinians are in danger because of this passage.

Susan Collins of Maine also knows what we all know, that many of her Maine constituents will be in danger after the Medicaid cuts go fully into effect in 2026.

They are counting on us to forget this travesty.

You know who won’t forget they sold us down the river? Alaskans.

Lisa Murkowski played a will she or won’t she game all weekend. But in the end she voted for it after she secured some carve outs for Alaskans. The carve outs were then rebuked and removed by the Parliamentarian. So she got little for her trouble.

This ugly monstrosity of a bill now goes back the House of Representatives.

Man those phones and call your representative now.

Call them tomorrow.

Call them the day after.

Get your parents to call. Get your siblings to call.

CALL them incessantly.

Mail them congratulations cards.

Congratulations on being cowards.

Remind them that they serve at our pleasure. Well, in North Carolina, they serve at the pleasure of the gerrymandered districts and the lopsided government that the state legislature willed into being. But that is a post for another day.

There will be more coming but I have to end with f’in cowards, the lot of them.

Post-script- I heard back from the other North Carolina senator. Did I call him a coward in my email message? You bet I did.

School Me Saturday 6/28/25- Students and AI- Part 1

ChatGPT was set forth unto the world like a biblical plague on November 30, 2022.

I was just finishing my first semester of the PhD program when our statistics professor announced it to the class. They said that AI was going to be a big thing for, well, the world. There was not going to be anything that AI couldn’t touch. These programs had the ability to analyze reams and reams of data in a blink.

Less than 3 years later we know better.

Yes, AI is capable of doing amazing things and has vastly sped up the analysis of critical data.

If you know the correct prompt. Or the proper way to word your request.

When it isn’t hallucinating citations and facts that aren’t there.

The pro-AI people say well, that’s because it wasn’t trained well enough. I say that if you put crap in, you get crap out.

My statistics professor also cautioned using the new programs for schoolwork.

Don’t forget, it was released just in time for finals.

Colleges and universities had to scramble to put in rules and explanations of the rules. Some AI is encouraged at some places for some papers for some classes. Some instructors have embraced it and are teaching students about it. Some instructors have not.

It is very confusing.

For me personally, I have only used an AI engine when it was an assignment. I want to be responsible for all that I write, incorrect or not. After all, I was able to survive all of my primary and secondary education without online search. In 1993, Creighton had just put all of their books into a computerized card catalog. I didn’t write my first paper using facts from the internet until 2015.

Now Google is a verb and AI slop is everywhere. AI slop refers to low quality media, including low quality writing and low quality images. Kind of like AI hallucinating things.

Yes, I am older than Google. Hell, I am older than the internet. What a time to be a student! The rules are made up anyway.

One thing that is a bit comforting is that AI is not subject to copy right. Because a copy right means that it was human made and AI is not human.

No Cookie Thursday 6/26/25- It’s too hot to bake

No cookies were baked this week.

The temperature and humidity combination were too great a hill. I am officially declaring today a baker’s holiday.

Also the fact that I worked until 0430 this morning. Then the cat couldn’t open the bedroom door herself at 0800 and she sat and cried outside the door until I got up and let her in to the bedroom. My husband felt this was a mistake but she settled down happily and slept with us until I woke up at 1000.

But it is true, I haven’t turned on the oven all week. Or the stove.

It has been a very leftover week for the microwave.

Or a nosh week with cheese and crackers.

Heck, I even ate a spoonful of peanut butter and called it dinner.

By the time the storm rolled in at 1700 it was too late to bake.

That just means that the planned cookie of the week, the red velvet cake mix cookie, will have to be postponed until July 3rd.

It is more patriotic that way.

I wonder if I should tint my planned icing blue.

So I can make a red white and blue pun.

Maybe not.

This is your reminder that it is probably time to renew your nursing license or at least work on the continuing education units

I renewed my North Carolina nursing license yesterday.

North Carolina, like most other states, has a 2 year limit on their nursing license.

In North Carolina, there are many options for proving you’re still registerable. The requirement I chose is 640 hours as a working nurse. This translates to roughly 16 weeks of full time 40 hours per week nursing work. Which is roughly 4 months out of 24 months. To choose this option, you also have to do 15 hours of CEUs.

These requirements must have been fulfilled in the 2 years window.

Additional options include

national certification by a credentialing body recognized by the board of nursing
30 hours of CEU
completion of a refresher course approved by the board of nursing
completion of a minimum of 2 semester hours of post-licensure education. This is your MSN and BSN bridge and DNP and PhD programs
15 CEUS and completions of a nursing project as the Principal Investigator for a nursing problem
15 CEUs and authoring an article, paper, book
15 CEUs and developing and doing a nursing CEU presentation of at least 5 contact hours

Of course I am an over achiever and have completed 6 of the 7 options. The only thing that I haven’t done is the refresher course.

What can I say? I am passionate about being a nurse.

The hospital systems do a good job of keeping you on task for renewing your nursing license. But pull it out and check it anyway.

Mistakes do happen.

But, Kate, what happens if my nursing license has expired?

This is a big bad.

Like really bad.

Like being charged with assault bad. The reason of the assault charge is that you are not licensed, therefore you are practicing nursing without legal protections. Both for you and your patient.

There is a reason it is called Fitness to Practice and the entire reason behind the two year cycle.

It is up to you to keep current on education, hence the CEUS. No one wants a nurse who isn’t aware of the newest things that affect patients. Remember 2020? I do.

So check the expiration date of your nursing license.

But if you have questions about how to find free CEUs, I have loads of options for you.

Tuesday Top of Mind 6/24/25- Rest in peace, Adriana Smith

In midst of yet another insane week, news of the taking the baby from its mother’s brain dead corpse June 18, 2025 was paraded through all the news media. Yes, technically this was a cesarean birth. In the broadest of broadest senses. A baby was born of a body. Yes, the body just happened to have a dead brain that was very much not directing all the minutiae that goes into balancing the pregnant body.

