25- It’s okay to lie to the Senate under oath, I guess. Noted.

This headline can mean so many, many things and so many, many lies. <Cough cough> Brett Cavanaugh, Amy Coney Barrett Neil Gorsuch and the settled law of Roe v Wade. <Cough cough> Michael Cohen and the plans to build a Trump tower in Moscow. <Cough cough> W. Samuel Patten and the little matter of being a foreign agent.

Man, I should really see someone about that cough.

But I will not see RFK Jr. as he is the latest one to outright lie in order to get confirmation.

He told the Senate that he would leave in place the vaccine advisory panel at DHHS. This is a board made up of outside experts on illnesses that can be mitigated by vaccines. You know, people who have been working for literal YEARS in the fight against illnesses that we have a vaccine for.

By this firing and attempting to ram in the anti vaccine zealots and toadies in their place, RFK has come out soundly against science.

Well, we knew that.

He says that to re-establish faith in vaccines this is a step that must be taken. Collectively the entire research community rolled their eyes so hard they could see their very big brains.

Um, dude, the person who broke the faith in vaccines was you. Just you. Also anyone who professed anti vaccine rhetoric for the ‘gram and for the views. And for the money that thrown at them.

It is always the money. The money and the power.

The call is coming from inside the house. And we should all be afraid.

The kicker is we warned you. And warned you. And warned you. We did everything except sky writing. But since we aren’t pretty blond trad wives we were ignored.

People are gonna die. I feel like I say that all the time. Let me check real fast the last several months/years of Tuesday Top of Mind.

Yes, I say it all the time and no one is listening.

Are you paying attention yet?

Medical fiction review 6/8/25- The Surgeon By Tess Gerritsen

The medical fiction book The Surgeon by Tess Gerritsen.

This is another reread. I read it for the first time shortly after its publication in 2001.

I was deep in a murder mystery kick.

Here was an amazing, kick ass, take no shit heroine, Jane Rizzoli. She is on the hunt of a copy-cat serial killer in Boston.

This book series, 13 in all, that introduced Jane Rizzoli police detective to Maura Isles coroner.

They solve crimes together. And were the headliners in a cop and medicine show, a la CSI, NCIS, Crossing Jordan, and a slew of others. This aired from 2010-2016 and had seven seasons in total. I severely curtailed my television viewing in 2010 and I missed this one entirely.

But this is the book that spawned all of that.

I remember at the time that I enjoyed it. Nothing like a good mystery with high stakes and bodies all around. The serial killer this copycat was well copy-catting is a trauma surgeon (Dr. Catherine Cordell) in a Boston hospital who killed the original serial killer. Who happened to be a fellow surgical resident in Georgia.

It sounds more convoluted than it is.

Dr. Cordell is the pre-Isles, I guess. She is traumatized by surviving the original serial killer and had to have the mental fortitude to help find the copy-cat.

Jane is a good all around detective with a chip on her shoulder. She is the only girl in a rough and tumble Boston family. Her fellow detectives treated her poorly, beside her fellow detective Frost. One of them left a tampon in a bottle of water on her desk, hoping for a rise out of her. There is another detective who will be instrumental to the case. And to healing Dr. Cordell.

Misogyny aside this was a solid book.

I thought it would be a stand alone book. I was wrong. Maura Isles is introduced in the next book, The Apprentice. And she and Rizzoli unite against the haters.

Dr. Cordell is off having her happily ever after with Detective Moore.

I give this book a solid B. My first reading was an A. But points off for misogyny that the detectives display and the in poor taste practical jokes they pull on one of their own. It isn’t her fault that she is more observant than them and has a set of breasts. This was before the backlash to the “boys will be boys” pervasive attitude that we’ve been trying to kill for YEARS.

I still have The Surgeon and the second book The Apprentice on my bookshelves.

FFS Friday 6/6/25- Lest We Forget

Today, June 6th, 2025 marks the 81st anniversary of the Allies storming the beaches of Normandy. This is also called the Normandy invasion. The beaches of Normandy ran red with blood that day.

