School Me Saturday 2/1/25- Funding and research and slamming on the brakes

I’ve written before about research is expensive.

You have to pay the salaries of the researchers, the physical places to do the research, the salaries of the research assistants, the incentives for participants, the salaries of the statistician to help with interpreting the data, in some instances the postage, the electricity to run the machines, sometimes you have to pay for access to the big data sets if you want to do a secondary analysis. If you are doing hard science with microscopes and reagents and all the things that drive the hard science research you have to pay for all of that too. Sometimes there are travel costs incurred to get to the participants, including airfare and hotel, and certainly gas to drive there. Wherever there is.

Once you have finished a research project and you have the results, you have to pay for dissemination. Journals charge for papers, which are the result of the research. You have to pay to go to conferences to present the research. This includes the conference fee, the travel to and from the conference,

Research costs a lot.

However, research also gives the public so much in return. From drugs, and safe surgery, and safe food, and safe cars. Research is how we understand the world and how it impacts everyday people and things.

On late Monday, 1/28/25, President Trump wrote a memo suspending federal funding.

Fait accompli. A bloodless takeover of America by the billionaire class.

With a swish of his sharpie, all research came to a grinding halt and researchers were looking at each other saying “What now?”

This halt famously included children’s cancer research.

The funding freeze has been walked back, hastily, but I, for one, have a bad taste in my mouth about the whims of a spoiled brat and how much damage can be done to the fabric of America.

But I know that we Americans dare not look away.

What is happening is known as Shock and Awe. Where there are a lot of horrible acts in a flurry and you are feeling pummeled.

Which is the shock and very much as designed.

When everyone is reeling and unsettled and unsure of which direction to pay attention to, then someone, you know who, will come in and make it “all better”.

Which is the awe and we have yet to experience this.

It is important to realize that it won’t be “all better”. Millions will have been lost, hard science has to reset their experiments after losing data, and previously scheduled meetings may or may not go on.

This is by design and it is important to pay attention.

FFS Friday 1/31/25- Finally February

There are a LOT of memes running around on how long this January has apparently been.

Some say it has been 31 days. And then they quantify it by adding a thousand. As in January has been 31,000 days long. This absolutely tracks.

I counter that the time since the inauguration of the great disrupter has been eleventy thousand days.

I understand that paying attention to all the crap coming at us every damned second is hard.

Seriously, it’s like trying to drink from a hose. A firehose. However, that is the point.

We have to keep paying attention to the atrocities that are happening.

This can be difficult and soul-killing but we have no choice.

Because if we don’t, who will.

But hey, it’s almost freaking finally fuckingFebruary.

Only 47 and a half months to go.

February is only a day away!

Smile. Because I am sure that someone is watching and noting down when you don’t smile.

Are you paying attention yet?

Cookie Thursday 1/30/2025- sourdough chocolate chip cookies

This is it. The last week of the Cookie Thursday is a Thing extravaganza.

I’ve gone through some CTIAT is a thing background details. I’ve gone through some of CTIAT secrets. And I made 5 weeks of the department’s favorite cookies of the past 10 years.

There was one of the original cookies with the Twix cookie.

There was the original experiment cookie- the Jalapeno chocolate chip cookie.

There was the second favorite cookie- the pepper jelly cheddar thumbprint.

There was the crust cookie and the story of how CTIAT got its name.

Today’s cookie was a sourdough chocolate chip cookie.

I’ve done this in the past. Heck, I’ve done all of these cookies before. What earns it a spot on the list is the interplay of how the sourdough changes the cookie consistency.

The cookie is crisp but still chewy.

Alchemy!

That means magic!

Last time the addition of sourdough waste added a different texture to the cookie. As it did today.

What I did differently was that I left the dough at room temperature so that it could ferment. I left it for 6 hours before baking, covered of course. This definitely changed the consistency of the dough, giving it a fluffy appearance. Some might say that cookie dough is already fluffy. It is the only way I can describe it.

Tomayto-tomahto.

Spoiler, I had a cookie for breakfast.

Now for the final secret of CTIAT.

I began CTIAT as a morale project for the evening shift of the operating room. This is still how I advertise and talk about it. I freely give out any recipe when asked. I genuinely think that weekly cookies, no matter the time elapsed, has an impact on morale.

I see it every time I walk into the lounge and its dedicated drawer is open, usually by people interested in the cookies. I hear it when people stop me to tell me their favorite cookies. I see it when I pick up the empty container the next day. There are weeks that people don’t know about the cookies or the OR is too busy. But that is when they need the cookies most.

However, what you might now know is that it has an impact on my morale. I don’t even have to see people enjoying the cookies. It is the act of planning and creation that is important to me.