Doctors were directing that instead. This kind of balancing act of a body that is no longer being directed by a brain but also pregnant is abhorrent.

They had hoped to keep the uterus pregnant until over 30 weeks but they were unable to keep the pregnancy going after 24 weeks and a few days. Because, you know, the brain was dead and not directing anything.

This was not a medical miracle.

This was medical horror.

The result is a 1 pound 12 oz baby that was excised from their brain dead mother. Probably taken straight to the NICU.

This was the mad scientists in the Georgia state legislature who masquerade as legislators who are masking as doctors throwing the dice after the fall of Roe.

This was an entirely predictable outcome to all of their women controlling laws.

A brain dead mother who is artificially kept alive for 4 months so that the infant could be delivered. They were so excited to think that they could, no legislature ever considered whether they should.

Who knows what will be the outcome? Who knows if the baby will have any deficits? Who knows the survivability chances of this perversion of healthcare and women’s rights for the baby?

But the self-satisfied, self-righteous so-called Christian right will hail this as a victory. After all a baby was saved. Saved into a world that their mother had been brain dead for four months before they were sliced out of the uterus.

And salivate over the idea of another.

You know, so that the lessons learned on this poor woman’s corpse can be expanded upon. Maybe the next baby can be incubated until 25 weeks, and so on. And on. And on. And on. Until they hit upon the magic formula to reach full gestation. No matter the cost.

How long until they “manufacture” a brain dead woman?

Emory, the hospital in question that this travesty took place has demurred, saying through a spokesperson “Emory Healthcare uses consensus from clinical experts, medical literature and legal guidance to support our providers as they make medical recommendations.”

I cannot say it louder that legal guidance has any bearing on medical recommendations. Especially in a situation such as this.

Rest in peace, Adriana Smith. They can’t torture your body anymore. Best wishes to the baby.

And sorrow for any other woman who is forced into continuing to gestate a fetus after they have been declared brain dead.

She won’t be the last.

Cry havoc and let slip the dogs of war

The title is a direct Shakespearian quote. It is a line spoken by Marc Antony in the play Julius Caesar. It is chaotic times like these that make me turn philosophical and remember that we’ve all been here before. Many, many, many times. In a call back to the June 13’s dispatch about too numerous to count. I was referring to cultures at the time but pretend war also fits.

There is a moment in Hannah Gadsby’s 2020 comic special “Douglas” when they are explaining that we don’t hold men accountable for their hormonal actions, instead society holds women accountable.

The audience claps and cheers that sentiment and they snap to the audience “It’s bait, you fucking idiots. It’s bait, leave it.”

This part of the bit is particularly genius.

It is at once acknowledging that society does women dirty by making us shoulder the entire weight of the world while at the same time cooing at the men and praising them for the fucking bare minimum. It is telling women that there is nothing wrong with how things are and if the women feel like there absolutely is, gaslighting women into toeing the line.

In the comedy special they go on “It’s not for you. Fuck. It’s not a rally.” To me this brings to mind all the political rallies that a certain president was giving, trying desperately to hold on to the job that he very much did not want, but enjoyed the special treatments that he got because of this. Also this was released in 2020, bringing that chaotic time specifically to mind.

This time with the same president is also chaotic as fuck. On purpose. Again.

The truest thing they said during the special is that “Confidence makes (Americans) stupid”.

And it truly does.

Individually we are not stupid, but collectively some of us are. Some of us know that the bombing of “nuclear” sites in Iran was bait. And some of us hang on every word that the president utters.

Why is it bait?

Well there were the dramatic “No Kings” protests on June 14th. Millions of Americans (I have heard estimates from 4 million to over 10 million) took to the streets to declare that America is not a place for Kings. No matter how the president wants to be made a king.

Making spurious and curious bombing decisions. A tanking economy that had been the envy of the world less than 6 months ago. A federal bank that won’t cut interest rates. Thousands of research projects that had the potential to save lives and relieve suffering wiped out by disastrous policies. Leaning in to the echo chamber about vaccines, regardless of them being wrong. A beyond catastrophic bill in the Senate that the House of Representatives passed only because 2 Democratic reps had died in the month before and were not yet replaced. Not to mention the tanking, and I mean tanking, approval ratings.

That same day there was a fairly disastrous military parade through the streets of the nation’s capital. Low turnout, sloppy marching, miserably huddled guest of honor.

He had to distract from last weekend somehow.

And what is the best distraction?

Millions of Americans being forthright about hating you.

What’s a president have to do to get the heat off? Bomb a sovereign county that your own intelligence head said had no nuclear bombs or capabilities.

Which is what the asshole did.

Remember this is how the then president got us into the Iraq War II. Lying about weapons of mass destruction? Where trillions of dollars were spent and thousands of American lives were lost? It feels very much like that. We were lied to then too.

Because we do.

The American public has been very outspoken about not wanting war.

We are very tired of war.

But you had to do something to change the narrative.

Too bad it was getting you out of the boiling pot and putting the rest of us in the fire.

See also Wilfred Owen’s poem “Dulce et Decorum Est”. I’ve written about this before. It is a poem about the atrocities of World War I and the agonies of the front line.

School Me Saturday 6/21/25- Bonus post- The First Department of Education

There I was, running an errand, Throughline on NPR when they started talking about creating the first department of education in the 1860s.

The title of the episode is The First Department of Education and it first ran on June 12, 2025.

The entire episode boils down to how educating people will decrease societal ills. One of the first points that I heard was education of all costs less than a jail.

Of course people who craved control were against it.

Just like today.

Quality episode, definitely worth your forty eight minute listen.