In the largest joint operating the world had ever or has ever seen, the Allies led a combined naval, air and land assault on Nazi occupied France. On Omaha beach, twenty four hundred American soldiers died. That was the deadliest day so far in WWII for Americans.

The British author Rudyard Kipling wrote the Recessional in 1897. The words ‘Lest We Forget’ is the repeated refrain.

We will not forget.

We shall not forget.

Until we do.

The United States of America is in the process of forgetting the hard won battles that brought us to global dominance after World War II. The United States of America is in the process of being led to forget about Allied blood that was spilled during WWII.

Because of attacks on education there are a shocking amount of people who no longer have the capacity to understand just what had happened in WWII. Or understand that Americans bled and died fighting against the very idea of fascism that they now embrace.

They only know what has been spoon fed to them by the algorithm. And their precious Fox news. And their elected officials who prefer when Americans are dumb.

Here is another frighteningly frank F for FFS Friday, Four hundred seven thousand Americans died in WW2.

How many will die in WW3?

Are you paying attention yet?

In other words, stop believing what they want you to believe and pick up a damned history book before they rewrite them.

Cookie Thursday 6/5/25- Cake mix cookies

You know how it goes, late night surgical case, you are shooting the breeze with the CRNA, they start telling you about the cookies they baked with their kids that were so easy and so fun. You say interesting. And they text you the recipe.

No?

Just me then. Okay.

For those who might be worried, the entire exchange took less then three minutes as they were just bursting to tell the department cookie lady about the cookies that they made.

But that got my brain thinking. After the initial ew, no reaction.

When I got home one of my friends had sent me an email of a baker making nearly the exact same cookie. Their recipe allowed for more creativity.

I decided to theme June as cake mix cookie month.

Baking is often seen as elitist. Because baking is very demanding of attention to detail. And precise measurements.

Unless you want to experiment.

I do like an experiment. See also the entire reason that Cookie Thursday still exists and has been going strong for over ten years.

The email from my friend laid out how to be experimental. Within the strict bounds of baking.

I started making lists of combinations of cake mix flavors and mix-ins I could do. A pairing, if you would.

It didn’t hurt that the cake mixes were on sale that week.

I did a quick math in my head. Each recipe takes 1 stick of butter and 2 eggs, plus the mix. Normally in a month I would use 2 pounds of butter as a recipe usually takes 2 sticks. There are 4 sticks in a pound of butter which means I normally go through 2 pounds per month. Butter is still egregiously expensive and is running around $5 a pound. This makes the butter cost of each CTIAT $2.50. The butter cost of these cookies will be cheaper IF I keep the cake mixes under $1.25.

The buy one get one free cake mix deal was looking pretty good. Even better was the coupon I had. AND the place where I bought them doubles coupons with a face value of $1.

The cost of the eggs is the same as a normal batch of cookies takes 2 eggs, just like this recipe.

Not only that but in the scratch and dent produce section, where they sell soon to be expired food stuffs, there was an entire bag of pink chocolate shavings, like you use on cake frosting for decoration. For $1.00. You cannot get chocolate chips for anything near the price.

I used half of the bag in the cookies.

My first thought as I was mixing these up is that there isn’t enough liquid for the amount of solid.

Spoiler alert- there was. Also the 1 tsp of vanilla was helpful.

I will delay judgement on what I really think of the cookies until week 4.

Tuesday Top of Mind 6/3/25- News flash- We are going to die!

The title is referring, of course, to Joni Ernst, an erstwhile senator from Iowa, and her reaction to a concerned constituent at a Town Hall event.

The concerned constituent yelled “Someone is gonna die”.

They were, of course, talking about the long standing plan to cut Medicaid. The bill that has us all on tenterhooks and reacting to how awful it is has passed the House and is at the Senate.

Her reaction, which launched what seems like a million articles, was to say “We are all going to die.” I’m not lying when I say it is giving “let them eat cake” energy.

Her probably supposed to be a joke (maybe) landed with a thud heard around the country. I say probably because that is the type of person she appears to be. Laughing at someone else’s pain. Voting consistently to harm others.

Her response to the backlash was to release a video and continue to joke about how she didn’t know she was telling grown adults a truth. The video was in a cemetery.