The weekly date with my kitchen doesn’t hurt.

Tuesday Top of Mind 1/28/2025- getting down the heart of the matter

I’ve been writing, ever since the fall of Roe, that the heart of the matter is that there aren’t enough babies being born. Scratch that, there are not enough WHITE babies being born.

That is the secret heart of the whole hullabaloo.

They want to control all women’s uteruses to control the output of said uteruses.

Bonus points if it is a white baby.

But, really, any baby will beef up the tax rolls.

You know, eventually.

But for now, babies can still help their community by collecting money from the federal government. This is done in a variety of ways, depending on the location of said child and which state they live in.

There are federal grants to help with schooling.

There are federal grants to help with feeding and nutrition.

The vice president just got up on stage this weekend at the yearly “March for Life” demonstration. Yes, the quotation marks are definitely needed. He got up and said that he wants more babies born in America.

If that isn’t a broad shot across the bow against women, I wouldn’t want to see them speak more plainly. This is sarcasm. I would like to know what they have planned.

He goes on to say that they want it known that it will be easier to find homes, easier to save up, and easier to kit out the nursery with a crib or a stroller.

The point that needs to be made is that there is no plan to assist in the bringing up of these children who are supposed to be happy. Just a blanket statement that he wants more babies, which become children, and young men and women. How they are supposed to be brought up to be happy, and how they are supposed to survive childhood with rampant gun violence and the food deserts that are proliferating must be magic.

Nope, never mind, the president just suspended and/or did away with all these grants and monies for those who need them with the flick of his Sharpie.

Never mind that the legislature, specifically the house of representative, hold the power of the government’s purse

Never mind any babies who are born alive during an abortion, which is from their imagination, and doesn’t happen, will have life-saving care. This passed the house but did not pass the senate. So that’s a nothing-burger and is just red meat for their base.

But what about the rest of us who know that this is nothing more than smoke and mirrors.

They want more babies in America with no plan to raise the children. This probably sounds good to their base but has no real information or teeth.

But, hey, at least he came out and told part of the truth. They want babies born but left out the white babies part.

This is a very unsettled time in America.

Post-it Sunday 1/26/25- OR as Aesop Fable Project

The gown card reads “OR as an Aesop Fable series- 3 pigs, Goldilocks”.

This was from a series I have on the back burner, I take it out every so often, and look at it and think “Someday.”

I got my start writing OR parodies. I did several and self-published, if that is what it can be called, at a little store near my house.

I wrote a bunch of them.

I wrote about the number of things I pick up off the floor.

I wrote about the very bad, no-good day, a surgeon had in an OR.

I wrote about Tiny Hiney, a green frog bottle opener.

I wrote about OR sign language.

I wrote about the 12 days of the OR Christmas and what an ass Jack Ashe the charge nurse was.

I had several more in the pipeline. By that I mean I was writing them, thinking about them, talking them up with my coworkers.

And then the store closed. RIP.

And then I went back to school and my brain was suddenly full of new concepts.

But I never forgot how I got my start.

The gown card lists two of the stories I was working on.

The 3 pigs were the charge nurses standing up to a blowhard surgeon.

Goldilocks was about a coworker that was trying all the different specialties like a wrecking ball. Spoiler alert, they never found the right fit.

I also wrote a Hickory Dickory Doc parable/funny.

I will get back to them, I promise. I may change them, but I will get back to them.

I just have the Big Write in front of me.

And I also have to be in the right frame of mind for comedy.

Don’t hold your breath because I won’t be holding mine.

School Me Saturday 1/25/25- Grants and other bad words

Psych!

This week’s School Me Saturday is not about any of the grants I have in the pipeline. However, it is about the grants that may never be.

Research is expensive. I mean the kind of research that is done correctly, not the diddle on your phone, and read some BS articles from BS sites that don’t know proper research from a hole in the ground.

Properly done research takes a principal investigator who has gone to further their education. They know how to search for research gaps, they know how to protect the people and things being researched, they know how to create a quality research protocol, and they know how to answer the question that prompted the research in the first place.

I am a nascent researcher. This means I have barely scraped the surface of how to do research, how to find gaps, how to answer the research question, and, most importantly, how to do all of this in a safe non-compromising way that keeps the data that is gleaned free from bias.

There are the hours the researcher puts in before a project can even begin, there is the research assistant who shoulders some of that work, there is the university that gives the researcher a place to do the research, there is the statistician who helps make sense of the gleaned data, there is the cost of doing the research, be it paying participants, feeding participants, and even FINDING participants. The point is there are a lot of moving parts to research. Don’t get me started on getting the research, when it is done, released to the public. This is called dissemination.

