Post-it Sunday 2/9/25- table height

The post-it reads “Height of the OR table is important.”

Height of the OR table is important and can be changed for a variety of scenarios.

When a tall person is intubating the patient, the OR table is high.

When a short person is intubating the patient, the OR table is low.

When a tall surgeon is working, the OR table is high.

When a short surgeon is working, the OR table is low.

You with me?

When a patient is on the fracture table or the CHIK table and the hip is being worked on, the table is high. Not only is that for surgeon comfort, but it is also so the C-arm, which is an x-ray machine, can clear the table in order to take pictures.

When a circulator is prepping a patient’s leg, the table should be low. This is for leverage and also changes the fulcrum of the balance of the weight of the leg. This also improves the circulator’s reach to ensure that all the skin is prepped.

I have always known this was important but I didn’t realize that other specialties do this too. Which is odd, because of course they do. I came to this realization when I was in the dentist’s chair going up and down, depending if it was the dentist or the hygienist working on my mouth.

Talk about your flash of the obvious.

Imagine me not even realizing of course it would be the same, even when they are sitting down.

But the number one thing to take home is that after the patient has been moved to the in-patient bed, the head of the bed should never be raised until it has been moved away from the OR table.

Why?

Because I’ve seen OR tables get tipped, a lot of degrees, by the head of the in-patient bed that is being raised.

Heck, I’ve also heard the cysto table groan as an anesthesiologist was raising the head of the patient bed after we moved the patient. And those tables weigh a ton and are not to be moved.

School Me Saturday 2/8/25- This is not psychics 101

I’ve been around this school game for a while now. And I’ve had the full gamut of teachers/instructors/professors. My least favorite is the kind that want you to read their mind.

If teaching was a group project, these would definitely be the ones coming in late with their instructions scribbled on a receipt that has been dipped in coffee. In pencil! Smeared pencil.

Their work is sloppy. Their instructions are haphazard and incomplete. Their assignment due dates are a thing of fiction. Their grading is harsh.

These are the kind of instructors who “never give an A”.

I am sure that 99.99% of learners have had this teacher in their classroom at some point. And you think that complaining does nothing.

Not so. We are not in high school anymore.

Complaining about the teacher who “forgets” to complete their assignment directions and penalizes a student for not being able to extrapolate what they meant is acceptable. After all, this is tantamount to being slapped on the wrist for not being able to read their mind.

I am no Jean Grey or Profession Charles Xavier.

The university or college probably has an office to deal with teachers like these.

Find it. Complain about them.

But it is important to bring receipts. By that, I mean examples.

They will listen. They will know that you are not trying to get a better grade. After all, your classmates might already know and are complaining as well.

Alternately tell your advisor. I hope that the terrible teacher is not your advisor. If they are, go to the head of the program.

Adult learning is hard enough without having to develop a whole new skill that doesn’t exist.

Cookie Thursday 2/6/25- Baking out the (baking) pantry. Andes mint cookies

New month, new theme for February. The theme for this month is Baking Out the (baking) pantry. Today’s offering is an Andes Mint cookie. At the end of last year, I scored several bags of chopped up Andes mints. You know the ones, peppermint and chocolate.

Hence, today’s cookie. The Andes mint cookie.

There’s not much else to write about these. The base cookie is the Tollhouse cookie recipe and instead of vanilla flavoring, I used peppermint.

I also slightly undercooked them to keep them soft.

It is very minty in here.

None for the husband, as we are pretty sure he is allergic to peppermint. All for the department.

Tuesday Top of Mind 2/4/25- We warned you but you didn’t listen Part I

Where to start? Which dumpster fire do I start with?

For me and for every healthcare worker I know, the logical starting place is the takedown and dumbing down of all the CDC web pages.

This is DANGEROUS!

But what galls me are the people just sitting in the sunlight, playing with their hair, playing with the sunlight saying “tra-la-la, I don’t see anything.”

Seriously?

Is that what you are going to say when the chaos impacts you and yours? When your child comes to you sobbing because (insert reason)? When you are denied an opportunity that instead went to a mediocre white man? When your parent suddenly has to move in with you because of the financial malfeasance going on in the social security offices and they can no longer live on their own?

When will it be enough?

What words or combination of words can be said to make you start to PAY ATTENTION to the country-ending shit that is going on in Washington?

By people who were not elected or confirmed by the senate?

Even if you won’t pay attention, I will. Someone has to watch as our government is pillaged and women and children are raped and denied proper healthcare because someone wants more babies in the US. Gilead and the Handmaid’s Tale is fiction, not a roadmap.

The dismantling of the CDC pages is just one step they have taken. It is a step that impacts all of us, sick or well.

What’s going on with the bird flu? Can’t tell you because those pages has been taken down.

What is the proper birth control method that a 26 y.o. female who has zero children but a life-limiting disease and who doesn’t want to risk a pregnancy ending her life prematurely? Can’t tell you because those pages have been taken down.

And the fact that RFK, who is the scariest nominee of them all, has passed the first hurdle? Makes me incandescent with rage. A lawyer who fucked up Samoa with his lies about the measles vaccine now potentially has the entire US to fuck up.

I understand the desire to look away from the atrocities that are being inflicted on us and our government is strong. Take time when you are feeling overwhelmed. I understand, I do.

Someone has to bear witness.

No post-it Sunday post- Cookie Thursday is a Thing changes

Cookie Thursday is a Thing is going to deviate from the theme schedule I made.

As long-time enjoyers of CTIAT will recall, I did two months of the Inflation Baking theme in late spring 2022, and, when the Supreme Court overturned Roe v Wade, I did an entire month of “If You Want Women to be in the 18th Century so badly” in July 2022. Oh, and I did an entire month of Eggceptional cookies when egg prices skyrocketed in February 2023.

I anticipate that grocery budgets are going to be screaming come Monday.

Since I and my husband are the sole providers and I am the sole baker of CTIAT, I will start off this new austerity with a Cleaning Out the Pantry theme for February.

Followed by Cleaning Out the Freezer theme for March.

April? Yet to be determined.

These were NOT the themes I had planned.

But needs must.

I don’t write that looking for sympathy or donations. In the 10 years CTIAT has been active I have received $45 and a 5# bag of flour.

This is more of a public service announcement.

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.