She also outed the tooth fairy as not being real. As always she completely misses the point.

Yes, everyone dies. It is a fact of life. There is a finite number of days that each person is granted. You can try not to die by wearing your seatbelt. Or, I don’t know, getting vaccinated against known killer viruses. You can exercise and eat right but that does not forestall death. None of us made a deal with the devil.

Everyone dies.

It is in the manner of death that is important.

The concerned constituent’s point was less o, save me, great and powerful senator, and more people are going to die badly.

Because they will.

Without Medicaid people no longer will have access to even the bare minimum of healthcare. Things like A1c checks for diabetic control would be too expensive for people. Women will no longer get cancer checks such as a pap smear or mammogram. Why? Because they can’t afford it. Cancer will no longer be caught in a treatable phase.

People will die in agony.

Entire towns and cities will suffer as hospitals close. This has already started happening. Becker’s Hospital Review, something I read myself, states that there have been 16 hospital closures in 2025. This rate is up from 25 in all of 2024, and overclocks the 14 cited by OR Manager as closing in 2023. To do the math that is just over 3 a month since January 1st.

People will die.

From neglect, from delayed diagnoses, and from Congress not giving a fuck.

Yes, we know, senator, that everyone will die. But do you have to add fuel to the fire as we all burn to death? Yes, even you.

I know I would prefer not to be tortured to death. Because none of us are getting out of here alive.

What’s in my bag?

I have a confession to make. Not something deep and dark but something a little more fun than that.

I do not carry a purse. I never ever ever have. Don’t get me wrong, a purse is a useful thing. To some people.

I am not that kind of people. I just never got into the habit of carrying anything other than my backpack when I was high school or college. Any of the colleges.

I just done see why I should carry a school bag and a purse. This seems counterintuitive to me. Why carry 2 things when one would do?

To carry the thought further, why carry 1 thing when nothing will work as well.

What about your wallet? I carry it.

What about your phone. I carry it.

What about your keys? I tuck them into the back of the pants/shorts/skirts that I am wearing. The larger key fob keys has made this possible.

There is also this new-fangled thing that men have enjoyed for centuries. It is a small pouch that is sewn into the seam of the pants they are wearing.

I think they call them pockets.

There are a couple of reasons why pockets for women disappeared.

Fashion is one of them. Of course it is. Dresses were cut closer to the body and there was no room for pockets. It would spoil the line, you see.

Apparently there wasn’t any call for women to carry money or to have access to money. After all, the men had pockets. It is the attitude akin to the why teach women to read. Reading and thinking is suspicious.

Eye roll.

Another more sinister reason is that women with pockets were suddenly especially suspicious.

Who knew what she was harboring in her skirts!

A puppy or kitten. Money she had saved from the shopping in order to run away from her abusive husband. Or political tracts/articles that she had no reason to read because she wouldn’t understand them anyway.

This is sarcasm. But what isn’t sarcasm is that it was yet another way to financially control women. Why would a woman need to have money if she could charge anything at the shop with the bills to be sent to her husband. Or her father. Or her brother.

Ahem.

Pockets and access to pockets is not the reason that I’ve never carried anything but a backpack for school or a work bag for the hospital. I have just never cared to.

It just always seemed like something to lose. Not to mention that you have to have one for day and one for going out. You have to match the purse of the day to your outfit.

Frankly, no thank you. I’m a simple soul and I don’t need a purse. But I would like pockets.

To that end all the clothes that I have bought in the last several years must have pockets. Yes, even pajamas. And dresses. And skirts.

The overall secret to this freedom?

Small wallet and minimal keychains. Too many keychains is bad on your ignition anyway.

But what if you need X, Y, Z?

We’ll look at what’s in the wallet next time. But it isn’t much. Simplicity is the keyword, after all.

School Me Saturday 5/31/25- Personal school dispatch

Well, I’ve not done one of these for a while now. In fact, I can’t remember the last one I did. And I find that is completely normal. After all, the not so stated plan for a PhD program is to remake you. It just might take a little longer.

In the beginning I was so energized and full of zeal to learn. What a difference three years makes. I am still energized about learning. I am still zealed (?!?) to learn about research.

Here comes the big but.