It is also of vital importance to have succession planning in place. After all, even the Wise Ones in Wicked knew they couldn’t live forever and they had to write down all their magic in a book. Students are also expensive, as is the cost of learning how to do university-level work. See also the con-man who came to Oz after a tornado in a balloon and bamboozled the Ozians into believing that he could read the book. That is a story for another time.

The US federal government cannot say the same. Which is why they disperse monies through the NIH. That is the National Institutes of Health.

Research is expensive. Without grants, research would be much, much, much, much, much smaller and the amount of research would drop. Precipitously. And it would have a subsequently diminished impact on the ones it should impact. Like Suzy, with childhood cancer, or Jen, with triple-negative breast cancer.

Bob with the male pattern baldness would probably be okay, there is always money to research white male problems.

Think to yourself why that is?

This week the newly inaugurated president wasted no time in freezing the review of grants at the NIH. Among all the other nonsense that took place. And there was a LOT of BS. The presidency, the revenge for small slights and maybe others know what they are doing, no wait, no they don’t, tour.

No review of grants, no grant approval. No grant approval, no research being done. Are you going to tell your child with cancer that sorry, the research wasn’t done? But you can ask them what color coffin they want.

But, sure, some ass in BFE US can claim they did their “research”.

No, no, you most assuredly did not.

FFS Friday 1/24/25-Feeling

How are you feeling? It is important that we check in with each other in this very uneasy time in our country.

Where it seems that every minute another more outrageous action is being undertaken and another right is on the verge of collapse. It is vital to pay attention to the fast-moving shocks. It is important to NOT look away.

Because that’s what they want you to do.

At this moment in history, their actions must not be done without witnesses.

I understand this is a high bar.

I also understand that people might not be feeling this.

I cannot stress how important it is to not let the actions that they are doing be unseen.

As the Washington Post’s official slogan says, “Democracy dies in darkness.”

To go back to the F prompt for this Friday, I am feeling determined, I am feeling overwhelmed, I am feeling for those who are under attack by this tantrum, and I am feeling tired.

But mostly I am feeling betrayed by the ones who didn’t know any better. The ones that were seduced by false promises of a brighter day where the cost of eggs was going to pre-pandemic levels and the cost of a house would suddenly be within reach.

Scratch that.

I am feeling a lot betrayed by people who “didn’t want to vote for a woman.” Or the ones who thought “We just had a black president.” The ones who thought the only immigrants that would be deported were the criminals. Yeah, every person who is here illegally is a criminal.

I am also feeling angry like a lot of other people.

To quote many, many people “how is the price of eggs? Are they cheaper yet?”

Don’t hold your breath.

Cookie Thursday 1/23/25- pepper jelly cheddar thumbprints

The Cookie Thursday is a Thing show must go on.

Especially in this crappy month/week/year/administration.

Especially for the 10th-anniversary celebration of CTIAT.

The cookie for today is the first savory cookie that I made. I had to persuade people to try them. I told them that these were really similar to a cheese straw, with just a touch of spice.

People were skeptical.

They had never had a savory cookie before.

Not a cookie, more of a cracker I said.

Finally, my boss tried them and then tried to take the entire batch into their office. Seriously. I had to cut them off.

Over time, these became known as one of the bright spots for CTIAT. Easy enough with a food processor and simple ingredients.

This was the cookie that allowed me to expand peoples’ minds as to what might constitute a treat.

It doesn’t always have to be sweet.

Savory has a home here at Cookie Thursday is a Thing too.

This was also the cookie that struck off my recipe shackles.

Let me explain.

All my life I’ve been taught to read a recipe carefully and follow it. Including oven temperature and baking time. Also including how to handle the dough.

The original recipe called for rolling out the dough and carefully cutting out the shapes. I don’t have time for that. Instead, I wondered what would happen if I made small balls instead, or used a cookie scoop. And it worked! My mind was blown. I saved myself at least 45 minutes that day. For a workaholic, that is a big time savings.

Of course, Cookie Thursday is a Thing being a place where I experiment, I got right to work. And started breaking culinary rules left and right.

I experimented with lower oven temperatures. This meant I had to be able to tell when to take the cookies out as they baked at different times with the lower temperatures.

I experimented with higher oven temperatures. This also meant that I had to adjust the baking times.

Around this time I got really loose when explaining baking times to people. I probably caused a lot of frustration. Because people want concrete answers about how hot an oven and how long to bake. They would go away frustrated when I said until whatever you are baking is done. Because all ovens are different and a lot of different things can impact baking time.

I experimented with different cookie sheet metals. Yes, baking times are different depending on the color of the cookie sheet. Because, science.