If I followed my learning timeline of what classes and when I was supposed to graduate at the beginning of May 2025.

Spoiler alert, I did not graduate in May 2025.

All of the core classes are completed. My pilot study has been completed. I even presented a poster based on the pilot study in April at the AORN convention and I am slated to present virtually at the hospital system research symposium in the beginning of June. I am also responsible for a virtual symposium presentation in November.

Yes, all based on the same research from the pilot. The last two are podium presentations where I have to actually talk to people. Maybe there will be a podium, if not I will pretend.

All of these different presentations, the poster and the podiums, is known as dissemination. Getting the information that I’ve worked very hard on for over a year out to the public. Well, other healthcare professionals.

Instead I had the most challenging health year of my life. Getting older is not for sissies. Midlife crap threw me for a loop. We don’t talk about that enough as women and I am so excited that perimenopause and menopause talk has entered the conversation in the mainstream. Perimenopause can cause a host of problems and I had most of them. Cutting to the quick of it, it certainly made my life hell in the last year and certainly knocked me for a loop. But that is a blog post for another time. And not the core reason my school plans got knocked a little awry.

That not so lovely reason is the 2024 election.

And the crap fall out from that.

Suddenly research was under even more stress, if not outright attacks from the people who find it more profitable to pretend not believe in it.

And then the attacks on the institutions who have massively contributed to our modern way of life through their research began.

Every day it felt like there was another strike.

And another.

I felt as if I had to bear witness to it all because someone has to be paying attention.

It was exhausting. Kind of like never ending bullshit torture akin to what I think being waterboarded feels like. Except it is shit decisions that have set the research community back many years. So many years.

All I could do was hold on and not give into the numbness that this crap is supposed to engender in people. Because that is their endgame.

I felt like we were thigh deep slogging through shit.

And then something flipped the mental switch.

I went from mad at the situation and the relentless attacks on research, on institutions to mad that they were making me doubt my path.

So what if research is a skeleton of what it used to be? I will be part of the resistance.

So what it publication is under attack and will no longer be the same. I will continue to write these dispatches.

So what if teaching jobs and professorships and colleges and programs and universities are retrenching their program offerings and job listings. I will continue to teach as I have, in small settings like the Call Bootcamp I run for new to the hospital nurses.

Because we are at war.

This is the “watch me” mad that fueled much of my other academic endeavors.

They think that they can make me stop? Through their pretend shock and awe campaign against the American people and institutions? Though unending waves of nonsense and threats and more threats?

It was a bad idea to make me mad to the “watch me” level.

Watch me resist this crap. Because I believe in science. I believe in research. I believe that colleges and universities. I believe in love. I believe that people have to right to own who they are. I believe in LGBTQIA+ rights. I believe that people have the right to read whatever they want to read, to watch whatever they want to watch. I believe that people are not pawns for the establishment.

You want me to fail because I am older? You want me to fail because I am a woman and that makes little men feel bad?

Fuck that.

Watch me succeed.

FFS Friday 5/30/25- F’in 5th circuit appeals court

Double F today.

Last week, the rage baiting 5th circuit appeals court. Yes, the same one that has been used as a basis for a Supreme Court judgement superhighway. You know, forum shopping. Also known as court shopping where the right judgement can be bought by choosing the right judge and getting on their calendar.

According to Merriam Webster, forum shopping is the “practice of choosing the court in which an action from among those courts that could properly exercise jurisdiction based on a determination of which court is likely to provide the most favorable outcome”.

The favorable outcome is, of course, a case to be adjudicated by the wildly biased and conservatively weighted Supreme Court. Then the Supreme Court can issue a for or against ruling, depending on the circumstances, that will warp this country to the will of the people who were court shopping.

We know their game. We have seen it in the relentless battering of some people against things THEY personally don’t like and don’t agree with. After all, why should people be allowed to love who they love. And marry them. I am looking at you people who want to overturn Obergefell. Or the shrill voices who pushed and pushed and pushed and pushed and pushed against Roe v. Wade for fifty years until they got the result they wanted.

Remember?