I experimented with different additions to cookies, trying to see what went well together and what didn’t. An early success here is using orange flavoring oil, white chocolate chips, and dried cranberries.

The baking world opened wide. And my recipe collection got unruly. If I recall, this was when I decided to theme the months to make CTIAT easier for me. I could be more economical in my ingredient sourcing.

The biggest takeaway is that a treat doesn’t need to be sweet.

And my long-held baking rules are just suggestions.

Best Kept Secrets of the OR #20- HIPAA still applies to immigrants

I cannot believe I have to write this.

The Health Insurance Portability and Accountability Act remains active for the immigrant population. You know the one that guides all of our interactions with patients? The one that if we breach it will lead to punitive action by your employer?

Yeah, that one.

Well, suppose the Immigration and Customs Enforcement comes to your hospital, and this has started. However, hospitals and churches were not overrun by ICE because there are reports of them coming to hospitals and asking about employees that may be illegal. In that case, HIPAA laws are still in effect.

What if they ask about patients?

HIPAA laws are still in effect.

Supposing the employee they are asking about is a patient of a doctor of the system, HIPAA laws are still in effect. And you can’t tell ICE anything without breaking the HIPAA law and policies.

This is a very scary time in this country. That should be acknowledged.

What should also be acknowledged is that this is a problem of their own making. Remember in 2024 there was a bipartisan law that passed one of the chambers and then was torpedoed by the other part of Congress? Because someone came out against it so he could run on immigration and border control? Remember that?

You might not. But look it up.

Misinformation is rampant and often used to their advantage. Don’t buy into their lies.

Make sure you take care of yourself.

And your patients.

Because that is why hospitals exist. To care for patients, no matter if they are from down the street or the next state or from somewhere else.

Hospitals and churches should be safe places. Schools, too, but we know what they think of that.

Tuesday Top of Mind 1/21/25- Limbering up the “NO, I don’t think so” muscle

Warning: this might be a VERY SWEARY and a VERY CAPS-LOCK post. Or not. Behave accordingly.

Somewhere not very far from where I am, about 390 miles give or take, is a man who has never heard the word no and not reacted like a spoiled, entitled brat.

To parody the meme, “Someone has never been told no and sent to bed without supper and it shows.”

Has anyone ever told this man no and slapped his hand while he was reaching for something that wasn’t his?

Strike that. I am sure that plenty of people have. He has the guilty verdicts to show for it.

Has this man ever had to face the consequences of his own actions? I would hazard a guess at that. And that guess would be no.

It helps to know that the crap that is going on in Washington D.C. amounts to nothing more than a tantrum.

A tantrum from a spoiled brat.

I just feel sorry for the people who will be hurt/killed/smeared out of existence by his very presence where he is. For the people who will lose their healthcare coverage, or their right to exist as they want to. The group that I am afraid will suffer the most are the women. I am lumping in ALL women, be they born female or not.

We are facing a very dark and dangerous future.

Because we as a nation told this spoiled man-child no.

How dare we?

And then we went and fought the pandemic that he mismanaged.

Inflation sucked, yes, but it sucked WAY harder in other countries who didn’t enjoy our “soft” landing.

Greed is the rot and the root of all the challenges that everyday Americans have lived with over the last four years. Corporate greed, individual greed, billionaire greed. Billionaires who are not content to have all the toys in the sandbox but instead demand the sand as well. Normies like you and me can play in the dirt. Until they want that too because we are surviving without them and that IS NOT in their business plan.

Today I am just going to breathe. I am not going to react, I am not going to rend my clothes or pull my hair, or do something rash.

What I am going to do is breathe and document. Just like a nurse in an emergency should.

I know I’ve written about my first ACLS teacher, the beginning of my first ACLS class, and her counseling us that the first thing to do in a code is to take our own pulse. This is to check in with ourselves and remind us that there is a patient who is dying in front of us, and we have to do something about it.

This is our code, Democracy and the America that I love is dying in front of us.

Take your pulse, check in with yourself, and get ready to resist.

Because he has been told no once, time for him to hear it a whole bunch of times. From every corner of the country. Together we can drown out the sycophants and cultists that, until now, have been shouting louder.

Bullies try to silence those who stand up to them. Have you ever considered why? If our voices didn’t have power, they wouldn’t try so hard to silence us.

As I tell my coworkers, if they are afraid to speak up call me and I will. I will absolutely yell back at the men in power, real or imagined. Tell me if you want me to be louder because you can’t. I don’t even need a reason to raise my voice.

See if I don’t.

I know how to use the word no and I am not afraid to use it.

Grieve if we must. I certainly understand the impulse but we also have to be ready to counter moves by the administration. Bought as it was.