Yeah, so those same judge (forum) shoppers are also against books that they don’t like. We’ve seen it in the book bans. No matter that they don’t have to read the books, the book banners want no one to have to right to read whatever the reader wants. They bleat save the children when it really isn’t about the children, never has been. But that’s a rant for another time.

Book banning at schools has reached a fever pitch over the last forever. Well, at least, that’s what it feels like. They are a slow erosion of America’s rights. And I think contribute to the dumbing down that we’ve been experiencing in society.

Yeah, yeah, Kate, we know. But did you know the newest gambit?

Last week the 5th Circuit Appeals Court effectively said that books in schools were the purview of the government and not subject for 1st Amendment rights.

The government is arguing that the books are the property of the government and therefore are immune from 1st Amendment rights arguments.

That is not a typo. I just find it so outrageous that I had to type it twice.

The Fifth Circuit Appeals court has fired a missile against a citizen’s right to receive and have information. In fact, Judge Kyle Duncan wrote those very words in the judgement, “that the First Amendment of the US Constitution does not grant a right to receive information.”

Are they reading the same U.S. Constitution that I am? Or is it the thought that we can have free exchange of information uninfected by harmful rhetoric and without bias that they object to?

I am chilled by the idea that words are not freely expressed in a written format are not, in fact, free. And that I, as an American citizen born in this country, does not have the right to information that they might object to.

Do they know how words work? Or are they just a shill for their corporate overlords who want the book banners to control what is written and read by EVERYONE and is trusting in the slow drip of poison getting them their way.

After all, it worked against Roe.

This is screaming capitals DANGEROUS!

Trust me, I’m a woman and I’ve seen this before. I’ve watched my right to own my body be dismantled. Even though we could see the train wreck coming and tried warning against it. For literal years.

Listen to Uncle Steven (King) on the subject, kids. “What I tell kids is, Don’t get mad, get even. Don’t spend time waving signs or carrying petitions around the neighborhood. Instead, run, don’t walk, to the nearest non-school library or to the local bookstore and get whatever it was that they banned.”

Cookie Thursday 5/29/25- Fudgey cocoa no bakes, redux with different “butter” + special ingredient

I have such an exciting idea for June CTIAT that I kind of blanked the last week of May.

It’s also a busy week with both my mother and my father having birthdays.

In my real life I’ve been trying different versions of cookie butter, because Aldi had some packages of speculous cookies for super sale that I want to make cookie butter out of. An experiment, if you would.

Because that is what cookie butter is. Kind of like peanut butter is made from nuts, cookie butter is made from grinding the crap out of cookies.

I wanted to try different versions of the speculous cookie butter. Never thinking that I was going to be a bear in Goldilocks and the 3 bears.

I bought a jar from Trader Joes while away at the nursing convention in April. Too sweet said my mouth. (daddy bear bed)

I bought another jar from Trader Joes, the crunch version this time, wondering if a texture change would be good. Nope. Too sweet with crunchies in it. (daddy bear bed who has been eating crackers in bed)

The Trader Joes jars were the Trader Joes brand.

I bought a jar from a rather bougie grocery store. This was from lotus Biscoff, the maker of the cookies. Again, way too sweet. I have got to investigate the ingredients. (mama bear bed)

Then I saw a version at the other local grocery store. This is another “store brand”. This one was just right. (baby bear bed)

Not too sweet, not too crunchy.

The only criticism that I have is that the product is almost too smooth. It’s consistency is almost pourable, instead of a semi-solid state.

I’ve made this cookie before with the Trader Joe’s branded cookie butter. The cookies were WAY too sweet and half of them went uneaten.

This time I used the third store jar, and replaced 1 of the cups of oatmeal with unsweetened coconut. And I used dark chocolate cocoa powder.

The resulting cookies were tender and not as break apart-y as the traditionally made cookie with peanut butter and the full 3 cups of oats.

These I will definitely not kick out of the cookie jar.

Tuesday Top of Mind 5/25/25- Be careful, germs are still trying to kill you

In a stunning surprise to no one who is interested in anything other than pursuing power and strengthening the echo chamber in which they live, this past however many days it has been since the inauguration and the shameful confirmation of an avowed anti-vaxxer to the chair of HHS has been an exercise in what the fuck.

Seriously though, is this man and his ilk interested in anything besides the cockamamie bullshit they believe, to the detriment of, well, everyone in the US.

Let’s count the says his administration of HHS has gone.

Number one is his insistence that, against all medical judgement and against swift action of diseases that we know are trying to kill us, that all vaccines must have an extra layer of blinded nonsense, a placebo barrier. The only thing that ‘obecalp’ ever did was kill people. (that is placebo spelled backward, they came up with this nonsense in the 1990s. It is basically a sugar pill to make you think you are being treated. Additional nonsense is up to and including the appointment of a known vaccine skeptic and all around terrible human and has no medical degree, David Geier, to investigate for the umpteenth time the debunked, but very real in their heads, link between vaccines and autism.

Maybe this time they will get an answer they think proves what they think. Spoiler alert, doing research with a foregone conclusion in your head is a terrible way to go about doing research.

THREE HUNDRED Americans are dying and will continue to die every week because of covid.

Yeah, still.

Bet you didn’t hear about that.

That is over one thousand a month.

Last week when the news broke that they were no longer recommending updated covid vaccines to those under 65, I immediately, without hesitation, made a covid appointment for the very next day. Not only that, I immediately texted my husband to make his own appointment. Again, for the very next day. This nonsense was released on Wednesday and by noon on Thursday we both had been vaccinated.

Other vaccine recommendation changes include that the vaccine is not recommended if you are under 65. Unless you have a concurrent comorbidity and are over 50, luckily obesity in the US is 40.3%. Otherwise you are out of luck. Today, they announced a stop to recommending that healthy children are no longer to get the covid vaccine. Never mind the one thousand and eighty six children who died from covid during what they consider the active pandemic. Taken against the estimated number of children in the US of 73,602,753, this comes out to a mortality rate of 0.0015%.

Not significant but not immaterial. Especially to the one thousand and eighty six families.

And whose definition of healthy?

Nothing was ever gained by denial and thrusting our heads into the sand.

Today HHS also came out against recommending the covid vaccine for pregnant women. Why? No idea. Because we know there is a link between covid infection and miscarriage. According to a study in the Lancet that Covid infection before or during pregnancy was associated with a two- to threefold increase in risk of miscarriage before 20 weeks. And since we already know that 1 in 4 pregnancies end in miscarriage, I feel that this is vastly short sighted.

Par for the course.

Of course, covid data is HARD to come by.

As if no one wants us to look at it.

Gee, I wonder why? (this is heavy sarcasm)

Congratulations to us! After canceling the meeting to decide on the 2025 flu vaccine, the FDA got their heads out of their collective asses and chose three viruses to include in the vaccine. Of course, selecting the viruses to be included is always a crap shoot. Just ask the 20,000 Americans who died of the flu in the 2024/2025 flu season.

Let me tell you, as a working nurse in the hospital during flu season and one who monitors bed usage and ER bed availability in my spare time, this last season was the worst one in years.

Tuberculosis remains a threat to school children in Kansas. Why is this important to know? TB kills the most people per year around the world. True it is most common in crowded living conditions. Like in jails or the new housing model for gen z. This is also known as pod living where you rent a bed (pod) in a house with other gen zers.

This most current outbreak in Kansas is still of concern. But you don’t hear of it, do you?

This bring us the third disease in our merry go round of death in America 2025, measles. There have been one thousand and forty six known cases in 31 states. Slightly less than the children who died of covid since 2020 (that we know of) but there have only been three deaths in this latest outbreak. Of course, two of them were children.

Yep, still a thing. Still spreading like wildfire because it is the most contagious illness in the world.

It is as if they want the immuno-compromised to die. After all, we spend sooooooooooooooooooooooooo much money on the chronically ill in America. According to the NIH, over ONE TRILLION dollars a year.

Do you see why medical professionals like me are concerned?

No.

Okay, well get your vaccinations. While you can.

I turn 50 in July and 50 is the age they offer the shingles vaccine. You bet I will be getting it the first week.

Idle question that popped into my head as I was finishing this, what happens if the autism rate goes up without vaccines? Or are they just “kidding”.